In a free society, the government should be in the business of education not banning substances, which are otherwise legal, and not immediately life threatening neither to the consumers of those substances nor to others in the society. Comparing the failure of the so-called ?war on drugs? to the success of anti-tobacco campaigns would indicate citizens would largely make healthy decisions when they are sufficiently educated on the topic. The government should educate and let people vote with their dollars. Recently McDonald?s has introduced salads to their menu. My guess is they did so in response to changing tastes in the market place and not to government pressure.

I think HMOs and medical insurance companies should consider covering basic gym fees. This might prove to be a cost-saving business decision due to reduced claims for minor ailments.

Remember Chris Farley? Sorry, but your comment on humor shows an area where you might have a blind spot. I prescribe more sedentary activity in front of your television Judge Posner.

"If the cause were biological, the well-documented increase in obesity over the last several decades would be inexplicable."

I understood your point-of-view, and would like to add a single perspective for the sake of a more complete discussion: although you say obesity is not biological, the general predisposition seen in humans when exposed to high-fat diet highlights a possible evolutionary trend of the human body to save energy by mantaining excess fat (as adiposity) while awaken instead of transforming it, spending it or entering into hibernation or torpor cycles (as we see in bears and marmots); therefore obesity's cause being in fact... biological. The behavioural component widespread nowadays (watching too much TV, lack of exercise, etc.) is basically the trigger for the whole mechanism that evolved over time, when the value of being fat in the population was much higher and precious (to withstand long and unpredictable starving periods) than today, as you pointed with the overweight negative effect to society. In my opinion, the biological perspective can't be neglected at all, although it cannot be as well analyzed as the single one existent on the planet. Mostly, because it's probably looking into the biological component that we'll be able to find a solution for the whole problem.

This said, I completely agree with your always brilliant economical point-of-view: banning junk food advertisement is not an effective policy. Since short-term response for an evolutionary trend is hard to get and I personally lack the background to discuss it, I would stick for now on an already existing long-term policy: funds for obesity research and obesity-related drug/technology development.

Judge Posner writes: "To the extent that, as Becker suggests, such advertising has a much greater effect on brand shares than on aggregate demand for the products, the advertisers as a whole might be better off if forbidden to advertise. With higher profits, and an important form of nonprice competition eliminated, advertisers might compete more on price, resulting in lower prices to consumers and therefore greater competition." (I assume the final sentence should read:"...resulting in lower prices to consumers and therefore greater *demand* [not competition].")

I'm wondering whether that would occur. I can understand how *restricting* the amount of advertising might benefit producers as a whole, but it strikes me as though *forbidding* producers to advertise might result in a decrease in demand by decreasing consumer awareness of the existence of fast food products. In other words, at the current level of advertising, marginal increases in money spent on advertising may very well be a zero-sum game among producers, but the first few bits of advertising may increase total demand. I suppose one would have to calculate the net effects (i.e. first few bits of advertising against less nonprice competition).

Also, there would have to be a total ban on advertising, not just on television advertising because otherwise producers would simply shift their advertising to other, less efficient media such as radio, print, billboards, etc. like the tobacco companies did.

An observation: Judge Posner's comment about the effect of time-saving and labor-saving devices as a cause for the rise in obesity among young people is the same probable rationale for the advent of the so-called "women's/feminist movement". Interestingly, both events occur at approximately the same time, i.e., starting in the 1960's. Both are a response to modern technologies which cause changes in the culture, i.e., the availability of the birth control pill for women and the prominence of television as an inducement to a more sedentary lifestyle. And both dovetail with each other, that is, the two income working household suggest less parental oversight and (coupled with the rise of cheap, easily puchased and tasty, high caloric fast food) a relatively inferior diet. Accepting these premises, could the resulting near-epidemic obesity among young people ever have been avoided?

Lucia's comment seems to confuse a key point. Yes, the body does have a biological mechanism to store fat as future energy. However, when exposed to high fat diets that are calorie dense, convenient, and cheap, people consume more calories/gram of food. As a result, the system responds by storing the excess as fat. This is a system that is operating normally but is dealing with an abnormal exposure to calories. As a result, the system is not "awakened," it is placed into overdrive.

i know this contributes nothing to this discussion, but you personally hit a pet peeve of mine: the video games. i am personally not innocent, but everytime i visit my cousins that's all they want to do. we go to the store they want me to buy them more video games. instead, i have adopted a policy to buy them strictly those things that encourage outdoor activities: football, bebee guns. what's even worse is that they have portable game machines and they take them everywhere they go. incidentally, they are headed on obese trajectory as well.
from a policy standpoint, other then parents not feeding the addiction i think robert is probably right -- this probably could not have been avoided.

