Food Addiction the Next Focus of Obesity Epipanic

In a study posted online that will appear in the August print issue of Archives of General Psychiatry, researchers used functional magnetic resonance imaging (fMRI) to study the response of 48 healthy young women in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution; and consumption of a chocolate milkshake vs. a tasteless solution.

The women ranged from lean to obese and had been recruited for a healthy weight maintenance trial. Their eating behavior was assessed using a food addiction scale developed by lead author Ashley Gearhardt, a doctoral student at Yale University.

“Similar patterns of neural activation are implicated in addictive-like eating behavior and substance abuse and dependence,” Gearhardt noted in the study.”Food and drug use both result in dopamine release in mesolimbic regions [of the brain] and the degree of release correlates with subjective reward from both food and drug use.”

Gearhardt and colleagues found that participants with higher food addiction scores showed more activity in brain areas linked with craving. “These findings support the theory that compulsive food consumption may be driven in part by an enhanced anticipation of the rewarding properties of food,” the authors write. “Similarly, addicted individuals are more likely to be physiologically, psychologically, and behaviorally reactive to substance-related cues.

The researchers said that if certain foods are addictive for some people, that could explain in part why they find it so hard to lose weight and keep it off.

While researchers have speculated that an addictive process may be involved in obesity, the authors said that this is the first study to identify distinctive neural or brain activity in people with addictive eating behavior.

In addition, Gearhardt said, ”If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts. Ubiquitous food advertising and the availability of inexpensive palatable foods may make it extremely difficult to adhere to healthier food choices because the omnipresent food cues trigger the reward system. (PsychCentral) (emphasis mine)

First, this is clearly a press release — the article doesn’t even come out in print until August. If I know anything about scientific publishing (and I know a little from my day job), it’s obvious that the ink was barely dry on their paper before they released it online, making sure to alert the major channels as soon as they hit “Upoad Article.”

Here’s the link to the online article. Naturally, the full text is behind a paywall. Any of my Fatosphere buds out there got an Athens login?

So this is what we have to go on without even knowing anything about the methodology beyond the statements released by a co-author.

First of all — 48 women. Not a giant sample size. Second — they weren’t all overweight or obese, and they were recruited from a “healthy weight maintenance trial” (if some were obese, and obesity is considered an ‘unhealthy weight,’ then does that imply the obese and possibly overweight women were dieting?) A natural question to ask is if this is going to be another round of ammunition against obese people in the grand moral crusade, how did these addictive responses correlate with BMI? This wasn’t mentioned in the vast majority of statement press-releases (nor in the article quoted above). I dug around and found one person at Consumer Reports who actually read the damn study (shocking, I know, most science ‘journalists’ can’t be bothered to actually read studies), and she said:

The researchers also found that a high score for food addiction didn’t correlate with having a high BMI. You can be lean, but still have an addictive relationship with food. They speculated that this might put lean individuals at an increased risk of future weight gain, unless they can develop behaviors to compensate and keep control of their food addiction. (emphasis mine)

Naturally, BMI isn’t mentioned in 95% of the articles except to implicate this as some factor in the Obesity! Epidemic!

Third — well, where to start. I’ll sketch my ideas, below, my first and later impressions.

First Impressions

As long as they use this study for what it actually shows — that some women out of a tiny sample with higher “food addiction” scores have higher activity in some brain areas linked to reward — and don’t try to generalize to all fat people or fat women, we’re good.

However, it’s unlikely that will happen, given the sensational nature of the science-illiterate press. Also, the co-author herself makes concluding remarks about how this might shape efforts to make people (excuse me, encourage!) lose weight. I.e., change the “current food environment” and restrict “availability of inexpensive palatable foods.”

Well, that’s a funny thing! How would we restrict availability of inexpensive palatable foods? Oh, by levying unpopular food taxes, you say? And you say that if we create a scare, make people afraid of fatty foods by suggesting the foods themselves are dangerous addictive toxins and — horror of horrors! — these are foods readily sought after by especially children and poor people, they might be more in favor of food taxes?

Yeah. Because it’s not like we can just stand by while poor people are actually able to afford energy-dense food, and might even — gasp! — feed it to their children.

Now onto the issue of ‘food addiction’ as an actual phenomenon parallel to addiction to substances like heroin.

When it comes down to it, an “addiction” to food is a silly idea, since it’s not a foreign substance that we can just quit. If someone exhibits higher pleasure or expectations eating food, then it would seem the real root of the issue is why? That ‘why’ is what needs to be discovered and addressed.

Also, food isn’t inherently addictive because there are people who eat loads of fatty, sugary, salty, etc food without experiencing an attachment beyond that being their regular diet. The issue is much more complex than the drug-addiction model, and simplifying it to that point loses precious information about what’s really going on.

