The size of Americans has become a sort of international punch line. Yes, we’re very large. Although with two-thirds of the country classified as overweight or obese, it’s hard to find anything to laugh about. This scary epidemic is showing no signs of slowing, and the widespread health effects continue to swell. America’s ballooning weight has pushed up the incidence of diabetes, and diabetes is the leading cause of kidney failure. As a result, the need for kidney transplants is reaching unprecedented levels.

Across the United States, there are approximately 73,000 people currently waiting for kidneys, and donations are not keeping pace. The Center for Disease Control estimates that 7 percent of Americans have diabetes, and there is no reason to believe that this percentage will decrease in the near future.

In many European countries, the need for organ donations has been met by policies that automatically treat everyone as an organ donor unless they opt-out of the program. This has the benefit of dramatically increasing the pool of donors, and it is not requiring anyone to donate. Others have advocated for the legalization of selling kidneys, but such a system would most likely exploit those in poverty who are in dire need of cash.

We need to have new policies that will prepare us for the increasing need for organs, specifically kidneys. An opt-out system of donation as used in Europe would truly help. Certain parts of the U.S. populace would certainly resist the idea, but opting-out should be made simple to assuage the feeling that the government is forcibly stealing organs.

Ideally, the United States needs to adopt new policies to address the obesity issue. This is the cause of many other health crises that are affecting our country. However, any changes addressing our size will be slow to implement, and we need to help those who are currently in need and prepare for the future demand for organs.