It's not until you spend time elsewhere that you realize just how bad the American obesity epidemic is. In Europe I felt fat, especially in France and Italy. But here a Body Mass Index of 28 is scarcely noticed.
Most people blame the demand side of the food equation. It's a lack of discipline, they say. We're bringing it on ourselves. Getting thin is just a matter of willpower.
But the problem is not demand, it's supply. It's the portions we have grown accustomed to.
In Italy I ate plates of pasta that took away my appetite for the meat courses that followed. In France I was given small portions of perfection, but always small ones. Only in Germany were the portions faintly familiar, but they were preceded by so much water and beer I couldn't finish them.
Add in a few Cokes a day, some salty snacks, maybe some sugary cereal or snack cakes, and it's easy to see why morbid obesity has become so common.
In America's defense, I should also add that many Europeans smoke like they were characters in Mad Men, and no one seems to notice. My guess is the 1998 Tobacco Settlement, however it was implemented, seems to have changed attitudes here. We smoke furtively, one precious cigarette at a time. The Europeans I saw smoked thoughtlessly, whenever they were outdoors, and no one calls them on it.
All this has an impact on our total health care bill. Chronic conditions like heart disease and diabetes are rampant. We can medicate them and hide the impact, but the costs are driving us under.
So what did I learn in Europe? Only that this President's most important initiative, by far, is his wife's Let's Move campaign. As with the stimulus, I wish it were doing more.
As I sat at my train station and watched a morbidly obese woman with a Body Mass Index approaching 50 waddle away from me, the conclusion was inescapable. No health care system, whether reformed or not, can pay the bills on a morbidly obese nation.
This post was originally published on Smartplanet.com