obesity final paper

Running head: IMPACT OF OBESITY ON AMERICA

Impact of Obesity on America

Irina Bubnova, Irma Isarraras, Stephanie Knippa

HCA 306A Health Care Economics

Professor Tokonitz

Warner Pacific College

June 7, 2015

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IMPACT OF OBESITY ON AMERICA

Abstract

Obesity in America has reached an epidemic level with health care costs escalating as a direct

result of overeating. It is estimated that in 2008 the annual medical cost of obesity was $147

billion (Centers for Disease Control and Prevention, 2014), and that is without calculating the

various indirect costs that are also burdening the social infrastructure. Multiple factors such as

advancements in technology, the food industry, advertisement, inexpensive energy-dense foods,

and poverty have all intertwined to form the perfect environment for this disease to take hold and

spread. The federal government and some public organizations have taken on the cause to

promote healthier food choices and a better lifestyle with multiples programs aimed at children

as well as adults. The desired results have yet to be realized and the rate of obesity has only been

increasing along with healthcare spending. Policy makers need to consider more drastic changes

such as subsidizing healthy food instead of corn and soy, the taxation of harmful energy-dense

foods, stringent regulations of the food allowed in schools, and standard insurance coverage with

a specialized treatment plan specifically for the obese. Without aggressive action the obesity rate

will continue to climb and economic losses will be great.

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Impact of Obesity on America

Obesity in the United States was first publicly recognized as a problem in the late 1970’s

when 15 percent of adults had a body mass index (BMI) of greater than 30. Almost 5 decades

later, the percentage of obese adults has doubled to over 30 percent with more than one-third of

the adult population clinically obese, and more than two-thirds of the adult population

overweight (Henderson, 2015). According to Goel (2006), “this problem has increased to an

extent that it is being labeled an epidemic and a leading cause of preventable deaths, second only

to smoking” (p. 317). Obesity is a major health concern not only because it is costly, but also

because it greatly reduces quality of life for the individual. Obesity carries with it many

comorbidities, and has been directly linked to multiple chronic conditions, such as type 2

diabetes, heart disease, high blood pressure, high cholesterol, and several specific cancers

(Hojjat, 2015). If allowed to go on unchecked, obesity could pose problems of a magnitude not

yet seen with any other disease to date. Wisdom would dictate that all necessary solutions

should be explored and implemented in a timely manner to stem the growth of obesity and the

resulting increase in healthcare spending and loss of productivity.

The principles of economics function primarily with the understanding that people make

rational decisions that would maximize utility (Henderson, 2015). In other words, people make

free choices that would most benefit them depending on the circumstances in which they live and

the limits of their resources. People have to manage their limited resources with trade-offs to

reach the best possible outcome and generally this means that people behave in predictable

patterns. Unfortunately when it comes to obesity, people do not act in a rational manner. The

choice to consume more calories does not result in more utility and the relative costs and benefits

of being obese are ignored. In fact, the economics of obesity function much more like that of

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addictive goods such as cigarettes and illegal drugs. Why else would an individual decide to

consume the extra calories knowing the cost such an action could incur?

Perhaps another explanation for the human behavior seen in obesity is not addiction but

rather the lack of information. In a perfect free market, everyone would have access to complete

information and would then base their decisions on that knowledge. It can be argued that many

people underestimate the consequences of becoming overweight and do not understand the

gravity of the risks involved. Mann (2008) says, “obesity is not a utility-maximizing decision

any more, but a results of individual miscalculations” (p. 168). Whatever the explanation may

be, it is hard to choose any one culprit, as this problem appears to be very complex with

numerous factors involved. Most research seems to point to technological advancements,

decreasing food prices, the food industry, advertising, and poverty as the big influences in the

obesity epidemic.

The twentieth century brought many changes to the level of technology utilized by

society at large and each individual personally. Changes in technology have affected all parts of

life, including labor, transportation, telecommunications, and even entertainment (Goel, 2006).

