Smoking, Overeating, Other Bad Habits, and the Government

The McKinsey Global Institute decided to count the many ways in which the obesity epidemic is believed to be vulnerable to pressure. Some of the methods were instrumental in cutting down tobacco use, although that does not necessarily guarantee that they are adaptable. Here is the scope:

Working in conjunction with policy advisers, population health academics, and individuals from companies, and drawing on an extensive review of research, we have identified 74 intervention levers that are being discussed or piloted around the world. The 74 intervention levers fall broadly into 18 groups.

The 18 groups are:

  1. Active transport
  2. Incentives offered by health-care payors
  3. Healthy meals
  4. Reduction of high-calorie food and drink availability
  5. Calorie and nutritional labeling
  6. Media restrictions
  7. Parental education
  8. Pharmaceuticals
  9. Portion control
  10. Price promotions
  11. Public-health campaigns
  12. Reformulation
  13. School curriculum
  14. Subsidies
  15. Taxes and prices
  16. Surgery
  17. Urban environment
  18. Weight-management programs
  19. Workplace wellness

A lot of things need to be done, with limited resources. Of all proposed social engineering schemes, most are never funded. Somebody has to perform triage to separate the viable ideas from the ones that don’t seem to have a chance. No matter what the bureaucrats do, a faction of the public will be mad at them.

Don’t tread on my coiled tape measure

Americans are particularly touchy about some areas of life. A morbidly obese person might wish he could be on “The Biggest Loser” TV show. Or she may not want to discuss her weight with anyone. The point being, nobody wants to be forced into taking either of those courses. What some call intervention, others call interference.

Like it or not, government is capable of either supporting or quashing activity. But as we have seen, not everything that can be done, should be done. The government, although professedly well-meaning, is in the compulsion business. So, discussions can become contentious.

A good laugh, or maybe cry

On the local, state, and federal levels, governments do a lot of things that touch upon obesity in some way. Here is a small but bizarre example from one state whose House of Delegates set out to pass a clean water bill. The West Virginia Manufacturers Association strongly objected to any tightening of standards. Journalist Erin Beck wrote,

They argue that the EPA encourages states to incorporate state-specific science, and that because West Virginians are heavier, their bodies can handle more pollutants, and that because they drink less water, they are less exposed to the pollutants.

“… because West Virginians are heavier, their bodies can handle more pollutants.” Is that a breathtakingly original brand of stigmatization, or just plain cray-cray? Actually, the excuse seems too preposterous to even require refutation.

But just to satisfy the conventions of journalism, representation for another viewpoint was sought. Environmental health professor and cancer expert Michael McCawley argues that “any amount of a carcinogen can be cancer-causing, and that heavier bodies may already have other problems, like inflammation, that increase risk for cancer.”

This is serious, because if the state passes safer clean water rules, Dow Chemical threatens to pick up and leave, and go poison somebody else’s water.

Your responses and feedback are welcome!

Source: “Overcoming obesity: An initial economic analysis,”, November 2014
Source: “House of Delegates passes bill without updated human health water quality standards,”, 03/05/19
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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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