It's time to crack down on obesity

Over the past several decades, the nation has made great progress against alcohol abuse, drug abuse and smoking. Of course, much remains to be accomplished, but the aggregate change for the better has been dramatic.

At the same time, America is going in reverse when it comes to the stupendous problem of being overweight or obese. Understanding why is essential in order to determine what must be done if we are ever to get a handle on this epidemic and its costs.

The changing profile of America is breathtakingly grotesque. I dug out my 1956 high school senior class year book as a starting point. There were 183 in our class. Only one classmate was obese, and only three or four were overweight. There was no shortage of candy, sodas, fries, burgers, hot dogs or pizza back then. We ate a lot of that food, and at least one of us still does.

But back then we were physically active, most of our parents were not fat, and fat kids were objects of scorn and derision. The system worked. At the senior prom, for example, no girl wore what resembled a multicolored pup tent. And none of us guys had to worry on the dance floor that, if our date zigged when she should have zagged, we'd end up with a fractured pelvis.

How have we made such progress against drugs, alcohol and smoking? It's not a hard question to answer. If you get cross-wise of the law on drugs, you end up in a world of hurt. Three felony drug convictions in California get you a life sentence. A DUI conviction can cost you your license and send you to jail or prison. Advertising for alcohol and tobacco products is tightly regulated. Alcohol and tobacco products are very heavily taxed. In New York City, a carton of cigarettes costs about $200! And more than half of that is tax.

So let's be real clear: The principal way our nation has chosen to come to grips with these problems is by using the long and coercive arm of government.

In fact, a large majority of Americans support what governments at all levels have done to attack these problems. Most Americans believe smoking and drug abuse are killer health problems. They also believe alcohol abuse, especially when it's coupled with teens and/or driving, is a killer. And so we've forged a collective consensus — the use of government power to punish bad behavior.

At the same time, America is eating itself to death. At the recent Weight of the Nation Conference in Washington, researchers from Duke and elsewhere reported that in just one more generation at least 42 percent of Americans will be obese. That's 110 million Americans, including millions of children.

Obese people are prime candidates for diabetes, heart disease, kidney failure, certain cancers and joint replacement. These are self-inflicted diseases that now cost $147 billion annually, and those costs are rising rapidly.

Elementary school children by the millions view their teachers as role models. And far too many of those teachers, mostly women, are sending the wrong subliminal message to their students every day — it's OK to be fat.

Thus, it's no surprise that retired U.S. Army generals John Shalikashvili and Hugh Shelton have stated that "being overweight or obese has become the leading medical reason recruits are rejected for military service." They call obesity a national security threat.

What are we doing about this epidemic? Virtually nothing. The landscape is littered with bad policy and bad actors. For example, too many physicians will not engage their patients on this life-and-death problem. They are afraid of making them mad. The government dithers and then produces guidelines and calorie charts that are universally ignored.

The first lady plants a vegetable garden on the White House lawn that grows lettuce, collards, chard and anise hyssop. Wow! Network television celebrates obesity with the Emmy-winning sitcom "Mike and Molly" or the disgusting competition called "The Biggest Loser."

Guess what? None of this nonsense works.

Where's the long arm of the law that made the difference for smoking, alcohol and drugs? It cowers in fear — fear of political reprisal by a super-fat supermajority. There's the truth of the matter. Porcine politics has paralyzed effective action.

Now don't get me wrong. If 110 million Americans are obsessively self-destructive enough to engage in slow-motion suicide, I'm good with that. But I'm not good with their being able to shift the staggeringly high cost of their narcissistic behavior to the rest of society.

There are numerous options that are available to policymakers. For example, just a few days ago, the mayor of New York City proposed a ban in the city on super-sized sugary drinks. While such a ban, if enacted, could be easily circumvented by the fact that it would not apply to all commercial entities that sold those drinks, it is a start down the road of government action that has been successfully applied to tobacco, drugs and alcohol.

In addition, it might become necessary to go much further by limiting the availability of publicly subsidized health insurance to those who are obese. In such a case, those people could either choose to pay for their medical care out of pocket or simply lose enough weight so that they continue to qualify for subsidized health insurance.

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