Only one-third of all Americans enjoy a normal weight -- forcing the redesign of everything from coffins and airline seats to insurance policies and taxes in order to fit the other two-thirds.
Americans stuffing themselves with fast food are finding it harder to stuff themselves into their cars, forcing engineers to redesign the interiors.
The sale of diet books has jumped. Salads have sprung up at burger joints, but the perpetual question is: "Wanna supersize that?" And Americans overwhelmingly end up supersizing themselves.
That's been the trend for 20 years. Since 1980, the number of obese Americans has doubled, to 59 million adults.
Sixty-four percent of the population is overweight or obese, according to the Centers for Disease Control and Prevention (CDC), which based its 2003 study on 1999 statistics.
The trend toward fat is not flattening off, forcing planners to let out the seams on insurance polices and even US taxes.
"There is an insidious epidemic in America," CDC Director Julie Gerberding said.
US eating habits show no sign of slowing down, Gerberding said. Even 25 percent of the children, the best indicator of future trends, are overweight or obese, a figure that has doubled since the 1970s.
The US Department of Health and Human Services estimates that obesity-related diseases -- such as cardio-vascular diseases, diabetes and cancers -- cost US$120 billion annually. They continue to rise.
The American Medical Association estimates that 300,000 deaths per year are linked to excess weight.
In the near future, food package labels will reflect the total number of calories inside -- not just per "portion," the current notion, which can vary widely from one consumer to another. The Food and Drug Administration (FDA) is expected to make its recommendation in February.
FDA Commissioner Mark McCellan would like to see restaurants keep a calorie count right on the menu.
"Obesity challenges us on every aspect of our efforts to protect and advance the public health," he said.
The weighty question for health planners and insurance companies is whether to classify obesity as a disease. Doing so would make hundreds of treatments reimbursable, at once raising costs but also making more money available for new treatments.
Including alcoholism as an illness helped increase the range of treatment available. The same classification for obesity could help those affected recognize they need seek treatment, and help the public not think of those overweight as being responsible for their condition.
"Many people believe that dealing with overweight and obesity is a personal responsibility," US Surgeon General David Satcher said.
"To some degree they are right, but it is also a community responsibility," he said.
Even the US Treasury Department will this year allow tax deductions for obesity treatments, but private insurance companies are holding the line against classifying obesity as a disease for economic reasons.
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