The Corner

Health Care

Wrong on Obesity

(Rick Wilking/Reuters)

There is a new weight-loss app for children ages 8–17, called “Kurbo,” by Weight Watchers. It purports to help children who struggle with their weight choose healthier foods and better manage their portion sizes. The app was developed at Stanford University with the aid of 30 years of research and lists several success stories on its website. It seems innocuous enough.

Which is why an article about the app from a CNN contributor last weekend titled “A weight-loss app for kids sends the wrong message,” puzzled me. The author acknowledges that we have dangerously high levels of childhood obesity in the United States, a problem that might be allayed, in some small way, by this app. But the author takes issue with the app’s premise, which is at fundamental odds with her view of obesity as something rather like a contagion that befalls people out of the blue, like the bubonic plague or swine flu. Obesity, the author says, has “social and economic roots which run far deeper than individual lifestyle choices. The privilege individuals have to change their lifestyle — be that buying or preparing different foods, or spending time on exercise, varies hugely, and depends a great deal on their social background, wealth status and where they live.”

But the difference in daily expense between the groups with the healthiest and unhealthiest diets is somewhere around $1.50, according to a literature review on the subject. That isn’t an insignificant sum to people who exist around the poverty line, but neither is it a Goliath figure. Stanford analysts with the National Bureau of Economic Research, meanwhile, found the “price” and “access” arguments wanting as causal factors in nutrition disparities, noting that “exposing low-income households to the same availability and prices experienced by high-income households reduces nutritional inequality by only 9%, while the remaining 91% is driven by differences in demand. These findings contrast with discussions of nutritional inequality that emphasize supply-side factors such as food deserts.”

This is not to suggest such outcomes aren’t worrisome unto themselves, but it is to say that focusing on “access” and “privilege,” as the CNN author does, is really to do an end-run around the issue. As Alex Tabarrok of Marginal Revolution argues, the reasons why “the poor choose to eat differently than the rich is an interesting and important question but one more amenable to answers focusing on culture, education and history than price and income.”

Later, in a particularly bizarre section, the author claims that having “a higher weight doesn’t automatically connote ill-health.” Being a lifelong smoker doesn’t “automatically connote ill-health” either, but how often are anecdotal counterfactuals dragged out when we talk about the health effects of tobacco? Never. But being overweight or obese is associated with a wide array of health problems. That the author would remark upon the existence of an anomalous overweight individual in good health is puzzling — what is the point other than to obscure the real and substantial health risks associated with obesity?

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