The Washington Post goes to Hidalgo County, Texas, one of the poorest counties in the nations — and one of the fattest. Excerpt:

The family checkup had been scheduled at the insistence of a school nurse, who wanted the Salas family to address two concerns: They were suffering from both a shortage of nutritious food and a diet of excess — paradoxical problems that have become increasingly interconnected in the United States, and especially in South Texas.

For almost a decade, Blanca had supported her five children by stretching $430 in monthly food stamp benefits, adding lard to thicken her refried beans and buying instant soup by the case at a nearby dollar store. She shopped for “quantity over quality,” she said, aiming to fill a grocery cart for $100 or less.

But the cheap foods she could afford on the standard government allotment of about $1.50 per meal also tended to be among the least nutritious — heavy in preservatives, fats, salt and refined sugar. Now Clarissa, her 13-year-old daughter, had a darkening ring around her neck that suggested early-onset diabetes from too much sugar. Now Antonio, 9, was sharing dosages of his mother’s cholesterol medication. Now Blanca herself was too sick to work, receiving disability payments at age 40 and testing her blood-sugar level twice each day to guard against the stroke doctors warned was forthcoming as a result of her diet.

Notice that this isn’t a matter of changing social stigma about obesity. This is a woman whose obesity makes her so unhealthy she cannot work, and whose life is in danger. More:

“El Futuro” is what some residents had begun calling the area, and here the future was unfolding in a cycle of cascading extremes:

Hidalgo County has one of the highest poverty rates in the nation . . . which has led almost 40 percent of residents to enroll in the food-stamp program . . . which means a widespread reliance on cheap, processed foods . . . which results in rates of diabetes and obesity that double the national average . . . which fuels the country’s highest per-capita spending on health care.

This is what El Futuro looks like in the Rio Grande Valley: The country’s hungriest region is also its most overweight, with 38.5 percent of the people obese. For one of the first times anywhere in the United States, children in South Texas have a projected life span that is a few years shorter than that of their parents.

It is a crisis at the heart of the Washington debate over food stamps, which now help support nearly 1 in 7 Americans. Has the massive growth of a government feeding program solved a problem, or created one? Is it enough for the government to help people buy food, or should it go further by also telling them what to eat?

Read the whole thing.  It talks about how political efforts to restrict what families can spend food stamps on — a state representative from this area wanted to forbid families from spending food stamps on energy drinks — failed in the legislature, because most people, including both industry and anti-hunger groups, didn’t want to regulate what people ate. Educational efforts also have failed. It’s a complex problem of economics and culture. And a costly one on the health care front. And a deadly one.