While in the past many jobs required strenuous labor, with high-tech advancements people began

operating machines that required a minimum of standing or sitting. Development of low cost

transportation made walking unappealing and telecommunications now only require individuals

to push a few buttons as opposed to delivering a message in person or going to the post office.

Televisions and computers provide hours of sedentary entertainment at home and leave no room

for exercise. This drastic change in lifestyle as a result of technological changes has greatly

predisposed people to obesity and is an important factor to acknowledge in the search for

solutions (Goel, 2006).

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Another significant cause of obesity is the decreasing price of processed food due to

agricultural subsidies as well as advancements in technology. According to Hojjat (2015), “The

government has poured billions of dollars into dietary campaigns. Agricultural subsidies

undercut those efforts by skewing the market in favor of unhealthful calories” (p. 86). The

subsidies basically drive down the cost of commodities such as corn resulting in cheap corn-

based products and corn-fed meats. Cheap corn is often times the principal ingredient in low

cost processed foods, and technology has provided a way to do it the most inexpensive way

possible. While food in general has not seen a decline in prices, unhealthy food has, and studies

are now beginning to show a clear link between obesity and low-cost foods (Hojjat, 2015).

When individuals shop for food and are met with the decision to spend less than more, often

times it’s a very easy decision to make especially for low-income families. Regrettably the act

of being thrifty and economical, more often than not, equates to being unhealthy and overweight.

The food industry and their advertisements are also partly to blame for the alarming rate

of obesity growth in America. Restaurants and fast food places are opening on every corner

making it convenient, fast, and relatively inexpensive to eat out. Brownell (2004), states that the

profit motive of the food industry makes it nearly impossible to attain the nutritional needs of

this country. More food consumption means more profit; cheaper ingredients means more profit.

This suggests that the least healthy ingredients will be used to cut costs and marketing will do

it’s best to get individuals to buy the product. Sadly advertisement is not only for adults but also

children. Children are bombarded with images of sugary cereals, soft drinks, and a variety of

unhealthy snacks. According to Brownell (2004), just banning these advertisements could result

in an 18 percent reduction in overweight children. The food industry is a powerful machine and

it will take a powerful force to overcome this obstacle in the fight against obesity.

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Many recent studies have shown that obesity rates are disproportionately high among

groups with low-incomes, suggesting that poverty is a causal factor for the occurrence of obesity.

According to Hojjat (2015), “during 2007-2009 the percentage of obese individuals has been the

highest for low-income families (35.2 percent) and the lowest for higher income families (24.5)”

(p. 87). Even though the cost of food in general has decreased by 16 percent relative to other

goods since the 1960’s, the cost of energy-dense foods or “junk food” has decreased even more

so (Hojjat, 2015). When a low-income family goes shopping for food, their choices are based on

buying the most amount of energy for the lowest cost possible, which basically results in an

unhealthy diet as healthy foods are less energy dense and cost relatively more (Martin, 2005).

While an unhealthy diet alone cannot cause obesity, most people do not account for the high

caloric content of the unhealthy food they buy, which results in eating the same amount of food

regardless of the food’s energy density. Martin (2005) writes about an U.S. study of low-income

women that found that a decrease of $10-20 per month in food expenditures resulted in a net

increase of 300 kcal/day in daily energy intakes. Therefore, an inverse relationship exists

between income and the amount of calories consumed. The lower the income, the more energy-

dense food consumed, the higher the rate of obesity.

The costs of obesity are fast approaching disastrous levels and could eventually lead to

great economic loses not only from growing medical expenses but also from low worker

productivity due to both physical and psychological disabilities (Hojjat, 2015). Currently it is

estimated that medical spending could very well be as much as 100 percent more for obese

individuals than for normal weight adults. Annually, the extra money spent on obesity related

health problems could amount to as much as $147 billion for adults and $14.3 billion for children

(Hojjat, 2015). These numbers are devastating not only because of the strain to the economy but

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also because they infer that people are dealing with any number of terrible diseases that are

preventable and unnecessary. According to Hojjat (2015), “around 80 percent of obese

individuals have diabetes, high cholesterol, high blood pressure or heart disease” (p. 88). Not to

mention are the host of other diseases that have been linked to obesity such as, stroke, uterine

cancer, breast cancer, colon cancer, gall bladder cancer, sleep apnea, arthritis, osteoarthritis, and

depression (Hojjat, 2015; Goel, 2006). The impact of eliminating obesity would be huge in

creating better health and substantially cutting healthcare spending.

