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October 15, 2012 | by  | in Opinion | [ssba]

C.R.E.A.M. – Cash Rules Everything Around Me

Let us be fat

This is me coming out. Three weeks ago, I realised I had changed. It had been gradual, predictable and, in hindsight, I should have seen it coming. Yet I was shocked when I stepped onto my grandparents’ scales and read ‘90.0 kg’. With a body-mass index of 25, I am now technically overweight.

I am not meant to like being fat. I am supposed to accept the overwhelming societal message that my life choices are irrational, lazy and wrong. Fat positivism is the idea that they are none of those things, and this column is in its defense. The ‘war on fat’ at first sounds inoffensive. Our society is chronically unhealthy; two million kiwis are overweight or obese; urgent action is apparently needed. ‘Harm-minimisation’ is the dominant public health paradigm, and its evidence-based approach is commendable. Yet beneath the rhetoric lies a patronising paternalism that should offend us all. By focussing only upon our actions’ harms and ignoring their benefits, harm-minimisation parodies our decision-making. It should not be allowed to capture the public health debate.

I confess: I often buy the $3.50 Large Chips from Illot Cafe. Maybe I need the pick-me-up. Maybe I see an all-nighter looming ahead. Maybe I can’t afford a $10 Wishbone sandwich. These decisions are not and should not be fetishisations of long-term health consequences; they are deliberate evaluations of that which is important for me. I know that these chips aren’t the healthiest thing in the world, and I know my lifestyle isn’t either, but for me these decisions make sense.

This is where economic theory differs from harm-minimisation: instead of assuming that all bads should be avoided, we start out with the basic understanding that, most of the time, people are doing what they think makes sense. If people are hurting their own health, then they may well have a good reason to be doing so. That ‘people are rational’ is often ridiculed as right-wing dogma, but it is not. Whatever your ideology, the idea that our choices determine the validity of our actions is an idea worth embracing.

And no, screeching ‘imperfect information’ or ‘externalities’ in not intellectually rigorous. Sure, I haven’t gone through med school, but I’m perfectly aware of the health consequences of my weight—I just think there are things that matter more. And yes, my health could cost the rest of society, but it probably won’t—most people end up dying one way or another, and those who take a hit sooner actually tend to cost less. Paternalism is paternalism, and it is crude to dress it as anything else.
The public health belligerents are cocking their weapons. Proposals like fat taxes and the outright prohibition of certain foods are patronising, ignoring the value of our choices. While harm-reduction is an idea painted as sympathy, disrespectful sympathy is sympathy that I can do without.


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