Why we may never solve the obesity crisis

Ezra Klein shares a story that is all too true for many of us. When we are eating out, we have no clue what the fat or calorie content is of the dishes on the menu. Not only that, the dishes that sound like good choices may turn out to be the worst ones. He writes (about the Cheesecake Factory menu):

On first glance, I would have figure the salmon for the lightest entree, followed by the chicken piccata, the carbonara, and the crispy beef. Not so. The salmon weighs in at 1,673 calories -- which is to say, a bit more than 75 percent of the food an adult male should eat in a day. The piccata is a comparably slim 1,385 calories. The crispy beef is 1,528 calories. And the carbonara? 2,191. The answer might be that someone looking for a healthful meal shouldn't go to the Cheesecake Factory. But insofar as you're already there, or your family wants to go there, making a good decision isn't a particularly straightforward proposition.

The problem here is threefold. Cheesecake creates their dishes with the intention of maximizing taste. And fat, sugar, and calories taste GOOD!! This is America and we have the right to eat whatever we want, even if it blows up our waistline (and our healthcare bills). So I would not want any regulations that prevent Cheesecake from serving up these dishes. But the other two problems are more worthy of attention.

First, if anyone wants to make a more healthful choice, they should have the information to do so. Again, this is America and we have that right. So either the descriptions need to give eaters a better idea of what’s in the dish or we need to require nutritional information on the menu (like several cities are already starting to do). You are free to ignore it if you want to, but it should be there for people who want it, or especially for people who need it for health reasons (diabetics, medically obese, etc).

Second, the costs of treating obesity-related disease is often covered by other people, either through Medicare/Medicaid or through shared insurance risk pools. If we have a new “public option” in the Obama plan, that would increase shared costs even further. I am OK if you want to overeat and get obese, but don’t make ME pay for the resulting medical care. Some company health plans are starting to offer discounts for people who are fit. But we need a way to make this more systematic to make it societally acceptable.

In essence, it comes down to what it always comes down to. We should have the freedom to make bad choices if we want to (smoking, eating, etc). But this freedom is taken away from us if we don’t have the information we need to evaluate the costs and benefits of our choices. We deserve both kinds of freedom.

And as soon as there are externalities (shared health costs, second hand smoke) on other people, we are infringing on THEIR rights. So we need mechanisms to either eliminate the externality or a payment system that compensates for it.