Monday, December 27, 2010

How did obesity become a partisan fight?

Is Elmo a Kenyan, too? Or maybe a Socialist? He is awfully red, after all.

I ask because the Sesame Street puppet recently visited the White House to support "Let's Move," first lady Michelle Obama's campaign against childhood obesity. And that campaign has become, in one of the more striking political stories of the past year, the latest battleground in the left-right culture wars.

It's never easy for the spouse of a president, who so far has always been a wife, to settle on a signature issue. Choose something trivial, and she'll be accused of frothiness unworthy of strong and independent womanhood. Choose something more controversial, and people immediately demand, "Who elected you?"

In that context, the first lady's campaign would seem to have struck Goldilocks perfection. The obesity epidemic is a genuine public health emergency, with vast implications for the nation's well-being, economy and even national security. And yet, could anyone really be against children eating healthier food and getting more exercise? Could anyone really object to White House assistant chef Sam Kass trying to interest Elmo in a vegetable-laden burrito?

Well, yes, if Michelle Obama is for it, someone will be against it. Someone like Glenn Beck, for example, who was moved to rail against carrot sticks, or Sarah Palin, who warned that Obama wants to deprive us all of dessert.

And when you look a little deeper, it's not surprising that a crusade seemingly beyond questioning would become a political battle. Interests that might feel threatened by Let's Move include the fast-food industry, agribusiness, soft-drink manufacturers, real estate developers (because suburban sprawl is implicated), broadcasters and their advertisers (of sugary cereals and the like), and the oil-and-gas and automotive sectors (because people ought to walk more and drive less).

Throw in connections to the health-care debate (because preventive services will be key to controlling the epidemic), race (because of differential patterns of obesity) and red state-blue state hostilities (the reddest states tend to be the fattest), and it turns out there are few landmines that Michelle Obama didn't trip by asking us all to shed a few pounds.

Insinuations from her critics notwithstanding, Obama has not endorsed nanny-state or controversial remedies such as ending sugar subsidies, imposing soda-pop taxes or zoning McDonald's out of certain neighborhoods. Instead, she is pushing for positive, voluntary change: more recess and physical activity, more playgrounds, more vegetable gardens, fresher food in schools and grocery stores, better education on the issue for parents and children.

All of this makes total sense, and historians will marvel (much as they will at climate-change deniers) that anyone could doubt it. The percentage of American adults who are obese more than doubled in the past 30 years, from 15 percent to 34 percent (with another 34 percent overweight); the share of obese children and teenagers more than tripled, from 5 percent to 17 percent. In fact, the astonishing acceleration of the epidemic (which may now have leveled off) might explain some of the skepticism; it takes a while for awareness to catch up to statistics.

But the statistics are scary. The implications for these children are heartbreaking, literally (obesity is associated with higher incidence of heart disease as well as diabetes) and figuratively. For the nation, it could be bankrupting. Obesity and its attendant ills already may add as much as $147 billion to health-care costs each year, one-tenth of the nation's medical bill, a figure that is certain to rise. And the Army reports that one in four young people is too fat to serve.

That's why obesity is not a Democratic or Republican issue. Obama has merely extended and amplified a campaign that began under President George W. Bush; Bush's last acting surgeon general, Steven K. Galson, made obesity a signature issue, calling it "a national health crisis . . . [that] is driving up healthcare costs and crippling the fabric of our communities."

The crisis won't be solved in one presidential term, either. "We're talking about changing habits that have been formed over generations," Obama has said.

You'll notice, if you watch the White House video, that Elmo never actually eats that red-pepper burrito, though he claims to be enticed. "Where's the sour cream?" he may be thinking. "And no melted cheese?"

"It's not going to be easy," Michelle Obama says. She's right - but also right to keep pushing.
Fred Hiatt Washington Post

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