The obesity epidemic in the United States is a complex issue, which in turn makes prevention strategies equally complex. Since this epidemic is likely comprised of environmental, biological, social, and economic components, prevention strategies would need to address each of these components to be effective.

The population in the United States is, on average, overweight or obese and research strongly suggests these numbers are on the rise. According to the Centers for Disease Control (CDC), the prevalence of obesity in the United States was 42.3% in 2017-2018. This is up from a rate of 30.5% from 1999-2000. In addition, the prevalence of severe obesity increased from 4.7% to 9.2% in that same time period. This issue is also a very costly one as the annual medical cost of obesity-related issues was $147 billion in the US in 2008, with the cost of $1,429 higher annually than those of a healthy weight.

In addition, obesity is different among groups. Generally, people with college degrees tend to have a lower prevalence of obesity than those with less education. Interestingly, among men, the prevalence of obesity was lowest in both the lowest and highest income groups when compared with those that would be classified as middle income. Among women, obesity prevalence was lowest in the highest income group, with a greater incidence among middle and lower-income groups.

The good news is that the public is making some effort to control obesity, as is evidenced by the popularity of a plethora of diets and exercise routines available to the public. However, these diets and exercise routines have done little to stop the epidemic.

The number of potential contributing factors to the high incidence of obesity among the American population is considerable. Though there exists an abundance of statistical data regarding the obesity epidemic, there is no information that is conclusive in naming any single cause. As stated earlier, the causal factors of obesity may likely be a combination of economic, social, environmental, and biological factors. Chief among the culprits is the fact that the American lifestyle has changed considerably over the last century and has created an abundance of high-calorie, low nutrient food. This food is relatively inexpensive in relation to income levels, and environmental cues such as the constant barrage by advertisers influence the public to eat almost non-stop. In addition, many communities are not designed to be fitness friendly and do little to encourage an active lifestyle, as is evidenced by the lack of walkable neighborhoods and the lack of available bicycle lanes. Neighborhoods are typically divided into zones that are strictly residential or commercial. This has created the need to drive everywhere and minimizes walking or the use of bicycles in everyday activities such as going to work or grocery shopping.

On average, Americans walk approximately 5,200 steps per day. This number is significantly lower than the 10,000 daily steps recommended by many health organizations. In contrast, the Amish, a group that lives with very little automation, walks 14,000-18,000 steps per day which likely contributes to their extremely low obesity rates.

Some experts propose that the addition of something as simple as walking an additional mile per day may be the answer to reversing the entire obesity epidemic and that it may be the key to tipping the trend in the opposite direction. However, my personal opinion is that it is also critical to address the abundance of processed food in our society. Simply, no amount of exercise will offset our weight gain until we change what we eat. Fortunately, on a local level, we are blessed with numerous farm stands and plenty of opportunities to obtain fresh, local produce and locally raised meat.

Dave Bellomo is a fitness trainer and wellness professional and can be reached at dave.bellomo@gmail.com or messaged through Bellomo Fitness on Facebook.