America, We’re Fat

As published in the Northgate Journal

“Our lives improve only when we take chances—and the first and most difficult risk we take is to be honest with ourselves.” —Walter Truett Anderson

Let’s be honest: America is fat. You see it on television. You see it at the airport. You see it in our schools. And unfortunately, if you are like the majority of Americans today, you probably see it in the mirror. I know, I know, you have been planning to lose some weight but just can’t find the time to do it or haven’t decided which fad diet sounds best. Or maybe you plan to start eating healthier, but when you go out to dinner, that fettuccine alfredo and Caesar salad just sound better than the chicken breast and sautéed vegetables.

As a physician, I hear people profess their desire to lose weight. I also hear their explanations of the roadblocks that prevent them from attaining their goals. I too have excuses every day to make myself feel better about eating a hamburger and fries or for not going out for a run. Frankly, I am tired of making excuses for myself. It is time for all of us to be honest with ourselves, start eating and living healthier and lose some weight. Our health depends on it.

First, let’s look at some facts. The National Health and Nutrition Examination Survey (NHANES), conducted in 2003 and 2004, measured the height and weight of thousands of Americans and calculated their Body Mass Index (BMI). Obesity is defined as a BMI greater than or equal to 30, which is roughly 221 pounds for someone six-feet tall. Overweight is defined as having a BMI greater than or equal to 25, or about 184 pounds for someone six-feet tall. According to NHANES, 66% of U.S. adults are overweight; about half of these (32% of U.S. adults) are obese.

A number of factors contribute to this staggering number, including the caloric intake and the activity level of Americans. In a society of fast-food meals and sugar-laden drinks, the typical American consumes an average of over 3500 calories each day. The daily recommended allowance for caloric intake (determined by age, gender and activity level) is closer to 2000–3000 calories per day, which means Americans are consuming some 500–1500 extra calories each day. Considering that every extra 3500 calories above an individual’s caloric needs generates one extra pound of weight, it is easy to see why we are getting fat.

Another contributing factor to our obesity is what we do with our spare time—our activities and activity level. We currently spend an average of three hours online and watch over one and a half hours of television every single day. In addition, many jobs today involve little, if any, physical exercise. So, between work and screen time, few Americans are finding the time to exercise and burn off those extra calories we consume.

So how do we save ourselves from a fatter future laden with the perils of obesity, including diabetes, hypertension, heart disease and arthritis? It starts by being honest with ourselves.

• Calculate your BMI. An easy, online calculator is available at the NHLB website.
• Keep track of how many calories you eat each day. You will be amazed at how quickly those calories add up. To discover how many calories are in that Starbucks latte or Baja Fresh burrito and to learn the nutritional content of the food at many other popular restaurants and hangouts, visit Chowbaby.
• Reevaluate your extracurricular activities. If you do not believe you have time for exercise, look at how much time you spend on the computer or in front of the television. Take an after-dinner stroll to unwind and digest; use the stairs instead of the elevator; get out and play with your kids. Such activities can get you started on your way to living healthier.
• Exercise and/or reduce your caloric intake. Since it takes 3500 calories to add a pound, you must shed an excess 3500 calories in order to lose one pound. By reducing your daily caloric intake to around the recommended 2000–3000 calories, you will stop gaining weight. Then, you also need to add exercise and/or further decrease your caloric intake in order to burn extra calories and start losing weight.
• Visit with your physician. Your physician can help to assess your baseline health. He or she also can help monitor your progress and provide helpful feedback and resources.
• Make your health a priority. Commit to a healthier lifestyle! Get your family and friends on board! You will feel better and live better. You can do it!

Dr. Brett Daniel is the Chief of Primary Care at Pacific Medical Centers and the Medical Director of PacMed’s Canyon Park clinic in Bothell. He is a board-certified Family Medicine physician who received his medical degree from the University of Washington and did his training at Valley Medical Center in Renton. He has been in practice at PacMed since 2005. Click here for more information about Dr. Daniel.

November 2006

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