EDITORIAL

To win, we have to lose the…

Weight of the Nation

R emember the war on poverty? Or the war on cancer? Or the war on alcohol? All failures. One might think that the last of these wars—the prohibition of “intoxicating liquors”—was such an abysmal failure that awareness of its unintended consequences—the rise of the gangster in society—would inoculate us against using it as a model for future campaigns. You would be wrong. Because we now find ourselves entering yet another battle, the banner of which has just been unfurled: the war on obesity. And it embraces all the erroneous presumptions and the worst mistakes of the earlier debacles.

The new war’s instigating report, “The Weight of the Nation,” has just been released by The Institute of Medicine, a not-for-profit, “non-governmental” organization founded in 1970 under the congressional charter of the National Academy of Sciences, and funded by the Federal government. This over-stuffed 462-page “advisement” endorses the use of the “full weight” of the law to regulate food, business, healthcare, transportation, real estate, and whatever else it takes to vanquish the enemy: obesity. Is this a prescription for disaster, or what? It certainly smacks of politics.


Tammany Hall’s William “Boss” Tweed, as depicted by 19th century political cartoonist Thomas Nast.
There can be little question that you needn’t be a politician to count the pounds of “opportunity” that are represented by America’s protruding waistline (The Boss Tweed’s of today would use it to build a political constituency). Nevertheless, obesity represents a health concern that affects the public and is indicative of a growing increase in our propensities for many diseases, including type 2 diabetes, cardiovascular disease, and stroke. According to the report, things really began to turn downhill during the last 25–30 years, and now more American’s are obese than those who smoke (remember that war?). Worst yet, there is no end in sight with 2 out of 3 adults overweight or obese, and 1 out of 3 children in similar conditions.

Not surprisingly, the “non-governmental” panelists are not asking for entitlement reform, let alone new incentives for individuals to maintain a healthy weight through diet and exercise. Their collective finger is pointed at “obesogenic environmental forces,” which they claim are the reasons for the obesity epidemic. These forces (i.e., what purports to represent the core of the free marketplace) encourage us to be fat, via the way foods are marketed and because they are all too available as calorie-rich foods and drinks that are low-cost. Consequently, they envision a government-led transformation “across all levels and sectors of society.” War gives you the rationale to that type of power.

The “real” problem—and this is what makes it a public health problem—is the cost, an estimated 20.6% of all medical expenses, and who pays the bill. That would be the taxpayers, the net-payers into the system, through Medicare and Medicaid. But the real problem is that once a government controls the means of the healthcare delivery, as it is scheduled to start doing next year if not derailed by the Supreme Court, it is a very small step to taking full command in the battle, telling people how to live and what to eat. For their own good, of course. As has occurred in Canada recently, we may soon follow what the Provincial governments have done in moving swiftly to begin regulating foods and contents thereof.

More dire yet, if the panelists of The Institute of Medicine who created the report succeed in reducing obesity (fat chance!), the expanding longevity will swamp the budget of the new cradle-to-grave healthcare system. Who knows? Perhaps in their desperation to save the day, they will recommend that tobacco be subsidized once again, because smoking does reduce appetite. Anything is possible.

Last salvos: The government wants to control what you eat, but ironically, if you criticize a fatso for their weight you are perpetrating a hate crime. Did you know that you can even claim Social Security disability if you do not control your weight? Therein lies the fundamental problem. If you are subsidized for a particular behavior, you are likely to engage in that activity even more so.

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