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April 6, 2002

It's the fat police
The U.S Surgeon General has launched an attack on

Pierre Lemieux
National Post
Illustration shows a lady eating a hamburger and a police officer shining a flashligh in her face.


The Minister of Fat -- pardon me, the Minister of Health -- Anne McLellan is jumping on the obesity bandwagon. Good exercise for her! "We are a nation," she said "or becoming a nation, of obese people." According to Statistics Canada, 46% of Canadians are overweight or obese. Does Ms. McLellan draw the democratic conclusion that more fat politicians should be elected, and fatter bureaucrats hired? No, she wants to social-engineer the people into the land of the thin and the obedient.

Follow the guide, i.e., the American guide. The U.S. Surgeon General recently argued that nearly as many people die from overweight and obesity as from smoking. Obesity, like smoking, is described as an "epidemic." Some 36% of Americans are overweight; another 23% are classified as obese. There is no official public health label covering both the overweight and the obese, so we might call them "the fat," or perhaps the "non-PC fat." The new American jihad is again being imitated by governments all over the world, which means assaults on what the Surgeon General calls "unhealthy dietary habits and sedentary behaviour."

The Quebec Department of Health will address obesity in its planned "national" program of public health. The ideas being circulated include subsidizing food deemed healthy by politicians and bureaucrats, taxes on junk food, and restrictions on advertising. "We must be as aggressive towards bad nutrition as we have been towards cigarette smoking," declares a Laval University professor. Another specialist notes that "we need to do more than just educating people."

As in all grand social-engineering schemes, the inconsistencies are numerous. Forcibly stimulated by the state, the drop in smoking may have contributed to the rise in obesity. Tomas Philipson, a professor of economics at University of Chicago, writes in the journal Health Economics: "Anti-smoking measures may increase obesity and by doing so reduce the health benefits of these measures because smoking is a method of weight control ..."

But the basic question is: Why does the state want to fight obesity? An intuitive answer is that nice politicians and bureaucrats care about the welfare of the population. This answer seems naive given what we know about both the history and the nature of the state.

Historically, the state has been anything but nice to its subjects. Has this changed with the democratic state? Let's be serious. The actual state is not really ruled by the majority. Most people are "rationally ignorant" of complex policy matters and, in any event, only vote periodically for muddy programs with unknown and unforeseeable consequences. The fat state belongs to the political and the bureaucratic classes, and is influenced by a host of minority, special interest groups. And even if the state were democratic, letting a majority impose its preferred lifestyle choices would be closer to what Alexis de Tocqueville called the "tyranny of the majority" than to the maximization of social welfare.

An individual's weight, what he eats, and how much he exercises, are all lifestyle choices. Professor Philipson and economist Richard Posner have analyzed the broad economic reasons behind the long-term growth in people's weight. "If health is not everything in life," writes Mr. Philipson, "rational people may ... prefer their high-paying sedentary jobs to more physically demanding ones that pay less."

But let's assume that the state has changed, and that we can now trust it to care about the public welfare. The problem is that, as demonstrated by a whole strand of economic analysis, there is no way to maximize welfare for everybody. The state can only promote some individuals' interests at the expense of other individuals' welfare. In the best case, the disadvantaged are a minority, but it is still true that their preferences are coercively overruled for the sake of others.

It is well documented that, contrary to smokers, the fat impose net costs to the rest of society. A RAND economist, Roland Sturm, shows that obesity carries more health risks and higher costs than smoking or drinking. Policies against obesity may benefit non-obese taxpayers, who would then have to subsidize lower medical expenditures for the obese. However, these policies will disadvantage those who will shoulder the burden of new regulations, be they the people whose lifestyles become regulated, or the owners of companies (like fast-food outlets) that cater to the fat, among other customers. Already, in Oakland, Calif., schools, selling soft drinks is forbidden.

The standard argument against sedentariness illustrates the arbitrary and dangerous character of the public health approach. Another RAND study concluded: "We estimate that lack of exercise imposes external costs of 24 cents for every mile that sedentary people do not walk, jog, or run." How can somebody impose a cost to others by, say, staying quietly in front of his TV set? Answer: Because the Welfare State has assumed part of the costs of lifestyle choices. This would mean that anybody who costs something to the Welfare State becomes a burden to others.

In fact, the groups most favoured by the coming jihad on fat will probably be the public health industry, i.e., health bureaucrats, subsidized public health specialists, and lawyers.

Now, despite their obvious interests, perhaps bureaucrats and subsidized public health crusaders do have a genuine concern for the people whose lifestyle choices they attack. Perhaps they sincerely believe that the fat will be happier if they are coercively restricted in their choices. This is called state paternalism: knowing better what's good for your subjects, and forcing them to behave accordingly.

One problem with state paternalism is that it requires much power and coercion. Indeed, there is a strange correlation between state power and interventions by the public health elite. "Food," said a Nazi slogan, "is not a private matter." The U.S. Surgeon General is more prudent. "Many people believe that dealing with overweight and obesity is a personal responsibility," he writes. "To some degree they are right, but it is also a community responsibility."

At any rate, who in his right mind would choose politicians, bureaucrats and subsidized public health crusaders, to make paternalistic choices for him? Perhaps some eccentric individuals would, but this does not justify forcing in the mould those who would not. Writes Mr. Philipson: "Just as you do not want your local economist to perform your next surgical intervention, you do not want the public health community to design your social interventions."

Pierre Lemieux ([email protected]) is co-director of the Economics and Liberty Research Group at the University of Quebec at Hull and a research fellow at the Independent Institute (Oakland, California).


Other Stories by this Writer

3/25/2002
- Banking's best-kept secrets
2/27/2002
- In praise of the unknown tax evader
2/20/2002
- Who's served by 'the public interest'?
8/17/2001
- Label ban a smokescreen for government agenda


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