Dec 23, 2012
Leaving the highly sensitive topic of “gun-control” aside for the time being, one can’t help but wonder if it isn’t time that the US government, seemingly hell-bent on regulating virtually everything in its quest to prove (to itself?) that America’s population can no longer be trusted with making any responsible decisions on it own (and in the process becoming even bigger), shouldn’t be more focused on “fat-control” instead. Why? Because while guns may or may not kill people, the bottom line is that of the 32K or so death attributed to firearms, roughly 20K, or two thirds were suicides, meaning firearm-based homicides were 11,015 in 2010. Putting this number in perspective, every year some 935,000 Americans suffer a heart attack, and 600,000 people die from some form heart disease: 1 in every 4 deaths. Net result to society: the cost of coronary heart disease borne by everyone is $108.9 billion each year. And of all proximal factors contributing to heart disease, obesity and overweight is the main one. But of course one can’t make a media spectacle out of 600,000 hospital wards where people quietly pass away, in many cases due to a lifetime of ill decisions relating primarily to food consumption. In fact, some estimate that obesity now accounts for one fifth of the total US health-care bill (the part of the budget which no amount of tax increase can offset). Which is why if the topic of gun-control has managed to promptly tear the country into two (or three, or more), just wait until fat-control (far more than the recent tepid overtures into this field such as Bloomberg’s NYC sugary soda ban) rears its ugly head and sends the already polarized (and weaponized) US society into a state of agitated hyperflux.
Some useful observations on this topic from The Economist:
IN 1937 George Orwell suggested that “changes of diet” might be more important than “changes of dynasty or even of religion”. Now he is being proved right in a way he might not have expected. Having spent millennia worrying about not having enough food, mankind’s main concern is now eating too much (see our special report on obesity).
The story of human health in the past few decades is a broadly encouraging one. Life expectancy has increased—globally, by 12 years for women and 11 years for men from 1970 to 2010. But greater longevity means that people spend more years chronically ill (see article). Obesity makes things worse by raising the risk of diabetes, heart disease, strokes and some cancers. In much of the world, being too fat is now the single largest driver of sickness.
In 2008 obesity rates were nearly double those of 1980. One in three adults was overweight, with a body-mass index (BMI) of 25 or more (at least 77kg for a man 175cm tall); 12% were obese, with a BMI of at least 30. In America, ever the world leader, about two-thirds of adults were overweight in 2008. But Britain lumbered close behind, with six in ten too fat. The problem is not confined to rich countries. Thanks to economic growth, people around the world are eating more food. Workers burn fewer calories at their desks than in the fields. Even in China, one in four adults was too fat in 2008. In Brazil more than half were. Obesity rates in Mexico, Venezuela and South Africa matched those of America. The Pacific islands and Gulf states are home to some of the world’s fattest people.
For those (like this newspaper) who believe that the state should generally keep its nose out of people’s private affairs, obesity presents a quandary. “A millionaire may enjoy breakfasting off orange juice and Ryvita biscuits,” Orwell pointed out; “an unemployed man doesn’t…You want to eat something a little bit tasty.” If people get great pleasure from eating more than is good for them, should they not be allowed to indulge themselves? After all, individuals bear the bulk of the costs of obesity, quite literally. They suffer at work, too: their wages are often lower and, in America, some employers also make fat workers pay more for health insurance.
Yet in most countries the state covers some or most of the costs of health care, so fat people raise costs for everyone. In America, for instance, a recent paper estimated that obesity was responsible for a fifth of the total health-care bill, of which nearly half is paid by the federal government. And there are broader social costs. The Pentagon says that obesity is shrinking its pool of soldiers. Obesity lowers labour productivity. And state intervention is justified where it saves people from great harm at little cost to themselves. Only zealots see seat-belt laws as an affront to personal liberty. Anti-smoking policies, controversial at first, are generally viewed as a success.
So which is it: state intervention? Or, as the Economist correctly asserts for once: individual liberties where people have no choice but to experience the consequences of one or more of their own wrong decisions? But what happens when the entire state is already broke from pre-funding generations of precisely these bad decisions, and there is nothing left in the state’s piggy bank for those who wish to behave prudently and sensibly? The Economist has some further thoughts:
In the absence of a single big solution to obesity, the state must try many small measures. Governments, some of which already intervene a lot in the first few months of people’s lives, should ensure that parents are warned of the dangers of overfeeding their babies. Schools should serve nutritious lunches, teach children how to eat healthily and give them time to run around. Urban planners should make streets and pavements friendlier to cyclists and pedestrians. Taxing sugary fizzy drinks—which unlike fatty foods have no nutritional value—and limiting the size of the containers in which they can be sold may work. Philadelphia and New York, for example, have implemented a range of such policies, and have seen child-obesity rates dip ever so slightly.
There is a limit, however, to what the state can or should do. In the end, the responsibility and power to change lie primarily with individuals. Whether people go on eating till they pop, or whether they opt for the healthier, slimmer life, will have a bigger effect on the future of the species than most of the weighty decisions that governments make.
Just like in the sensitive issue of gun-control, there is no easy, or definitive answer when it comes to the world’s most overweight nation. Perhaps, however, the best clue to what should happen comes from the WSJ’s interview with the 107 year old Irving Khan, one of Wall Street’s oldest investors and Ben Graham’s research assistant, who made the following remark on unwholesome lifestyles: “Millions of people die every year of something they could cure themselves: lack of wisdom and lack of ability to control their impulses.”
And that’s really it. Sadly, the government, in its encroaching desire to become the world’s nanny state par excellence, already believes it can offset everything else, including human stupidity and impulse control. That it can’t will become very apparent in time, but only when everyone finally wakes up from the 150 year old dream that started with Bismarck’s ‘Welfare State’ utopia, and sadly ends in bloodshed. With or without gun control.