The Obesity Epidemic: The business opportunities in obesity


In
early October there was a quirky report about U.S coffin makers
increasing the size of their product. What this reveals is anything
but funny. Obesity is one of today’s biggest health crises—1
in 4 of the world’s 4 billion adults are overweight and 300
million are clinically obese. In the U.S., where the crisis is most
pronounced, nearly a third of the population is obese and two-thirds
overweight, with the rates substantially higher among the poor.
Since 1990 the U.S. obesity rate has doubled and approximately 127
million adults are now overweight and 60 million are obese. During
the same period the number of people who are severely obese has
nearly quadrupled to nine million. Child obesity is also increasing
rapidly. 

Outside
the U.S., especially in the more advanced capitalist nations, obesity
is also skyrocketing. In Canada between 1985 and 2001, the prevalence
of obesity more than doubled from 7 percent to 14 percent among
women and to 16 percent from 6 percent among men. Like the U.S.,
the rates are substantially higher among the poor. According to
a study published in the August edition of the International
Journal of Obesity
, 6.4 percent of children in the wealthiest
quarter of the population compared with 12.8 percent of those in
the poorest quarter are obese. 

The
health effects of the obesity epidemic are immense. Researchers
claim there are links between obesity and more then 30 medical conditions
including heart disease, diabetes, hypertension, cancers, and possibly
Alzheimers. According to the Centers for Disease and Control Prevention,
1 in 3 U.S children—nearly 50 percent of black and Latino children—born
in 2000 will become diabetic unless people start exercising more
and eating less. Some 90,000 U.S. cancer deaths a year are linked
to obesity. Worldwide, diet-related afflictions such as heart disease,
hypertension, and diabetes account for almost 60 percent of deaths
annually. 

Even
in crude economic terms obesity is costly. The U.S. National Institute
of Health estimates that the annual costs of treating obesity-related
conditions are at least $120 billion. 

Invariably
though, within a capitalist system some see profit opportunities
in the current obesity epidemic. Companies have long used body image
as a mechanism to control women. The diet industry is the main beneficiary
of rising obesity—or as the Economist recently put it,
“the business opportunities in obesity.” In North America
the diet market runs at $30 billion a year, which is expected to
increase by nearly 25 percent in the next 3 years to $37 billion
in 2006. 

Some
doctors with a stake in the game push deadly weight-loss drugs such
as Ephedra. Those who put their faith in the pharmaceutical industry
expect a miracle weight-loss drug to save them. In the meantime,
severely obese people can get gastric bypass surgery to reduce their
stomach size. This $25,000 (up to $100,000 with over-all costs)
weight-loss procedure is becoming more popular. More than 100,000
U.S. residents will have the surgery this year, even though 10 to
20 percent of those operated on suffer serious complications, including
death. If this doesn’t work, a medical company has a plan B.
If their company- funded studies are to be believed, a highly successful
gastric stimulator has been created that sends the stomach electrical
impulses to combat hunger.

According
to a survey by the Calorie Control Council, 48 million—or 25
percent—of the U.S. adult population are currently on a diet
and, if other studies are correct, over 60 percent of U.S. men and
70 percent of women are trying to shed a few extra pounds. A recently
published study found that 9 to 14-year-olds who diet may actually
gain weight in the long run—possibly due to metabolic changes,
but more likely because they resort to binge eating. 

Throughout
the advanced capitalist world, and to a lesser extent in the periphery,
people’s diets have changed drastically over the past 30 years.
In the U.S., spending on fast food now totals $110 billion annually,
having increased 18-fold since 1970. The number of fast food outlets,
often started with government subsidies, has doubled from 1 per
2,000 residents to 1 in 1,000 since 1980. Poor areas often have
an even higher exposure to fast food restaurants and fewer supermarkets,
four times less in black neighborhoods than white neighborhoods,
where healthier products can be found (even though there is evidence
that supermarkets in poorer neighborhoods are more profitable per
square foot). Outside the U.S., fast food restaurants are also rapidly
expanding. For instance, in 1995 Dunkin Donuts opened 1,000 international
stores, which by 2000 had increased to 5,000. 

It’s
not only at fast food restaurants where unhealthy products are being
consumed in greater quantities. U.S residents on average consume
an astounding 848—2.3 per day—8-ounce servings of soft
drinks annually. In poorer countries people are also increasingly
consuming high calorie soda pop instead of more nutritious drinks.
The Mexican soft drink market, 70 percent controlled by Coca- Cola,
totals some 633 eight-ounce servings per person annually.  

