Last week, under a mandate from Congress, the Institute of Medicine initiated a report to battle childhood obesity in America.
The report was sweeping in scope, calling on government at all levels to muster resources, and to take decisive action. It called for massive federal intervention in public education, federal nutrition requirements in school lunches, heavy regulation of soda and snack machines, and for Federal Trade Commission authority over the marketing of food to children.
The report also called on local governments to change zoning laws to favor pedestrians and bicyclists over automobiles.
"We're talking about something that's nothing less than a revolution," Dr. Thomas Robinson, one of the authors, told the Boston Globe. "It has to involve so many elements in our society. ... It's really going to require a major sea change in how we look at this problem."
That's the kind of language government usually invokes in times of war, not in response to a hard-to-define condition with ambiguous consequences brought on by voluntary behavior. Indeed, Surgeon General Richard Carmona recently said that our expanding waistlines were "every bit as threatening as the terrorist threat."
Our political leaders are asking that we enlist every sector of society to wage what is essentially a war on baby fat.
But even the commission's "revolution" wasn't enough for some nutrition activists. "As it stands, the recommendations are weak," longtime nutrition warrior Marion Nestle told the Chicago Tribune. "There is nothing here with any teeth in it."
This childhood obesity scare, however, is just part of an alleged obesity epidemic among the adult population. But, just how severe is America's obesity problem? Do we really have a developing public health disaster on our hands?
The data suggest not.
According to Rockefeller University professor Jeffrey Friedman, as quoted in The New York Times, Americans have been getting modestly chubbier since the early 1980s. Friedman also told the Times that most of us are carrying an extra 4-6 pounds — not much to worry about — while the very obese among us have gotten very much more obese. The result is a significant increase in the population's average weight, but an increase that's mostly caused by those very heavy people, not by the vast majority of the population, as media reports and nutrition activists would have you believe.
Indeed, if the whole of America has, over the past two decades, been getting as fat as alarmist headlines have suggested, we should be starting to see the early signals of this coming public health crisis. That's just not the case.
According to the National Center for Health Statistics, Americans are living longer than ever before. A child born today into almost any demographic group can expect to live more years than at any other time in American history.
The Centers for Disease Control and Prevention reports that, since 1985, the number of states reporting obesity rates of 10 percent or more stood at eight; by 2001, it was all 50. Yet average life expectancy over that period increased by about 2.5 years. Obesity rates in African-American women increased 50 percent more than in white women between 1988 and 2001, yet African-American women saw an increase in life expectancy of 2.3 years, compared to just 1.3 years in white women.
According to the American Heart Association, coronary heart disease is down 25 percent since 1990. Total cardiovascular disease is down 16.5 percent. Stroke is down over 10 percent. Deaths from cancer have fallen by about 1.1 percent per year every year since 1993, including in nine of the ten types of cancer most associated with obesity.
Of course, these drops in disease rates can be explained by medical advances, increased public awareness and early diagnosis, and no one is suggesting that obesity is healthy or that being overweight does not cause health risks. However, if the anti-fat activists are correct, we should be seeing at least the front end of this looming health catastrophe. It simply hasn't happened.
In fact, the only disease commonly associated with obesity that has seen a rise in the last 20 years is diabetes. But, even the CDC acknowledges on its own Web site that many factors other than obesity have contributed to the diabetes spike, among those factors an aging population, increased awareness of the disease and changes in the way diabetes is defined, diagnosed and reported.
Which brings us to childhood obesity and diabetes. An increase in Type II diabetes cases among children is the principal battle cry among those advocating heavy government intervention. The CDC reports that about 7.2 children per 100,000 are now diagnosed with the disease. However, the number of children with eating disorders such as anorexia and bulimia is estimated by the National Mental Health Association to be around 2,500 per 100,000. When kids are 347 times more likely to have an illness associated with poor body image than they are an illness associated with obesity, asking our public schools to have growing kids step on the scale — as the Institute of Medicine report recommends — doesn't seem like such a great idea.
Even if the tenuous connections between obesity and illness were as firm as the anti-fat warriors would have us believe, there's still reason for caution when calling for government intervention. Any far-reaching government program is likely to be costly, and just as likely to restrict personal choice and undermine personal responsibility. Most government programs also come with the hidden costs of unintended consequences, such as incubating eating disorders among young girls by asking them to weigh themselves in front of their peers. There's also no guarantee that any of these programs will be effective.
The best thing Congress can do in the fight against obesity is understand that there are some spheres of life that simply aren't within the purview of government. How and when and how much we eat — and how we raise our kids with respect to diet, food and exercise — ought to be one of those spheres.