The Fattening of America: How the Economy Makes Us Fat, If It Matters, and What to Do About It
by Eric Finkelstein and Laurie Zuckerman
John Wiley & Sons, 2008
274 pages, hardcover, $26.95, ISBN: 978-0470124666
available on Amazon.com
Americans are bigger today than ever before. Some scientific research, many news stories, and the occasional movie claim our growing girth imposes strains on the health care system, raises costs throughout the economy, and shortens lives. The popular argument is that restaurants, food companies, television, video games, and the Internet are to blame.
‘Cheaper to Be Heavy’
Not so, says Eric Finkelstein, an economist at RTI International. In his book The Fattening of America, coauthored by Laurie Zuckerman, he argues most American adults have simply decided it is cheaper to be heavy. Companies and people have responded to economic incentives and made rational decisions about how to use their time and money.
In addition, Finkelstein notes, government policies are also to blame for increased obesity.
Finkelstein notes the market that helped make obesity cost-effective will also make healthy choices cost-effective if left alone for adults, but he thinks government has a role in forcing children into healthier behavior.
Finkelstein’s argument about the strengths of the market is a useful retort to many of the health-based arguments for “smart” urban growth, fat taxes, advertising bans, and mandatory employer-provided benefits.
Unfortunately, he does not go nearly far enough in his skepticism toward the contemporary obesity frenzy. Setting aside for the moment the debate about children, which can often provide a back door to broader government powers, a major shortcoming of the book is the author’s unquestioning acceptance of many claims about the relation of other health problems to obesity without exploring the possible alternative explanation that such issues could be co-occurring conditions instead of direct results of excess weight.
Dieting Can Hurt Health
Dieting may even be part of the reason people get heavier and heavy people are less healthy. Results from the Framingham Heart Study show weight fluctuations may lead to heart problems and other negative health outcomes regardless of a person’s total weight.
While Finkelstein rightly lauds the willingness of private-sector firms to respond to consumer demands for weight loss products and programs, he pays little attention to the adverse effects of most diets.
On the other hand, he does recognize the importance of small, long-term behavioral changes to reach and maintain a healthy weight. He warns, “If you are losing weight quickly, you’ve likely made substantial changes … that you’ll probably find to be too costly to sustain.”
If a person can improve his diet and increase his activity a little at a time, he will have better health whatever his weight, and healthy weight loss will follow. Unfortunately, books such as The Fattening of America make it easier to ridicule those who are overweight or obese by suggesting they are not just subjectively unattractive but also objectively unhealthy.
Who Should Decide?
This brings us back to the arguments about government regulation of children’s diets and exercise habits. Finkelstein correctly finds it acceptable for insurance companies to charge different premiums based on body mass index (BMI) for adults and for companies to provide incentives for their workers, and he thinks obesity is a poor reason for mass transit or city planning concepts. However, he has little compunction about direct government interventions to keep children thin.
Some of these steps would be as simple and market-friendly as removing some of the federally subsidized unhealthy choices from school lunches. Others, such as putting children’s BMI scores on their report cards and banning soda sales in schools, rely on soft paternalism and are much less defensible. Fortunately, the economist in Finkelstein is strong enough at least to oppose the hard paternalism of advertising bans and fat taxes even for the sake of children.
Despite its weaknesses, Finkelstein’s book provides a balanced approach to the economics of obesity. He recognizes that whatever the consumer desires and needs–be it big steaks or gastric bypass surgery–the market provides incentives for private-sector firms and individuals to meet those demands. So, he says, the average weight for Americans now is their ideal weight, given the current economic and social environment.
In fact, he notes, government policies have influenced that environment to make it less expensive to be overweight or obese. Those policies include expensive subsidies for corn and soybeans, and zoning restrictions that prohibit the walkable neighborhoods some people prefer.
Finkelstein’s grounding in economics helps him recognize the unintended consequences of basing government policy on his personal preferences and the snack restrictions he imposes on his son’s soccer team. Now if he’d only see that even when it comes to children, government isn’t a better judge than the market.
Joseph Coletti ([email protected]) is fiscal and health care policy analyst at the John Locke Foundation.