Overweight and over-hyped

Which of these should keep you awake at night counting the minutes till the clock strikes Doomsday? Terrorism? Climate change? SARS? AIDS? None of the above, according to public health expert Lawrence Gostin, of Georgetown University. In a burst of impassioned rhetoric, he told a summit run by the Oxford Health Alliance (OxHA) in Sydney this week that although global terrorism is "a real threat", it’s just a teddy bear next to the 800-pound gorilla of obesity.

"Ever since September 11, we've been lurching from one crisis to the next, which has really frightened the public," Gostin said.(1) "While we've been focusing so much attention on that, we've had this silent epidemic of obesity that's killing millions of people around the world, and we're devoting very little attention to it and a negligible amount of money."

Purblind politicians, it seems, are averting their gaze from the horrors to come. "In the current US Presidential campaign, prevention of obesity and the effect it is having on the poor has so far registered barely a blip on the Democratic side of politics and zero on the Republican side," said Gostin in the Summit's official press release.

These rhetorical fireworks seem to signal an audacious tilt by obesitarians at knocking the global warming industry from pole position. "It is true that new and re-emerging health threats such as SARS, avian flu, HIV/AIDS, terrorism, bioterrorism and climate change are dramatic and emotive," said Professor Stig Pramming, an Oxford don who is the group's executive director. "However, it is preventable chronic disease that will send health systems and economies to the wall."

Scary stuff. But obesity is just one of many threats to national finances in the year 2030. What about oil shortages, depression, ageing populations, Ebola, mass migration, internet meltdown and nuclear warfare -- to say nothing of all those known unknowns and unknown unknowns? Although the prospect of millions of avoidable deaths through heart disease, diabetes and cancer is dismaying, why should the Oscar for moral panic (and the lion’s share of research funding) go to global obesity rather than to global terrorism or global warming?

At work here is not only a cynical public relations campaign by the chronic disease lobby but a profound moral confusion. The obesity epidemic is unlike its rivals, which are beyond any single individual's control. Obesity is qualitatively different. It represent a crisis of freedom and personal responsibility. The obese have sold their birthright of a trim physique for a mess of pottage – a lounge in front of the television and a Mars bar. Framing lifestyle disease as a calamity as unavoidable as a collision with an asteroid helps no one because it leaves out the crucial ingredient of free will.

A host of other factors are at work in the obesity epidemic, of course: faulty genes, obesogenic working environments, peer pressure, advertising, poverty, family break-up and so on. But there is a spiritual component which Gostin’s rhetoric ignores. Some research suggests that excessive materialism and individualism, as well as the decline in existential meaning which comes from religious belief are important factors. More funding and more government intervention will not have an impact on these.

There are a number of other fallacies in the obesitarian narrative.

The politics, to begin with. Gostin got this wrong. Obesity is an issue in the US presidential campaign. Republic hopeful Mike Huckabee is the most famous ex-obese man in America. His triumphant loss of 110 pounds and his book Quit Digging Your Grave with a Knife and Fork help explain an electoral appeal which baffles foreigners. Since he clearly has the upper hand in the obesity stakes, it’s little wonder the other candidates have ignored it.

Second, and more seriously, there is the moral equivalence of death by terrorism and death by gobbling. Terrorism rends the fabric of political life, striking at the law and order which underpin a workable democratic society. A suicide bomber killing dozens in a Baghdad food market is simply not the same as sloooowly killing yourself in a supermarket with a supersize Coke and a roast chicken. The former, if unchecked, will destroy a democratic state and human rights. But a democracy of obese voters is still a democracy. It is indecent to equate the two.

Third, in any case, Gostin’s foreboding calculations may be completely wrong. They do not appear to account for the savings that public health systems will achieve through a decline in life expectancy. Ghoulish as it may sound, a study in the New England Journal of Medicine has forecast that obesity will rescue the American social security system from bankruptcy. (2) Which will cost more: death from obesity at 65 or death at 85 after 20 years with Alzheimer's? The idea that for the first time since 1900 the average lifespan of a generation could be shorter than its parents is dismaying. But the impact on the bottom line should not be ignored -- if OxHA is interested in the truth rather than playing Chicken Little.

The problem with calculating the economic impact of obesity is that its victims would have died anyway. The relevant issue is by how many years their life expectancy will be reduced. The authors of the NEJM study estimate that it is only "one third to three fourths of a year". This not negligible when spread over millions of Americans. But lethal childhood diseases in the Developing World deprive millions of victims of decades of life. Pro-life supporters could even trump this by multiplying the 40 million annual abortions by the world average life expectancy. Statistics is a game that two can play.

Finally, pooh-poohing the danger of terrorism is bound to be a damp squib. OxHA wants to enlist youth, activists and environmentalists in a "coalition of the committed" who will build a world of weight-watchers. Sorry, guys, but it’s impossible to get starry-eyed about calorie-counting and regular exercise. Fighting terror, and even fighting global warming, has a social justice dimension which obesity lacks. Ultimately death by obesity is a lifestyle choice. Death by terror isn’t.

Michael Cook is editor of MercatorNet.


(1) "Obesity more dangerous than terrorism: experts". The Age (Melbourne). Feb 25, 2008.

(2) S. J. Olshansky and Others. "A Potential Decline in Life Expectancy in the United States in the 21st Century". New England Journal of Medicine. 17 Mar, 2005


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