Fatwa on Fat

The Surgeon General snoops into private health, again.


The Surgeon General of the United States has hit the American people with a public health bombshell: being too fat can be bad for your health. David Satcher vows that he will launch a campaign against girth equivalent to the one the office launched in 1964 against smoking.

Three hundred thousand Americans a year, he tells us, die because of obesity. Secretary of Health and Human Services Tommy Thompson chimed in with a request that all Americans—as their patriotic duty—lose 10 pounds.

Such proclamations may seem harmless enough. Hey, it's good advice, right? It has been said that, after 9/11, the days of government bashing

are over. In the face of implacable external (and possibly internal) enemies to our safety and security, we all should recognize the vital importance of the federal government.

But it is in the context of the Afghan War that the Surgeon General's Fat War seems almost tailor-made to remind us why criticism of the government never goes out of style.

Satcher's new campaign is a huge blinking neon sign of how government agencies overstep any conceivably legitimate authority in search of new excuses to live. The Surgeon General's office, if it has any purpose at all, should be dedicated to issues that actually concern public health—like infectious diseases that spread unbidden to people. Like, just for example, anthrax.

Obesity, like smoking, no matter how many people die from it, is overwhelmingly a matter of private health. It is a personal problem for specific individuals with no particular public policy implications. Why is it the government's concern?

Taxpayer-funded agencies should think twice about spending Americans' money to lecture us about our chosen behavior—especially one like overeating, whose unpleasant side effects are so universally understood.

The endless stream of popular diet books makes one wonder how the Surgeon General could possibly think we need him to tell us we could stand to lose a few pounds.

What the Surgeon General misses is that obesity is not a disease–not something caused by an outside pathogen or injury whose bad consequences are then unavoidable without expert medical treatment.

Obesity is a condition. It is caused by freely chosen behavior. Certainly, some real diseases, like sexually transmitted ones, are usually obtained by chosen behaviors as well. But they involve pathogens that then do their thing no matter what we want or choose. People can "cure" themselves of obesity any time by universally understood mechanisms: eating less and exercising more. Why spend tax money on a campaign against it?

Campaigns like the Surgeon General's are not harmless, even beyond the question of public funds being wasted on unnecessary purposes. By declaring conditions caused by–and reversible by–freely chosen behaviors to be "diseases," the Surgeon General damages the vital concept of individual responsibility. He helps fosters a positively unhealthy culture where people blame outside forces and phony "diseases"

for their own choices. And extending the discipline of "public health"—with the extensions of government power that go with it– over personal pleasures or vices like smoking and overeating is a dangerous precedent.

People warned that the government's war on tobacco launched it on a slippery slope. So far the Surgeon General is just talking about education on the perils of poundage. But that's how the tobacco wars started.

They ended in massive legislation, smoking bans, new taxes, and huge lawsuits. Satcher appears set to launch us down that same slope when it comes to our eating habits. Americans should tell him that we can certainly decide for ourselves how much we want to eat and exercise.

In the season of anthrax, government health officials have more important things to worry about.