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Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 7, Number 3, 2002

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 Scene from El Paso, Texas The Crisis of

by Donna Eberwine
Photos by Hermínio Oliveira

You’re in your car at the intersection of University Ave. and N. Mesa in El Paso, Texas, less than a mile from the U.S.-Mexico border. Suddenly your stomach growls, your mouth waters and you feel a strong craving for something to eat. No problem. Just a block up the street is Taco Bell, where this week’s special is the ‘Extreme Quesadilla’ for only $1.24. There’s a drive-through window, so you don’t even have to get out of your car.

If you’re not in the mood for Mexican, no matter. There are four or five convenience stores within half a mile offering everything from doughnuts to 44-ounce soft drinks and one-third-pound hot dogs, all at bargain prices. A bit farther, but only a couple of minutes by car, are Arby’s, Burger King, Jack-inthe- Box, McDonald’s and Wendy’s—not to mention Pizza Pro’s, Peking Garden, Wienerschnitzel and Rib Hut.

 Street Scene from El Paso  Fernando Botero Painting  Street Scene from El Paso

For Jose Roman, a 72-year-old pediatrician who has practiced for four decades in this west central El Paso neighborhood, the culinary abundance is much more a bane than a blessing. "Every three blocks you see restaurants advertising large portions at low prices," he says. "Two burgers for 99 cents." He and others are convinced it’s one of the reasons El Pasoans are getting fatter every year.

The trend is a disturbing one, and it is readily evident in Roman’s young, mostly Mexican-American patients. The number of obese children in his practice has increased dramatically, he says, particularly in the last five to 10 years. "Probably 20 to 30 percent of the children I see each month are significantly overweight."

The problem is even worse among adults, according to Muriel Hall, executive director of the El Paso Diabetes Association. "El Paso stands above many other communities in being chunky," she says.

In fact, however, El Paso is not alone in having what public health advocates describe as an epidemic of obesity. In the United States as a whole, the latest data show that two out of three adults are overweight, and nearly one in three is obese. What is more alarming, similar trends are emerging around the world, in both developed and developing regions. In countries as diverse as the Czech Republic, Finland, Germany, Kuwait and Jamaica, at least half the population is overweight and one in five is obese.

The health impact of this obesity pandemic can be seen most clearly in fast-rising rates of Type 2 diabetes, for which obesity is the main known risk factor. According to the Brussels-based International Diabetes Federation, the number of diabetics worldwide has grown to more than 150 million, a fivefold increase since 1985.

Obesity is also known to put people at higher risk of other serious health problems, including cardiovascular disease, arthritis, gallbladder and kidney disease, and cancers of the breast, colon, uterus, esophagus and kidneys. In the United States alone the direct health care costs of obesity now exceed $100 billion a year, according to the American Obesity Association.

Add to this the social stigma, psychological distress and economic discrimination often suffered by the obese, and the costs are heavy in terms of both health and quality of life.

"The combined impact of obesity and weight-related illness is in fact as great as if not greater than tobacco," says Neville Rigby, director of policy and public affairs for the London-based International Obesity Task Force. "We need to approach the obesity issue with the same degree of concern and vigor."

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