Should the growing weight of the nation be put in government's hands?
Public health officials say yes; others say trimming the fat is up to individuals
When it comes to fighting obesity, "we need to stop putting the pizza in our mouth," says Steve Siebold, author of “Die Fat or Get Tough.” (Zbigniew Bzdak/Chicago Tribune)
With two-thirds of all U.S. adults classified as obese or overweight, public health officials warn that much of the population is at dangerously high risk of diabetes, heart disease and other chronic and costly illnesses.
But who should be responsible for slimming down the nation?
Several recently released obesity action plans — including one for Illinois — suggest the government can do it through public policy measures ranging from soda taxes, healthier school lunches and mandatory school gym to calorie listings on menus, fitness-friendly infrastructure and restrictions on junk food advertising.
Drawing from other public health successes, they theorize that if taxes and laws can get Americans to wear safety belts and to stop smoking, they can also persuade us to exercise, eat better and, thus, lose weight.
But a growing chorus of critics, including some conservative politicians, say the government has no business — or hope of succeeding — in the weight-loss arena.
"It's the individual's responsibility," said Steve Siebold, author of "Die Fat or Get Tough." "For the majority of us, we need to stop putting the pizza in our mouth, and it's not the government that's going to get us to do that. It's about making a personal decision to make it happen, not letting the nanny state take care of us."
Last fall, former Alaska Gov. Sarah Palin characterized first lady Michelle Obama's "Let's Move" anti-obesity campaign as an assault on individual rights.
"What she is telling us is that we can't trust parents to make decisions for their families in what we should eat," Palin told radio host Laura Ingraham. "Instead of a government thinking that they need to take over and make decisions for us according to some politician or politician's wife priorities, just leave us alone."
Advocates of anti-obesity policies, however, say the government has a responsibility to intervene when taxpayers pick up much of the nation's obesity-related health care costs, calculated at $147 billion in 2008 by the Centers for Disease Control and Prevention.
In Illinois, obesity results in $3.4 billion a year in additional medical costs, a figure that is projected to rise to $15 billion by 2018 if trends continue, said Elissa Bassler, chief executive of the Illinois Public Health Institute.
"So if you are not even concerned about health and care only about economics, you can still see how this affects the bottom line for employers, the business community and policymakers," she said. "The cost to their pocketbook is just overwhelming."
In response to the state's rising obesity level — which has increased more than 80 percent since 1995, according to the CDC — public and private stakeholders formed the Illinois Alliance to Prevent Obesity in January 2010. This month the group presented a State Obesity Action Roadmap featuring eight objectives — from making healthy food more accessible to promoting safe and active transportation — aimed at stabilizing state obesity levels by 2015 and reversing the trend by 2018.
But to Paul Campos, author of "The Obesity Myth", such initiatives reflect a refusal to accept the ineffectiveness of populationwide weight reduction programs.
Campos, a University of Colorado law professor, bases much of his pessimism on long-term health interventions by Johns Hopkins University and the University of Minnesota that resulted in improved health behaviors but no weight loss. He also notes that the most reliable CDC data show a plateauing of obesity rates over the last decade.
"We don't know how to make fat people thin or how to keep thin people from getting fat on a populationwide basis," Campos said. "This is considered a heretical and anathematizing thing to say in these public policy debates, but it's a critical detail that tends to be ignored by policymakers. They are recommending interventions that have been tested repeatedly and don't work."
Supporters of anti-obesity policies don't deny past problems but note that many of the newer strategies have not yet been tried or at least not for very long.
Among these strategies are calorie labeling requirements at chain restaurants that will go into effect nationally in 2012. New voluntary guidelines on advertising junk food to children were also released last week, to protests by the food industry.
As nutrition policy director for the Center for Science in the Public Interest, Margo Wootan has been working on both issues for about a decade, and only today is she seeing the first glimmers of results, she said.