Wealth and Waistlines

Is a fatter population an inevitable consequence of an advanced economy? Health economist Eric Finkelstein, co-author of the new book "The Fattening of America" (John Wiley), thinks so. Thanks to economic advances, he argues, we spend more time on our butts—at the computer, in front of the TV, in the car—than our parents and grandparents did, and we spend less time in the kitchen making healthful meals or outdoors burning calories. And everywhere we go we're tempted by a growing array of cheap, high-calorie, fat- and sugar-laden treats. The result: nearly two-thirds of American adults now qualify as overweight or obese. Can the same economic forces eventually help reverse the trend? Or should the government intervene? NEWSWEEK's Jennifer Barrett spoke with Finkelstein. Excerpts:

NEWSWEEK: How exactly is the U.S. economy making Americans fat?
Eric Finkelstein: There's a huge demand for low-cost, convenient, tasty foods, for labor saving devices that make us more productive at work and at home, and for sedentary leisuretime activities. And suppliers are responding. The net result is that we're eating more calorie-dense food and we have lots of cool sedentary leisuretime technologies—the Internet, DVDs, videogames, the list goes on—that basically crowd out physical activity. It's not that we have less willpower today than 30 years ago. It's that we have more choices, so we're making different choices that lead us to be less active and to eat more.

Worse choices?
Not from an economist's perspective. We're fatter, but that does not mean that we are worse off. We could do without the low-cost food or the new technology, but most Americans would prefer not to. The reason is that the costs of being thin, in terms of what they would have to forgo, have just gotten so high that people are saying "I'd rather be fat" than make the increasingly difficult sacrifices necessary to be thin.

What about the costs to our health of carrying around a lot of extra weight?
Our research suggests that, even with this knowledge, many people will still choose to be overweight. We found that overweight individuals are aware that their excess weight makes them more likely to get diabetes, cancer, and heart disease. They also predicted a life expectancy [for themselves] that was several years shorter than the predictions for the normal weight group. It appears that they know obesity is putting their health at risk, but they also know how hard it is to eat less and engage in regular exercise.

You write that your Uncle Al, a rich, successful lawyer, made a rational decision that being overweight is in his best interest. How?
That's right. In fact, if he spent less time at the firm and more time exercising, it is very likely he would not be nearly as rich or successful. Like many of us, he chose a career that requires him to be sedentary for 40-plus hours per week. Not to mention the high-calorie client dinners a few nights a week.

Doesn't he worry about his health?
There was an article published in the Journal of the American Medical Association that shows that today's obese population has better cholesterol and blood pressure values than normal-weight individuals did 30 years ago. The reason, of course, is because they are very likely today to be on statins, blood-pressure medication and other drugs that treat obesity-related diseases. Medical technologies have lowered the cost of being fat. So rational overweight people like Uncle Al might think, "Maybe I'll live a little bit shorter and I'll have to take some drugs, but I can eat whatever I want and I don't have to spend my time eating healthy foods and exercising."