By Miriam Nelson
According to “Lifetime health and economic consequences of obesity” from researchers at Brigham and Women's Hospital, Policy Analysis Inc., and Harvard Medical School, obesity costs the United States hundreds of billions of dollars every year. However, policies that attempt to address this issue, such as the Presidential FitnessGram or Michelle Obama’s Let’s Move campaign, tend to be based on the assumption that obesity is the sole cause of the health issues associated with it. In actuality, while higher body-mass index does correlate with mortality rates, this does not mean that a causal relationship exists—especially since data on obesity and mortality often does not take socioeconomic factors into account. According to a 2010 study, “Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults” from Paula Lantz and others at the University of Michigan, “obesity is not a significant factor in mortality rates when socioeconomic and other risk factors are controlled for.” Alternatively, risk factors such as having a low level of physical activity, smoking, and especially, having a low income, do predict mortality rates. This suggests that instead of obesity being the cause of health issues, obesity and health issues alike are results of socioeconomic circumstances.
Another body-image related health crisis that continues to grow parallel to the American “obesity epidemic” is disordered eating. The National Eating Disorder Association reports that roughly 9% of Americans will experience an eating disorderin their lifetime. As shown by the Harvard T.H. Chan School of Public Health’s 2020 “Report on the Social and Economic Cost of Eating Disorders in the United States of America,” the financial cost of eating disorders in the U.S. was $64.7 billion in 2018-2019, averaging $11,808 per person with an eating disorder. This immense figure does not even account for the intangible costs of eating disorders—the toll on individuals’ mental and physical health—or for the increased rates of eating disorders over the course of the pandemic. Given that people living in poverty are much more likely to face food insecurity and have greater barriers to healthcare, it is unsurprising that poverty is also a risk factor for disordered eating.
Understanding that both obesity and eating disorders, on a large scale, stem from socioeconomic factors is essential to finding lasting solutions. Instead of diverting more and more resources into teaching kids how to count calories or implementing programs to weigh students in schools, both of which have been shown not to work, policymakers should work to address the root causes of America's health issues. An obsessive work culture that detracts from home cooking, barriers to quality mental and physical healthcare, environmental discrimination, and food waste are all examples of problems that must be addressed before Americans can have a truly healthy relationship with food and their bodies. Until these issues are solved, the U.S. will continue having to pay the steep psychological and economic costs of obesity and eating disorders.