Obesity has been a topic front and center during the health care policy debate. Obesity may cost $147 billion in health care costs according to a Centers for Disease Control and Prevention.
The big question: What are you going to do about it?
Everyone knows the cure. Exercise more. Eat less. But we go back to the cheeseburger and laptop. Short of going back to the farm and working the fields we just burn a lot fewer calories these days.
What if you removed all the bad stuff from the environment? No junk food. No TV. No nothing.
The Wall Street Journal highlights programs that enlist entire towns to fight the fat. An excerpt:
Instead of hoping that individuals can muster the self-discipline on their own to avoid processed foods, fast food and days without physical exercise, the idea is that governments must actively work to change environments and reduce the menu of harmful options available in everyday life.
As a result, hundreds of towns in Europe and elsewhere have adopted a version of this strategy, aimed particularly at preventing children from becoming overweight and obese. They hired dietitians to counsel children and their families in schools, organized walk-to-school days, hired sports educators and built new sporting facilities. The U.S. government, meanwhile, is increasing its funding for cities and towns to pursue so-called community-based obesity prevention, in an effort to gather data about which kinds of tactics work best.
Sounds rather nanny state no?
Perhaps these approaches will work, but it's kind of doubtful. Why?
Consider the following headlines:
- New York City requires that fast-food chains report calories in their food. The general idea: People will eat less junk. The reality: New York City diners wound up ordering more junk. Check out a few studies from Health Affairs.
- Then there's the fact that people use food as therapy. Twenty-eight percent of Americans are more likely to eat than see a therapist. Well, it is cheaper.
- And finally you can't put people in a bubble of healthy habits despite a lot of efforts to influence behavior.
It's too early to know whether these community-based obesity fighting attempts will work, but it's worth a shot. Nothing else has worked yet.
Among the questions we need to ponder regarding obesity:
- Do we need a carrot, stick or something in between to fight obesity?
- Do people have the right to be obese?
- Do we have an obligation to pay for all the health problems obesity brings?