HEALTH CARE/Joan Retsinas

Fat State Promotes Obesity

A test for state legislators: More than a third (35%) of your population is obese. It ranks number #1 in pulchritude – the fattest of the 50 states. Since the other states are not especially trim, that rank is noteworthy. A lot of sodas and chips contributed to it.

What do you, as a state, do?

a) Make restaurants turn out healthier cuisines: ban over-sized sodas, for a start.

b) Require restaurants to post calorie counts beside menu items.

c) Nothing. You leave the market of food-vendors and the buyers-of-foodstuffs alone.

d) You expressly forbid any governmental effort to regulate the size of sodas, or to post calorie-counts.

If you are Mississippi, the answer is (d).

Most of the country is sufficiently concerned about obesity to talk about solutions, including making restaurants post calorie-counts on their menus. Indeed, New York City’s Mayor Bloomberg earned a place in legislative annals with his Bloomberg rule, barring city restaurants from peddling super-sized soft drinks – a bar that a state Judge just overturned.

But Mississippi has earned its place in legislative annals. A fat shout-out to Mississippi for resolutely turning back any efforts of cities or towns to moderate restaurant’s fare! The stated reason: legislators don’t want a hodgepodge of local regulations on food. But since the state has not instituted any regulations on their end, the ban on local action constitutes enthusiastic support for the eating-style that will lead to obesity.

Civil libertarians have a point: a government’s decision to regulate restaurants’ choices borders on Big Brother extremism. Ice cream, cheesecake, chocolate bombes – restaurants push an array of delectable desserts. Favorite non-desserts include French fries, doughnuts, double bacon cheeseburgers … Singling out large sodas seems useless, as well as illegal. After all, freedom surely includes the freedom to eat what we like.

So a New York judge struck down this incursion of the city Board of Health. Since the edict seemed unfair (bodegas and convenience stores were excluded, as were milk-based drinks), most New Yorkers were relieved. And the soft-drink industry, which spent millions battling the ban, exulted.

Yet the impetus behind all the Bloomberg-type edicts is valid. Obesity is not so much a personal ailment as a political one.

The usual bromides against our epidemic of obesity zero in on the consequences for the eater: diabetes, heart disease, some kinds of cancer, joint problems … If obesity isn’t the cause, it contributes to the impact. With a numbing regularity physicians admonish overweight patients to lose weight– not just before the dreaded diagnosis, but afterward, to help with management of the disease. But patients know the basic math: calories in, calories expended. They can almost calculate the pounds gained or lost. In fact, one Mississippi school district lists the calorie-counts behind their public school menu: a cheesy burger bake for lunch constitutes 590 calories. Add the rest, and you have a 900-calorie lunch. Students (and their parents) can count. They make the decision.

The state, though, is not a passive onlooker, watching citizens eat their way to obesity. Those obese citizens depress productivity. Consider a typical city workforce. A police officer who is 30 pounds overweight cannot race to catch a robber as nimbly as a fit officer. Ditto for firefighters. An obese teacher is more likely to need sick days than a trim one. Private sector firms have “employee wellness” programs not so much to bolster employee wellbeing, but to bolster productivity.

When obese citizens fall ill, moreover, they may end up on the government’s insurance tab – either Medicare or Medicaid. They will be staying in the hospital, undergoing tests and procedures, taking medications, receiving home-health visits – a drain on the insurance rolls. (Not surprisingly, Mississippi has no state ban on smoking in restaurants. In 2011 and 2012, the legislature refused to enact any such law (though more than 50 municipalities have enacted their own smoking bans) – even though smokers, like overeaters, are likely to run up big medical bills.)

Mississippi boasts that it has limited government’s scope, keeping it out of the lives of citizens. Ironically, these limits cost taxpayers.

Since Mississippi waited 150 years to ratify the ban on slavery, perhaps they will require the posting of calories in the 22nd century.

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

From The Progressive Populist, April 15, 2013