Gapping Generations: Greatest to XL. What Happened?

Philip J. Goscienski, M.D.

September 2007

While standing in line at the post office one day I couldn't help notice something that no Stone-Ager would ever have seen. There were four clerks behind the counter and four patrons in front of it. Of the 8, one was of average build; the other 7 were frankly obese. Not just a few pounds overweight, but downright obese. At least one appeared to my physician's eye to weight more than 300 pounds. A statistician would shout that my sample size was too small. Of course it was! But unless the Western world does an about face very soon my sample size of 8 will represent almost the entire population.

Obesity is about to overtake smoking as the leading cause of death in the United States. Type 2 diabetes, coronary heart disease, hypertension and lots of other serious health problems go hand in hand with excess weight. The complications of diabetes itself are numerous and last for years. The major ones are kidney failure, blindness, and amputations. With health insurance premiums already at record highs, about $9,000 a year and rising, voters will demand that the government take on their health care costs. That scenario is highly likely because more than two-thirds of Americans are overweight -- and they vote! No matter that Medicare will run a deficit in a decade or that the Medicare prescription program is underestimated by at least half.

Anyone who has seen photos from the World War II era and earlier can't miss the observation that Americans were thinner then and not because the war years and the earlier Great Depression were hard on us. What changed?

We had fewer labor-saving devices so we burned a lot more calories on the job and doing housework. Golfers didn't ride in carts. We walked to school, to work and to the grocery store because most families had only one car.

If we had a TV set there wasn't much to see until after dinner. There was just a test pattern for most of the day so we might as well be outdoors. When we played games we used more than two fingers on a couple of buttons and we worked up a sweat.

We ate at home almost all the time. If we didn't have a garden our relatives and neighbors might and they often raised more than they could eat or preserve — especially zucchini. Our fast food places were drive-ins, where the hamburgers weighed two ounces and a milk shake was a generous 12 ounces. (When I worked as a soda jerk my boss kept an eye on me to make sure that I didn't go over the 12-ounce line, especially when my buddies were at the counter.)

We drank milk every day. Coke came in an eight-ounce bottle. It was OK to drink plain water.

What changed? The answers are in our everyday vocabulary: full-schedule TV on 250 channels, videogames and PCs, McDonald's et al., supersizing, high fructose corn syrup, Hagen-Daas, school budget cuts (no P.E.), Mom's taxi.

We don't have to back to the 1940s but maybe it's time to borrow some of those lifestyle ideas — especially the 2-ounce hamburgers, and hold the fries.

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