There are also various indirect costs of obesity that are detrimental to the economy and

society. Obesity tends to cause low worker productivity and premature mortality which results

in losses for U.S. businesses. “Mortality costs include future income lost as a results of

premature death. Morbidity costs factor income lost from decreased productivity, restricted

activity, and absence from work” (Hojjat, 2015, p. 88). It is estimated that $73.1 billion per year

are lost in the United States among full-time employees as a result of obesity (Hojjat, 2015).

Beyond these monetary costs, obese people also bear substantial emotional costs due to societal

prejudices against the overweight. There is evidence that weight-related discrimination exists in

the market for jobs as well as with promotions (Goel, 2006). Consequently, obesity is

detrimental on all fronts and at all levels of the social infrastructure in the United States. It is

imperative to find effective solutions quickly to stop the high medical, economic, and social

costs obesity is causing.

Although it is clear that the obesity rate in America is growing at an alarming rate, it does

not mean that policy makers aren’t trying to come up with ways to solve the problem. Because

there is strong evidence linking obesity to eating away from home, the government passed The

Health, Hunger-Free Kids Act, in December of 2010. This act called for the U.S. Department of

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Agriculture (USDA) to update nutritional standards for school meals and the standards for

healthier school meals took full effect at the beginning of the 2012-2013 school year. “Meals

that meet the standards include more fruits, vegetables and whole grains, low-fat dairy products

and fewer unhealthy sugars and fats” (The State of Obesity, 2014). In the 2014 school year, 86

percent of schools were serving healthier meals and by doing so the schools were receiving an

incentive of six cents per meal served. The idea is for schools to continue striving to provide

healthier meals (The State of Obesity, 2014).

Reports show that “Millions of children rely on the school meals program. For some

children, the only reliable meals they have are in school” (The State of Obesity, 2014). Children

spend most of their lives in school, and there is no surprise that they consume more than half of

their total daily calories at school. Therefore, having healthy school nutrition policies can have a

positive impact on children's health. The current policies put in place in schools not only ensure

that junk food is less likely to be sold on school grounds, but also guarantee that children will be

provided healthy meals for breakfast and lunch (The State of Obesity, 2014).

Fast food meals have grown to be very popular, but they hold no nutritional value. The

meals have high caloric density and are marketed directly to young children. In many cases the

meals come with a toy, which makes it no surprise that children often times prefer a fast food

meal over a nutritional meal at home, in the end resulting in obese and overweight children.

According to a study conducted by the Yale Rudd Center for Food Policy & Obesity, in 2009 the

fast food industry spent $4.2 billion on advertising to all ages and in 2006, $660 million was

spent directly on advertising specifically to young people (Harris, 2010). Studies have found that

children who are only 3-6 years old are able to fully understand and remember advertising

especially when cartoon characters are used (Harris, 2010). The close proximity of restaurants

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also does not help as they are often close to schools and children’s homes making a huge impact

on children’s weight.

A Policy that is currently in the works will hopefully successfully restrict advertising to

children, especially in schools. As it stands now, food and beverage companies are able to reach

children in schools through “signs, scoreboards, posters, branded fundraisers, corporate incentive

programs, scholarships, and education materials” (The State of Obesity, 2014). The USDA is

focusing on this problem with a provision that will put a limit on unhealthy food marketing in

schools. “Once the rule is finalized, school districts would need to have policies in place that

only allow marketing of foods and beverages that meet the updated Smart Snacks in School

nutrition standards set by USDA” (The State of Obesity, 2014). This will be highly beneficial as

children spend much of their time in school and less exposure to unhealthy ads will help open the

doors for healthy snacks and meals.

