Lots to lose — How obesity is costing America

Soon after he was elected in 1960, John F. Kennedy made physical fitness a defining principle of his presidency. In an article for Sports Illustrated titled “The Soft American,” the president-elect wrote: “It is my hope … that the communities will … make it possible for young boys and girls to participate actively in the physical life; and that men and women who have reached the age of maturity will concern themselves with maintaining their own participation in this phase of national vigor — national life.”

More than a half century later, it is safe to say Kennedy would be appalled at the physical condition of our people. One-third of Americans are obese, while two-thirds of adults are overweight or obese. And the problem is only getting worse in younger generations — by age 5, 20 percent of American youths are overweight or obese. The percentage of obese adults in the United States is expected to reach 42 percent by 2030.

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The obesity crisis is developing alongside the related epidemic of chronic disease. More than 20 million Americans have diabetes, and 79 million are pre-diabetic — a ticking time bomb. Shockingly, our children will be the first American generation to have a shorter life expectancy than their parents’, due in large part to obesity.

Apart from adverse impacts on quality and length of life, the economic costs of this epidemic are staggering: $147 billion per year in direct costs, and $300 billion if indirect costs like lost productivity are included. Moreover, as experts from across the political spectrum have noted, escalating healthcare costs are the main driver of our national debt and the fastest growing part of our national budget, which simply cannot be brought under control unless we reduce long-term health costs. 

Obesity is also harming our national security. More than a quarter of Americans of military age (17-24) are not qualified to join the military largely because they are obese or overweight. Attrition rates are higher among new recruits than in previous years because of health issues. All of this means the Pentagon must spend increasing amounts of time and money simply to find qualified recruits and retain them once they are trained.

The health-and-obesity crisis has reached such profound proportions, we felt compelled to issue a new Bipartisan Policy Center report outlining proposals for change, including:

Encouraging large public- and private-sector institutions to purchase and serve healthier foods. This is more easily achievable than it might appear. Just three major food-service companies in the United States sell food to a majority of our nation’s universities, hospitals and entertainment venues, touching the lives of hundreds of thousands of people every day.

Increasing training for our nation’s healthcare professionals and changing insurers’ reimbursement policies to help prevent obesity and related chronic diseases. Today, there are no comprehensive standards for nutrition and physical activity training in our medical schools, residency programs or continuing education requirements, even though healthcare professionals are uniquely positioned to inform and motivate Americans on the importance of good nutrition and physical activity. 

Creating workforce wellness programs throughout public and private businesses. These are among the smartest investments businesses and other institutions can make. A dollar spent on employee wellness can return up to $3.27 in healthcare cost savings and $2.73 in reduced costs for absenteeism.

We have to improve health early and often in a child’s first six years of life. Currently, our focus on nutrition and physical activity starts in kindergarten — which is often too late. Focus must start much earlier, particularly as research shows that taste, habit and metabolism rates are established during a child’s pre-school years.

These are just a few of the many ways we can begin to reverse this national crisis. We stand eager to work with the president, Congress, governors, corporations, the military, health professionals, schools and — most importantly — families and individuals to implement these and the many good ideas of others.

Our recommendations, we must note, are not about creating a “nanny state” — just the opposite. They are intended to empower our people to live healthier, wealthier and longer lives in the face of a real and present danger to our security, economy and well-being. 

While many Americans are familiar with President Kennedy’s role in creating the President’s Council on Physical Fitness, it was his immediate predecessor, former President Eisenhower, who laid the groundwork on the issue by creating the President’s Council on Youth Fitness. Thus from the beginning have the issues of health and fitness brought together our political parties and our finest leaders. They continue to do so today. We urge leaders of both parties and all Americans to join us as we work together to address this critical challenge.

Glickman and Veneman, former secretaries of Agriculture; and Shalala and Leavitt, former secretaries of Health and Human Services, co-chair the Bipartisan Policy Center’s Nutrition and Physical Activity Initiative.