Bad ideas for fighting obesity

Barbara Kay, National Post · Wednesday, Jan. 19, 2011

Woody Allen famously said, "The heart wants what it wants" -- a benign metaphor for the body part he really meant, residing lower in the body, whose appetites, uncurbed, have caused endless social misery throughout human history. "The mouth wants what it wants," too, but until mere decades ago, the mouth could have what it wanted with no social cost.

Rich countries are getting fatter, but on the whole it isn't rich people who are gaining weight (except for Hillary Clinton, who has gained 40 pounds and has -- according to the edition of the National Enquirer I was reading at the supermarket -- been put on a macrobiotic diet by daughter Chelsea).

Half the adults in this country are either overweight or obese, according to Statistics Canada. A new study says obesity is costing us about $30-billion a year. So even the most ardent libertarian can't realistically claim it isn't the government's business what people weigh. It is. Unfortunately, the government has so far not come up with a successful strategy for stemming the trend.

Neither encouragement, like the old ParticipACTION pep talks, nor information-peddling, like food labelling and calorie charts in fast food restaurants, seem to work. Many obese people are inured to social pressure; and those who are sincerely motivated to lose weight generally know what they should and shouldn't be eating.

Taxing is the government's fallback position for unhealthy appetites. But unlike tobacco and alcohol, food is a necessity of life. Since you can't deny access to food in general or declare it off limits to children or criminalize trade in it, no free society can control weight gain in individuals. Why should a trim triathlete in top shape pay more for doughnuts just so Jabba the Hutt will think twice before buying his second dozen?

Moral lines are blurred on this issue, because genetically lucky people (anyone who denies the genetic factor just isn't paying attention) can pig out with impunity and feel superior to those disposed to gain weight easily. For those who lack social aspirations and peer role models (I am mainly talking about the poor and the less educated) long term avoidance of ubiquitous, cheap, seductive and fattening junk food is an unrealistic expectation. (If they had that kind of discipline and ability to curb or defer gratification of their appetite, they wouldn't be poor and uneducated.)

What is to be done? The newest suggestion, profiled in Saturday's Globe and Mail, indicates just how desperate health professionals have become in seeking a workable solution.

In their soon-to-be-released book, XXL: Obesity and the Limits of Shame, Neil Seeman, director of the Health Strategy Innovation Cell at the University of Toronto, and co-author Patrick Luciani, propose that all Canadians be given a "healthy-living voucher" -- a $5,000 payment to every Canadian over age 16 to design a personal health plan in consultation with a doctor. The money would supposedly target individual weight problems at the source: One person might use the money for personal training, another for mental-health counselling and so forth.

If we are meant to take this breathtakingly naive and unworkable plan seriously, then the policy cupboard on obesity must be pretty bare. The authors liken "health vouchers" to "education vouchers." But it's a false analogy. The obese may know health is better for them, but achieving it involves sacrifice, a curtailment of appetite -- like renouncing promiscuity for fidelity. With education, on the other hand, there's not only no sacrifice of appetite in attending better schools, there's the enticement of greater satisfaction in every respect than lousy schools provide.

Anyway, a lump sum might kickstart a healthy lifestyle for some people, but is far more likely to be spent frivolously by the weak-willed, a category that describes the majority of overweight people. Why must we bribe people to look after their own health anyway? The problem is intractable, because human nature is what it is, and self-destructive tendencies can only be collectively eliminated by totalitarian methods we aren't prepared to adopt (I hope).

So we can't ban the sale of frappuccinos and french fries, or we wouldn't be the nation we want to be. Faced with the AIDS epidemic, we didn't ban indiscriminate sex. We accepted that "the genitals want what they want"; instead we put money into finding a cure. Putting $5,000 per person into research that may result in a childhood vaccine against excessive weight gain makes more sense than blowing it on wishful thinking about human nature. And it beats removing fat children from their parents on grounds of child abuse. Which, by the way, it is.

bkay@videotron.ca