The topic of obesity is a familiar one in the United States. The condition has become so closely associated with American life that some even consider it one of the nation’s chief exports, and up until recently America was the most obese country on Earth.

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I’ve been pleased with the direction obesity discussions are taking lately. More and more mainstream media outlets are reporting on the problems associated with obesity, and even the First Lady of the United States has taken the time to focus on the topic. There have been good results too: obesity rate increases have stalled in the USA, a sign that at the very least we’ve come close to rock bottom with this epidemic and seen things get about as bad as they can get.

That being said, there is still a lot of delusional talk out there about obesity. Fat acceptance movements persist, claims of “fatphobia” are still being thrown at critics of the obese, and many mainstream media outlets still lament the persistence of what they call “fat shaming”.

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Now don’t get me wrong, I can see where some critique of the current dialogue on obesity is welcome. For some people obesity is an actual result of serious genetic conditions or illnesses, but these people are quite rare (much rarer than the pro-fat camp would have you believe). Similarly, I acknowledge that the BMI isn’t a perfect measure of healthy weight in humans. There are many men who are “obese” simply because they lift weights, but can’t be considered anything less than in peak physical shape. There are also probably a few women who are overweight for similar reasons. These people aren’t very common but I’m aware of their existence.

That being said, the excuses above do not apply to the vast majority of America’s obese population, nearly all of whom are the way they are because of poor diets and poor (or nonexistent) exercise habits. The vast majority are not victims of genetic diseases—they are victims of misinformation and a society that still seems all too willing to assuage their ego by telling them how “all bodies are beautiful” (lamenting any critique of them as “fat shaming”), instead of actually dealing with a very real issue.

Here are three reasons why we can’t afford to let this proceed:

1. Lifespans

For the first time in the modern era, the United States is projected to witness a significant decline in the life expectancy of its citizens.

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Over the next few decades, life expectancy for the average American could decline by as much as 5 years unless aggressive efforts are made to slow rising rates of obesity, according to a team of scientists supported in part by the National Institute on Aging (NIA), a component of the National Institutes of Health (NIH) of the Department of Health and Human Services (DHHS).

Additional research has shown that people who are severely obese — with a BMI greater than 45 — live up to 20 years less than people who are not overweight. Some researchers have estimated that obesity causes about 300,000 deaths in the U.S. annually. In addition, obesity is fueling an epidemic of type 2 diabetes, which also reduces lifespan.

To estimate the overall effect of obesity on life expectancy in the U.S., Olshansky and his colleagues calculated the reduction in death rates that would occur if everyone who is currently obese were to achieve the difficult goal of losing enough weight to reach an “optimal” BMI of 24. The calculation was based, in part, on age, race, and sex-specific prevalence of obesity in the United States from the Third National Health and Nutrition Examination Survey. Based on these calculations, the researchers estimated that life expectancy at birth would be higher by 0.33 to 0.93 year for white men, 0.30 to 0.81 year for white women, 0.30 to 1.08 year for black men, and 0.21 to 0.73 year for black women if obesity did not exist.

People want to enjoy healthy, long lives. As a society, we want all of our citizens to enjoy healthy, long lives. Obesity is genuinely limiting the ability of Americans to do these things in the future, and is a factor that is literally jeopardizing our future by ensuring that Americans have less of it to look forward to.

2. Healthcare Costs

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The most direct costs of obesity relate to healthcare expenditures, and they are quite extensive:

Reports on obesity-related medical spending (direct costs) have charted a steady rise in obesity’s cost over the years, as the epidemic has grown. One widely-quoted estimate from Finkelstein and colleagues, based on data from the U.S. Medical Expenditure Panel Survey (MEPS), found that obesity was responsible for about 6 percent of medical costs in 1998, or about $42 billion (in 2008 dollars). By 2006, obesity was responsible for closer to 10 percent of medical costs—nearly $86 billion a year. More recently, Cawley and Meyerhoefer drew headlines with their estimate that obesity accounts for 21 percent of medical spending—$190 billion in 2005—more than double Finkelstein and colleagues’ earlier estimate from MEPS data.

Looking ahead, researchers have estimated that by 2030, if obesity trends continue unchecked, obesity-related medical costs alone could rise by $48 to $66 billion a year in the U.S.

Countries with lower obesity rates than the U.S. spend a smaller share of their healthcare dollars on obesity, but the burden is still sizable.

On a per person basis, the obese are very expensive:

Several investigators have evaluated the cost of obesity on an individual level. Finkelstein and colleagues found that in 2006, per capita medical spending for obese individuals was an additional $1,429 (42 percent higher) compared to individuals of normal weight. Cawley and Meyerhoefer, meanwhile, found that per capita medical spending was $2,741 higher for obese individuals than for individuals who were not obese—a 150 percent increase.

I think that the seriousness of this spending cannot be overstated. We’re in the midst of a shutdown of the U.S. Federal Government that resulted in large part from debates over healthcare programs and the costs associated with them. As the American population gets older these costs will only go up, meaning that we will need to find more money to fund healthcare programs. Where this money will come from is anybody’s guess, as there don’t seem to be an abundance of options.

3. Economic Costs

The healthcare costs are just the tip of the iceberg. The more indirect costs of obesity hit hard as well.

How hard? Try $390 Billion a year:

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We are approaching a period of very serious challenges to our prosperity. Western nations like the United States are getting older, and that rising number of senior citizens will lead to rising healthcare costs and significant losses in economic productivity (youth = higher productivity, lower likelihood of retirement, etc). As the golden days of seemingly endless prosperity that American Baby Boomers grew up with come to an end, their children and grandchildren will be left to face a much less economically certain future. They’ll be in no position to face the challenges that future will bring if they can’t take an objective look at issues like obesity, objectively examining the consequences of said issues and making a conscious effort to reduce them.

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The objective truth is simple: we are living in a society that simply cannot afford the obesity epidemic we’re facing now. Feelings will be hurt and labels of “fat shaming” will fly, but a sustained effort to combat obesity—an effort which will require fully acknowledging that it is not a positive thing and that saying “You’re beautiful the way you are!” is no excuse—will eventually need to happen.

Those unwilling to face this reality had best be willing to pay, or have their children ready to pay in the future, the exorbitant price that will accompany their refusal.

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