The New Health Dialogue

Shannon Brownlee's recent piece on TIME Ideas is sure to provoke some vehement reactions. Here's her conclusion:

"Maybe it’s time to be at least a little more willing to similarly demonize excess poundage. Our rapidly rising rate of obesity harms us financially, because we pay for health care collectively. Insurance premiums paid by the healthy subsidize the care of the sick. That means we are all paying for the costs of treating obesity and that treatment is one of the things that is helping to send health care spending through the roof. The war on smoking worked because it made smoking shameful and the public health measures needed to fight it permissible. It may take an even tougher approach to combat obesity, beginning with the recognition that it’s bad for all of us."

We definitely see the value of social pressure as a means of changing behavior. Brownlee is right that the social pressures are an important reason why people stopped smoking, and why more people don't start now. UCLA professor Mark Kleiman commented earlier this month on The Reality-Based Community that a similar. more severe transition has happened for any number of other activities. However, it's crucial that such social pressure is directed at behaviors, not at people. Berating fat people and promulgating the idea that the obese are morally inferior is not the goal. Rather, public health advocates should focus on curbing unhealthy behaviors like overeating and inactivity.