Restaurants also pose a problem, as the menus for children do not differ than the menus

for adults. The Produce Marketing Association (PMA) and Sesame Workshop began working

together to address this problem and the resulting epidemic of childhood obesity. In October

2013, their efforts paid off and fast food chains began to change their menu options for children

and offer more nutritional meals (Harris, 2010). Subway was the first to jump on making a

healthier menu for children and spent $41 million to market healthier fruit and vegetable options

to children. The next fast food chain to follow was McDonald's by offering fruit and taking out

the soda option on the children’s menu (Harris, 2010). This is a good step in the right directions,

but many more such steps are needed to make a substantial impact on childhood obesity.

Studies show that children who live in areas of lower income homes, more fast food

restaurant, and more small convenience stores tend to be more overweight than children who live

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in neighborhoods with nearby grocery stores (The State of Obesity, 2014). “More than 29

million Americans lack access to healthy, affordable foods. They live in ‘food deserts,’ meaning

they do not have a supermarket or supercenter within a mile of their home if they live in an urban

area, or within 10 miles of their home if they live in a rural area” (The State of Obesity, 2014).

Supermarkets are seen more often in predominantly white neighborhoods, while Black and

Latinos most often have access to convenience stores that offer less healthy food choices. Data

shows that adults living in neighborhoods with grocery stores have the lowest rates of obesity

(21 percent), while those living in neighborhoods with only convenience stores had the highest

rates (32-40 percent) of obesity (The State of Obesity, 2014). Consequently, proximity to

healthy food sources plays an important role in helping to understand the food choices of lower

income families and what can be done to remedy the situation.

A public-private partnership called Healthy Food Financing Initiatives (HFFI) has been

one of the channels used to help communities in need of healthier foods, where “grants and loans

are provided to full-service supermarkets or farmers’ markets that locate in lower-income urban

or rural communities” (The State of Obesity, 2014). To date the HFFI is active in 21 states and

receives funds from federal, state, and private sources. The federal government alone has

allocated more than $109 million in grants to help support healthy food grocery stores, farmers’

markets, and urban farms, and with the passing of The Agriculture Act of 2014 better known as

the Farm Bill, another $125 million has been authorized for HFFI use (The State of Obesity,

2014).

Another initiative available under the Farm Bill is called the Supplemental Nutrition

Assistance Program (SNAP), which is a direct food assistance program. In 2013, SNAP

provided “$76.06 billion in benefits to 47.6 million Americans” to help them gain access to

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healthier food choices (The State of Obesity, 2014). Besides being a direct food assistance

program, SNAP has many components which including nutrition education, state incentives to

promote smart shopping and healthy eating habits, and stocking requirements for retailers to

ensure that people in the program have healthier food options. SNAP even set aside funds to

develop strategies to provide its recipients with incentives to buy more fruits and vegetables (The

State of Obesity, 2014).

Overeating is not the only cause for the obesity epidemic in the United States. Physical

activity has greatly decreased among adults and children. Busses and cars have mostly

completely replaced walking and bicycling and sports activities in schools tend to be the first to

be cut due to financial constraints. “National recommendations call for children and adolescents

to get at least 60 minutes of physical activity per day, most of which should be moderate or

vigorous in intensity” (The State of Obesity, 2014). Unfortunately, as of 2014, the first U.S.

report card on physical activity found that only about a quarter of children met that

recommendation (The State of Obesity, 2014). Currently the only federal funding for physical

education comes from The Carol M. White Physical Education Program (PEP) which provides

grants to school districts that have physical fitness programs in place that could help students

reach state physical education standards. In 2014, $74.6 million was allocated for PEP and while

all public schools in the nation have some sort of physical education, only about 5 percent of

school districts actually meet the recommended daily amount of physical education (The State of

Obesity, 2014).