"The benefits of preventive health can be exaggerated. It increases the percentage of the elderly in the population, and the elderly are very heavy demanders of expensive--and subsidized--health care and pensions." - Posner

You have support for your point regarding the obese from a famous authority: "If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."

And seasons greetings to you, too!

Clinton

The human body operates on a rather simple formula, which is: when caloric expenditure is greater than caloric intake stored fat is used up; when caloric expenditure is less than caloric intake, fat is stored. The obesity problem, is simply a quantity balance problem. In other words, one's caloric intake should match the lifestyle in order for obesity to be avoided. As all doctors seem to point out, "eat less, exercise more!"

It seems ironic that the Media pushes this point, then runs cooking shows that produce all sorts of delectables and ads for all types of foods, both fast and not. Consume! Consume! and consume some more! The more you consume the better you'll feel. And we wonder why there is a growing problem of obesity?

"...a countervailing factor is that employers may distrust the commitment to work of employees who look as if they spend most of their day in the gym"

amen, although the distrust may not be due to fear of excess time in the gym.

One more on the distrusting commitment of employees who are too fit...

This is kind of ironic. Being fit does not take excess time commitment. Rather, I found that it took discipline and restraint more than time in teh gym. Examples: walking up stairs instead of using the elevator, jogging every saturday morning with other people, refraining from fast food, eating (vs. skipping) breakfast, cutting back on desert, coffee with no frills, etc etc etc.

you would think employers would find a way to tape into this discipline and restaint, and prosper (vs. retaliate out of distrust). the retaliation can thing be a discouragement and downer. employers may need more structure and discipline.

I tend to think that obesity is not a market failure. I think personal utility of eating is very high, and deep-seeded biologically. The cost of being obese seems to be a few years at best, especially with the availability of pharmaceutical treatments for type II diabetes, high blood pressure, high cholesterol, etc.

The normative effects of group obesity, as Posner identifies, are very important. People feel little pressure to lose weight if their friends are similarly fat - I believe the correlation of fatness among friends causes the social costs of obesity to be overestimated, i.e., fat people would feel really fat if they associated with skinny people, but they are mostly friends with other fat people, so they feel pretty normal.

Well said, Josh!

I am know kids spend too much time in front of the TV, but I can't talk. I have gained almost 20 pounds since I began law school. Talk about sitting around and doing nothing. Every one of my friends has gained appreciable weight in law school. We should petition the administration to provide an on-site gym so that we could remain the beautiful people that will get good jobs, thus enhancing the prestige of the law school.

I would think that society as a whole gains dramatically if the population is healthier, in productivity, happiness, and a reduction in health care costs. I can see no conceivable reason why the government should not, at the very least, use its bully pulpit to promote a healthy diet and lifestyle. And, I would think that any employer would prefer a healthy workforce, espeically if the employer provides health insurance for its workers. If there are any statistics to the contrary, I would like to see them presented..

1. "If there are any statistics to the contrary, I would like to see them presented.."

Look up unemployment statistics and labor force participation by categories (men and women, older and younger, sexual orientation or preference, ethnic background, etc) and explain the difference. A lot of this is on-line at government sites. Tie it all out and explain all variations across categories. Then tell me that employment is entirely logical and fair. This being said, the U.S. is still a pretty good place (at least for now).

1. "And, I would think that any employer would prefer a healthy workforce, espeically if the employer provides health insurance for its workers"

I am not a health care expert. However, ... "any" employer is a very broad, absolute kind of statement. All I have to do is find 1 employer that does not prefer a healthy workforce, and your thinking is not valid. Is it possible that at least one employer may have puerile or sadistic needs that can be met by employing certain sick people and not others sick people? Consider watching the movie Philadelphia. You may be naive.

2. health insurance - I am not a health care expertare employer health insurance premiums linked

edits:

the second "1." should be a "2."

strike point "2. health insurance -"

I disagree Nate, I think what Dave was saying was that any employer who provides health care benefits would want a healthy workforce. I think that is a valid point. It would be a strange business where the benefit of employing sick people while providing health care outweighs the loss that you will have in health care premiums and costs. Of course this post assumes that the health of the workers based on obesity is a real factor in determing health care costs.

Of course you can always say that irrespective of health care costs, employing people more likely to become ill will hurt productivity, increase training costs for replacement employees, and disrupt continuity in the office. All of these things are important to most employers seeking to make money.

matt k

Businesses do go under. Why?

Second, some people at employers make money (gobs of it) while the employer simultaneously does not make money. In some instances, the employer destroys incredible amounts of value for society and the community while certain people at the employer make out like bandits.

