"I’m too busy" is the mantra of the 90s. But what are people doing that makes them "too busy?" I’ve never figured that one out.

The time’s certainly not being taken up by exercise. I’ve written about this trend in my column before, but it’s worth repeating. Americans are getting fatter and lazier by the day. I think it’s come to the point that being a wealthy nation isn’t helping us any more. Its side-effects are actually killing us.

There was a new study published this week in the New England Journal of Medicine, all about obesity and the risk of premature death. It found that excess weight by itself increases the risk of death and disease. American Cancer Society epidemiologist Eugenia Calle, lead author of the study, said, "The message is we’re too fat and it’s killing us. We need to come up with ways as a society to eat less and exercise more."

We’re all rich now, so we get rich-people’s diseases. We go to the supermarket and choose from 2,000 flavors of high-fat ice cream and sticky pastries. We eat at the best restaurants with rich sauces and gigantic portions. We take the escalator. We don’t even have to carry our shopping bags now that we can order everything online for next-day delivery.

And since all our neighbors, co-workers, and friends are fat, the amount of fat that’s acceptable on a person has been creeping up. It’s not unusual these days to go out in public and see a 300-pound woman or a 350-pound man. Sadly, it’s common. 54% of all adults and 25% of all children are overweight in the U.S.

This new study found that the fattest men—278 pounds at 5’10", for example—were over 2 ½ times more likely to die than a man of the same height who weighed 153 to 170 pounds. Just big boned? I don’t think so.

So what does the future hold? Is this report a watershed, like the Surgeon General’s report on smoking in the 60s? Maybe. But remember, here we are 35 years after the Surgeon General’s report, and a fifth of the adult population still smokes. Smoking is increasing rapidly among college students. There’s been progress in reducing the incidence and social acceptability of smoking, but there is a very long way to go. I think the same will be true with obesity. In 35 years we might see some progress.

James Hill, an obesity researcher at the University of Colorado, isn’t optimistic. In a recent article, he said, "The trend will continue. There is no indication that it will turn around. Actually, it seems to be getting worse. The predictions are that it is increasing at such a rate that we’ll all be overweight at some point."

It’s a fact that the percentage of overweight Americans has increased by about a third in the last 20 years, and the growing number of fat kids means there will be future adults who are even fatter.

Now, there are a couple ways to look at this whole situation. If you look from a public health standpoint, we’re absolutely doomed. Guts will grow so massive that heart attacks, strokes, diabetes, and high blood pressure will be even more common than they are now, and there’s little that can be done to slow the trend. At least the politicians aren’t talking about a "population explosion" anymore. (Remember that old fear? So 70s! AIDS and obesity have pretty much put that one to bed.)

But if you look from a personal standpoint, there’s a lot of promise in conquering obesity. People need to realize that they can choose their own behavior. Being fat isn’t inevitable, regardless of your genetics or your environment—it’s a consequence of behavioral choices made over a period of years by a single person—you. Change those behaviors, and over time, you get thinner. Then the risk of fat-related disease nearly disappears. Talk about "Think Globally, Act Locally!"

Granted, losing weight and getting fit is easier said than done. But it is possible if you make the commitment. You also end up looking better and having more energy.

I guess what worries me so much is that it’s nearly impossible to convince someone that they need to get fit, even in life-threatening circumstances. Most people would rather have a heart attack than do basic exercise and eat a moderate diet.

I always thought that if people were given proper health information, they would make the right choices. After all, you can’t act if you don’t know what the problem is. But I don’t feel that way anymore. I’ve spoken with so many people who say their doctor has told them to lose weight, but they refuse to make the effort. "It takes too much time to exercise. It’s too inconvenient. I sweat and get tired. I don’t want to spend the money."

Clearly, in their minds, a heart attack is the preferred option. These people know full well that being really fat is really bad. But they consciously make that choice. They also know that they shouldn’t smoke and that they should wear seat belts. You’d have to be a total idiot not to have that basic information floating around in your head. Still, so many people have the information, but they make so many unhealthful choices.

Having the information isn’t the whole answer. Getting up off your butt and doing something about the information is. There’s little hope of changing society’s gut-busting ways. But by putting health information into practice on a daily basis, you can greatly improve the quality of your own life.