Read William Saletan's "Human Nature" column on obesity and genetics.
But these estimates are more than meaningless—they actually make the problem worse. A second study, published in the American Journal of Public Health on Jan. 30, looked at the relationship between body image and health. The authors compared people of similar age, gender, education level, and rates of diabetes and hypertension, and examined how often they reported feeling under the weather over a 30-day period. It turned out that body image had a much bigger impact on their health than body size. In other words, two equally obese women would have very different health outcomes, depending on how they felt about their bodies. Likewise, two women with similar insecurities would have more similar health outcomes, even if one were fat and the other thin.
These results suggest that the stigma associated with being obese—feeling fat—is a major contributor to obesity-related disease and ill health. This would account for the strong association between body-mass index and depression (especially among women), and the high rates of morbidity and mortality that ensue. Sure enough, racial and cultural subgroups with more moderate attitudes toward obesity seem to experience more moderate health effects. Overweight and obese African-Americans, for example, are much less vulnerable to weight-related illness—even among women who are 5 feet 5 inches and 250 pounds.
Politicians love to throw around cost-of-obesity numbers as support for fat-prevention programs, overeating legislation, or, in the case of Sens. Obama and Clinton, massive health-care reform. These shocking statistics are also supposed to guilt-trip consumers into pursuing a healthier lifestyle. Putting on weight is as much a social decision as a personal one: When we overeat, we're killing both ourselves and the economy.
This chew-and-screw narrative feeds on itself. First, it inflates the numbers by ignoring the real effects of an aging population. Then it promotes bias by supplying phony evidence that heavy people are lazy, useless, and a drag on the nation. This in turn makes anyone who thinks he's a little chubby feel even fatter, which worsens his health and lowers his quality of life. As a result, he spends more money on medical bills and more days at home crying into a bowl of ice cream. And guess what? All of this only increases the cost of obesity!
We're all interested in the most efficient ways to extend life spans and improve our quality of life. But the rhetoric of wasted fat dollars does little for our health; the claim that obesity costs the government $1 trillion is absurd at best and self-fulfilling at worst. Instead, the presidential candidates should pledge support for a federal ban on weight-based discrimination. If we stop blaming fat people for our problems, they might start feeling better—and start saving us money.
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