Sept. 18, 2012 -- By 2030, more than half of Americans could be obese, resulting in millions of new cases of diabetes, coronary heart disease, and stroke -- a constellation of illness that could cost the United States up to $66 billion in treatment and over $500 billion in lost economic productivity.
It's a sobering scenario to say the least. And it is what is now being projected by a new 124-page report released Tuesday morning by The Trust for America's Health and the Robert Wood Johnson Foundation titled, "F as in Fat: How Obesity Threatens America's Future."
"With 6 million new cases of diabetes, 5 million cases of heart disease and stroke, and more than 400,000 cases of cancer in the next 20 years, we are on a tragic course that will have a horrible impact on the quality of life of millions of Americans and could overwhelm an already over burdened health care system," said Dr. Jeffery Levi, study author and executive director of Trust for America's Health.
The annual report looks at the state of the obesity epidemic, as well as ways to address it. This year, for the first time, it includes new data on how obesity could impact the health and wealth of the U.S. over the next 20 years.
Using a prediction model published in The Lancet last year, analysts estimated that if adult obesity rates continue on their current path, all 50 states could have rates above 44 percent by 2030. Thirty-nine states could have rates above 50 percent, and 13 states could have adult obesity rates over 60 percent.
These rising rates translate into increased disease. The number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020 and then double again by 2030. The cost of treating these preventable obesity-related diseases is estimated to increase from $18 billion per year in 2011 to $66 billion per year by 2030.
Experts not involved in the analysis or the report agreed that the effects of obesity are profound.
"Obesity is on the causal pathway to every major chronic disease that plagues our society -- heart disease, cancer, stroke, diabetes, pulmonary diseases, arthritis," said Dr. David Katz, director of the Yale University Prevention Research Center. "So it is best thought of as the canary in the coal mine of chronic diseases. As goes obesity, so goes health."
Katz added that he sees the effect of obesity on adults and children in his work every day.
"What concerns me most is that obesity in children is causing what used to be exclusively adult-onset chronic diseases there as well," he said. "There is no telling where this process will end."
Connie Diekman, director of nutrition at Washington University in St Louis, said the economic ramifications are equally worrying.
"Our society is not in a position to financially manage these increased costs and the implication of that is significant compromise to quality of life -- and possibly longevity -- for many people," she said.
Katz agreed. "This is a reminder that this problem is very big, and not going away," he said. "It is a reminder that the human and dollar costs of this crisis are not sustainable. It is a reminder that our goose is cooking, and we better get serious about putting out the fire."
The researchers said, however, that though the projections are grim, they need not be our destiny. If every state decreased their average body mass index by 5 percent by 2030, they said, millions of people would be spared from obesity-related disease and billions of dollars in health care spending would be saved.
Simply put, Levi said, this basically amounts to everyone losing about 10 pounds.
"That's an achievable goal," he said. "Relatively small changes can make a big difference."
Levi said two programs in the Affordable Care Act are moving things in the right direction. One of these programs is comprised of Community Transformation Grants, which have as one of their goals reducing BMI by 5 percent. The Diabetes Prevention Program is another initiative highlighted in the report that has been shown to prevent the progression from pre-diabetes to diabetes.
Investments in these programs and others like them are part of the answer to this reversing the current trajectory, Levi said.
"If states and the nation invest in interventions targeted toward adults, we could save billions of dollars," he said. "That's part of the battle. The other part is ensuring healthier environments for children so they remain healthy in the first place.
"So, if we can do these two things, Americans will be healthier, happier and more productive."