Also, employer utility may be derived by more than making money.

"It would be a strange business where the benefit of employing sick people while providing health care outweighs the loss that you will have in health care premiums and costs."

See Krugman in the NYT on GM-

I realize this Krugman reference is a little bit of a stretch and not perfectly related to the discussion at hand. GM may have very high health costs on a per auto basis even thought he work force is very healthy. I am not sure.

I think that the obesity epidemic is not only the result of a market failure, it also points to a fundamental flaw at the heart of econimic theory. It is assumed in economics that it is valid to trade off any preference against any other (and that the free market is the most efficient and effective mechanism for accomplishing this). But just because preferences _can_ be traded off against each other doesn't mean it makes sense to do so in all cases. Further, life and the free market are biased toward short-term survival and short-term satisfaction of needs and preferences, particularly in individual consumer behavior. Early man (Olduvai Gorge or post-Eden) needed to survive a day at a time on slim pickins before he would survive a year. Alas, we are not rational actors, and there is undoubtedly a Gestalt aspect to the structure of preferences.

Most people know how to lose weight - eat less and exercise more. The diet industry is successful because people know that but can't get themselves to do it. People want either a magic diet pill or a way to bring their behavior into line with their long-term preference for non-obesity that has thus far lost out to their short-term preferences for excess food and inactivity. An economist might say that we have preferences for all three things, and market activity is merely a reflection of the relative strength of these preferences, which happen to be in conflict. But, I suspect if you surveyed obese people and could quantify their preferences, they would generally express a greater conscious preference for non-obesity than the combination of excess food and inactivity. Granted that's conjecture, but I for one think it is true and represents an economic paradox. What do you think?

Ian, I've always believed in the good/evil-virtue/vice paradox and the nature of human kind. it's really all a question of gluttony, lust, and sloth. And it's so much more pleasureable to be Screwtape.

i think part of it was touched on earlier by Lucia that the way that man has evolved has made it such that our bodies are more naturally inclined to store fat and shed muscle. i dont know; even though we may desire to be fit, if biology is against us, then maybe it isn't econmically rational to allocate resources to obtain this goal. thus, i guess i am arguing that the market reflects subconscious behavior: that it's not economically worth fighting biology.

Whether you agree or disagree, anybody who likes economics and has a sense of humor has to appreciate how awesome this sentence is. Posner is the best!

----------------------------------------------
In addition, thin people should have a significant advantage in competing for jobs involving trust, since thinness signifies self-control and in turn a low discount rate, which should make a worker more concerned with his reputation and therefore more trustworthy...

Becker and Posner are fantastic bloggers. Keep up the good work. I might be a lot more likely to buy a book by one of these two due to the blog. I also might be a lot more educated.

Thank you!

Posner: Political correctness may even be a factor. Jokes at the expense of fat people used to be a staple of comedy (remember Abbott and Costello?). No more. Political correctness has reduced the use of ridicule to enforce social norms.

When Bill Maher hosted Politically Correct on ABC, one of his favorite recurring themes was to make jokes about fat people and to complain that mocking fat people was no longer socially acceptable. It did not seem to occur to him that returning to this argument night after night on a nationally broadcast humor/talk show was self-refuting.

Abbott and Costello were before my time, but I wonder if Judge Posner is familiar with the movies of Chris Farley.

I agree with Posner's points. Obesity among the populace is rampant, and while studies may disagree on the cause, I think that the major cause of obesity is the lifestyle we have chosen to live. America lives at a terrifically fast pace compared to the rest of the world. Instead of kids playing by themselves, we have super scheduled them into activities where they are entertained. We are so busy, that fast food becomes a convenience because our kids can eat it quickly between activities in the car.

Our lifestyle will have to change before the epidemic of obesity changes direction.

Increasing obesity in the US is certainly one factor, among many, that has contributed to the rising cost of healthcare. How is this increased cost borne, however?

The portfolio effect of health insurance coverage at large employers insulates individuals from from price signals associated with the personal health risks and choices that individuals may make (a healthy person pays the same monthly premium as a an unhealthy person).

If group health insurance were more efficiently priced, and individuals paid premiums that truly reflected their unique risk of coverage... then I believe behaviors and attitudes towards obesity would begin to change. I know that if my healthcare premiums would significantly reduce if I lost weight, then I would probably try harder to lose weight. Conversely, if I knew that my healthcare premiums could significantly increase if I were to gain weight, I would try my best to avoid doing so. My level of effort, naturally, would be impacted by the amount of the potential premium increase or decrease.

