Fat Old Fred

Philip J. Goscienski, M.D.

April 2007

I am not making this up! And I apologize to all readers named Fred.

As a CPR instructor certified by the American Red Cross and the American Heart Association I regularly receive product catalogs from companies that distribute manikins and other training materials. For those who are familiar with manikins named Resusci-Anne®, Little Anne™, Brad™ and Paul™, the next time you renew your CPR certification you may be practicing on a new member of their family: Fat Old Fred™.

Fred, according to the catalog, is more characteristic of a cardiac arrest (heart attack) victim than his predecessors. He's much older-appearing and has a large body type and extra fat layer. Emergency medical responders, of course, are quite aware that more heart attack victims resemble Fred than Anne, Brad or Paul. But then, more Americans resemble Fred. CPR instruction is simply keeping up with the times.

Have we passed the tipping point, where overweight becomes the standard? Now that two-thirds of us are overweight our willingness to view that as more acceptable is shifting rapidly. A 1995 poll showed that most of us (55 percent) viewed obese persons to be less attractive. Only 24 percent of Americans felt that way in 2004. That's good news and bad news. If outward appearance has diminishing importance in our value system, humankind is making progress. But if overweight is the norm we will have accepted the health problems that accompany extra accumulations of fat and we are literally putting our population in jeopardy. The complications of obesity are painful, prolonged and impoverishing.

If the trends toward overeating and underexercising continue, demographers tell us, nearly all Americans will be overweight by the end of the century, more than half will be obese and three-quarters will have type 2 diabetes. That won't happen, of course, as legislators realize that no state or federal treasury — or their political careers — can survive the dollar drain. The Centers for Medicare and Medicaid project that nearly 19 percent of the entire U.S. economy will go to health care in 2014.

Politicians rarely respond rationally to any crisis. Junk food taxes are an example, and only the beginning. An article in the Journal of the American Medical Association lists eight legal interventions to control overweight and obesity, including higher taxes on nutrient-poor foods. Some foods will be banned altogether as in the case of trans fats. Legislators have already proposed new zoning laws to restrict fast food restaurants. One thing is certain: the cost of food will go up in direct proportion to the number of laws passed to regulate the obesity problem.

Losing fat isn't easy but Arkansas' former governor Mike Huckabee showed the way by losing more than 100 pounds when he learned that he had type 2 diabetes. Huckabee has become a poster boy — a politician that made a rational decision when faced with a crisis.

Tax-deductions for exercise equipment and tax incentives for developers of neighborhood fitness centers will probably work better than tax penalties. So will lower health insurance premiums based on documentation of good health habits.

If these measures fail, Chunky Anne will join Fat Fred at a future CPR class.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.