Philip J. Goscienski, M.D.
June 2010
For the past million or so years, few humans carried more than 15 or 20 pounds of fat on their muscular bodies. It was enough to provide a reserve of energy when bad weather, the need for migration or some emergency made food less available. Nature provided even more protection for women during their childbearing years. An extra layer of fat on the hips that would stay out of the way of an enlarging uterus would release energy for the infant in the womb.
When archeologists unearthed small statuettes from the Stone Age that clearly depicted remarkably rotund females it appeared that obesity might not be a modern phenomenon after all. Yet even these examples did not resemble the morbidly obese of the present day.
The generally accepted definition of morbid obesity is 100 pounds over standard weight. About one American in 20 now falls in that category and the numbers increase decade by decade. The circus fat lady of the early 20th century wouldn't find a job at the side show now — there's too much competition. In a stroll through the local mall you'll encounter several folks who weigh more than 300 pounds, some of them gliding along in the motorized carts that the mall owners provide for them in order not to slow down their spending.
Morbid obesity represents a growing market and there is no lack of inventive entrepreneurs to take advantage of it. The morbidly obese have their own online shopping sites. They offer oversized clothing, gadgets that make it easier to reach now unreachable body parts, furniture and fixtures that will accommodate a thousand-pound frame.
Personal needs affect personal finances but the medical requirements of the morbidly obese impose a cost on all of us. New hospital construction reflects the new obesity. Hospital doorways are wider now. Rooms have built-in hoists. Examination tables and surgical platforms must be able to accommodate half a ton. Needles for drug delivery are twice as long as they were only a generation ago. The annual cost of medical care for the morbidly obese patient is nearly four times that of the normal-weight individual.
The world's heaviest humans die early, some in their 20's. Few reach retirement age.
Genetics does not explain the obesity epidemic. Each of us carries hundreds of "fat genes" but so did our great-grandparents. I tip my hat to TV's Biggest Losers. They prove that lifestyle matters.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.