


Stick or carrot?

When it comes to obesity, Michelle Obama can teach Michael Bloomberg something

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Health Care does not exist in merica-What does exist is Illness cre and it is inadequae and expensive.
Health Caare would begin Byissuing an obligatory H number to every new born American. This number will follow him to the grave,varying slightly with Other Identity numbers like drivers or pilot's license numbers and would open the health sory of his life.
All physical and mental conditions including age, weight and stature
would be fed into the individual file by parents,wards, and the individual. Laboratory and other test results, medication etc would be registered.
The program would contemplate auomatic and periodic analysis of the individual and of thecity,region, or any of a series of affiliations to develop early warning notifications of potential serious damagge to "good health".
The potential for preventive medicine should outweigh deficiencis in detal at this moment.
Norbert Wiener foresaw this and Sociologists like Wm Ogburn were statistic oriented.

The ability of facebook to handle 700 million users suggests how easy it would be for a Surgeon General's Cibermedic orientedtaskforce tocome up with a versatile tool to helpAmericans as individuals, as fatties, or Diabetics, as robust or sickly society members to get on and stay on the highroadto healthy living and thinking.
I'm only weighing 8 pounds less than when I was mustered out of the Navy in 1946.


I guess it is unrealistic for apartment dominated American cities to contemplate small "victory" gardens. Cooking at home with fresh vegetables and herbs from your garden and thereby supplementing those from the rmarket adds enormously to meals, if you like cooking, especially from first principles.
Mrs Obama is setting an excellent example of what Americans can do if they have a little land free. For many city dwellers though, it must look like apple pie in the heavens.

Gopherus Agassizii

Let's keep in mind that Bloomberg is targeting those mega-sodas consumed by obese people or soon-to-be obese people, not anyone's right to vote, peacefully assemble, pursuit of (real) happiness, free speech or anything else that matters. Not only will this contribute to a healthier city, but should also cut down on the irritating slurping sounds these people make in movie theaters.

Bruce Warner

Obviously a big part of the problem is that supply works to meet demand. I frequently travel to Japan, and marvel at their smaller portion sizes, compared to ours.
Part of this is for practical reasons: Japanese tend to be smaller in frame, and have less storage space and walk more simply because they, on average, tend to be more urbanized than most Americans, and live in smaller homes. The result is that you can only carry a limited amount of packages with you, which means smaller portion sizes and fresher eating as you're constantly replenishing. It's also part of why food there is so expensive.
Unfortunately, what works in Japan is highly impractical in most of America. The popular mantra of getting Americans to walk or ride more frequently just doesn't work due to the fact that most of us are spread out over a much larger land mass and human-powered and mass transportation are only practical in urbanized settings.
To the food industry's credit, I often see smaller packaging out there. But people tend to prefer to buy large, which makes these smaller packaging attemps apt to fail. It seems to makes practical sense: Why should I buy a 16oz bottle of soda for $0.99 when I can buy a 32oz soda for $1.09 at the Kwikie Mart?
Since around the mid-1990's, the Super-size fever has gripped America. The theory is that buying in bulk not only is more valuable, but due to economics of scale, the vendor can afford to charge lower per-item or per-pound than buying smaller sizes.
Bulk buying is great for grocery-shopping families, but not so great for individual meals. Practically speaking, how many of us are going to buy that 1/2lb burger with large fries & drink and split it with someone?
There is no single solution to this problem. However, I think the most effective methods will involve increased education and public awareness, while government regulations may end up being the most costly and least effective. There are a few things the government can do to *encourage* change, but forceful measures will backfire.
It wont happen overnight, and will probably get worse before it gets better, but if we can engage in a long-term campaign, we'll eventually start seeing results like we have with the anti-smoking campaign.

jbazan87 in reply to Bruce Warner

Bruce, thank you for a well-thought comment.

I agree with you that government regulation will not render the best solutions. However, i do believe that some type of incentive for gym membership or miles walked/run/biked would be a good incentive for those who already exercised to continue exercising and thus motivating its peers to do so (it works like the idea behind Facebook's "likes" or "recommend"feature).

