Overheard: Whose fault is obesity?

This post is part of the Overheard on CNN.com series, a regular feature that examines interesting comments and thought-provoking conversations posted by the community.

Obesity is a huge problem in the United States, and it’s linked to serious illnesses such as diabetes, stroke, heart disease and certain cancers.

A new report suggests that by 2030 nearly half of all Americans will be obese, and these expanding waistlines will translate into billions of dollars of health care costs. The study authors advocate for nationwide interventions to get children and adults to be more physically active and eat healthier.

More than 400 readers commented on the story. The most popular reader comment came from Joe Skinner, who says:

This is something I've been saying forever, the problem isn't "Romneycare" or "Obamacare," it's fat Americans who are the problem and they are more willing to blame politicians for health care cost problems than to say the 300-pound reading on the scale might have something to do with it.

Bruce Force responded that weight loss alone won’t solve the problem:

I agree that we are responsible for our own health but I think this obsession with losing weight is the wrong way to go about it. When we talk about fitness, we never talk about skills and that's unfortunate because that what being fit is about: developing skills in order to survive.

Chichetr proposed the radical measure of taxing overweight people per pound, a comment that got 59 “likes” :

I'm sick and tired of seeing my fellow Americans waddling around from fast food restaurant to fast food restaurant, their giant bellies swaying and bulging out under their shirts. It's absolutely shameful.

I propose that we start charging health care costs by the pound. How many of these people do you think are going to keel over from 1, 2 or 3 heart attacks, strokes, cardiovascular disorders of every kind? The list goes on and on. How many of these people can actually PAY for the tremendous health care costs associated with their weight? Not many.
I as a taxpayer, I refuse to pay for these people. Tax the overweight and obese NOW!

But pgauthi responded with a more pragmatic approach:

Those of us living in the real world realize we can't just let people "take responsibility," because we have decided that everyone has the right to emergency treatment. So as much as it pains me to pay for the lazy obese I would rather pay for their preventive care than for their emergencies.
I would love it though if medicare tax and/or health premiums were based on BMI and cardiovascular fitness.

Delishus Cake represented the point of view that the high cost of healthy foods compared to fattening foods is part of the problem:

If fresh fruit was affordable year round and a salad didn't cost the same as 4 double cheeseburgers people might not be so fat. Low income people typically choose whichever option looks to be the most bang for your buck. If you've got $4 and you want to eat are you going to buy a salad or 2 double cheeseburgers, a large coke, and a fry?

But halfthestory argues the opposite viewpoint:

So tired of hearing the "it costs too much to eat healthy" argument. Plan your budget and buy healthier foods ... fast food is not much cheaper and is much less healthier. It's a lifestyle change and not a financial issue in most cases. It's just easier to justify when you say "it costs too much".

Chemical BPA linked to children's obesity

Finally, the usage of body mass index as a measure of obesity is imperfect, as readers such as CatMagnet noted. Height and weight are the factors that go into calculating BMI, but for some people that is not an accurate assessment of whether they are healthy.

On Twitter, science writer @miriamgordon responded to the story by citing this New York Times article from Tuesday, which notes that obesity as we know it may not be the whole story: “In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments.”

Part of the problem is that if you measure obesity with body mass index, you are ignoring other potentially critical measurements of health, including metabolic abnormalities, lean muscle mass and body fat, the article said.

Another science writer, @daviddespain, responded with an article he had written on his blog suggesting that young Asian-American women may be improperly categorized as healthy using the traditional BMI scale; they may have low BMI but high body fat percentage.

The state-by-state obesity data from the Centers for Disease Control and Prevention do not take these deviations from the traditional BMI picture into account, nor do the 2030 predictions.