I do realize that such pricing could be politically problematic, particularly when other genetic risk factors or disease come into play...and pricing could appear unfair or inhumane. Without more efficient pricing, however, healthy people will continue to subsidize unhealthy people.

Note to Lucia Malla:

The judge wrote: "If the cause were biological, the well-documented increase in obesity over the last several decades would be inexplicable."

The "biology" he was referring to wasn't human weight gain in general--it was referring to the argument that obesity is genetic; that is to say, some people are more genetically disposed to obesity than others.

If this were true then there wouldn't be any rise in obesity, unless our genetics had changed substantially over the last several decades.

Yet another arena in which people senselessly distinguish overeating from smoking.

Few Quick Questions:

Why don't we allow Joe Camel to pander to kids as blatantly as he used to?

Why don't we have cigarettes machines in schools?

Why do we openly speak disparagingly of smokers, but wait till we get home to mock fat people?

Why is so acceptable to show contempt for the smell of a smoker, but rude to gag at the profile of a fat person?

In short, why do we make the allowances for the fat which we deem unnecessary protections of the smoker?

As you might have guessed, I believe what's good for the geese...

John, I think there are two concepts here:

1) Obesity is a caused by genetic predisposition to some people, so some obese people are expected in the population due to this natural variability. In this sense, I agree with you.

2) Overall obesity in the population is a consequence of an overburnt normal, standard system - our body - facing new challenges (sedentary behaviour, for instance), independent in some ways of personal genetic status but dependent of evolutionary trends.

Evolutionary trends fulfill the biological aspect as well, and that's what I pinpointed in my first comment. Biology is not only genetics, and that's what I tried to illustrate by commenting here. But I agree with you: at that particular sentence, judge Posner was just pointing the "improbability" of biology being the only one to blame for the obesity epidemy.

The world changed for Homo sapiens; we have comfortable technology that makes us sedentary, and overall, obesity can't be blamed only because of some genetic predisposition anymore. For some, yes, but not in the rates we see nowadays.

I don't know if I got your comment straight, John, but that's what I understood. Please let me know if I cleared or confused you more... :-)

Thank you, Avi, for pointing out the dangers of destroying freedom, even when it seems like such a good idea. It was easy enough to demonize the cigarette companies and take away their basic rights, and now that we've done that, there will always be many more Avi's who point to other areas where we still have freedom and say "hey, why don't we take away the freedom over there--we've done it before, let's do it again."

This entire thread assumes that the definition of "obesity" as a pathological life-threatening condition is a well-established scientific fact, and that the USA faces some sort of health crisis because of the increased body mass of its populace. These assumptions are, to put it mildly, problematic.

For recent in-depths reviews of the issue see my THE OBESITY MYTH and Eric Oliver's FAT POLITICS. For a brief summary of the epidemiological evidence, go here: http://ije.oxfordjournals.org/cgi/reprint/dyi254?ijkey=5Z19Zq421PiNgMw&keytype=ref

Professor Posner's final paragraph troubles me:

"The main costs of obesity, in increased illness and disability, are borne by the obese themselves, which greatly weakens the economic case for intervention. True, the obese are able to shift some of their medical and disability costs to others through the Medicaid, Medicare, and social security disability programs, which are subsidized health and disability programs that do not limit benefits to the obese even though the obese experience increased illness and disability as a consequence of their obesity. Yet the benefits of preventive health can be exaggerated."

Is he laying out a case of facts here, or trying to persuade us? I suspect mainly the latter. Why else would someone as obviously capable as he ignore the private health care system-- a pool nearly as collective as the federal government itself--and leave unstated the costs of manageable, yet nearly lifelong diseases, such as type II diabetes, elevated blood pressure, and high cholesterol, the main outcomes for people who are obese from an early age. I am no Posner, but the health care math surely doesn't make sense here.

Obese children who for example contract lifelong type II diabetes in their teens or twenties and live into their 60's or even 70's will surely cost more than elderly people, whose maladies last for far fewer years. Diabetics will pay more doctor visits, take more medications, require more surgeries, for perhaps 40 to 50 years. Then they too will get old and have other normal maladies not related to their diabetes alone. Drug companies will see to it that diabetics live a long time, taking at least one pill, and probably more, each day to prevent the death that would await them were they not to take their pill(s). All of this will be paid for by a weakening private health insurance system as well as the government programs professor Posner mentioned.

Can the government eradicate type II diabetes and thus save money. I'd say the odds here are better than winning the war on terror.

A significant difference between smoking and obesity is the negative externality of second-hand smoke, to which obesity has no counterpart. Obesity is a health risk to the obese person only, whereas smoking is a health risk to all the surrounding people who may or may not choose to smoke for themselves. This somewhat negates Avi's point; the reason it is ok to regulate smoking (and to socially demonize the activity) is to protect non-smokers from the harmful decisions of others. However, obese people pose no direct health threat to fit people.

