clear
Thursday, 29 July 2021
Obesity, Responsibility, and Freedom
Share
clear

by Theodore Dalrymple

There is another pandemic that, in the long run, may be more harmful to the health of humanity than that of COVID-19. It will ultimately cause the loss of many more years of human life, if it does not already do so.

Whether pandemic is quite the right word for it might be disputed. I am referring to the vast increase in obesity in most parts of the world in recent decades. The word pandemic suggests illness, but is obesity in itself an illness? That it causes illness, no one will dispute: but many things cause illnesses without being themselves illnesses.

Increasingly, however, medical journals write of obesity, as they do of addiction, as if it were in the same category as, say, multiple sclerosis or Parkinson’s disease, that is to say an unfortunate mischance. There is now, after all, surgery for obesity which works; drug companies research drugs to reduce obesity from which, if found, they will make fat profits, if I may be allowed a slight pun.

On the other hand, most people think, with varying degrees of reticence to express their thoughts in public, that obesity is the consequence of weakness of will. Greed is not illness but a sin, or at least a moral failure. We are fat because we give into temptation, that which Oscar Wilde said was the only thing that he could not resist.

 

The British government is thinking of paying people, bribing them in effect, to buy and eat healthier, less fattening foods. It will reward them financially for their weight loss or for the choices they make in supermarkets. This, of course, flies in the face of the illness concept of obesity: not even a British government would think of paying patients with hypothyroidism to produce more thyroid hormone from their own glands.

There is no doubt that obesity is a problem in Britain, where it is more prevalent than in most countries. This clearly results from the eating habits of the population, now inculcated early in childhood. Not long ago, for example, I witness in a baker’s shop in my small town a fat and slatternly mother force a cake on her three-year-old child, who was slightly overweight but not yet fat.

The child had not asked for a cake, nor did he want it when presented with it, but the mother insisted that he eat it as if it were his duty to do so, as once children were told to eat up their greens. She was like an evangelist for obesity, and it is amusing to note how often fat people have fat dogs. Botero, the Colombian painter, was not just an artist, but a prophet.

The proposal to pay people according to their behavior (made possible by information technology) is a sinister extension of state power, but there is no denying that it has a certain logic.

Where people surrender their right to choose how to meet their medical needs, and hand over responsibility to the state (or for that matter, any third-party payer), it is hardly surprising that they will before long surrender their right to choose how they behave.

If someone else pays for the consequences of your actions, it is only natural that, one day, he will demand to control your actions. After all, freedom without responsibility creates an unjust burden on others.

Why should I pay, either through taxation or insurance premiums, for the consequences of the choices of others, when the proposal to bribe them into better choices is a recognition that their choices are under conscious control? (Such bribery has been tried in the cases of alcoholism and addiction to heroin, and work to an extent.)

It is easy to see what the justification for such bribery would be. If it works, it may produce savings to the state greater than its cost. (I leave aside the health benefits to the successfully bribed.)

This, of course, assumes that the state, or some third-party payer, must bear the medical costs of treating the consequences of eating too much, especially of the wrong things. It also assumes that utilitarian calculation is the be-all and end-all of ethics. If it works, it is good; if it doesn’t, it is bad.

The problem for libertarians is that it is very difficult to ensure that individuals bear the entire semi-predictable costs of their conduct (not every obese person becomes expensively ill as a consequence of his obesity). Given the enormous costs of medical treatment, which third-party payment inflates, some system of such payment is inevitable.

Either the insurance disregards the conduct of the insured, which is unjust towards those who behave responsibly, or it gives the insurer, state or private, the locus standi to interfere endlessly in the most intimate aspects of the lives of the insured.

Most of us are probably willing to bear some costs of predictably dangerous behavior, for example that of mountaineers. The additional costs are trivial, and therefore not worth bothering about either for the sake of a reduction of costs or of philosophical consistency; but it has been estimated that the additional cost of treating disease caused by obesity in Britain amounts to $150 per head per annum, that is to say $600 for a family of four.

And, of course, the burden of taxation (which in Britain pays for most health care) falls unevenly on the population, the obese being, statistically, in the class that pays the least. Many families must pay $3000 or more, which equates to $5000 of gross income, to pay to treat the obese.

But no civilized country could possibly refuse treatment of the obese merely because they had eaten their way to ill-health and were therefore the authors of their own misfortunes. Thus we are faced by a stark choice: either pay up or allow the government to supervise and interfere in the smallest detail of our lives.

The former is probably the better choice in the circumstances, albeit that taxation is a form of interference. The best would be if people behaved responsibly, and they would be encouraged to do so if they bore the costs of their behavior: but that is not possible.

What is needed, then, to reconcile freedom of choice with sensible conduct, is a kind of mass religious revival with diet as its object. Naturally, I proceed on the assumption that it is best for people not to be obese, but the obese may think differently.

First published in the Epoch Times.

clear
Posted on 07/29/2021 5:42 AM by Theodore Dalrymple
Comments
29 Jul 2021
Roland
In libertarian America, you can't tell people to mask up indoors, get vaccinated or eat less sweets, without getting a violent reaction. Libertarianism encourages anti-social behavior

29 Jul 2021
Lou the cheap beer sommelier
I think "slatternly" is going to be my favorite word this week. Dr Dalrymple has apparently not been paying attention to the cultural advances in the United States that now help us all here to identify a chunked-out fat slob as "body positive." The "beauty" magazines are helping us to understand all of this better by publishing photographs of slatternly people in swimwear with excesses of text explaining about the beauties and benefits of "body positivity." We're all very inclusive and exceptionally tolerant in the United States now except when we discriminate against others because of the particular identity group(s) they are in. We're learning as rapidly as we can here and perhaps it would be better to follow the UK model and bribe body positive people to chow down less than they do. But where is the benefit in chowing down less when the negativity around being a fatty is now "body positivity?" For us troubled Americans there are no incentives at all to chuck the potato chips, twinkies, and fatty hamburgers and high calorie ice cream treats because the more slatternly and chunked out we get the more positive and beautiful we become.

