Obesity--Sometimes a Function of Money

Nearly twenty years ago I sat in a young physician’s office and listened to him lecture me on my obesity. (I’m no way as slim as was when I smoked and made higher salaries.) I also no longer enjoy the higher salary I once did.
My mouth watered as he described the foods I ought to be eating. After a few moments, I stopped him and asked if he had any idea what the diet he advocated would cost—fresh meat, fresh fruits, fresh veggies. He looked startled for a moment. Then he thought.
No, he admitted. He had no idea. “My wife,” he said, “never considers costs when she shops. I never thought about it before, either.” Nice to be an affluent young doc, in a thriving medical practice—where you don’t have to check your wallet before you shop.
Not so nice to assume your patients are as affluent as you are—and make recommendations that take no account of cost. The pre-printed diets from large and reputable medical organizations also seemed to take no account of the cost of groceries either.
It matters when you’ve got two young kids to feed. It matters when they are in college or senior high school, still eating at home. (The money they get does not toward food at home; try auto insurance, maintenance—one commutes miles to a university—gas, tuition and text books, and so forth, and so forth.)
When it comes to food, they are the farthest thing from revenue neutral. When we can (rarely) afford food that’s not cooked at home, it’s pretty much pizza and burgers. Food for four adult sized appetites at a real restaurant can knock an awful hole in a century note.
I got a heads up on this back in 1968. I was living in Washington and working a couple of weeks in New York City. I figured out that the cheapest and nearly fastest way to go was either by train or Gray Hound—both of which had terminals near my home.
On one bus trip I got to chatting with an admittedly chubby young British girl. She had, she told me taken off for a year-long trip around the world. She had come through Europe, the Near and Middle East. She’d stayed in then peaceful Kabul and floated down the Mekong River. She had arrived in this country only a month or two before.
“Look at me,” she gestured at her extra poundage, “I didn’t gain a pound until I landed in San Francisco. The only thing I can afford to eat in this country is your fast foods—and they are FATTENING!” She was both puzzled and unhappy at this phenomenon.
She described the luscious fruits and fresh meat she had consumed on all the rest of her trip. It had all been well within her limited budget. But in no way could her budget stretch to eat as healthily in America as she had on a large raft in the Mekong River.
My wife is desperate to lose weight—but the high protein, fresh food diet that works for her is way too expensive for all four of us to eat. Pasta, rice, bread, cereal—not sugared ones!), potatoes, peanut butter and cheese have to fill in some of the gap. We almost never eat desert—but, in warm weather we bring half-gallons of ice cream home.
It’s fattening, I admit. But it’s affordable. (Yes, we could give up fast food—but when all four of us have spent hours raking the lawn and winterizing the place and darkness comes, no one really wants to go into the kitchen and make a nice healthy meal. Someone goes out to McDonald’s or Burger King and no one has to cook or wash up. That’s just exhaustion.)
Obesity is no doubt going to prove a very expensive medical problem for this country. Serious consideration might also be given to making all the things that might prevent obesity more affordable. NO ONE is going to want to think about that.