Disturbing News...

It wasn’t the 300 pound 17 year old patient I saw today, it wasn’t even the morbidly obese woman’s request for “tummy tuck” that I found disturbing, it was more mundane. Apparently Mission Hospital is installing twin steel I beams in the ceiling of their operating rooms; a massive girder system to lift and move the obese. Overwhelmed I’m sure from workman’s comp claims, lost work days of their employees due to injuries and the demand for simply more hands to physically move 30% of our population…the obese. I wonder if this same system will be placed in selective patient rooms, so called heavy rooms.

We Americans are not alone, it seems the Canadians are just behind us with 15% obese, Great Britain is actually closer to our rates and even France has their issues with 10% obese. The World Health Organization is drafting proposals but lacks consensus. As in all things we did not arrive in this crisis of obesity alone nor was it quick. Years of farm policy which has mercifully under girded our farming system but has inadvertently made corn, corn products such as high fructose corn syrup and sugar itself inexpensive and readily available. These high energy sweeteners have been infused into foods which are readily available, easy to transport and store. They just don’t go bad and they taste good. It seems also that even our diet drinks are so sweet they actually give us a hankering for sweet foods with calories thus increasing our dietary calorie intake.

Just when our food got really sweet, our physical activity dropped to nil. We have a 1964 Corvair. It may be unsafe at any speed but it was my wife’s first car and it’s a convertible. Driving that car, in a thousand ways, I use more energy. The windows are hand cranked, the clutch is stiff, no power steering … don’t even think of using a cell phone. Gas is back down to a respectable price as the economy flounders it should stay low for quite some time. Why walk when we can drive? You can barely buy a push lawn mower and we would all rather play WII fit than actually get outside and toss a ball.

As our population grows in girth (NC is presently 8th nationally in pediatric obesity and 17th in adult obesity), the cost of care of this demographic sky rockets. Presently care for the obese accounts for some 10% of our total health care dollar. Obesity however may soon be considered a disability thus removing even more workers from our ever shrinking work force.

How do we overcome this in a time of economic unrest? It is time for the “fat tax”. New York has already started but their plan is to use revenues gained from the taxation of soft drinks to fund budgetary shortfalls. That may raise money but will not change obesity rates. I propose sweeping taxes on all soft drinks, all foods containing high fructose corn syrup and all fast food restaurants. The proceeds from these taxes are to be earmarked for investment into our schools to promote physical fitness programs, programs that decrease sedentary times in front of TV sets and simple dietary education programs. These types of programs have been done across the country with varying levels of success. Each program has succumbed to lack of funding. A fat tax properly administrated would provide ongoing monies to address the number one health care problem we are facing as a people today.

D. Scott Donaldson, M.D. • Hendersonville, NC