29 Jul 2021
HRH
Roland is a moron. Libertarianism would work except that there are people just like Roland.

30 Jul 2021
Andy Riley
A solution in some cases is to tax those products that cause illness such as obesity at a level where the excess societal costs of treatment are covered.

30 Jul 2021
Send an emailHoward Nelson
Simple tough love solution to our fat-chance takers: Redirect all government taxes applied to fat ill-health problems to aid for those starving, drought-suffering, severely ill-housed and ill-educated (for self-support). This redirection of funds to occur asap after a 60-day warning to all fatheads of the cutoff of fat favoritism. // Fat control is a simple arithmetic (some call it mathematic) problem, viz., reduced wasteful food caloric intake, reduced body fat production. // Lost fat, if found, with a wick, may serve to romantically illuminate candle-lit dinners. Hopefully, the dinner will be better prepared than this paragraph’s penultimate sentence.


Order on Amazon or Amazon UK today!


Order on Amazon or Amazon UK today!


Order on Amazon or Amazon UK today!

Subscribe

Categories

Adam Selene (2) A.J. Caschetta (7) Ahnaf Kalam (2) Alexander Murinson (1) Andrew E. Harrod (2) Andrew Harrod (5) Anne-Christine Hoff (1) Bat Ye'or (6) Bill Corden (6) Bradley Betters (1) Brex I Teer (9) Brian of London (32) Bruce Bawer (22) Carol Sebastian (1) Christina McIntosh (869) Christopher DeGroot (2) Conrad Black (752) Daniel Mallock (5) David Ashton (1) David J. Baldovin (3) David P. Gontar (7) David Solway (78) David Wemyss (1) Devdutta Maji (1) Dexter Van Zile (75) Donald J. Trump (1) Dr. Michael Welner (3) E. B Samuel (1) Elisabeth Sabaditsch-Wolff (1) Emmet Scott (1) Eric Rozenman (13) Esmerelda Weatherwax (10098) Fergus Downie (23) Fred Leder (1) Friedrich Hansen (7) G. Murphy Donovan (77) G. Tod Slone (1) Gary Fouse (182) Geert Wilders (13) Geoffrey Botkin (1) Geoffrey Clarfield (346) George Rojas (1) Hannah Rubenstein (3) Hesham Shehab and Anne-Christine Hoff (1) Hossein Khorram (2) Howard Rotberg (31) Hugh Fitzgerald (21503) Ibn Warraq (10) Ilana Freedman (2) James Como (25) James Robbins (1) James Stevens Curl (2) Janet Charlesworth (1) Janice Fiamengo (4) jeffrey burghauser (2) Jenna Wright (1) Jerry Gordon (2522) Jerry Gordon and Lt. Gen. Abakar M. Abdallah (4) Jesse Sandoval (1) John Constantine (122) John Hajjar (6) John M. Joyce (394) John Rossomando (1) Jonathan Ferguson (1) Jonathan Hausman (4) Jordan Cope (1) Joseph S. Spoerl (10) Kenneth Francis (2) Kenneth Hanson (1) Kenneth Lasson (1) Kenneth Timmerman (29) Lawrence Eubank (1) Lev Tsitrin (22) Lorna Salzman (9) Louis Rene Beres (37) Manda Zand Ervin (3) Marc Epstein (9) Mark Anthony Signorelli (11) Mark Durie (7) Mark Zaslav (1) Martha Shelley (1) Mary Jackson (5065) Matthew Hausman (50) Matthew Stewart (2) Michael Curtis (783) Michael Rechtenwald (61) Mordechai Nisan (2) Moshe Dann (1) NER (2594) New English Review Press (133) Nidra Poller (73) Nikos A. Salingaros (1) Nonie Darwish (10) Norman Berdichevsky (86) Paul Oakley (1) Paul Weston (5) Paula Boddington (1) Peter McGregor (1) Peter McLoughlin (1) Philip Blake (1) Phyllis Chesler (232) Rebecca Bynum (7246) Reg Green (30) Richard Butrick (24) Richard Kostelanetz (18) Richard L. Benkin (21) Richard L. Cravatts (7) Richard L. Rubenstein (44) Robert Harris (85) Sally Ross (36) Sam Bluefarb (1) Sam Westrop (2) Samuel Chamberlain (2) Sha’i ben-Tekoa (1) Springtime for Snowflakes (4) Stacey McKenna (1) Stephen Schecter (1) Steve Hecht (34) Sumner Park (1) Ted Belman (8) The Law (90) Theodore Dalrymple (975) Thomas J. Scheff (6) Thomas Ország-Land (3) Tom Harb (4) Tyler Curtis (1) Walid Phares (33) Winfield Myers (1) z - all below inactive (7) z - Ares Demertzis (2) z - Andrew Bostom (74) z - Andy McCarthy (536) z - Artemis Gordon Glidden (881) z - DL Adams (21) z - John Derbyshire (1013) z - Marisol Seibold (26) z - Mark Butterworth (49) z- Robert Bove (1189) zz - Ali Sina (2)
clear
Site Archive