Obesity in ToledoWritten by Casey Harper | | firstname.lastname@example.org
Losing nearly half your body weight isn’t easy. But Mark Greenblatt weighed 330 pounds and he knew something had to change.
He took medicine for his cholesterol and blood sugar. He experienced the asthma, sleep apnea and insecurity that come with carrying around the weight of a second person.
Then he lost 150 pounds through diet and exercise, trading sleep apnea, asthma and medications for restful nights of sleep, high energy and a whole new wardrobe.
“When I started, my pants were a 54-inch waist,” he said. “Last September, I had a 32-inch waist, which is something I hadn’t had since junior high.”
Greenblatt’s journey to obesity was, like many Americans’, a gradual accumulation of lifestyle choices that hit a critical mass.
Recent data indicate his is only one story in a much larger narrative. Obesity rates around the country have risen to unprecedented levels, and Toledo’s is among the worst.
In April, the online news site 24/7 Wall Street ranked Toledo the “7th fattest city in America.”
“Yeah, we’re pretty fat, it’s true,” said Lucas County Health Commissioner Dr. David Grossman. “It’s funny; at one of our health care meetings we were saying how we’re famous for things that you don’t want to be famous for.”
Bursting at the seams
According to the Centers for Disease Control and Prevention (CDC), 22.9 percent of Americans 20 and older were obese in 1988-94. By 2010, that number had risen to 35.7 percent.
A person is obese if his or her body mass index (BMI) is 30 or higher. BMI is calculated using height and weight. A 5-foot-6-inch woman weighing 160 pounds would have a BMI of 25.8. If that same woman gained 40 pounds, her BMI would jump to 32.3, putting her in the obese category.
Statistics differ between surveys, but the percent national obesity rate cited by the CDC was obtained through actual measurement, while state numbers are obtained through self-reporting.
In 2011, the CDC’s self-reported obesity rate for the state of Ohio was 29.6 percent, the 12th most obese state in the nation. According to the 2011 Lucas County Community Health Needs Assessment, also self-reported, Lucas County’s obesity rate is 35 percent. The percentages vary, but Lucas County stands out either way.
The Ohio Department of Health divides Ohio into 10 regions and nine large counties. Of those 19 areas, Lucas County is tied for the fifth highest obesity rate.
“What we’re seeing is many, many, many people who are obese, who are too heavy, and what’s happening is they are developing diabetes and … heart problems and high blood pressure,” said Barbara Gunning, director of health services for the Toledo-Lucas County Health Department.
Toledo, however, trumps most national heavyweights. Gallup recently surveyed 189 U.S. metropolitan areas. Only six had higher obesity rates than Toledo.
24/7 Wall Street evaluated Gallup’s 11 metropolitan areas with the highest obesity rates and also evaluated other obesity factors like healthy eating and exercise, as well as health effects like hypertension and diabetes. The site ranked Toledo as the “7th fattest city in America” and the fattest in Ohio, stating, “Toledo residents were more likely than most Americans to have high cholesterol, high blood pressure or diabetes, or to have suffered a heart attack.”
Grossman said many Lucas County residents do not exercise much and that hard economic times drive people to buy cheaper, easier-to-prepare unhealthy foods as opposed to healthier foods, which are more expensive and take more time to prepare.
For example, a meal-sized salad at McDonald’s costs $4.95 without a drink or any sides. For that same price, you could buy four double cheeseburgers and a large sweet tea off the dollar menu. So if you’re feeding four kids, you can buy them all cheeseburgers for a total of $4 or you can buy them all salads for nearly $20.
Healthy eating can hurt the piggy bank, and simply put, Americans aren’t willing to pay extra for food that doesn’t taste as good.
According to the CDC, obesity-related conditions include heart disease, stroke, Type 2 diabetes and certain types of cancer — some of the leading causes of preventable death.
“The medical dangers of being obese, there are many,” said Amy Watkins, program director at Mercy Weight Management Center. “There are actually hundreds of conditions that are related to obesity. It really does have an impact on every aspect of the body. It definitely can decrease life expectancy by five to 10 years easily. So it can take five to 10 years off of your life.”
In 2008, medical costs associated with obesity were estimated at $147 billion, with obese people paying on average $1,429 more than those of normal weight, according to the CDC.
“If I spend a little bit more money to have fresh food and vegetables around, at least I’m not paying for copays and all the medicine and doctor visits,” Greenblatt said.
The little things
America’s obesity problem is primarily behavioral and cultural, Watkins said.
“We move a lot less and we have a greater excess of food,” she said. “Thirty years ago, the percentage of obese Americans was minimal. Our sense of portion control and portion sizes has changed a lot in the last 30 years. The first McDonald’s, when it opened in the ’50s, [an adult meal] was basically the size of a kids meal, and look what we have today. I remember as a little kid you got a small hamburger and a little package of fries. Today they’ve quadrupled that.”
Greenblatt battled his weight for years while working on his feet at his carryout and delivery pizza shop, but switching to a desk job sent him into his heaviest days.
His BMI was 46 at his peak. He tried to lose weight several times to no avail.
“I had worked one-on-one with a nutritionist a few years prior to that and maybe I lost 20 pounds for four months,” he said. “I had tried other programs and had no success with them. Didn’t like the meetings, didn’t like the programs.”
Greenblatt’s big change came when he decided to join Mercy Weight Management Center’s nonsurgical weight loss program in June 2011, beginning the day after Father’s Day — a journey he hoped would keep him around longer for his two young boys ages 3 and 6.
“My inspiration now is to maintain a healthy lifestyle and set a good example for my kids,” Greenblatt said.
He joined the program with a group as part of a fundraiser. The group gathered sponsors who would pay for every pound they lost. Greenblatt made his donors more charitable than they ever expected.
“Once I had done that and made it public, I didn’t feel like there was any room for failure,” he said.
Mercy’s program involves attending weekly behavioral classes, working with a personal weight-loss coach and eating a structured diet that can be medically monitored.
“The first 50 pounds came off in 10 weeks, 100 in six months,” Greenblatt said. “Knowing that I was eating to live rather than living to eat was a big thing.”
With such rapid weight loss, Greenblatt struggled to keep a wardrobe that fit his shrinking figure. He spent thousands of dollars replacing clothes in a life-changing 18 months. He would buy just enough to last him until he needed to drop down another size. At one point, he had only two pairs of pants that fit.
“I’ve got one going into the dryer and one coming out of the dryer,” he said. “I went from wearing a 4X T-shirt to a large. At my peak I was able to get down to a medium. I just had to start shopping. It was absolutely crazy. It’s a good problem to have.”
Greenblatt’s wife Denise did the program and lost 40 pounds. She said their new lifestyle has improved their relationship with their children.
“[The kids] absolutely love it because we’re out there playing ball, we go bike riding,” she said. “Any chance we can we’re out there doing activities. They love it. I would say that being healthy, eating healthy, and being active is very important in our life so that we can stay young and healthy to stay in our children’s life in every way possible for as long as possible. He’s a definite inspiration to myself and the kids and a great motivator.”
Greenblatt runs, bikes, plays basketball and softball and does cross-training. He works out at least four days a week for at least an hour. He still attends the weekly program meetings to hold himself accountable and encourage others in the process.
“Everything in my life was changed in many ways as a result of going through the program,” Mark said. “Anybody can have the same success I had if they listen to what the program said they are supposed to do and don’t challenge it.”