Megan: Aside from rising health care costs? Paul: Because we're in the midst of a moral panic over fat, which has transformed the heavier than average into folk devils, to whom all sorts of social ills are ascribed. Megan: So why is the public health community so set on this issue as the major driver of our health care costs? Actually it's a lot crazier, because there actually are significant health differences between men and women and the old and the young - much more so than between the fat and the thin. So saying "let's improve health by turning fat people into thin people" is every bit as irrational as saying "let's improve health by turning men into women or old people into young people". And the reason there's no evidence is that there's no way to do it. There is literally not a shred of evidence that turning fat people into thin people improves their health. The extent to which those correlations are causal is poorly established. Paul: The correlations between higher weight and greater health risk are weak except at statistical extremes. If there's one thing that everyone in America knows, it's that being fat is really unhealthy. Third, focusing on making Americans thinner diverts resources from real public health issues. Second, the solutions for the problem are non-existent, even assuming the problem existed. There are three big problems with attempting to control health care costs by reducing so-called "obesity." First, it's a fake problem. Paul: It's a terrible idea on all sorts of levels. As we're debating the costs of a public health care plan, controlling obesity is moving even further to the forefront of the American public health agenda. In conjunction with this, the journal "Health Affairs" just published a study showing that almost 10% of US medical costs may be due to obesity.
Megan: The CDC is sponsoring a conference on obesity this week.
The book, which everyone should read, argues that the health benefits of losing weight are largely imaginary that we are using "health" to advance our class bias in favor of thin people, particularly thin women. So I decided to ask Paul Campos, the author of The Obesity Myth, what he thought. This week, Health Affairs published a new study showing that-quel surprise!-obesity accounts for an ever growing share of our health care costs. But still, the idea's power seems to be growing every day. Obesity seems to be a growing favorite: wouldn't it be great if we could make everyone look like Jennifer Anniston, and be cheaper to treat? There are a lot of holes in this theory-the morbidly obese are very sick, but die young, while lower levels of overweight/obesity aren't so well correlated with poor health. With health care in the news, everyone's looking for magic bullets to save money.
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