HEALTH CARE/Joan Retsinas

America: Fat, Fatter, Fattest

Each year Americans are expanding, girth-wise. Doorways are widening, as are airplane seats. Fashionistas proclaim size 14 the new 10. Extrapolating not too far into the future, the United States may eventually sink into the ocean.

Glum analysts recount the health consequences — more diabetes, cardiovascular disease, cancer, lung diseases, osteoarthritis, even gout. Avoirdupois is not good for the body.

But the avalanche of warnings hasn’t put many people off their fat-laden diets. In the past year, more Americans weighed in above their ideal body mass index than the previous year. Indeed, there may be a direct correlation: bad news about fat and mounting body weight.

Nor is our expanding avoirdupois good for the body politick. Obesity has pumped up the nation’s health tab. The Centers for Disease Control and Prevention estimate that last year the overweight/obesity epidemic cost the nation $51.5 billion (including Medicare, Medicaid, private insurance, and out of pocket costs). (See

There may be a political solution to the obesity epidemic. I don’t mean more government money for gym classes, jogging trails, and nutrition counseling. And I don’t mean taxes for the high-but-empty calorie chips and soda. The government hasn’t made us fat; and the government is not the solution.

But conservatives — those who loathe government and value personal independence — may hold the key. Consider the correlation between states’ obesity and political ethos: red states tend to be fatter; blue states, leaner. Mississippi weighs in as the fattest state: two-thirds of adults are overweight or obese. Trailing Mississippi are West Virginia, Alabama, and Georgia. The thinnest states are blue: Colorado, Hawaii, Connecticut, Massachusetts, Vermont. Of course fat people live in thin states: 56% of Coloradoans are obese or overweight. And many fat-state residents are thin. Yet the correlation between girth and ethos suggests a way to accomplish two goals: pare ourselves, while paring government spending.

How about a new “Contract with America?” for conservatives? The Gingrich-era contract promised to shrink government. The Personal Responsibility Act of the contract pledged to reduce teenage pregnancy and illegitimate births. As a 21st century extension of the “Personal Responsibility Act,” we can add “obesity” to the list. All Americans (whatever their political suasion) will commit to reducing his/her own net caloric intake.

Of course, in the old Contract, conservatives preached to change the behavior of other people, people they might never meet. The legislators promoting the conservative Contract were not likely candidates for teenage pregnancies and illegitimate births. But this codicil to the old Contract will ask for sacrifices from conservatives themselves.

That will mean lifestyle changes: no more fries and soda. No more “finger-licking good” anything for that matter. Lots of leafy greens. No more television-marathons. Instead, hours walking, jogging, running (perhaps reducing our nation’s gluttonous dependence on gasoline).

But we will be slimming down in a patriotic spirit. Much as World-War II Americans planted victory gardens, 21st century Americans will embrace victory diets.

The fiscal consequences are huge. Dieters will reduce not just the size of America’s cumulative girth, but the size of government’s cumulative spending. Medicare spending will plummet as our weight drops. So will Medicaid spending. Today’s overweight children (destined to be tomorrow’s overweight adults) suffer from consequences that drive up Medicaid’s tab. Private insurers will spend less — leading maybe to lower premiums, which will maybe quell the clamor for national intervention – another boon to the conservative ethos.

Personal responsibility. Small government. Private initiative. To these conservative mantras, let’s add: Healthy diets. If we shrink ourselves, we’ll be shrinking government.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, September 1, 2009

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