The Prohibitionist mindset never seems to die. The current war on drugs, with its obsessive focus on particular drugs and lifestyles, its racist overtones, and its flagrant disregard for civil liberties, has become a source of the very crime and disrespect for law it decries. Despite its high body count, drug use isn't diminishing. Nonetheless, even as public awareness of its damage to families and state budgets belatedly creeps into public consciousness, society appears poised to mount another crusade: on obesity.
Public health authorities warn us that we are becoming a nation of what grade school children derisively label "fatsos." Obesity is viewed as the cause of 400,000 premature deaths a year, placing it up there with smoking. Both the private sector and the public advocacy community have entered this fray. Fad diets are now big business. The liberal Center for Science in the Public Interest has suggested a tax on soda and junk food. Some airlines are considering a tax on passengers based on their weight and some businesses have fired employees who are deemed overweight. These steps are far from an irreversible trend, but they should give us pause. Is panic about obesity well grounded and might not some of our responses do more harm than good?
We might begin with a basic question: What does it mean to be obese? In an era that loves quantification, the standard is the body mass index (BMI) based on body weight and height. Yet, as Paul Campos, author of The Obesity Myth, points out, by BMI standards most of the running backs in the National Football League are obese. Campos also presents considerable evidence that even substantially obese people are not less healthy simply because they're fat. Rather, other factors are causing them to be both fat and unhealthy. Chief among these are sedentary lifestyle and diet-driven weight fluctuation. When researchers factor in activity levels, body mass appears to have no relevance to health whatsoever -- even among people who are substantially "obese." "Obese" people regularly engaged in even moderate levels of physical activity have radically lower rates of premature death than sedentary people with ideal weights.
Should we be discouraging sin foods via tax and regulatory policies such as removing them from schools? The assumption underlying many public health approaches is that body size reflects personal choice and that slothful or uninformed choices need to be sanctioned or prevented. But even apart from the problematic scientific underpinning of that perspective, one needs to be concerned about a forbidden fruit phenomenon that might make junk attractive.
Campos is not denying that nutrition makes a difference, nor is he an advocate of the couch-potato lifestyle. Major food processors and restaurant chains should be required to provide full nutritional information so that we may be informed consumers. And I agree with many public health advocates who deplore big food's efforts to rewrite federal nutritional guidelines. Food choices should not be compelled, but individuals should be given the information they need to make an informed choice.
It is at least as important to explore why so many make inappropriate choices and also exercise so little. Paradoxically, we may eat so much because we are in a hurry. The French, whose diets have their fair share of rich food, also suffer lower rates of heart disease and obesity. The author of a popular book on French cuisine, Mireille Guiliano, points out: "They eat slowly, savor every bite and make dining a ritual -- using all five senses and enjoying multicourse meals on separate plates. People have to realize how great it is to be for hours around the table." Guiliano's critics point out that obesity, though still far less prevalent than in the US, in on the rise in France. Yet one could also point out that time itself is becoming increasingly contested in France as business elites seek to roll back traditional guarantees of free time. At the very least the role that free time plays in eating habits needs far more investigation before we impose new restrictions on dietary choice. Those free hours may be not only intrinsically valuable but also vital to public health.
The European example also raises the question of time for physical activity. Physical activity, a better predictor of heart disease, is in part a function of time, facilities and cultural approaches to physical education. The London Guardian reports that in Finland, where remarkable gains in the last decade have been made against heart disease, authorities began by asking citizens what physical activities they would most enjoy:
"Over the past 10 years or so, hundreds of local schemes have been set up across Finland, drawing previously inactive people into cycling, Nordic walking, cross-country skiing and ball games, all of which were either free or substantially subsidised to ensure no one was excluded."
People have always come in all shapes and sizes. Thin is in within the world of modeling, and thin has often been seen as evidence of aristocratic breeding. Guardian columnist Polly Toynbee reminds us that the hidden subtext in much of the current obesity discussion is class. Rates of obesity and inactivity have grown in many western nations, but Britain, the US and Australia top that dubious list. All share a near religious faith in the market and growing economic disparity between social classes. The poor enjoy the least access to recreational resources, too little time, and diminished hopes for the future. Our society condemns the obese among them and offers little more than expensive or compulsory diet agendas.
Marie Antoinette would today offer different recommendations for the poor: "Let them eat no cake."
John Buell lives in Southwest Harbor, Maine, and writes regularly on labor and environmental issues. Email jbuell@prexar.com.