Obesity and the Government

Obesity is an epidemic and the major cause of Type 2 Diabetes. As we have argued in our draft online book on Obesity and Type 2 Diabetes (with some 10,000 downloads!), the solution is quite simple, stop eating. Or at least get down to where your caloric input equals or is less than you burn rate, generally about 1,800 to 2,200 kcal per day. Recall that a pound gain in weight occurs for every cumulative 3500 kcal above the burn rate. 200 Kcal sodas consumed at 17.5 per week add a pound. Pizza at 800 Kcal, well you can do the math.

Now in JAMA two authors, one being the head of NIH state:

The obesity epidemic is not the first major health crisis that the United States has faced. In recent decades, progress has been made against such daunting challenges as tobacco use, infant mortality, and HIV/AIDS. However, obesity may pose the most significant challenge yet because it involves changing approaches to 2 fundamental aspects of daily life: food consumption and physical activity. To have any chance of release from obesity's ever-tightening grip, the nation will require broad-based efforts in every corner of society: homes, schools, community organizations, all levels of government, urban design, transportation, agriculture, the food industry, the media, medical practice, and, without question, biomedical research....

To address this need, research must proceed swiftly on 2 parallel fronts. The first is to devise practical and effective strategies for intervention, with special emphasis on preventive strategies that can be rapidly implemented in health care and community settings. The second is to evaluate community-based efforts that will soon be launched or are already under way, to gather data about their effectiveness, and to use that information to develop evidence-based interventions that can be applied on a wider scale.

 I respectfully disagree. Obesity is 50 to 100 times worse than AIDS, and it is simply controlled by controlling consumption. It does not require retroviral drugs it just requires reduction in calories. So let's look at the above.

First, intervention, as any GP or Internet knows if you get 1% of your patients to voluntarily control intake it is a miracle.  You see them frequently, adjust the metformin or insulin, send them to specialists and at best they never really get any better. They must see this as an economic issue, they must pay more for the right to get fat, and then we must pocket the funds to pay for the inevitable. Frankly it worked with tobacco.

Now as a community issue, we all too often see obese families, obese groups of people, and they do reinforce one another. Thus Collins et al pose the need for some community approach.  Again in  my experience this is difficult if not impossible. "Mother" has food on the table, and often an excess. Societal pressure creates an accelerated demand. Again there is no motivator other than price, an economic motivator.

As we have argued before,  there are two economic approaches, Pigou and Coase. Pigou taxes at the point of consumption, tax on carbs, and Coase at the point of impact, if your BMI exceeds 25.0 you are taxed. This thus is a medial problem ex post but an economic problem ex ante.