FAT IS THE NEW SMOKING Here's How The Public Health War On Obesity Will Unfold
April 23, 2006
By William Saletan, The Washington Post

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Goodbye, war on smoking. Hello, war on fat.

In a span of two months, smoking bans have been imposed in Scotland, enacted in England, Denmark and Uruguay, proposed by the government of Portugal and endorsed by the French public. China has banned new cigarette factories. In Virginia, our third most prolific tobacco-producing state, senators voted to ban smoking in nearly all public places. The Arkansas legislature, backed by a Republican governor, passed a similar ban and voted to extend this policy to cars in which a child is present. Tobacco companies have won a few skirmishes, but always in retreat.

So we've found a new enemy: obesity. Two years ago, the U.S. government discovered that the targets of previous crusades - booze, sex, guns and cigarettes - were killing a smaller percentage of Americans than they used to. The one thing you're not allowed to do in a culture war is win it, so we searched the mortality data for the next big menace.

The answer was as plain as the other chin on your face. Obesity, federal officials told us, would soon surpass tobacco as the chief cause of preventable death. They compared it to the Black Death and the Asian tsunami. They sent a team of "disease detectives" to West Virginia to investigate an obesity outbreak. Last month, Surgeon General Richard Carmona called obesity "the terror within" and said it would "dwarf 9/11."

How do we fight it? Everyone agrees on exercise and eating responsibly. The debate is over what the government should do. Health advocates want to restrict junk food sales, regulate advertising, require more explicit labels and ban trans fats (also known as partially hydrogenated oils), which are often put into crackers, cookies and other products to prolong shelf life.

They marshal the kind of evidence that won the war on smoking: correlations between soda, junk food, obesity, disease and death.

Lawyers who made their fortunes suing tobacco companies are preparing lawsuits against soda companies. Two months ago, when President Bush gave a health care speech at the headquarters of Wendy's, activists compared the hamburger chain to Philip Morris. They see themselves waging the same brave struggle, this time against "the food industry."

But somehow, "the food industry" doesn't sound quite as evil as "the tobacco industry." Something about food - the fact that it keeps us alive, perhaps - makes its purveyors hard to hate. For that matter, the rationale for recent bans on smoking is the injustice of secondhand smoke - and there's no such thing as secondhand obesity.

A Pew Research Center poll last year found that 74 percent of Americans viewed tobacco companies unfavorably, but only 39 percent viewed fast food companies unfavorably. A Pew survey last week found that more Americans blame obesity, especially their own, on lack of exercise and willpower than on "the kinds of foods marketed at restaurants and grocery stores."

These obstacles don't make the assault on junk food futile. But they do clarify how it will unfold. It will rely on three arguments: First, we should protect kids. Second, fat people are burdening the rest of us. Third, junk food isn't really food.

Targeting kids is a familiar way to impose morals without threatening liberties. You can have a beer or an abortion, but your daughter can't.

The conservative aspect of this argument is that you're entitled, as a parent, to decide what your kids can do or buy. That's the pitch Sen. Tom Harkin, D-Iowa, made last week in a bill to crack down on junk food in schools. The liberal half of the argument is that kids are too young to make informed choices. In this case, it's true. Studies show that little kids ask for products they see on television, fail to distinguish ads from programs, and are heavily targeted by companies peddling candy, fast food and sugared cereal.

This stage of the fat war will be a rout. In schools, the audience is young and captive, and the facts are appalling. According to a government report, 75 percent of high schools, 65 percent of middle schools and 30 percent of elementary schools have contracts with "beverage" - i.e., soda - companies. The sodas are commonly sold through vending machines. The contracts stipulate how many thousands of cases each district has to buy, and they offer schools a bigger cut of the profits from soda than from juice or water.

Soda companies, realizing they're going to lose this fight, are fleeing elementary schools and arguing that high-schoolers are old enough to choose. But health advocates refuse to draw such a line. They're not going to stop at kids.

To keep junk food away from adults, fat fighters will have to explain why obesity is the government's business.

Some say the government created the problem by subsidizing sugar, cream, high-fructose corn syrup and other crud. Harkin reasons that the government pays for school lunches and must protect this "investment." But the main argument is that obesity inflates health care costs and hurts the economy through disability and lost productivity.

A few weeks ago, former President Bill Clinton, a confessed overeater, told the nation's governors that obesity has caused more than a quarter of the rise in health care costs since 1987 and threatens our economic competitiveness. It's not our dependence on foreign oil that's killing us. It's our dependence on vegetable oil.

If the fat fighters win that argument, they'll reach the final obstacle: the sanctity of food. Food is a basic need and a human right. Marlboros won't keep you alive on a desert island, but Fritos will. To lower junk food to the level of cigarettes, its opponents must convince you that it isn't really food.

They're certainly trying. Soda isn't sustenance, they argue; it's "liquid candy." Crackers aren't baked; they're "engineered," like illegal drugs, to addict people. Last year, New York City's health commissioner asked restaurants to stop using trans fats, which he likened to asbestos. But he ignored saturated fats, which are equally bad and more pervasive. Why are trans fats an easier whipping-cream boy? Because they're mostly artificial.

This, I suspect, is where the war will end. Ban all the creepy-soft processed cookies you want to, but respect nature and nutrition. New York City is purging whole milk from its schools, despite the fact that milk has steadily lost market share to soda during the obesity surge. A fact sheet from Harkin implies that schools should treat milk, french fries and pizza like soda, jelly beans and gum.

Come on. How many people died in the Irish jelly bean famine? How many babies have nursed on 7-Up? How many food groups does gum share with pizza? If you can't tell the difference, don't tell us what to eat.

William Saletan covers science and technology for Slate, the online magazine at www.slate.com. He wrote this for The Washington Post.