She contends:
"I do agree with some ... core propositions:
- Study after study shows that most people are unable to lose more than a small percentage of their body weight and keep it off ......"
That is a true fact but the contrary fact is that a few do manage to keep the weight off. Why the few, well the answer I have from experience is will power. If you know what happens when you have nephropathy from Type 2 Diabetes, a direct result of excess weight, then you heed the call of the portent and change. Most people lack the will power, just as we control smoking and alchohol, we have a duty to control obesity. It harms the obese person and it harms the others who have managed to control their weight by having them pay the incumbent costs.
Remember the basic formula:
Input - Output = Net Accumulation
And with weight it is 3500 kcal per pound. You burn 2000 kcal per day and you eat 2500 kcal per day, those cookies and sodas, then it is 1 pound per week or 52 pounds per year! It is no more difficult that that.
She continues:
"- There is evidence to show that this is physiologic rather than psychological--it is nearly impossible for very heavy people to simply "eat less and exercise more" to a "normal" weight ....."
My response is are you nuts. It is the law of mass balance. Plain and simple. We just stated it above. It works everywhere, it is almost a tautology! She continues:
"- The fact that this often operates through the appetite system does not mean it's "all in their heads" or a lack of will power. ..."
It is pure and simple will power. Do not eat that candy, do not drink that soda, diet all the time, yes it is painful but eventually you will get used to it, just weigh yourself.
"-Much of the panic about the obesity epidemic comes from lumping all weights together--everyone over a BMI of 30 becomes an obese people with high relative risks for various diseases, even though the whatever health risks exist among the lower overweight ranges are not anything like the dire health effects of morbid obesity..."
This I do not think I fully understand. Obesity, BMI above 30, results in excess inflammatory responses in the body. Inflammatory responses result in retinopathy, nephropathy, and neuropathy, as well as cardiovascular deterioration and cancers. The inflammatory responses reduce the immune responses of the body. Yes, a BMI of 22 in a person will not guarantee that they will not get a melanoma. Less sun exposure may help but most likely they have the gene that predisposes them. In contrast a BMI of 33 or excess alcohol in a person with prostate cancer may exacerbate it and turn it into an aggressive form.
She continues:
"- At the moment, it's unclear whether there are any adverse health effects associated with overweight or even mild obesity, and to the extent that there are adverse effects, it is also unclear whether they are a result of the body fat, ..."
This regrettably is just wrong. See my recent book on Health Care Policy. The author then takes her erstwhile libertarian stand and says:
"To be sure, even I, the pessimistic libertarian, do not see any actual means for the government to prevent food processors from making their food taste very good. ...The government could raise the price of fat, salt, and sweeteners, processed food, and restaurant meals. But I very much doubt that if our legislators actually enacted a food tax adequate to prevent obesity, they would get much thanks from anyone except the sort of people who ask each other, with wide eyes, if anyone else has noticed how disgustingly fat all the people are at the mall--and never eat at Cheesecake Factory. So I think that this, too, is unlikely. "
But these people are costing the rest of us considerable sums. As we had shown in an earlier entry obesity is the major driver for the increase in health care costs. That means those of us who manage to keep withing the limits are paying for those who do not. In auto insurance those who have multiple speeding tickets pay more than those who have none.
It is a fundamental principle of fairness. Libertarians believe that people should be allowed to do whatever they want IF it does no harm to others. Obesity costs me money, that is harm, thus you have no right to over eat especially if we mandate universal health care, or even if we as a society agree to give you dialysis treatments for your failed kidneys as a benefit from the taxpayers.
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