As the first lady, Michelle Obama saw the need for more physical activity among

children and started a campaign called Let’s Move! Active Schools. The campaign states that

childhood obesity rates have tripled in the United Stated just over the past three decades. As of

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today, one in three American children are overweight or obese, with that number closer to 40

percent for African American and Hispanic children (Let’s Move, n.d.). The prediction is that

“one third of all children born in 2000 or later will suffer from diabetes at some point in their

lives. Many other will face chronic obesity-related health problems like heart disease, high

blood pressure, cancer, and asthma” (Let’s Move, n.d.). Schools are encouraged to sign up for

Let’s Move! Active Schools, where they will receive help in developing a fitness program for

their school. Each school will have access to activation grants, program materials, in-person

training, and support from certified professionals (The State of Obesity, 2014). Even though

physical activity is not where it should be, the resources are out their for school to utilize in

making a more healthy lifestyle for their students possible.

With the rate of obesity in the United States at this time, the outlook for the future is not

good and borders on catastrophic. The Centers for Disease Control (CDC) estimated that in

2008, the annual medical cost of obesity in the U.S. was a staggering $147 billion. Obese people

had on average, medical costs that where $1,429 higher than those of normal weight people

(Centers for Disease Control and Prevention, 2014). These numbers can only be expected to rise

if dramatic changes do not take place in the near future and that will mean enormous economic

losses that will affect society at large. “Future economic losses could mean the difference

between solvency and bankruptcy for Medicare, between expanding and shrinking health care

coverage, and between investment in and neglect of our social infrastructure, with profound

implications for our international competitiveness” (Hojatt, 2015, p. 89). Above all, the human

cost due to obesity related diseases such as coronary heart disease, type 2 diabetes, cancers,

hypertension, dyslipidemia, stroke, liver and gallbladder disease, sleep apnea, respiratory

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problems, osteoarthritis, gynecological problems, infertility, and mental health conditions would

be immeasurable (Centers for Disease Control and Prevention, 2014).

First lady Michelle Obama has taken a step in the right direction, as have many various

federal and public organizations. A solution is out there, but it will take more than the president

and more than the federal government to change the way people are. Parents are going to have

to encourage their children to play outside, to change the foods they are giving them and limiting

the amount of sugars and unhealthy fats they are consuming. Schools will need to serve less

processed and frozen food items, and offer options like a salad bar and fresh fruit. This is also

going to require the government to give more funding to schools in order for them to be able to

afford the changes. More physical activity should become a big priority just like math and

science are. Role models need to step up and begin taking action, just like the National Football

League (NFL) has with a campaign called “NFL Play 60.” This campaign encourages children

to get outside and play for 60 minutes every day (National Football League, 2007). They even

held camps, and went out into the community and offered their time to teach children how to

play football, in the hopes that more people would join their campaign. Community outreach is

important in fighting obesity because it gives people the opportunity to get educated on the

subject. Children are the future, therefore it’s important to give them hope, success, and healthy

living so that they can go on and teach their children the same.

The United States government plays a huge role in providing better foods, as they are

largely responsible for supporting schools in supplying meals for students who can’t afford it.

“The National School Lunch Program supports student nutrition in over 101,000 schools and

residential facilities. It provides free and reduced priced meals to low-income children before

school, during school, after school, and over the summer” (New America Foundation, 2014).

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This is a benefit to the children that will otherwise go hungry, but the nutritional content of the

food provided is often times questionable. In the documentary Fed Up, many high school

students were followed in their journey of struggling with obesity. Most of their schools offered

low fat, fat free, or sugar free foods. Unfortunately these pseudo healthy options were in fact full

of either sugar or fat to make them taste good, which makes them less healthy than the original

version (Soechtig, 2014). The government is promoting a healthy diet for students, but the

standards and regulations are lacking. To fully utilize the power they hold will require a more

stringent measurement of what can and cannot be allowed in schools throughout America.

