Thinner wallets, fatter bellies

How the bad economy is encouraging bad habits - and how health officials are fighting back

Lisa Lawton has opted for group workouts instead of pricier one-on-one training sessions. Lisa Lawton has opted for group workouts instead of pricier one-on-one training sessions. (John Tlumacki/Globe Staff)
By Elizabeth Cooney
Globe Correspondent / July 20, 2009
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As if it wasn’t hard enough to lose weight, along comes this relentless recession to make it even more challenging.

Fattening foods are cheaper and easier to find than healthier fare. People are working longer hours for less pay, taking second jobs to make up lost earnings, and struggling to maintain a gym membership - or all three. Worrying about work translates into wider waistlines, it turns out, mostly for people who are already overweight. Oh, and losing sleep, too? That’ll add on the pounds, as well.

While it’s giving a whole new meaning to the phrase “the weight of the recession,’’ it has also presented doctors and health officials with an opportunity to remind people that healthy choices can be made in boom times and in bad times.

State and national health experts say it’s too soon to tell if the anemic economy is boosting obesity. But healthcare providers and exercise experts are seeing changes they tie to tighter times, for better or worse. Whether people turn to fast food because it’s what they can afford or skip exercise because they’re starved for time, the result can be unhealthy weight gain.

“There certainly are dangers during these difficult economic times,’’ John Auerbach, commissioner of the state Department of Public Health, said. “It becomes more challenging for people to try to eat the healthiest foods or exercise regularly. It is an issue we are concerned about.’’

For Jean Drew in Epsom, N.H., putting healthy food on the table for her family requires some ingenuity. Her daughter Rebecca, 10, is learning how to read nutrition labels in the grocery store to comply with prescriptions from a Children’s Hospital Boston program she attends to achieve a healthier weight. Drew scours supermarkets and farm stands for savings on the fruits, vegetables, chicken, and fish she knows are better than less expensive macaroni and cheese.

But stretching the family food dollar got harder four months ago when Drew’s husband, Scott, a truck driver, had his hours cut. She now works two part-time jobs, as a graphic artist and in retail, to pick up the slack.

“It was a challenge before. The economy is making everything hard,’’ Drew said. “It’s hard to stay on top of the bills.’’

To keep ahead of the food bill and teach Rebecca how food is grown, the family now picks raspberries at her grandparents’ patch, some of which they trade for vegetables grown in friends’ gardens. They also grow tomatoes and zucchini at her other grandmother’s house, where they also share meals to save money.

“We’re all eating better,’’ Drew said.

Better nutrition is the goal of the food pantry at Boston Medical Center, believed to be the only one of its kind in the country. Dr. Caroline Apovian sees the economy’s hand both in the hospital’s busy food pantry and in her weight management clinic at the hospital. From 400 people a month last year, the pantry’s patrons have soared to 7,000 per month this year. Many are obese, she said, owing to past reliance on cheap food high in fat and calories.

In her clinic she sees other barriers to achieving a healthy weight. Prescription obesity drugs are not covered by insurance, but patients got help with the more than $100 a month price tag from pharmaceutical company coupons. When the economic downturn deepened last fall, drug makers pulled back some of their discount programs. At the same time, gym memberships are also moving out of reach for some of Apovian’s patients.

“It’s all sort of drying up at once and the person who suffers the most is the one who is looking for the amenities to help them with weight loss,’’ she said.

In response, the hospital and the Roxbury YMCA launched a pilot partnership last month to teach people at risk for diabetes better nutrition and encourage developing new exercise habits. But people who already have access to gyms don’t always get to use them.

“The typical reason I get why my patients can’t exercise is because they are working too much,’’ Apovian said. “They’re having to get up early to get to work and they work later hours, and then they’re exhausted.’’

Job-related stress and weight gain are companions, according to a paper published last week by Dr. Jason P. Block of Brigham and Women’s Hospital. He and his Harvard colleagues found that stress on the job and trouble paying bills were the biggest risk factors for weight gain among men and women who were already overweight. For women, stress in relationships was also associated with weight gain, if they were above normal weight to begin with.

“People do respond differently to stress,’’ Block said. “Some people eat more under stress and some people eat less. It appears that where you start in terms of weight potentially sets you up for more problems if you have a higher weight.’’

A fitness specialist suggests working out as a way to counteract work-related stress.

“If you’re able to maintain a regular exercise program, it gives you a sense of accomplishment,’’ said Pete McCall, an exercise physiologist and spokesman for the American Council on Exercise. “What your employer does is really out of your control. What you can do on a day-to-day basis in exercise is something you can control.’’

A national survey conducted in the spring for the council found that current exercisers are not giving up on their routines, but many are finding more frugal ways to keep fit. In and around Boston, for example, people are switching from one-on-one sessions with personal trainers to small groups of four to eight people at one-third the price for each participant, said Sam Berry, director of personal training for Fitcorp. The company has 11 centers and also contracts with businesses to offer fitness benefits to their employees.

Lisa Lawton, whose job and workouts are in the same building in Boston’s financial district, made the switch in January.

“With the economic downturn, it’s definitely more affordable to do the group training versus the one-on-one,’’ she said. Vice president of human resources at AMR Research, Lawton said the company continues to provide discounted Fitcorp memberships to its employees, despite the recession.

She wouldn’t trade the camaraderie she has found with the group, which she credits for more inches lost and fitness gained this year. Nor would she part with the payoff in her workday.

“You have a built-in support system that provides you with motivation and encouragement,’’ Lawton said. “After I work out, I’m so much more relaxed and productive.’’

Stress can take a toll on entire families already struggling, according to Dr. David Ludwig, director of the Optimal Weight for Life program at Children’s that Rebecca Drew belongs to.

“It’s too soon to tell how the economy is affecting obesity prevalence, but it’s another factor,’’ he said. “On top of the unavailability of good food and recreational opportunities is the emotional and psychological stress that parental unemployment, food insecurity, and the general level of crisis in our society has directly on families and indirectly on children.’’

Amid the gloom, a Boston University nutrition professor sees an opportunity in the economic downturn.

“To get the most bang for your buck, you’re now forced to rethink where your food dollars go,’’ said Joan Salge Blake, who is also an American Dietetic Association spokesperson.

She recommends filling the shopping cart with fresh fruits and vegetables when they are in season or on sale, and heading to the frozen vegetables aisle otherwise. Meat, fish, or poultry should be in 3-ounce portions and whole grains should make up the rest of a well-balanced varied diet.

“It’s a recipe to keep a healthy weight, whether boom or bust,’’ she said. “I think this whole economy is a wake-up call to what we should be doing all the time.’’

Elizabeth Cooney can be reached at

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