Japan is smaller and more dense than the U.S., therefore your argument is very important. Moreover, the U.S. citizens are more obsessed with sizes. if you don't believe me, look at the car sizes made in the U.S. before the fall of the big three and one will see how in America "size matters" or the height of our presidents is another example of this obsession with height/weight and power.

Once again, early education needs to be encouraged and thought out to produce positive benefits for our country in the long-run rather than short-term gains. I am all for education reform and its long-term benefits rather than short-term goals and benefits.

Bugs10 in reply to Bruce Warner

WRT shopping in bulk, land use and suburban design also play a role-- I'd say most Americans shop by all their food for a week all at once. They keep food in the house because it is too inconvenient to stop into the shop (driving, traffic, parking, lines, etc.). If you have a supply of food in your home, you're more likely to eat it when you don't actually need it.

Also, If you have junk food or some kind of "indulgence" food in your home, at some point you'll feel compelled to eat it. I'm all for intuitive eating, and I don't think there's anything wrong with satisfying a craving for the sweet or savory, but I think when you have such an urge to indulge, you should go out and procure the food to satisfy it-- not buy the food in advance *in case* you get that urge over the course of the week. That's what most suburban Americans do, stock up, *in case* they want to eat something. I think it has a lot more to with shopping well than with denying yourself foods you enjoy.

Bugs10 in reply to jbazan87

Fitness incentives sound all well-and-good on the surface, but there are too many variables. Providing gym memberships or incentives for walking or running will not free up people's time to do it, it won't make gyms and bike paths available in all areas, it won't provide childcare, etc. I think there are many people in this country who are not obese because they are lazy or they don't want to work out or eat healthy, but because their lifestyles, the design of the community they live in, etc prohibits it. And obviously, some people's weight and health would be more affected by these outside factors than others. No one can claim that every non-obese person they know gets a lot of exercise or eats perfectly. There are obviously people who have a real problem with overeating who become severely obese, but these people cannot be equated to the average person who falls just over the obesity line. I don't think most people in the latter group would choose to be obese if their lifestyles permitted otherwise.

Bruce Warner in reply to Bugs10

Not to imply your comment necessarily says so, but I like how people seem to assume the "suburban lifestyle" is always like the one portrayed on popular TV shows (i.e., creepy housewives driving large SUVs, with shallow lives). Not all people live in suburbs because they're rich and want to live indulgent lifestyles. For most of us (who don't live in McMansions), it's about the fact that you can find housing larger and more affordable than city housing -- even when gas prices are factored in.
Speaking of practicality: buying a couple weeks' worth of groceries at a time is a great way to save money due to bulk discounting and lower fuel expenditures. There are two things that keep you from eating it all though: 1) realizing you'll be out of food (because you're now out of money) if you just simply eat it all when you want and 2) proper planning (we make a 2-week menu - it really focuses what we buy and cuts costs/extra calories).
There's obviously no single thing you can do, but proper planning is a big part of not only fiscal but physical fitness responsibility.
On the flip side... There is a very nice, and very long bike/jogging trail not 100' behind my house. I'm ashamed to say my family and I hardly ever use it. There's no membership required to use it, and it's in great condition. I just don't take advantage of it, and neither would many Americans if we had free gym memberships.
However, as part of a wider campaign, I believe that encouraging physical fitness and preventive medicine practices via monetary incentives should be an integral part of our healthcare system.
I know it works because, despite the trail behind me, I'm forced to be fit in my own way (military requirements: if I don't pass fitness tests I'm not recommended for retention when my enlistment is up). Incentives work!
Most insurance companies know this, although I guess the real question is how do you implement such a program in a practical way without discouraging people from seeking medical treatment when they really do need it? It's certainly an aspect of the new health care plan I support, and even an imperfect plan is better than none -- it gets the ball rolling and perhaps continues the debate for reform.


How about taxing people for being fat? May be call it MAT (Mass added tax) just like VAT. And it could even be made progressive based on a age, sex, ethnicity adjusted BMI scale. For example a 5'10'' 225 pound guy pays $30 in extra taxes when he flies roundtrip from New York to LA as compared to a 5'10 165 pound guy.

