The Democratic presidential debate on Sept. 12 raised numerous issues related to health care, gun control, and immigration reform. Why didn’t one of the media representatives ask “How do you plan to address the obesity epidemic?”
Obesity should be the plum topic. It affects 40 percent of eligible voters (the same percentage of the population as all registered Democrats) plus 20 percent of our children. There are ethnic/racial disparities. African, Asian, Latino and Native Americans are disproportionately affected. There are income disparities.
The approximately 17 million individuals earning below $25,000 are about 40 percent more likely to have obesity than the approximately 17 million individuals who earn above $75,000.
This disease is costing us over $200 billion dollars per year in health-care costs alone, with a projected annual cost of $390 billion to $520 billion by 2030.
According to the National Institutes of Health, obesity accounts for over 300,000 deaths per year among U.S. citizens. A recent systematic review even reported interactions between global warming and obesity.
Best of all, for democratic candidates, the Trump administration has seemingly done nothing about it. While the Democratic presidential debate was revving up, the president was speaking at a rally in New Hampshire.
He said to a heckler, “That guy’s got a serious weight problem. Go home. Start exercising,” followed by comments regarding how ashamed the heckler’s mother must be of his weight. This is a gift to the media and Democratic candidates, but fat has become so toxic in the political arena that it is just not addressed.
Using various search engines and the name of each candidate plus the term “overweight” or “obesity” resulted in the following “report card. Former Vice President Joe Biden, Sens. Bernie Sanders (D-Vt.), Kamala Harris (D-Calif.), and former Rep. Beto O’Rourke do not appear to have addressed this issue at all.
Some candidates are “disappointing.” Andrew Yang has linked obesity to mental health by stating on his website “if someone comes to the hospital suffering from diabetes, obesity, or substance abuse, there is often a link to their holistic mental health.”
In 2012, Sen. Amy Klobuchar (D-Minn.) opposed public health efforts to drop the least nutritious items from the school lunch menu. She supported efforts by food companies to preserve French fries as a menu staple and to declare pizza, with its tomato sauce, to be a vegetable. (Minnesota is home to Schwan Food Co., which at the time controlled 70 percent of the frozen pizza market).
However, are a few standouts in this venue, and none of them among “the top 3” candidates. Sen. Cory Booker embraced this issue as mayor of Newark; in 2016, along with Sens. Bill Nelson (D-Fla.), Tom Carper (D-Del.) and Chris Coons (D-Del.), he introduced the Bill to Combat Childhood Obesity which would significantly enhance community-based childhood obesity prevention initiatives.
Former HUD Secretary Julian Castro implemented numerous health initiatives during his tenure as the mayor of San Antonio and brought the city’s obesity rate down below the state average. South Bend Mayor Pete Buttigeig has been a supporter of efforts to stem the epidemic and recently proposed a college grant program to combat obesity.
Bill Maher’s comment last week that more fat shaming would help cure obesity and James Corden’s appropriate rebuttal brought an important issue to the headlines. Fat shaming negatively affects psychological and biological health, as well as educational and economic achievement in all age groups.
The candidates condemn discrimination on the basis of race, gender, sexual orientation, or age (maybe excluding Castro). Yet only Sen. Elizabeth Warren (D-Mass.) and Buttigeig have actually spoken out against it. Yang’s fat shaming of the president is just an emulation of political incorrectness.
To be sure, this is a complex issue but there are some obvious opportunities for candidates to address it. For example, there are numerous highly cost-effective bills that have not made it out of congressional committees most often in deference to Big Food.
The Stop Subsidizing Childhood Obesity Act of 2012 would have ended federal tax subsidies for advertisements promoting unhealthy food and forwarded additional tax revenues towards better nutrition programs in low-income elementary schools with an estimated return of $32.50 in health-care costs for every dollar invested.
The bipartisan Treat and Reduce Obesity Act (introduced in 2013) would improve insurance coverage for obesity at an estimated Medicare cost saving of $19 bill to $21 billion over the next decade. The SWEET act (first proposed in 2014) would tax sweetened beverages with an estimated return of over $30 per dollar invested.
Booker’s Bill to Combat Childhood still languishes in committee. Candidates could comment on how they will undo the damage of Agriculture Secretary Sonny Perdue’s efforts to exempt schools from some of the demonstrably effective USDA nutrition requirements listed in the Healthy, Hunger Free Kids Act — one of the few obesity-related bills to actually make it out of committee.
This is not an endorsement for any candidate. It is a reminder that the obesity epidemic and how they propose to address it should enter into their campaign repertoire. It shouldn’t be relegated to a place behind the curtain in the “Wizard of Oz.”
Most of us watching these debates want to know about the issues that most affect us and our families. Obesity affects over 90 million American adults and a steadily increasing percentage of our children. The candidates who have not addressed the issue of obesity in the United States should certainly be called to task. The media even more so because they are neglecting an obligation to ask.
Dr. Michael Rosenbaum is a professor of pediatrics and Medicine at Columbia University Irving Medical Center and a regular op-ed contributor on issues relating government and health and has spent over 25 years researching obesity.