America is fat, but Americans disagree about what this means. Either the country’s obesity rates—one third of all adults are obese—are a dangerous health crisis, or they show that the nation is healthier and wealthier than ever. Either the government must act immediately to curb our waistlines, or we must act to curb our bloated government. These were the questions debated in NYU’s Skirball Center last night at the Slate/Intelligence Squared live debate, in which four health and policy experts argued the motion that “Obesity is the government’s business.”
Polled at the outset of the debate, 55 percent of the audience supported the motion, 19 percent opposed it, and 26 percent were undecided. By the close of the evening, the “yes” vote remained at 55 percent, but the “no” vote had swung up 16 percentage points to 35 percent, leaving only 10 percent undecided. According to Oxford-style rules, whichever side succeeds in changing the greatest number of minds wins, so the motion’s detractors (who believed that the state should butt out of our eating habits) carried the day.
Panelists attacked the question of government involvement in the nation’s obesity crisis from four directions. Dr. Pamela Peeke, physician and chief lifestyle expert at WebMD, spread a gospel of weight loss through behavioral adjustments—several of which, she argued, should be facilitated by Uncle Sam. From her partner Dr. David Satcher, the 16th surgeon general of the United States, came a fervent defense of the government as primary caretaker and an insistence on links between obesity and Type 2 diabetes. Across the aisle, Fox News host John Stossel lived up to his libertarian reputation by painting tax-funded anti-obesity measures as Stalinist nightmares. And Paul Campos, an author and law professor at the University of Colorado, Boulder, implored Americans to embrace body diversity and focus on achieving healthier lifestyles.
By moderator John Donvan’s account, the debate got off to a slow start. Satcher struggled to support his statement that obesity increases the risk of chronic disease. Peeke, ticking off weight-loss success stories, insisted that the government partner with citizens instead of bossing them around—yet her reliance on catchphrases like “bigger brain, better choices” and “no park, no play” may have alienated the audience. Stossel’s challenge to the welfare state also got a stony reception (though a ripple of laughter ran through the hall when he mocked a recent law exempting Kit-Kat bars from “candy” status in schools because they contain flour). Campos was the first to engage the sold-out crowd with his suggestion that the debate topic itself used misleading language.
“To have a motion that says, ‘Obesity is the government's business’,” he said, “frames the debate as one … about a supposedly pathological state. Imagine if this debate were framed as ‘Eliminating body diversity is the government’s business.’ I think that would sound a lot different, but in point of fact there is no practical distinction between the two.”
Campos unspooled a string of data suggesting that obesity’s adverse health effects were overblown. (Much of his case boiled down to the difference between correlation and causation.) Even if carrying extra weight were demonstrably unhealthy, he added, science knows no effective method for converting fat humans into thin humans.
“The vast majority of people, and I'm going to say this about 27 times tonight, cannot intentionally modify their body mass in a long-term fashion,” he averred, before proposing that the drug companies funding obesity research have a strong interest in convincing us otherwise.
In response, Peeke cited the National Weight Control Registry, a collection of 10,000 “successful losers” who dropped at least 30 pounds and maintained their slimmer build for more than a year. She highlighted the role of education in such success, as well as the virtues of walking and eating a nutritious breakfast. Peeke maintained that the government could advance public health by weaving useful tips about obesity prevention and treatment into school curricula. Donvan took the opportunity to ask Stossel why he found gentler, information-based approaches to state intervention problematic.
“Because the schools can barely teach reading, writing, and arithmetic,” Stossel answered, to roars of laughter.
But moments later, Satcher neatly toppled this call for triage: “Children who develop good eating habits and regular physical activity do better academically,” he countered. Plus, “the goal of these programs is to help children develop lifetime habits.”
When Stossel replied that they could do so by watching Peeke’s show on the Discovery Channel, Peeke was ready with the death blow. “Unfortunately, many people don’t have the Discovery Channel,” she scolded him. The crowd cheered.
Former Surgeon General Satcher envisioned the broadest role for the federal government in the battle of the bulge. The state has unmatched resources to spread opportunity, he told me. For the former surgeon general, federal intervention fell into three categories: Assessment (the collection of population data), making sure people have access to opportunities to live healthfully (e.g. building urban parks), and policy (e.g. establishing nutrition standards for school breakfasts and lunches). Though benign, his picture almost paralled Stossel’s three-part description of the process by which government grows and liberty yields: “It starts with information. It moves to taxes. Then it moves to limits on what you can consume.”
Meanwhile, Campos traced the nation’s fat-phobia not to any kind of welfare imperative (or encroaching fascism), but to the desire for social status.
“Body weight functions as a proxy for class,” he told me backstage. “All this health business is a smokescreen for a false construct—obesity—that expresses our unconscious prejudices.”
Among other things, Feb. 7 was a night of analogies. Both Peeke and Satcher returned frequently to smoking as a doppelganger for overeating and observed that government intervention paid off in the tobacco wars. (Campos at one point challenged the comparison by asking, half seriously, whether his debate opponents recommended people renounce food.) Obesity was also compared to breast cancer, the aging process, and erectile dysfunction.
The debate ended with a sensational closing-statement arms race. It began when John Stossel brandished the directions for a package of birth control pills and groused about how complicated they were, thanks to federal regulations. Then David Satcher conjured the ghost of a racist South to show that he was no stranger to government corruption. (“I’ve seen government at its worst, but I’ve also seen government at its best,’” he concluded.) Next, Paul Campos likened the pathologizing of erectile dysfunction—a natural symptom of being 50 years old, he said—to the pharmaceutical-company-fueled belief that obesity is a disease. Not to be outdone, Pamela Peeke used her two-minute closing statement to recount a story about being chased by feral dogs in a poor neighborhood, ostensibly because it showed that it’s not always safe to exercise outside.