Then the Tax Act would be challenged in courts for a "Bill of Rights" violation and lawyers make lot of money. Media gets a ball reporting it. But the government gets extra money and they use it to subsidize corn. The Nominal GDP goes up as result of all this activity and everybody is happy except may be the Fat people.

PPSARKAR in reply to YuppieScum

Agreed. However, it is a the cheapest approximation of a healthy human weight. The accurate physiological measurements of body fat %, skeletal mass, skeletal muscle mass etc are expensive and commercially non viable (at least for identifying people with obesity).

Bugs10 in reply to PPSARKAR

And even then it's not perfect. PLus, one individual could fluctuate over and under the limit in a matter of days. And what about thin people with terrible habits who just happen to small? Or small people with bad habits who have rolls of fat because they are out of shape but not necessarily obese? I think it is impossible to draw any sort of lines when the question is individual bodies.


There are many causes of obesity, but unfortunately, we as Americans no longer know where our food comes from. Is it grown or made in a factory? Processed food, full of empty calories and sodium, are cheap and readily available in enormous quantities. If we limit large soda sizes, should we also limit the following: all you can eat buffets, large restaurant serving sizes and the amount of sugar or high fructose corn syrup added to many foods? Do we punish the obese and reward the thin, active members of our society? So many questions and not enought answers. What about personnal responsibility and are we all just food addicts? Isn't it time we got off the couch, turned off the computer or television and went outside. No more excuses either!

Tomato Boy

Preface: As a devoted Lexington fan and native of its namesake, I wish to pay my respects to Peter David for his excellent work.

As usual, Lexington offers a sensible perspective. Mayor Bloomberg's proposal smacks of desperation and Lexington offers a good basic outline of the many drawbacks of trying to regulate diet. Mrs. Obama's enthusiastic, positive approach to the issue is clearly preferable. I wonder, however, if the consequences of the obesity epidemic are now so grave that solving them will require extreme measures (and I admit I can't imagine what they would be). I just read an article about this issue at nytimes.com that provided a more detailed perspective from health care providers. I sympathize with the great frustration they must feel at the ever-growing time and resources they devote to treating obese patients. The support of public health officials for radical, problematic attempts to regulate consumption of junk foods is understandable. I'm not offering any answers here, just starting to grapple with the issue and the public policy consequences.

In 2008, the owner of a home in neighboring Woburn, MA painted BLOOMBERG 2008 across the front facade of the house. There is no sign yet of this person's preference in this year's election.


An ineffective blanket ban such as the one proposed by Nanny B is simply not going to work, because in the end, the obese guy who wants to drink more soda WILL drink more soda.

Assuming that overconsumption of sugary drinks leads to obesity, (which again, is contentious), the end goal is prevent the obese guy from drinking the soda, or better yet, to get not-obese-yet people drinking healthier drinks earlier. Banning sodas in schools and having healthier choices for schoolkids WORKS. Also, while waffly and relatively 'timid', Mrs O's book/suggestion hits closer to the heart of the problem. Its about families, adults and kids eating better and healthier togther. You don't see French adults/kids guzzling 1 ltr bottles of coke "light"; and this isn't because the drinks are not available in that size.
Doing something != Solving something


"Most foods are not harmful in moderation"

And that is exactly why it is a good idea to reduce container size.

pick your poison

I'm actually underweight for my height and would love to continue buying whatever food I like for whatever it should cost without restrictions. Frankly I don't care about obese people, they're incredibly stupid to have allowed themselves to have fallen into that category and it takes a massive effort to even reach that BMI. Social engineering and government regulation isn't going to make a difference and I don't want to pay for it.

Mr. Careful:

I disagree with both of your assertions. With respect to the nanny state, any government that will ban transfats will eventually discover the dangers of saturated fats, and seek to ban those as well.

With respect to not caring about people, I care enough about them to let them make their own decisions, because that's what I'd like them to do for me.


“It is all in the mind!” Another saying explains why people go into mischief: “Idle hands are the devils tools.” The focus should be on the mind of people and the exchange of their human resources & energy. To develop complete people is by creating a viable economy. For your information Google “The World Monetary Order to Come”.