Unhealthy food taxation, or what is commonly referred to as the “fat tax,” has been hotly

debated in the recent years. The idea of taxing unhealthy food and or raising the prices is a way

to help reduce the amount purchased and to influence food choice in the direction of more

healthy choices. While the price increase would be difficult for low-income families, it would

make many re-think the purchase of “junk food,” as the price would be equal to or more than

healthier foods. It is estimated that “A tax of at least 20 percent placed on sugar-sweetened

drinks could drop obesity rates by 3.5 percent and prevent 2,700 heart-related deaths each year”

(Salahi, 2012). The hope is that an unhealthy food tax will guide people to purchase other goods

that are healthier and contain less sugar, sodium, and unhealthy fats.

A way to make healthy foods more affordable is to cut existing agricultural subsidies for

commodities such as corn and soy and instead to subsidize fruit and vegetable cultivators. The

current subsidies keep the cost of unhealthy foods low and the cost of healthy foods comparably

high. Subsidized corn is one of the main ingredients in most “junk food,” and the principle

sweetener for most products. Americans are estimated to consume 73 percent of corn-derived

sweeteners per person, per year, which unfortunately is a direct result of the government’s farm

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policy (Hojatt, 2015). Many question whether lowering the prices of healthy foods and

increasing the prices of energy-dense foods will in fact have an impact on what people buy.

After all it is difficult to change ones eating behavior after years of developing certain tastes and

habits. To test this theory, several small-scale experiments where done where healthy food was

made more affordable than unhealthy food at different schools and work sites. The results

suggest that this theory is indeed sounds, as the consumption of healthy food was increased when

the prices became more economically appealing (Martin, 2005). It is time for the U.S.

government to take a firm stand on this issue and make some concrete resolutions about what

should and should not be subsidized.

Obesity is very complex with many different factors involved and thus requires perhaps

more dedication and commitment from both the healthcare professional and individual than any

other disease. Insurance companies are very significant in that they have the ability to either

deny or approve the kind of help an obese person may need. Sometimes what is needed is not

strictly medical in nature but is still absolutely necessary for the process to work. Insurance

companies should provide coverage for items such as a nutritionist, gym memberships, bariatric

surgeries, and even personal trainers. Those who are obese need a lot of support and guidance

when it comes to physical activity and eating right, as there is some danger involved if the

regimen is not performed correctly. The costs of providing alternative and preventative care are

greatly lower than the costs of expensive surgeries and costly secondary diseases such as

diabetes and coronary heart disease. By providing coverage for less expensive options, money

could be saved in the long run from preventative efforts.

With the introduction of the Affordable Health Care Act, insurance companies are now

required to offer some sort of plan to help obese people lose weight. Screening and counseling is

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required under the new healthcare act but the rest of the coverage plan is up to each individual

insurance company to decide. “Plans vary widely in what they will do. Some insurers are

offering telephone counseling; others cover visits with a health coach, and some cover group

sessions that offer lifestyle advice. Some are even referring patients to Weight Watchers”

(Hellmich, 2013). More needs to be done to standardize treatment and coverage for obesity so

that people don’t fall through the cracks of bureaucracy. There are some who will completely

miss out on the added benefits of the Affordable Health Care Act because “some grandfathered

plans don’t have to cover obesity screening and treatment if they haven’t changed their overall

coverage since 2010 when the law was passed” (Hellmich, 2013). To put a dent in the obesity

epidemic, this disease needs to be recognized as a serious medical condition with an aggressive

standardized treatment plan that is covered by all insurances with no stipulations.

Obesity was just recently recognized as an official disease by the American Medical

Association, the nations largest physician organization (Hellmich, 2013). Finally the obesity

epidemic is being acknowledged for what it is, a terrible expensive disease that could cause

devastating economic and human losses in the future. Changes in technology, the progressive

food industry, pervasive advertising, inexpensive “junk food,” and poverty have all converged

into a vortex of bad choices and unhealthy living. As healthcare spending began to soar due to

obesity and the numerous diseases that came with it, federal and public organizations finally

began to address the problem. Campaigns and programs such as Let’s Move! Active Schools,

NFL Play 60, the Healthy Hunger-Free Kids Act, HFFI, SNAP, and PEP began to spring up and

take action. Unfortunately the efforts of today are not enough to stem the tide of the damages

already done. The World Health Organization (WHO) has stated that, “the key to maintaining a

healthy weight is an affordable supply of fresh nutrient-rich foods” (Hojjat, 2015, p. 89). The

