Government And Obesity

There’s little argument among most experts that adult obesity has become a public health concern for the governments of developed countries around the world.  We Americans have a kind of global reputation for obesity at this point, but of course, many governments are exploring different approaches at promoting exercise and weight loss for adults.

Government And Obesity — Promoting Adult Exercise

Its interesting to me how governments attempt to influence the behavior of their citizens.  They do so through a variety of techniques.  For instance, they attempt to promote (or discourage) many behaviors based on interest rates and tax policy.  Behaviors influenced by such decisions in the U.S. include things like home ownership, family size, and investment choices.  The U.S. government also promotes certain purchasing decisions when it comes to cars and home upgrades through tax policy.  They can also discourage certain behaviors based on legislation (i.e. recreational drugs and the use of tobacco products).  But one area they’re struggling with is adult obesity and exercise.

The Australian government conducted a study to evaluate the cost effectiveness of a variety of “interventions” to promote adult exercise.  They included ideas such as offering exercise advice on government websites, doctor-prescribed exercise to overweight patients, pedometer giveaways, and mass media promotion of walking paths/greenways.  Their finding was that the final two approaches were the most cost effective.  However, researchers raised the possibility that all the approaches taken in aggregate may provide the greatest cost-benefit potential.

As far as doctor-prescribed exercise goes, I’ve personally never known anyone who has lost weight just because their doctor suggested it.  Quite frankly, most of the people I know who have been given that suggestion (myself included) blatantly ignored the advice.  Of course, it has also been my experience that most doctors prescribe weight loss when a health problem has been detected  (i.e. high blood pressure).  At that point, most people here are more inclined to simply ask for a pill to solve problem.

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The Problem With Government And Obesity Intervention

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One problem with government intervention and obesity is that they’re promoting exercise for weight loss, and we’ve already established that daily exercise to lose weight simply does not work.  That’s not to suggest that daily exercise is bad.  There is no doubt that even low intensity exercise provides a huge array of health benefits, not the least of which is its one of the best natural ways to lower blood pressure.  Most people would benefit from walking an average of 30 minutes a day.  But, the only way to effectively lose weight is through a reduction in calories.  The real question becomes how does government influence the behavior of citizens at the dinner table, and that’s a loaded hot potato.

Let us go back to the two primary tools that government has at its disposal to influence the behavior of the citizenry.  They are tax policy and legislation.  How would either of these two approaches work?

Legislation and Obesity

There is no legitimate way for governments to legislate the food, or quantity of food that people consume, short of outlawing “unhealthy” foods.  Now, let us consider what would be declared “unhealthy.”  Imagine for a second what that fight would look like, with all the special interest groups involved.  Take for example, kids cereal.  Right now, anyone can find examples high sugar kids cereals proclaiming the health benefits of their whole grains.  Never mind the wasted calories.

Taxation and Obesity

How about the idea of a fat tax?  That one’s been floated around for a while now in several different incarnations, with one favored approach being to charge higher insurance premiums to people who are obese.  The reasoning behind this is that people who choose to be obese incur higher medical costs.  There’s the rub.  Applying the same rationale as has been used in charging higher insurance premiums to tobacco users requires the assumption that everyone who is obese suffers from obesity does so as a matter of choice.  While we could argue the validity of the research, there is certainly a body of evidence to support the notion that some people have a genetic predisposition toward obesity.  Once that link has been made, obesity is no longer a lifestyle choice, but a condition outside the control of the individual.  If that holds true, then:

Taxation = Discrimination

Which, of course, will never work in any developed nation.

A second approach to taxation is to tag on a sin tax to unhealthy foods.  Take, for instance, New York State’s tax on soda products.  One thing that governments have found is that their populace has shown very little resistance to sin taxes.  If you don’t believe that, just take a look at taxes leveled against cigarettes and alcohol.  Governments have regularly shown both the notion and ability to pass taxes on products considered luxuries or sin products.

Quite frankly, the only way I can see government and obesity playing in the sandbox is by this approach, and even would be fraught with problems.  For instance, who decides what products get the extra tax?  Sweetened soda products are an easy mark, but what about those made with artificial sweeteners?  What other products would we see get an added tax?

I’ll give an example.  One metric I generally use for the health of non-meat products is their fiber content.  If a serving of food contains at least 2-grams of fiber per (reasonably sized) serving, then I generally consider eating one serving to be acceptable.  It’s now possible for purchase whole grain Pop-Tarts, and a single pastry has 5-grams of fiber and 200-calories.  Would this incur a sin tax?

In general, I’m not a fan of government intervention is our daily lives.  My libertarian tendencies run too deep for me to support that notion.  But I’m also a a realist, and I don’t see this issue going away any time soon.  Since obesity is, without a doubt, a contributor to the ongoing increases in healthcare costs, governments will try to find ways to encourage the populace to reduce our collective waistlines.  The only question becomes, how they will go about it.