That’s part of the problem. Obesity and malnutrition go hand-in-hand in this country because healthy foods are more expensive and more difficult to procure and prepare for people who are just scraping by. People will rant and holler about how poor people are so stupid for buying and eating fast food when buying ingredients and cooking can be cheaper and is definitely healthier, but that does not account for the people who are working 2 or 3 jobs to make ends meet and they simply do not have time for grocery shopping and cooking. There’s also the astonishingly dystopian reality of “food deserts” where there are people who don’t have access to actual grocery stores that sell fresh produce and meat. There are plenty of neighborhoods and even entire towns in America that do not have a store where they can buy fresh food, and even more where they don’t have access to affordable fresh food. It’s abominable.

As a medical professional, I see patients with tons of health problems including obesity, diabetes, hypertension, metabolic syndrome…the list goes on…and they simply do not have reliable, functional access to the healthier diet that would go a long way towards fixing those health problems. There are morbidly obese children with diseases like pellagra because of vitamin deficiencies, or obese people with muscle wasting because the food they have access to is mostly carbs and fat with very little protein. It is so frustrating and appalling to me that people on the outside of these situations look down on people struggling with obesity and diabetes and whatnot as if those people had any meaningful control over their situations.

One of my attending physicians in the family medicine clinic described it as “regular, small-town Midwest problems”. Often, the best we can do is recommend that they try to get more fruits and vegetables, whole grains, fish or chicken instead of red meat…but we also prescribe multivitamins and weight loss, diabetes, and hypertension medications because insurance will at least help pay for those. Honestly, health insurance companies could save literal billions of dollars if they offered rebate programs for healthy food and supported local farmers’ markets or something. Diet and exercise will lower someone’s high blood pressure 5 times as much as most of the medications will.