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way to accomplish this is to subsidize producers of fruit and vegetables and stop the

subsidization of corn and soy, which are key ingredients in energy-dense foods commonly know

as “junk food.” The federal government needs to have more rigid and strict dietary rules for

schools and all health insurance plans should have standardized coverage for obese patients to

not allow the disease to go unchecked. Simply put, the nation needs to take personal and social

responsibility for allowing this problem to get to this point. Only education, acknowledgment,

and the will to make changes in personal and social spheres will be able to stop the epidemic

know as obesity.

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References

Brownell, K. D., & Horgen K. B. (2004). Food fight: The inside story of the food industry,

America’s obesity crisis, and what we can do about it. Chicago, IL: Contemporary

Books.

Centers for Disease Control and Prevention. (2014). Adult obesity facts. Retrieved from

http://www.cdc.gov/obesity/data/adult.html

Goel, R. K. (2006). Obesity: An economic and financial perspective. Journal of Economics and

Finance, 3, 317-324. doi: 10.1007/BF02752738

Harris, J. L., & Schwartz, M. B., & Brownell, K.D. (2010). Evaluating fast food nutrition and

marketing to youth. Retrieved from http://www.fastfoodmarketing.org/media/FastFoo

dFACTS_Report_2010.pdf

Hellmich, N. (2013, July). Obamacare requires most insurers to tackle obesity. USA Today.

Retrieved from http://www.usatoday.com/story/news/nation/2013/07/04/obesity-disease-

insurance-coverage/2447217/

Henderson, J. W. (2015). Health economics and policy. Stamford, CT: Cengage Learning.

Hojjat, T. A. (2015). The economic analysis of obesity. Review of Business and Finance Studies,

6 (1), 81-98. Retrieved from http://ssrn.com/abstract=2497126

Let’s Move. (n.d.). Learn the facts. Retrieved from http://www.letsmove.gov/learnfacts/epidemi

c-childhood-obesity

Mann, S. (2008). Framing obesity in economic theory and policy. Review of Social Economy, 66

(2), 163-179. doi: 10.1080/00346760701668461

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http://www.letsmove.gov/learn

http://www.usatoday.com/story/news/nation/2013/07/04/obesity-disease-

http://www.fastfoodmarketing.org/media/FastFoo


Martin, S. S. (2005). From poverty to obesity: Exploration of the food choice constraint model

and the impact of an energy-dense food tax. American Economist, 49 (2), 78-86.

Retrieved from http://www.jstor.org/stable/25604329

National Football League. (2007). NFL launches NFL Play 60. Retrieved from http://www.nfl.co

m/news/story/09000d5d80316e42/article/nfl-launches-nfl-play-60

New America Foundation (2014). Federal School Nutrition Programs. Retrieved from http://fe

bp.newamerica.net/background-analysis/federal-school-nutrition-

Salahi, L., & Meaney, S. (2012, May). ‘Fat tax’ to lower obesity. ABC News. Retrieved from

http://abcnews.go.com/Health/Wellness/fat-tax-lower-obesity/story?id=16353067

Soechtig, S. (Producer), & Soechtig, S. (Director). (2014). Fed up [Motion picture]. United

States: Atlas Films

The State of Obesity. (2014). School foods and beverages. Retrieved from http://www.stateofob

esity.org/school-foods/

The State of Obesity. (2014). Food and beverage marketing. Retrieved from http://www.stateofo

besity.org/food-marketing/

The State of Obesity. (2014). Healthy affordable foods. Retrieved from http://www.stateofobesit

y.org/healthy-affordable-foods/

The State of Obesity. (2014). Physical activity before, during and after school. Retrieved from

http://www.stateofobesity.org/physical-activity-in-school/

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http://www.stateofobesit/

http://www.stateofo/

http://www.stateofob/

http://fe/

http://www.nfl.co/

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