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Obesity and the Gubernatorial Race
Contributed by: Donna Feldman on 9/6/2006

In the hit TV show "House", Dr. House is fond of saying "patients lie", and in the show, it turns out he's frequently right. I could be the "House" of Registered Dietitians, because as far as I'm concerned, people lie about how much they eat. Perhaps not deliberately, perhaps out of sheer ignorance, but they lie. There are actually reliable studies that measure this. Overweight people tend to be the worst at accurately reporting how much they eat. This might happen because they forgot what they ate, or because they don't really understand portion sizes or because they don't want to embarrass themselves.

Now a study has shown that people also lie about their weight. No surprise to many of you reading this, who have probably told that exact lie. The problem is, recent large-scale obesity studies were conducted by phone, which means respondents were expected to tell the stranger on the phone how much they weighed. If most of them were reporting weights that were too low, then the population is even more overweight than previously presumed.

Despite the dismissive arguments of people who aren't involved in health care (Paul Campos comes immediately to mind), there are many serious ramifications to the obesity epidemic. Shortened lifespan is just one. For example, we now burn more jet fuel to get planes full of overweight people off the ground. So thanks to obesity we're burning up extra petrochemicals, and everyone will pay more for plane tickets.

But the most significant and troubling effect has to be the astronomical increase in health care expenses, for everything from the deadly chronic diseases like diabetes and heart disease to the less deadly chronic conditions like arthritis and reflux disease. Speakers at the International Congress of Obesity meeting, in Australia, point out that the cost of treating obesity-related medical problems is in the billions and growing. As far as they're concerned, obesity has morphed from a scientific problem to a global economic issue that will overwhelm healthcare systems if nothing is done.

Experts from this group estimate that over 1 billion people are overweight, more than the number of undernourished people. I did some math, assuming being overweight meant an average of 20 extra pounds (a likely underestimate). A pound of fat amounts to about 3500 stored calories. That means at least 70,000,000,000,000 excess fat calories in the world's population. That's a lot of carbon atoms stored up in human bodies. Note to Al Gore: if more people gain weight maybe we can reverse global warming. Even if that worked, we'd just be trading one problem for another that has drastic economic consequences.

All this heady stuff relates to our humble gubernatorial race in Colorado. The candidates have decidedly different opinions about ballooning health care costs. Mr. Ritter wants to give everyone a free lunch, at taxpayer expense of course. Mr. Beauprez wants people to take personal responsibility for their health, a position for which he is mocked by such deep thinkers as Susan Barnes-Gelt in the Sunday Post. She paints the healthcare situation as the lucky health "haves" vs the unlucky "have nots". Good health is something that falls out of the sky. Bad health is inevitable and there's nothing you can do about it, so we need free healthcare so those unlucky victims of bad health can get all the care they need or want. Mr. Beauprez and his advisors have come to the opposite conclusion. He proposes that if individuals would take steps (literally in fact) to reduce their weight, demand for expensive healthcare for chronic diseases would also be reduced.

I used to have a horse, and here's what he taught me: if you reward a behavior, you will get more of it, whether or not the behavior is actually desirable. Mr. Ritter is proposing to reward obesity and the lifestyle that causes it by protecting people from the economic consequences of their choices. The inevitable result will be that the obesity rates continue to climb, even in lean mean Colorado, and healthcare costs will continue to soar.

Mr. Beauprez wants everyone to take personal responsibility for their own health with lifestyle choices. Getting back to that horse analogy - you can lead it to water.... We obviously can't force people to lose weight and do more walking. As far as I can see, the only thing that works to motivate people in this country is money. You could peg health insurance premiums and deductibles to weight. Right now, in employer-based health plans, everyone pays the same rate regardless of weight, a clear benefit to the people who make the most demands on the system. The problem with this system is people who lie about their weight. Not much incentive to be truthful if your insurance premium is based on your weight.

Since nobody asked me, I have some ideas. Let's charge for plane tickets by weight. Instead of those nonfunctional "puffer" machines, we can have body fat scanners. The passenger walks through a scanner and the fare is computed on the spot based on excess fat. The scanner wouldn't lie, unlike Dr. House's patients. Or how about a fat tax on gasoline? Or computer games? It's politically correct to call for a fat tax on fast food, but how about all those pint-sized containers of Ben 'n Jerry's? You can lie until the cows come home about eating the whole pint, but the government would still collect the tax.

Controlling healthcare costs means controlling the obesity epidemic. Any politician or political candidate who fails to address that fact is, well, lying. Dr. House would not be sympathetic.


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CONTRIBUTOR INFORMATION

Donna Feldman

Louisville , CO

Donna Feldman has posted 130 stories and 1 comment since joining on 9/14/2005. Donna Feldman 's average story rating is 4.9.
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