Tags
cultural norms, health, IOM, medicine, obesity, obesity experts, obesity in the united states, public health problem, WSJ
“The Weight of the Nation” editorial is so blatantly biased and ignores the 462 page tome – clearly the writers did not bother to read it.
The writers admit: “No question the bulging U.S. waistline is a public health problem. Two-thirds of Americans are now overweight or obese, a trend that began in earnest only over the last 25 or 30 years. For the first time in history, more Americans are obese than smoke. The report estimates 20.6% of annual medical spending is attributable to obesity, much of it absorbed by taxpayers via Medicare and Medicaid.”
Indeed this is the issue and we need a multi system approach to help solve it. Obesity-related medical costs in general are expected to rise significantly, especially because today’s obese children are likely to become tomorrow’s obese adults – the nation will incur higher costs for disability and unemployment benefits, and businesses will face the additional costs associated with obesity-related job absenteeism and lost productivity
The editorial makes this accusation: “The institute’s panelists don’t come out for entitlement reform or new incentives for individuals to maintain a healthy weight through diet and exercise, “
This is blatantly wrong. The IOM report is a product of years of research and consensus building among our country’s most reputable obesity experts. As it states, causes of increased obesity in the United States—the influences that have led people to consume more calories (or energy) through food and beverages than they expend through physical activity—are multifactorial, ranging from cultural norms, to the availability of sidewalks and affordable foods, to what is seen on television.
If a community has no safe places to walk or play, lacks food outlets offering affordable healthy foods, and is bombarded by advertisements for unhealthy foods and beverages, its residents will have less opportunity to engage in physical activity and eating behaviors that allow them to achieve and maintain a healthy weight. Successful obesity prevention thus involves reducing negative and increasing positive influences on a societal level
THE IOM addresses the difficulty of maintaining energy balance when sedentary lives are the norm and high-calorie foods are ubiquitous. They determined this was best done by approaching in 5 ‘stakeholder’ areas:
1) integrate physical activity every day in every way
2) market what matters for a healthy life
3) make healthy foods and beverages available everywhere
4) activate employers and healthcare professionals
5) strengthen schools as the heart of health
Science is about embracing the rational, and it is irrational to watch our country’s medical bill rise above 2.9 trillion dollars, and our national obesity rate head toward 40%, and not do something. It is also irrational to expect people to be able to avoid obesity if the tools –healthy diet and daily exercise—are not available to them. What our free market system has done, by commodifying necessities, is to create food deserts (communities where poverty has limited food sources to corner bodegas selling junk food) and a transportation system that makes walking and biking hazardous to your health.
The solution of course is to make it easy to be healthy and hard to be unhealthy, and we know how to do that. First, we confront junk food as we did tobacco, and recognize it for the engineered, addictive combination of fat, salt and sugar that it is. It does not deserve the privileged tax free status that food enjoys, nor do its raw ingredients deserve the subsidies they currently have, and the tax income can go to subsidize small, local farms. Then, we invest in a public transportation system designed around walking and biking, since it has been shown that simply using busses and trains instead of cars gives people the 22 minutes a day of physical activity they need to stay healthy. This is what the IOM report does in its 462 pages. Take what we know and apply it.
The editorial states: “Others are more novel—zoning rules that encourage bike paths, parks and grocery stores (but not gyms and health clubs)“– who would pay for gyms in poor neighborhoods? Parks are free. In many parts of the United States, low-income individuals and families live, learn, work, and play in neighborhoods that lack sufficient health-protective resources such as parks and open space, grocery stores, walkable streets, and high-quality schools. The first step is to ensure that changes.
The editorial accuses: “But the most dangerous idea is the call to turn over a large part of fiscal policy to a scientific committee. “
How is it dangerous? You would rather religious zealots and politicians make policies that have failed? Some of which are dangerous? “The panelists want to expand farm subsidies—entitlements for plants and animals—to include fruits and vegetables.” This is bad why? One of the main issues is the cost of fresh fruit and vegetables. “They would have done far better to endorse an end to subsidies for row crops like corn, which become low-quality calories via refined starches and high-fructose corn syrup”. – ahh so take up the political mantel that HAS been tried and failed due to large lobby. This can happen when we stop compromising democracy and our future with unlimited political spending – which was NOT the point of this report.
“”The Weight of the Nation” also comes out for using the tax code to promote social policy via “substantial and specific excise taxes on sugar-sweetened beverages,” aka a soda tax.” No – it is VERY clear that this is not just soda, but energy drinks, flavored coffees and teas which have been the issue. The wording: excise taxes on sugar-sweetened beverages (e.g., cents per ounce of liquid, cents per teaspoon of added sugar), with the revenues being dedicated to obesity prevention programs “This option will grow more appealing to the political class as federal and state balance sheets continue to deteriorate, but one thing it won’t do is improve public health.” Wrong again: both California and Boston school programs clearly show decrease in consumption of soda with incentives. By reducing calorie intake among students, even modestly, it will result in 16 fewer pounds gained per year. Cigarette taxes have dramatically reduced teen smoking rates so why do you doubt its application to sweetened beverages (which of course gets at the underlying corn subsidy since much of corn ends up as High Fructose Corn Syrup)?
It comes down to: whom do you believe? We choose to believe the dedicated scientific experts of the Institute of Medicine rather than the Wall Street Journal Editorial Board. We will let you judge who has partisan motivations and who has ambitions to better the health of our nation.
(this post was written with generous help from Chris Lillis, MD and Becky Jones, MD)
