Oct 22, 2018

Health and wellness are booming, but we're fatter than ever

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Data: Obesity, NCHS National Health Interview Survey. Gym memberships, IHRSA Global Report. Stress, APA Stress in America Survey; Chart: Andrew Witherspoon/Axios

Between Soul Cycle, Fitbit, Whole30 diets and social media health gurus, the health and wellness industry is booming — but Americans are more likely to be obese today than ever before.

The problem: Despite promises made by gyms and fitness programs, physical activity does little to help people lose weight, says Ashkan Afshin from the Institute for Health Metrics and Evaluation at the University of Washington. And Americans' diets are still terrible.

It’s the only disease that we put the blame on the patient and remove it from the health care provider.
— Fatima Cody Stanford, obesity medicine physician scientist, Massachusetts General Hospital and Harvard Medical School

One key trend: The prevalence of diseases most attributed to obesity — high blood pressure, diabetes and high cholesterol — has held steady or even fallen over the past few years, according to data from the Centers for Disease Control and Prevention.

  • But that's mostly due to increased treatment for those conditions, health experts say.

Meanwhile, obesity has created a thriving industry in the U.S., even though many programs have little medical or scientific backing.

The U.S. fitness industry is the most lucrative in the world, bringing in $30 billion worth of revenue in 2017, according to the latest report by the International Health, Racquet and Sportsclub Association (IHRSA) — a global trade association for the fitness industry.

  • Since 2008, the number of gym members has increased by more than 33% in the U.S., according to the same report.
  • The commercial weight loss program market was worth $2.77 billion in 2016 and was expected to grow 9.4% to $3.03 billion in 2017, according to Marketdata.
  • Fitbit's consumers have grown from 500,000 to more than 25 million in just 5 years, according to data collected by Statista.
  • Fitness apps and wearables overall are projected to be used by 16.4% of people in the market by 2023, up from 15.7% in 2016, per Statista.

But food is the key problem when it comes to obesity, according to Afshin.

  • "Data shows there is increased availability, affordability and accessibility of high energy-dense foods," Afshin said. And many Americans are eating more than their bodies need.
  • More than a third of Americans eat fast food every day — an industry notorious for high caloric, low nutrition meals — and only 1 in 10 eat the recommended amount of fruits and vegetables, per CDC.
  • Eat better, not less: Stanford argues that eating less isn't always the solution either. Some dietitians argue that the quality of the food matters more than the number of calories.

Three other key contributors to obesity that often get overlooked:

  • Stress has been shown to induce weight gain even without any changes to diet or exercise, as the human body turns to survival mode and begins storing up energy.
  • Lack of sleep, especially high-quality sleep, also causes weight gain. Stanford said that the fact that "we live and eat and breathe with our phones" has had a detrimental impact.
  • Medications often cause weight gain as well, and patients are not always aware of the side effect.

The bottom line: "Our bodies are now supportive of an environment that really supports obesity," Stanford said. Meanwhile, the medical community and insurance regulations are slow to help obese patients until they've been diagnosed with other serious health issues associated with the disease.

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