Politics & Policy

Poor and Fat

A special problem in America.

From the February 10, 2003, issue of National Review.

When Bush budget officials recently reviewed the federal government’s spending habits, they realized they weren’t the only ones looking to trim some fat. Federal agencies, concerned with our eating habits, were proposing a host of initiatives aimed at fighting obesity; clearly, it isn’t just the federal budget that needs a diet. About 60 percent of Americans are overweight, to such an extent that they risk health problems; 20 percent of us are obese; and 5 million Americans meet the criteria for being identified as morbidly so. With rates of excess weight and obesity highest among low-income households, budget officials should be asking themselves why tens of billions of dollars are being spent each year by federal nutrition programs aimed at boosting food consumption by the poor.

That’s the question Douglas Besharov of the American Enterprise Institute posed in a recent paper, “We’re Feeding the Poor as if They’re Starving.” He examines the three major nutrition programs run by the Department of Agriculture and concludes that they are badly in need of modernization to meet the current need for less food consumption by large numbers of large low-income Americans.

The government spends about $35 billion a year on feeding the poor. The evidence that the rate of hunger in America is very small, while health experts now see the rate of obesity as an epidemic, prompted then-agriculture secretary Dan Glickman to say during the Clinton administration: “The simple fact is that more people die in the United States of too much food than of too little, and the habits that lead to this epidemic become ingrained at an early age.” In his slim but alarming new book, Fat Land, Greg Critser declares, “Today Americans are the fattest people on the face of the earth (save for the inhabitants of a few South Sea islands).”

Critser explains that children are most at risk for obesity, with 25 percent of all children under the age of 19 overweight or obese, a rate double that of 30 years ago. The author cites a recent RAND/University of Chicago study, which found that “more Americans are obese than smoke, use illegal drugs, or suffer from ailments unrelated to obesity.” He assigns part of the blame to fast-food outlets, arguing that they have super-sized us by super-sizing their portions.

In examining the effects of the government’s nutrition programs on food consumption, Besharov begins with the biggest. The federal food-stamp program was designed to ensure that the poor don’t spend money budgeted for food on other things; it now provides benefits to about 20 million people a month. (It was also designed to benefit farmers, by subsidizing the purchase of excess commodities.) According to Robert Rector of the Heritage Foundation, half of all food-stamp spending goes to individuals who receive benefits for over eight years. Government studies show that the program raises calorie consumption by as much as 10 percent. Since the coupons can’t be spent on anything else, recipients wind up buying more food than they otherwise would. Turning the program into an unconditional cash grant would permit low-income families to make their own decisions about how much to spend on food. But, despite President Bush’s recent declaration that “people on welfare are not charges of the state,” the federal government — through the food-stamp program — remains intent on influencing their eating habits.

The federal government’s school-based nutrition programs are responsible for a different kind of over-consumption. Federal regulations on the mandated caloric content of school meals date back to 1946, and were designed in response to studies of G.I.’s that alarmed officials about the incidence of youth malnutrition. Now, obesity is a far more prevalent problem among young people, but the feds still demand that school breakfast programs, which serve 8 million kids, provide 25 percent of the Recommended Dietary Allowance of calories, and that lunch provide fully a third of the daily allowance. For children who eat both meals at school, only 42 percent of the amount of calories they should have each day are left for snacks and dinner. Besharov notes that the 28 million school lunches served daily also typically exceed the standard for fat content, owing to portion sizes and poor preparation. He concludes that while fattening school meals might have made sense many years ago, with the federal government now providing other kinds of food assistance too, school meals should be simpler and smaller. “If a turkey sandwich with lettuce and tomato is good enough for me, why not for a school kid?” he asks.

In his analysis of how the federal government is contributing to the fat of the land, Besharov finally turns his attention to the third large food-assistance program run by Washington; this program too operates as though no other food program existed. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was started in 1972 as a modest two-year pilot program, and now provides monthly food packages to more than 7 million women and children. A Bush budget official allows that the program’s enrollment of half of all newborns, because they are allegedly at “nutritional risk,” is a “shocking statistic.” In addition to the controversy over the high-calorie, high-cholesterol monthly packages provided for one- to four-year-olds, WIC’s provision of baby formula is also criticized: About 50 percent of all the infant formula bought in the U.S. is purchased with WIC dollars, and this may discourage breast-feeding by low-income mothers.

A review of the studies of the WIC program’s nutritional benefits led Besharov to conclude: “The evidence about the effectiveness of almost 90 percent of the WIC program is limited and suggests only small to modest effects.” In this year’s budget, the Bush administration is launching a new WIC initiative aimed at boosting its effectiveness — at reducing obesity. Nutritional counseling is already part of the WIC program, and another $5 million will be spent on demonstration projects to test whether the program can teach pregnant women and mothers about good eating habits and the dangers of being overweight.

The clear and expensive dangers are highlighted in Critser’s book. As one example, the author points to the striking increase in the incidence among children of type 2 diabetes, a chronic and potentially crippling disease. As recently as ten years ago, most pediatric-diabetes centers reported only 2 to 4 percent of their patients as suffering from type 2. Two years later, type 2 diabetes represented 16 percent of their cases, and in some parts of the country the incidence is now approaching about half. The American Medical Association estimates that 280,000 Americans die prematurely each year owing to obesity-related illnesses. The care and treatment of diabetes cost about $100 billion a year, and the majority of new cases are blamed on obesity. One in every four Medicare dollars is spent on treating diabetes.

With the problem of obesity becoming, well, too big to ignore, why does the government remain bent on boosting the amount of food its beneficiaries eat? Both Doug Besharov and Robert Rector finger liberal advocacy groups for thwarting reform. Despite the clear evidence that hunger in America is largely a relic of the past, there are a host of advocacy outfits in the business of hyping hunger. And it is a business. ConAgra Foods, “North America’s second-largest food company,” runs one of the campaigns devoted to exaggerating the incidence of child hunger. These groups all rely on a Department of Agriculture survey that measures something called “food insecurity” — a “meaningless” category, according to Rector. A full 10.7 percent of all U.S. households were labeled “food insecure” in 2001. Another survey, which Rector credits as a “pretty reasonable measure,” found that only 3.3 percent of households experienced hunger in 2001; Rector says hunger is “declining rapidly and significantly.”

Forty years ago, liberal poverty warriors argued that chronic malnutrition needed a federal cure. When it became hard to find poverty-related malnutrition, widespread hunger had to be addressed. Now, with the incidence of hunger in America real, but small and declining, “food insecurity” is the battle cry — but there has been no decrease in the liberals’ state of alarm. And they have allies in high places. When I asked a Bush administration official at the Department of Agriculture about the government’s persistent efforts to address what appeared to be a non-problem, I was told that there are “13.6 million hungry children” in America — which is the “food insecure” category hyped by the liberal groups funded by the food outfits. But the department’s own estimate is that 0.6 percent of American children experience hunger — a rate that has been cut in half over the past five years, concurrent with welfare reform.

The “hunger crisis” has plainly been overtaken by an obesity crisis. Why is the Bush administration sounding an alarm about the growing incidence of obesity, while still decrying widespread hunger in America and force-feeding America’s poor?

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