The Obesity Epidemic and Why Most Public Health Initiatives Don’t Work

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Obesity Rates in United States – 2012 (CDC)

The following is part of a conversation I had with someone in the field of Public Health. It’s an email I sent explaining why the push from government to curb obesity is doomed to failure. 

Before I get to the email, some notes on public initiatives:

I hesitate to use the word ‘epidemic’ to describe the Obesity problem in America.

Recorded Obesity rates will be inflated as long as statistical tools that don’t account for muscle mass (see: BMI) remain in play. Many of the athletes in the NBA and NFL would be classified as ‘Obese’ under the parameters of the Body Mass Index test.

You can’t expect much objective analysis from the news media. They have little interest in taking a critical look at statistics; hysteria is more profitable.

Special interest groups also have an incentive to juke the stats—they’re competing for public grants and set-asides. The scarier and more prevalent the problem appears, the easier they secure funding.

The bottom line is this:

There are a lot of overweight, out-of-shape people in America, but the problem isn’t as widespread as reported.

This also begs the question of whether the government should even be in the business of leading public wellness crusades, given their poor track record.

Yes, government has a greater ability to reach and coordinate the population than any single private organization, but that doesn’t mean they’ll get the job done. We’ve seen them assume control of previously successful operations and run them into the ground—literally.

My high school American History Teacher, Mr. Friedman, had a saying we called “Friedman’s Law”: In interactions with the American Government, the Native Americans always lose—except in the casinosThanks to current government policy, that streak remains alive and well.

Are government-led health initiatives really the best use of taxpayer dollars? Are there other parties who could lead the cause and create solutions that actually work?

There’s nothing wrong with government-funded support of an idea or campaign—as long as it’s got widespread benefit and has proven effective.

Some might respond to this argument by stating “if a public health initiative helps even one person fight obesity, it’s worth it”.

To that I’d say, “there’s no such thing as a free lunch”.

Spending money on problem ‘A’ means you have less money to tackle problem ‘B’. New expenditures means cuts in service somewhere else or the introduction of new taxes.

But how can politicians and government officials fund new programs without unpopular cuts or spikes in income taxes?

Consumption taxes are their dirty, little secret.

Taxes on consumer spending allow politicians to promise their constituents the world without levying explicit taxes on income. Every time you make certain purchases, additional fees are tacked on to the cost of your item.That’s why your cell phone bill and plane tickets have all those curious, hidden charges.

You’re paying for new legislation; you just don’t know it. All the more reason to take a critical look at campaigns.

Think about this next time you hear someone say “If we help even one person defeat [INSERT PROBLEM], this expenditure is worth it”. It’s a well-intended, but misguided line of thinking.

And good intentions are no substitute for results.

(My email begins below)


[Name of Person],

I checked out your research project on childhood obesity. Good stuff. Nutrition is an area of interest for me.

If you’re working on anything related to that now or in the future, this documentary might be of interest:

It’s called Fathead, inspired by Morgan Spurlock’s Supersize Me. It’s an excellent watch that presents a few novel ideas on why so many people are less healthy than they’d like to be.

Many nutritionists/doctors/health professionals are peddling conventional wisdom (e.g. eat less fat, load up on whole grains) that is flawed at best and harmful at worst.

The government has spent a ton of money bringing greens to food deserts and forcing restaurants to post calorie counts on menus. Both were a waste of taxpayer money because they don’t get at the root of the problem: consumer demand and, to a lesser extent, actual facts.

Fast food chains don’t create the demand for fast food; they just meet pre-existing demand. Processed foods are usually cheaper, easier to prepare, and have more taste than green foods. No surprise that policies telling people to ‘drop that hamburger and pick up that celery’ produce minimal impact.

There are many overweight people who actually put the work in to lose fat (days of eating just salad and fish; 45-minute workouts), but their best efforts have been sabotaged by incorrect information.

It’s not so much that health professionals want to prevent sustainable fat loss—they just never take the time to question the efficacy of certain policies. They take certain health principles for granted (e.g. If you eat less/exercise more, you’ll get skinny or Cholesterol is bad for your heart).

People focus more on confirming what they already know instead of asking ‘is this actually true?’. It’s no surprise that reliance on antiquated, dubious research remains the standard.

The most common logic behind continuous support of failed programs?

1) “We haven’t given this proposal/law/measure enough time to have an impact yet.”

2) “This method isn’t working because people are uneducated.”

Both arguments allow proponents to avoid questioning the facts and methodology behind an initiative.

Education isn’t enough. By and large, people know eating out four times a week isn’t healthy. Talking at people doesn’t get the job done; you’ve got to understand why they do what they do. People want to enjoy what they are eating and feel sated. Eating food that tastes good is a respite from an otherwise stressful existence.

You can’t expect people to stay on diets that leave them hungry.

Implementing systems that encourage people to adopt–and stick to–choices that actually encourage sustainable fat loss is critical as well. Food bans and taxes are ineffective and unethical.

At the very least, the Do No Harm principle should be in effect. There’s too much inertia on this matter by people in and around this industry (some of it encouraged by financial interests).

There’s no one right way to eat. Different body types respond to protein, fat, and carbs differently.

There are a few ‘best consumption practices’ though. Prolonged periods of low-fat eating (not just ‘healthy’ fats—saturated fat as well) isn’t one of them.

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