The Sum of All Vices

I highly recommend to everyone Marc Ambinder’s Atlantic article on beating obesity which is both smart, brave, and an excellent example of the kind of long-formal feature policy writing that won’t exist at all 5-10 years from now. This followup and others he’s offered on his blog are also worth reading. It’s a great piece so I won’t try to summarize it. Instead, I thought I might mention two other factors that I think often go missing from this policy discussion:

SMOKING: One reason for America’s expanding waistline has to be our extraordinary success in getting fewer people to smoke. Certainly I gained about 25 pounds in the three years after I quit smoking, a process I’m currently making progress on reversing by drawing on the kind of resources that, as Ambinder observes, working class and poor Americans generally don’t have access to. Smoking is an appetite suppressant. It’s also a substitute for snacking just in terms of having something to do. I found looking into it that nearly any realistic combination of mealtime options would be consistent with me losing at least some weight, but that the problem was snacking between meals (which would be easier to avoid if I just smoked a cigarette every time I thought I wanted to mucn) and then our second factor. Public health professionals don’t like to emphasize this point because they want to encourage people to quit smoking. But to an extent making progress on one public health problem has contributed to a second, albeit less serious, one.

DRINKING: Beer has tons of calories! You wouldn’t generally go out to dinner Friday night and then go grab a Big Mac with friends. But if you drink four Budweiser’s at the bar on Friday after dinner, that’s actually more calories. And unlike eating food, even really bad for you food, drinking beer doesn’t make you less hungry (if anything, it makes you want to grab some jumbo slice). The real price of alcoholic beverages has declined over the past twenty years as has the real price of excise taxes on alcoholic beverages. The public health benefits that would be associated with higher booze taxes for reasons that have nothing to do with obesity would be giant but reduced obesity would be another impact.

Last, I think some of the apparently “contagious” aspects of obesity should make us somewhat optimistic. Among other things, it seems to indicate that if you’re able to reverse the overall social trend—even just a little bit—that that would create momentum for further progress.