Portion
sizes have also expanded. Compared with 20 years ago U.S. hamburger
servings have increased by 112 percent, bagels 195 percent, steaks
224 percent, muffins 333 percent, pasta 480 percent, and chocolate
chip cookies 700 percent. It has been shown that people consume
about 30 percent more when served larger portions. Fast food outlets
and the rest of the food industry often promote their products based
on their larger, somehow more empowering, size. As of 1996, a quarter
of the $97 billion spent on fast food came from items promoted on
the basis of either extra size or larger portions. 

The
main reason that people are consuming more, especially unhealthy
products, is the food industry’s relentless advertising, especially
to children. U.S. food companies spend more than $30 billion to
sell their products, not counting what they spend lobbying favorable
policies and support. In 2001, Coca-Cola and Pepsi together spent
$3 billion in advertising.

When
targeting young kids, companies use cartoon characters, toys, and
other items that have a powerful influence over children. In the
early 1970s the U.S. food industry fought off regulation of their
advertising practices and instead adopted industry-regulated standards—the
Children’s Advertising Review Unit. Now 40 percent of McDonald’s
advertising targets children and, according to a 1998 study, they’ve
been highly successful. Of 10,000 children surveyed, 100 percent
of U.S., 98 percent of Japanese, and 93 percent of UK children recognized
Ronald McDonald, with many of these kids believing Ronald McDonald
knows what’s best for their health.  

The
fast food and soft drink companies have also been successful at
getting their products into cash- strapped schools. They get ad
spots on Channel One, which is shown in classes. In Texas, the food
giants give $54 million a year to schools to sell their wares in
vending machines. Maybe the most disturbing example of school infiltration
was in 1998 when Colorado Springs school officials agreed to an
exclusive agreement with Coke, based on a tripling of school soft
drink sales. Recently Coca-Cola Enterprises became an official sponsor
of the PTA and John H. Downs Jr., the company’s senior vice
president for public affairs and chief lobbyist, got a seat on the
PTA’s board. 

The
food interests are also hard at work lobbying governments, both
behind the scenes and with front groups such as the Center for Consumer
Freedom. Three years ago sugar producers and the soft drink industry
won a big victory in getting the USDA to soften its dietary guidelines
on sugar. Likewise, they convinced a subservient American Dietetic
Association to refrain from labeling any foods as unhealthy since
according to them, “all foods can fit into a healthy eating
style.” 

Last
September, within a week of the European Commission strengthening
regulations on companies promoting the health benefits of foods
high in fat and sugars, the Food and Drug Administration weakened
its guidelines to allow food packages to advertise possible benefits
before they are fully approved. Currently, different sectors of
the food industry are hard at work shaping changes to the New Food
Pyramid. 

Internationally
a similar process is at work. This past April the World Health Organization
(WHO) and the UN food and agricultural organization backed down
(due to pressure from the sugar industry) on guidelines, stating
that people should limit daily consumption of free sugars to a maximum
of 10 percent of energy intakes to avoid chronic diseases. U.S.
sugar producers had indicated that they may lobby the Bush administration
and Congress to link U.S funding—about one-fifth of the WHO
budget—to changes in research methods at the UN agency. 

The
food giants are well represented in other ways. In 1978 Coca-Cola,
Pepsi-Cola, Kraft, and other food companies founded the International
Life Sciences Institute (ILSI) to lobby WHO. It won a position as
an NGO “in official relations” with WHO and a specialized
consultative status with the Food and Agricultural Organization
in 1991. In 1992 the ILSI congratulated themselves after steering
the WHO and FAO away from any curbs on sugar consumption. 

The
10 percent or 200-calorie increase in energy consumption by the
average U.S resident over the past 25 years is tied to incessant
food advertising, political lobbying, and larger portions. Underlying
this rise, however, is an agricultural sector that has increased
output by some 500 calories per person during this period—after
the Nixon administration altered government subsidies effectively
increasing farmers incentives to expand their yields.  

Obesity
is related to a variety of other social factors some of which have
received minimal scrutiny. A yet to be properly studied link is
between obesity and nuclear materials, which emit radioactive iodine,
tied to thyroid damage. Thyroid disorders, recently found to occur
twice as often as previously believed, are linked to weight gain. 

