America is a country in love with excess, and unfortunately, it appears to be catching up with us.
More people are gaining weight and binge drinking than ever before, resulting in a host of preventable problems and deaths, according to two federal studies published last week in the Journal of the American Medical Assn. And the number of related illnesses isn't expected to decline in the year ahead.
The country's obesity rate rose from 19.8% in 2000 to 20.9% in 2001. Diabetes diagnoses climbed as well, from 7.3% in 2000 to 7.9% in 2001, according to the federal Centers for Disease Control and Prevention, which surveyed about 200,000 adults across the country. In addition to diabetes, obesity is also linked to high blood pressure and heart disease.
"Americans are not doing enough," said Ali Mokdad, a senior epidemiologist who led the research. "Even though the messages about losing weight are out there, about 20% of people who are trying to lose weight are doing less than what's needed. About 25% of people are doing nothing at all."
Mokdad blames a number of factors: an increasingly sedentary lifestyle, the easy availability and low cost of fatty foods, and busy schedules that leave little time for regular exercise. While he advocates building walking-friendly neighborhoods, more corporate gyms and greater emphasis on healthy foods, Mokdad said he would be happy if Americans tried to at least not gain weight.
"If people can just maintain their weight," he said, "and achieve a balance between calories consumed and expended, then they can gradually lose weight, and maintain that weight loss."
Nothing in the study surprised John Foreyt, an obesity researcher at the Baylor College of Medicine in Houston. "The bottom line is that obesity is going to increase, and we're not going to see anything that's going to slow the rise. It looks like in the next 30 or 40 years, all of us will be overweight. It's happening in other countries, too, that's the scary part. And obesity brings out diabetes, and that causes the big-money health-care costs. This could break the bank in all other countries and our own."
Obesity statistics aren't the only ones inching up -- binge drinking is on the rise as well, with one in four Americans consuming five or more drinks at one time with the intention of getting drunk.
The total number of binge-drinking episodes among adults went from about 1.2 billion in 1993 to 1.5 billion in 2001. Binge drinking episodes per person per year increased 35% between 1995 and 2001. Men make up the majority of binge drinkers (81%), and although rates of binge drinking episodes were highest among those 18 to 25, 69% of episodes occurred among those 26 and older.
"It's not a pretty picture," said Dr. Tim Naimi, an epidemiologist with the CDC and lead investigator on the study. "It's a serious problem. It's not a joke, it's not a rite of passage. It's responsible for alcohol-related car deaths, burns, hypothermia, sexual assaults, falls, child abuse, and unprotected sex leading to unwanted pregnancies and sexually transmitted diseases. It kills about 50,000 people a year but affects many more."
Not necessarily alcoholics
The study found that 47% of binge-drinking episodes occurred among moderate drinkers.
"They have jobs, families, they're not all alcoholics," he said. "But that doesn't mean this isn't an important component of alcohol abuse."
As drunk driving has become an undesirable social stigma, so should binge drinking, Naimi believes: "Historically, we've had a deep ambivalence to alcohol. We tell underage youth not to drink, but then say to adults that moderate drinking is OK, and to drink responsibly. There's a lot of confusion about it."
He advocates a nationwide adoption of the 0.08% blood alcohol limit for drivers, higher alcohol taxes, and more thorough alcohol screening and intervention programs by health-care providers.
Although Naimi didn't offer any speculation on why rates of binge drinking have increased, he did say, "As a culture we are given to excesses, and it calls into question how we should behave as individuals and what our incentives are as a society to live healthy lives in the future."