Sense Seeker

The Economist again in heroic defence of free enterprise. Michele Obama's approach has not been proven to work any more than Bloomberg's (in fact, I would contend Bloomberg has the better papers) but Bloomberg dares to put restrictions on what can be sold and we can't have that, of course.

The obesity 'epidemic' is caused by inadequate levels of physical activity / too much sitting, and the ubiquity of cheap, palatable, energy dense foods. Large portion sizes are likely to lead to overconsumption, so banning large drink sizes is likely to reduce consumption of energy-rich drinks.

In this field, TE seems stuck at the individual level. But we know very well that interventions that try to make individuals change their behavior have only modest and temporary effects. Check any recent systematic review. We need to look at the structural changes in our societies, and this article is severely deficient in that respect.

Fossil American

Just one word to these politicians: GET LOST.

What on earth give you the idea that YOU, a politician in America, have the right to control American’s private and legal activities? If that is what you want to do, go run for office in another country.


We will throw you out of office as soon as we can.


Actually, it costs less to care for smokers and obese people in the long term simply because they don't live that long. So in actuality, it costs less in the long term for people to be obese, smoke, and die younger. Somewhat counter intuitive, but true.

Can't we just let people live their lives without trying to MAKE THEM better?

pick your poison in reply to Orenv

Unfortunately what your saying just isn't true. If obesity was back to the percentages of the 60's there wouldn't be a healthcare issue at all. That's why obesity is a big issue. People who are not obese live healthy lives and then die of natural causes. Obese people slowly die starting from a young age putting additional pressure on medicaid and eventually medicare. I don't support government intervention either but its important to get the facts straight and know why you don't support something for the right reasons.

Orenv in reply to pick your poison

The fact is that everyone gets end of life care that is way too expensive. Americans spend 50% of all their lifetime health care costs in the last 6 months of life whether they are skinny, smokers, or not. The savings come in all those years of care that are not given because smokers and fat people are dead sooner. Basically what I am saying is that the additional cost of caring for fat people and smokers while they are alive has been proven to be less costly then caring for healthy people who live 20 years longer and get 20 years worth of annual checkups, visits for sniffles, broken legs, car wrecks, etc. Counter-intuitive perhaps, but look into it and see for yourself. That is the fact.

The reason health care cost is high is because everyone wants "cadillac" care with some unknown entity paying the price (insurance company, government, aka, someone elses money). Whenever a third party makes the payment, the cost goes up. Is that really so hard to imagine? If we bought cars the same way we buy health care, the cost of cars would increase.

This is a classic tragedy of the commons problem. There is no incentive for anyone to save money.


Just stop supplementing the production of corn and the processed, high-caloric foods won't be so incredibly cheap.


Absurd. Obesity is out of control, no doubt. However, this proposal by the Mayor is ridiculous. I'm not happy about many things coming from the White House these days, but Michelle is on a better path than Mr. Bloomberg in this case.

Fanatical Centrist

How bout giving healthy people a "I'm not a fatty" ID card, so they get discount "junk" foods, and then jack up taxes and prices on all the junk food. It is about consuming moderation, and the ID would identify those that are capable of being moderate. And it would be easier statistically to give cards to non-obese people (ID's can be issued by various health departments).

Incentive to get healthly!

Reluctant Polluter

@ Reido:
"What people need is to eat fewer calories".
So the best option, by your logic, is to put those who wouldn't understand their own good to slave labor camps: minimum calories, lots of exercise mainly outdoors, indoctrination... oups, sorry, - enlightenment lessons during the "free time". Chanting Michelle's Little Red Book as entertainment of choice...

Reluctant Polluter in reply to teacup775

Camps are better: fairer. Progressive politicians are infallible, as are governments staffed by them, so the heavy price will be paid exclusively by bad guys (enemies of themselves, hence - of the people).
If you charge $10 per gallon of gas, good guys (those who drink organic carrot juice only, are not overweight and can cite by heart every utterance of Michelle Obama ever made) will suffer together with the bad.
Even if you organize special distribution centres for the "nomenklatura", with no-charge on gas or anything, it won't resolve the problem: the revenue wouldn't be sufficient to cover the costs of additional infrastructure and equipment.
No, no, no! Camps - that's the way to go.
Besides, it's a time proven tradition of the Left.


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