“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…

“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.”

“In an editorial, the Journal pointed out that the first lady’s efforts to date are in keeping with what Palin herself has supported in the past.

“‘Health-care reform on an individual basis is often just this simple: we could save a lot of money and a lot of grief by making smarter choices,’ Palin said in her 2009 State of the State address, according to the Journal. ‘It starts by ending destructive habits and beginning healthy habits in eating and exercise.

“‘Mrs. Obama’s campaign is grounded in similar sentiments, and in that sense is unusual for this White House in emphasizing personal responsibility,’ the editorial continues. ‘Mrs. Palin would be more effective if she made some distinctions among the Obama policies that really are worth opposing.'”

“America’s national perspective on obesity is marred by two principal misunderstandings – one evident in Palin’s flippant treatment of the epidemic, and the other apparent in Obama’s misdirected policy agenda.

“First, and cardinally, obesity is a slow epidemic, and therefore does not elicit the same sense of urgency as less deadly, but more rapid-acting epidemics, such as the H1N1 flu epidemic (which only killed 4% as many Americans as obesity did in 2009). Second, while exposure to other diseases seems independent of individual choices, obesity appears to be completely dependent on individual lifestyle choices. This is untrue. Convincing epidemiological research demonstrates that factors beyond individual behaviour – factors such as race, poverty, neighbourhood, national region and even personal contacts – can influence obesity risk by influencing access to healthy foods and opportunities for physical activity, and cultures of diet and exercise. So, obesity is more complex than the simple choice to go for a walk or to ‘eat dessert’…

“To her credit, Obama has attempted to tackle the issue in a non-partisan manner – in fact, the Healthy, Hunger-Free Kids Act of 2010, legislation endorsed by the first lady, passed in the Senate by unanimous assent. However, a major flaw of the “Let’s Move” agenda is that it primarily addresses individual behaviours, largely neglecting the structural factors that are so important in shaping them.”

“[G]iven how much sugary drinks contribute to obesity and, therefore, impose costs on society that their prices don’t reflect, modest soda taxes aren’t a bad idea, either. Something like a cent and ounce, which a group of doctors, researchers and policy advocates proposed last year in the New England Journal of Medicine.

“Every time I write something like this, one of my colleagues pulls me aside and reminds me, “But McDonalds fries are delicious. Every now and then, I need a few.’ True. So don’t ban them, or dessert or sugary drinks. But don’t expect everyone else to help you pay for them.

“You may not feel it, but if you pay taxes, you’re subsidizing others’ unhealthy lifestyles every day, either through direct subsidy of their ingredients or through higher medical bills, the costs of which are often socialized. These policies aren’t about making bad-for-you foods unnaturally expensive. Sugary drink taxes and other such things are about not making pancreas-busting foods deceptively cheap.”