I agree with Becker that one must be hesitant to recommend governmental intervention in personal choice. Government lacks good information about consumer preferences in a country as vast and diverse as the United States, and government is buffetted by interest groups. But the case for some government intervention in the obesity epidemic (and it is an epidemic—obesity begets obesity, as I’ll suggest) seems to me compelling.
I am not particularly interested in saving the obese from themselves. I am concerned about the negative externalities of obesity—the costs that the obese impose on others. Some of the others are the purchasers of health insurance and the taxpayers who pay for Medicaid and Medicare and social security disability benefits. Though the obese die on average earlier than the non-obese, which reduces their average health costs somewhat, the reduction is more than offset by the higher health costs that they incur (and by incurring impose, to a considerable extent, on others) because of the effect of obesity on chronic health conditions such as diabetes, heart disease, and joint problems, on mobility generally, and, because of these conditions, on ability to work (and hence on social security disability costs) and on employability (and hence on unemployment insurance costs). Obesity kills, but slowly, and en route to dying the obese run up heavy bills that, to a great extent, others pay.
Even more serious are the harmful effects of obesity, and of the food habits that contribute to it, on children. Obesity is sometimes a consequence of genetic factors but more often of gluttony, eating the wrong foods, eating between meals, drinking large quantities of sugared soft drinks (the straightest path to obesity), failing to exercise or even to move around, lack of self-discipline. These qualities “nourish” obesity and are in turn nourished by it, in a vicious cycle. Children who grow up in a household of obese parents (often there is just one parent, and she is obese) very often acquire the same bad habits.
One might think that since most parents are altruistic toward their children, parents would strive to prevent their children from acquiring their bad habits. But if they don’t know how to avoid becoming obese themselves, it is unlikely that they know how to prevent their children from becoming obese.
Then too, the more people in one’s family or circle of friends or coworkers who are obese, the more obesity seems normal. This is an implication of the fact that homo sapiens is a social animal. We want to blend in with our social peers. The more obese people there are, the likelier they are to think thin people scrawny, unattractive, even unhealthy. (That is why I called obesity an epidemic—it’s contagious, though as a result of social factors rather than of pathogens.) What lends impetus to New York Mayor Michael Bloomberg’s proposal to limit the size of containers in which sugared beverages may be sold is that two-thirds of the population of the Bronx is overweight and almost one-third is obese. There must be communities in the Bronx in which a majority of adults are obese. It must be very difficult for children growing up in such communities to avoid becoming obese themselves.
Bloomberg’s proposal is widely criticized, not only on the shallow ground that it interferes with freedom of choice, but on the more substantial ground that it can’t have much effect, since the same sugared drinks can be sold in smaller containers. But this misses two important points. The first is that the only reason for selling a product in different-size containers is that there are consumer preferences for the different container sizes; for it would be cheaper to sell all one’s product in identical containers. This suggests that if the sale of sugared drinks in big containers is forbidden, there will be at least a slight drop in the purchase of those drinks and hence in their consumption; there will not be perfect substitution of smaller containers; and this could be significant because sugared soft drinks are as I said the straightest path to obesity.
More important is the symbolic significance of Bloomberg’s proposal (if it is adopted and enforced). It is an attention getter! It tells New Yorkers that obesity is a social problem warranting government intervention, and not just a personal choice.
Think of the history of cigarette regulation. That smoking is unhealthful was discovered early on. (Oddly enough, the pioneers in discovering the link between smoking and lung cancer were doctors in Nazi Germany, and the Nazi government actually campaigned to discourage smoking.) But the initial steps to discourage it in this country were tepid—polite warning labels on cigarettes. Later, warnings were required in ads as well. Then the warnings in both labels and ads became scarier. Cigarette companies were sued for concealing the dangers of smoking. Zoning ordinances imposed increasingly tight restrictions on where one could smoke. The federal government banned smoking in federal buildings. Cigarette smoking fell, from an average of 40 percent of the adult population in the 1970s to 19 percent today. There is some grumbling about this massive governmental intrusion into consumer choice, but very little. I certainly am not grumbling about it.
If there is to be a parallel movement to reduce obesity, it has to start somewhere. Maybe it will start with Bloomberg’s container proposal—an attention getter. Maybe it will grow. Maybe someday it will be as effective, and receive as much public approbation, as the anti-smoking movement.