Re "Revised Policy Treats Obesity Under Medicare," July 16, and "Big Fat Mistake About Your Body," an Opinion article by Paul F. Campos on July 4: As a physician working with many overweight and obese patients, I felt compelled to offer my two cents on the oft-cited Washington, D.C.-based Cato Institute position, which suggests that Americans who make healthy lifestyle decisions will now be subsidizing those who do not. This view also reflects law professor Campos' refrain about our scientifically unfounded sociocultural preoccupation with weight and body image.
Both commonly held positions fail to appreciate the significant difference between the overweight but essentially healthy Americans who struggle with an extra 10 or 15 pounds and may indeed be preoccupied with appearance, as Campos suggests, and the important group of obese, morbidly obese and "super obese" individuals who are unable to improve their health simply by reducing caloric input and increasing energy output.
