The thin, not the meek, shall inherit the earth

Philip J. Goscienski, M.D.

February 2013

If the statisticians are correct and if the present trend continues, 100 percent of Americans will be obese in the year 2150. From a meager 10 percent or so at the end of World War II the obesity rate has skyrocketed to more than 33 percent today. About 40 percent of us are simply overweight, leaving barely a quarter of the population in the normal-weight range. Even that figure is overstated since it is estimated that some persons are categorized as normal-weight obese, a medical term indicating that body fat has replaced muscle while weight is unchanged. The scale really does lie.

We'll never reach 100 percent obesity, of course. Not only is the rate of increase in obesity beginning to flatten out, there will always be fitness die-hards who are determined to maintain a healthy lifestyle. Further, the economic burden of fatness and the soaring medical costs that result from its complications will evoke government intervention on a massive scale. Rationing of medical care is the most dreaded prospect but you can expect that not many more years will pass before there are high taxes on imprudent lifestyles. The camel's nose is already under the tent in the form of tobacco taxes, and soda taxes in some municipalities.

The sugar industry will take a hit as a major cause of childhood obesity and type 2 diabetes. Health insurance premiums, already increasing by double digits each year, will rise for persons who are fat, not fit, for smokers and for those with risk factors that predict costly medical problems.

Healthy leanness, which rules out anorexia nervosa and bulimia, will bring with it financial benefits. Not having a chronic disease will mean lower premiums for medical coverage as it does now for life insurance. In an effort to encourage healthy habits tax laws will provide credits for participation in monitored fitness programs, subsidize operators of neighborhood gyms, increase taxes on refined grains and sugar and support lower prices for fruits and vegetables. Business owners will be allowed to discriminate against the obese in their hiring practices as they do now against smokers. Slender airline passengers will fly at reduced rates — but will probably be just as uncomfortable in the narrow seats reserved for them.

With better employment opportunities and tax breaks, the fit will prosper. That is, of course, unless they are outvoted by the overweight majority.

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