Another
contributing factor is the large numbers of teenagers and children
not involved in physical activity. Cutbacks to physical education
budgets have not helped. The often-elitist nature of school and
community sports dissuades many kids from participating. For this
reason and others ranging from prescribed gender roles to society’s
indifference to their specific sporting inclinations (such as skateboarding),
many teenagers, especially girls, have negative attitudes towards
exercise. 

Workplaces
and their power struggles also affect obesity. The automation of
work reduces the amount of energy workers expend. In and of itself
this needn’t be problematic since automation should also reduce
the number of hours worked and increase time for active leisure;
not in the U.S, where people are working 200 hours a year more than
they did in the early 1970s.  

According
to Linda Rosenstock the former Director of the National Institute
for Occupational Safety and Health, “It turns out that a quarter
to a third of workers have high job stress and are drained and used
up at the end of the day.” Thus, many working people have less
time to take part in activities. In addition, after a long days
work, people often turn to TV watching, which is inversely linked
to time spent exercising. Busy parents, especially poor working
class people, use TV as a babysitter. In this setting children who
are naturally active are hindered from activity.

Often
the same automation technology, which is supposed to reduce the
workload, results in an increased workload (stress level) for those
who retain their jobs. A growing body of evidence shows that workers
who don’t feel in control of their work environment have higher
job stress levels. Scientists believe there is a link between stress
and the impulse to eat. Food with lots of sugar, fat, and calories
appear literally to calm down the body’s response to chronic
stress. In addition, research indicates that stress hormones encourage
the formation of fat cells, particularly the kind that are the most
dangerous to health. 

Oddly
enough a historical determinant in work related stress —repetitive
assembly line work —has also contributed to obesity in another
way. Urban planning, which is intimately linked to the expansion
of capital, plays a central role in obesity. How the suburban landscape
became the norm is told, in part, by Colleen Fuller in Caring
for Profit
. “Beginning in the 1920s, General Motors president
Alfred Sloan and top company executives masterminded a scheme to
create a consumer market for automobiles in the United States. At
the time, 9 out of 10 people relied on the trolley networks that
crisscrossed cities across the country. GM first purchased and then
dismantled the nation’s trolley companies, ripping up tracks
and setting bonfires composed of railcars. In 30 short years GM
succeeded in destroying a mass-transit infrastructure that would
cost many billions of dollars to resurrect—more money than
municipal governments could raise. ” 

 It’s
not just the auto industry (broadly defined) that has reorganized
cities in a way that encourages obesity. Land developers are notorious
for buying up cheap agricultural land on the outskirts of cities
and pushing for land rezoning and the extension of public amenities
to these plots. There is substantially more money to be made from
selling houses or commercial space than there is in harvesting vegetables.
Similarly, today in many towns Wal-Mart has played no small role
in undermining the downtown core, one of the only places where people
regularly walked. 

The
suburban landscape is almost entirely subservient to the car. Sidewalks
are non-existent or disconnected, crosswalks are absent or poorly
marked, and the speed and volume of vehicular traffic is overwhelming,
which makes walking or biking either impractical or dangerous. So
people who might otherwise walk are forced to drive even short distances
and kids who could easily walk to school must be chauffeured. 

A
study released in September showed that in the 25 most sprawling
U.S. counties people were on average 6 pounds heavier than in the
25 most compact counties. In the past 20 years the number of trips
taken on foot in the U.S. has dropped by 42 percent. Now, fewer
than 10 percent of children walk or bike to school regularly, down
from 66 percent 30 years ago. 

To
combat the obesity epidemic we need tighter limits on fast food
marketing. Junk food companies should be kicked out of schools.
Perhaps governments should subsidize fruits and vegetables as well
as other healthy products. Increased funding for physical education
classes, park spaces, and children’s sports would help. Increasing
exercise opportunities at work, which a group of large employers,
ironically headed by Ford Motors and Pepsi Co., is already working
on, could help. Also there could be some form of tax break for exercise
as is the case in Finland where some 70 percent of the population
exercises for 30 minutes 5 times a week. 

Most
important we need a movement that effectively challenges the capitalist
entities that push their interests no matter the weight or health
effects.
 


Yves Engler is
a Montreal-based activist current writing a book on student activism.