To summarize: regulation of smoking is justified because it produces externalities, but regulation of obesity could not be justified on the same grounds.

Prof. B, you don't think replacing junk food TV ads with healthy-diet public service messages would have statistically significant effect? Are you saying nothing on TV affects how much TV we watch? You're jumping from skepticism to an insinuation of positive claims that are more dubious than the authors'.

Well said. I totally agree with you. The point you are making here does make sense.

I think tv is quite an important factor in this issue.

Paul makes a good point: smoking is a bad decision which affects us all. I have no doubt this is what's at play in the regulations which started in California and quickly took hold in Boston and New York.

What interests me more, however, is the paternalism inherent in the anti-smoking rhetoric. Tobacco companies are evil because they manufacture poison. Smokers are idiots because they poison themselves for very limited ends. We restrict tobacco advertising and tax it as heavily as we do under the guise of this paternalism, and also undoubtedly because it is just so damn profitable.

We can't tax McDonalds. It only works because it's so cheap. But what if we limited their advertising overhead the way Posner suggests? Could we keep the difference, like we do in the tobacco industry? McDonalds makes poison. There foods makes people fat. Fatness is as unhealthy as smoking.

This is my point. There is a distinction in the way we think about these things from a moral perspective that cannot be sustained, and is irrespective of the second-hand effects of smoking.

Avi

I agree. The rationale for restricting tobacco because it is a poison is flawed because many things we consume is a poison, in the sense that they reduce life expectancy. Were the "poison rule" adopted consistently, we would ban many contact sports and outdoor activities, the majority of foods in a supermarket, and possibly even motor vehicles. It is not a matter of degree: provided people are informed then consuming especially strong "poisons" will only occur if the private payoff is large enough.

Anti-obesity advocates do not understand that each of us is constantly trading off quality and longevity of life. We make this trade-off in deciding whether to snack on chocolate or lettuce, or to ride motorbikes or in cars, and we make those decisions according to our preferences. Clearly, living long and being very healthy is not an objective shared by all, so having that objective imposed must be unhelpful. Unless externalities are especially severe in obesity, and they do not appear to be, welfare can only be harmed by government intervention.

Rejecting the "poison" standard in favor of an externalities test doesn't mean anything goes: when there are significant negative externalities associated with the use of a strong "poison", as there probably is with narcotics abuse, for example, then government intervention can still be justified on economic grounds.

the link below takes you to the chicagoist blog.

there are many hidden costs to obesity.

http://simurl.com/bb-pp-mm

Think about this cost: buying new seats, installing the new seats, potentially less ongoing throughput and revenue, time spent by mgt looking to buy new seats, opportunity cost - mgt could have been doing other things, any other switching costs, etc.

Nate

The cost you cite is irrelevant to policy setting unless there is an externality. I doubt there is one for bus seating because buses compete against other transport and users pay a fare to ride. Businesses constantly make adjustments to suit customers' preferences, and there is no reason to point to seat width as especially costly.

You are right about business making adjustments. Businesses employ "price discrimination." Computers and technology enable a business to do all kinds of things unavailable a long time ago.

http://eyetrack.morris.com/story_pages/5_a/03.shtml

http://www.cswd.org/airseats.html

So if the buses were like a "business", in the sense that I think you use the word "business", the buses may charge overweight people more money to ride the bus. Maybe Posner can give us more legal background on this. Would it be legal to charge overweight people more to ride the bus? Otherwise, slim and disciplined people that use public transportation are subsidizing larger people.

"I doubt there is one for bus seating because buses compete against other transport and users pay a fare to ride"

Is it possible that buses may have a quasi-monopoly on transportation for certain segments and areas of the population?

one more:

It may be important to redefine mores a little bit. I am not sure why "thin" is desirable. People should be comfortable, confident and have positive self-esteem regardless of weight. People should look for the beauty within.

Also, on being heavy: it seems to me like there are at least two types of overweight people. One type is a glutton: a person with no discipline who, given a lower cost of fat, will inevitably become overweight. The other type is a person who has some sort of genetic predisposition to being overweight. It is really hard to distinguish between these two types, and I am not God and do not want to commit Type I and Type II errors. As a fortunate "skinny" person (at least historically), I am okay subsidizing the cost of seating on public transportation, and even an airplane, due to the fact that some people are overweight for reasons beyond their control.

It should be noted that SW Airlines is consistently profitable. SW Airlines charged overweight people more to fly on airplanes.