Stigmatize the Obese - Even More?

File this one under candidates for Worse Ideas, Ever.  

A so-called bioethics leader, Daniel Callahan, has written an article, that according one source,  argues that 

the public health community can learn from one of the most successful public health campaigns: the anti-smoking campaign. A primary strategy has been to stigmatize smokers, he says, making it clear that their behavior is not only unhealthy for them but is also socially unacceptable. While the public health community has decisively rejected the stigmatization of obesity, Callahan directly challenges that rejection.

In original report, which you can find here, the author proposes "stigmatization lite" to exert social pressure on people by asking overweight folks question like:

If you are overweight or obese, are you pleased with the way you look?

Are you happy that your added weight has made many ordinary activities, such as walking up a long fight of stairs, harder?

Would you prefer to lessen your risk of heart disease and diabetes?

Are you aware that, once you gain a signifcant amount of weight, your chances of taking that weight back off and keeping it off are poor?

Are you pleased when your obese children are called “fatty” or otherwise teased at school?

Fair or not, do you know that many people look down upon those excessively overweight or obese, often in fact discriminating against them and making fun of them or calling them lazy and lacking in self-control?

What I don't follow is that the author fully acknowledges that the overweight are already stigmatized.  Not only to the extremely obese earn lower wages, spend more on health care, and die sooner than normal weight folk, I have yet to see the supermarket tabloids do anything but make fun of even the skinniest celebrity who has put on a few pounds.  Does anyone doubt the clear message our culture sends? Thin is cool, fat is not.  

I don't doubt that a bit more cultural shame (or stigmatization lite) might result in a few pounds being lost.  But, at what cost?  How many pounds would someone need to lose for it to be ethically justifiable to make them feel bad about themselves?  Moreover, why do I have any interest in making someone else feel bad about themselves?    And, as already mentioned, there are already many costs to being obese - why add insult to injury with even more social shame?

What one weights is a complex result of factors related to personal decisions, preferences, technology, genetics, and environmental factors like food prices and availability.  I suspect there are many obese individuals who would say they'd like to weight less, but that's just talk.  I'd like to drive a Porsche.  I don't drive one (and the obese don't weigh less) because life involves constraints and a series of difficult tradeoffs.  So, what's the use in telling me that I'm a loser because I haven't chosen to allocate my salary toward a 911 Carrera Cabriolet?   Perhaps I just need to apply some stigmatization lite to this problem: 

If you drive a Chevy, are you pleased with the way you look in your car?

Are you happy that owning a Chevy has made many ordinary activities, such as driving to work or washing the car in the drive, uncool?

Would you prefer to drive zero to 60 in under four seconds?

Are you aware that, once you buy a Chevy, your chances of every getting a Porsche are poor?

Will Fat Taxes Kill You?

That's the tongue-in-cheek title of my article in Townhall.com.  Here are a couple excerpts:

 It is more than a little disconcerting, then, to learn that the mounting number of federal, state, and local policies aimed at slimming our waists may be misguided. The results from a careful literature review recently published in the Journal of the American Medical Association showed that people who are overweight and even a bit obese actually live longer than normal weight folk.

and

The pathologizing of extreme body types by public health professionals, pharmaceutical companies, and the federal government, for example by referring to obesity as an “epidemic”, has added insult to injury. And, it has licensed the actions of those who want to use the power of the government to restrict what we eat. Yet, if being overweight increases your lifespan, is it possible that government mandated fat taxes and soda bans may prematurely kill us?

and

But, if the overweight are living longer than the normal weight, where is the justification for public intervention to control our weight? Indeed, a study published last year in the Journal of Health Economics showed that health care expenditures are lower among overweight as compared to normal-weight men.

I go on to talk about the fallacy of using Medicare and Medicaid expenditures as justification for public intervention.  

Can Behavioral Economics Combat Obesity?

Obesity is a serious health problem. This article demonstrates that using behavioral economics to guide regulations is both misguided and can be counterproductive to obese and nonobese citizens alike.

That's the conclusion of an article in Regulation by Michael Marlow and Sherzod Abdukadirov.  I have a whole chapter in the Food Police on precisely this topic.

Are Healthy Foods More Expensive?

Are healthy grocery items more expensive than their regular within category counterparts? How do purchases of foods with positive health attributes change given negative unemployment shocks? To answer these questions, I supplement five years of multi-market, multi-chain scanner data with additional information on positive health attributes to create a unique dataset. First, this enables a robust descriptive analysis of the price of products with positive health attributes versus their regular within category counterparts; I find no evidence that products with positive health attributes are systematically more expensive or promoted systematically less.

That's from the job market paper of Jessica Rider in the Agricultural and Resource Economics Department at UC Berkeley.  

This is an interesting contribution to the debate between some folks at the USDA, who argue that healthy foods are not more expensive, and the work of people like Adam Drewnowski who say the opposite (here is just one example of many news stories on the debate).  

Coca-Cola Fights Back

A remarkably large number of pundits and public health professionals have focused their angst on sugar-sweetened sodas.  The proposals range from soda taxes, bans on large soda sizes, removals of soda machines from schools, to prohibitions against purchases of sodas with food stamps, to vilifying Beyonce for starring in Pepsi commercials (apparently she is no longer up to snuff to sing the National Anthem at Obama's re-inauguration).  It's hard to know how much traction these proposals will ultimately gain, but there does seem to be some concerted effort focused on this issue at present.  (I previously blogged about one of the biggest anti-sugar activists here).

According to this bit on the Fox News Channel, it appears Coca-Cola is (sort of) fighting back.  From the small snippet available in the preview on Fox, it appears their main defense goes something like this: almost all foods, including Coke, have calories; yes, we want folks to lose weight but why single out calories from Coke?  Oh, and we're also developing non-calorie sweeteners.    

I somehow doubt this response will alleviate the angst those who abhor Big Food.  Whether it is convincing to the average consumer is a different question.  Will Coca-Cola's response have any impact?  Hard to say . . .