Anti-anti-obesity

Girth of a Nation
By PAUL KRUGMAN
Published: July 4, 2005

The Center for Consumer Freedom, an advocacy group financed by
Coca-Cola, Wendy's and Tyson Foods, among others, has a Fourth of July
message for you: worrying about the rapid rise in American obesity is
unpatriotic.

"Far too few Americans," declares the center's Web site, "remember that
the Founding Fathers, authors of modern liberty, greatly enjoyed their
food and drink. ... Now it seems that food liberty - just one of the
many important areas of personal choice fought for by the original
American patriots - is constantly under attack."

It sounds like a parody, but don't laugh. These people are blocking
efforts to help America's children.

I've been looking into the issues surrounding obesity because it plays
an important role in health care costs. According to a study recently
published in the journal Health Affairs, the extra costs associated
with caring for the obese rose from 2 percent of total private
insurance spending in 1987 to 11.6 percent in 2002. The study didn't
cover Medicare and Medicaid, but it's a good bet that obesity-related
expenses are an important factor in the rising costs of
taxpayer-financed programs, too. Fat is a fiscal issue.

But it's also, alas, a partisan issue.

First, let's talk about what isn't in dispute: around 1980, Americans
started getting rapidly fatter.

Some pundits still dismiss American pudge as a benign "affliction of
affluence," a sign that people can afford to eat tasty foods, drive
cars and avoid hard physical labor. But all of that was already true by
1980, which is roughly when Americans really started losing the battle
of the bulge.

The great majority of us (yes, me too) are now overweight, and the
percentage of adults considered obese has doubled, to more than 30
percent. Most alarmingly, obesity, once rare among the young, has
become common among adolescents, and even among children.

Is that a bad thing? Well, obesity clearly increases the risks of heart
disease, diabetes, back problems and more. And the cost of treating
these weight-related diseases is an important factor in rising health
care spending.

So there is, understandably, a movement to do something about rising
obesity, especially among the young. Bills that would require schools
to serve healthier lunches, remove vending machines selling sweets and
soda, and so on have been introduced in a number of state legislatures.
By the way, Britain - with the second-highest obesity among advanced
countries - has introduced stringent new guidelines on school meals.

But even these mild steps have run into fierce opposition from
conservatives. Why?

In part, this is yet another red-blue cultural conflict. On average,
people living outside metropolitan areas are heavier than urban or
suburban residents, and people in the South and Midwest are heavier
than those on the coasts. So it's all too easy for worries about
America's weight to come off as cultural elitism.

More important, however, is the role of the food industry. The debate
over obesity, it turns out, is a lot like the debate over global
warming. In both cases, major companies protect their profits not only
by lobbying against policies they don't like, but also by financing
advocacy groups devoted to debunking research whose conclusions they
don't like.

The pro-obesity forces - or, if you prefer, the anti-anti-obesity
forces - make their case in part by claiming that America's weight gain
does no harm. There was much glee on the right when a new study, using
data from the Centers for Disease Control and Prevention, appeared to
reject the conventional view that obesity has a large negative effect
on life expectancy.

But as officials from the C.D.C. have pointed out, mortality isn't the
only measure of health. There's no question that obesity plays an
important role in many diseases that diminish the quality of life and,
crucially, require expensive treatment.

The growing availability of such treatment probably explains why the
strong relationship between obesity and mortality visible in data from
the 1970's has weakened. But the cost of treating the obese is helping
to break the back of our health care system.

So what can we do?

The first step is to recognize the industry-financed campaign against
doing anything for the cynical exercise it is. Remember, nobody is
proposing that adult Americans be prevented from eating whatever they
want. The question is whether big companies will have a free hand in
their efforts to get children into the habit of eating food that's bad
for them.

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