I wonder how many of the women who scored high on the “food addiction” scale were former dieters or were currently dieting? I recall items like milkshakes, pizza, etc holding MUCH more fantastic interest when I was dieting (and I’ve heard many, many other dieters talk about this food-fantasy effect, and Keyes did a study years ago that shows it’s a side effect of one’s body experiencing famine). Could it be their wiring is a bit shot, or sensitive, because they’re restricting or have restricted in the past and a bit of their ‘famine’ mindset is still at work?

Final Impressions

This is why a lot of these studies are little more than junk reinforcing cultural biases against fat people or people who overeat. There are so many obvious questions that go unanswered, because all they want to do is generate a quick correlation for a press release. The medical research looking into body size is rife with these kinds of examples.

I took screenshots of a Google News search to prove this thing was an unabashed press release, intended to be — in a very calculated way, mind you — a seminal work in the war against obese people (excuse me, obesity). Some of the article headlines:

  • Heroin vs. Haagan-Dazs: What food addiction looks like in the brain (healthland.time.com)
  • Freakonomics: Another Obesity Explanation: Food Addiction (freakonomics.com)
  • Craving a milkshake? You might be a junk-food addict (Globe and Mail)
  • Can people be addicted to food? (CBS News, 20 hrs ago)
  • Compulsive Eaters May Have ‘Food Addiction,’ Study Finds (BusinessWeek, 14 hrs ago)
  • For Some, Food ‘Addiction’ Similar to Substance Abuse (PsychCentral, 1 hr ago, complete with pic of Sad Addicted Fatty)
  • For Food Junkies, Brains React to Milkshakes Like Drugs (LiveScience.com, April 4, complete with pic of Bad Woman Inhaling Chocolate)
  • ‘Tempting foods as addictive as cocaine’ (Times of India, 11 hrs ago)

What do you think about this study?

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Shaking the Foundations of Conventional Beauty

This morning Kath at Fat Heffalump had yet another brilliant post about the Freedman/Cannold debacle. If you aren’t familiar with the rights of the debacle, they are, in a nutshell:

Freedman says some not-so-nice things about fat people and fatness on Twitter. Specifically, Dr Samantha Thomas broke an ironic screenshot of Freedman saying, “If you have to ask, your bum does look big in that. #rulesforlife”

From anyone else, it’s a shallow, classic trollish tweet that should be promptly ignored and filed away into oblivion like every other immature tweet of its type. But Freedman is 1) a grown woman; 2) a body-image advocate.

But don’t worry! Whenever there’s angry fatties responding to a celebrity troll, there’s a well-meaning journalist buddy to rush in and save the troll, white-knight-style. Cannold, a friend of Freedman, pens this. Besides her shocking tear through the land of logical fallacies and fat hatred, she actually says, in all seriousness, that “it is also the case that being obese or underweight are risk factors for mortality.” So the normal BMI are immortal, now? Forget hounding on fat people, Cannold needs to go back and re-take English Composition 201. It makes me sad that she gets paid to write nonsensical garbage like that, and the more-talented bloggers like Kath construct their careful, well-researched arguments for free!

At any rate, read Kath’s first post on the issue to get a better breakdown, and then her most recent post about fatshion. In short, Cannold claims that fat people dressing up nicely and blogging about it means fat people aren’t allowed to criticize mainstream beauty. No, really. Then she stretches this specious analysis to conclude that since us fat fatties are all just a bunch of clownish hypocrites, we can’t say a damn thing about Freedman’s blatant hypocrisy. So leave her alone, you heavily-makeupped obeses!

Sigh. Right.

Kath courageously turns that argument on its head. She presents fatshion bloggers, their pictures, and their testimonies as to why they blog about fatshion (and, shock, none of it has to do with desperately wanting to be like the popular kids! I mean, thin models). Kath’s post inspired me.

I’ve never showed myself here, besides the mugshot on the sidebar. Well, there was that wedding photo from a while ago, but I scraped that. I was nervous about showing myself — not because I was afraid of being judged, but because I don’t have anything to show in particular and don’t really want my picture being bandied about the internet. But, you know what, fuck it. I’ve blogged about fatshion from time to time, and it’s something that interests me. I love beautiful clothing, and over the years dressing my 6′ 0″ female body at varying weights has been a real challenge. It’s turned me on to what works and what I like, and more importantly, what I don’t like.

So here I am, wearing a gorgeous maxi from eShakti and a corset belt from Torrid:

Here are my further comments from the Kath’s post, which I hope explain why I’m finally “coming out” with my picture, and my love of fatshion.

Blogging about fatshion isn’t about some desperate attempt to conform to the mainstream, the sad fat girl trying her darndest to emulate conventional beauty (and getting it *so* wrong, amirite?!). It’s about challenging conventional beauty; it’s about challenging the assumption that beauty is some narrow field to which fatties must aspire but never, never reach.

Further, doesn’t this also ring true for the vast majority of thin women, who will also never look like the airbrushed models on the covers of magazines? Heck, those models don’t look the airbrushed version of themselves! The standard of beauty is no longer just a shrinkingly tiny percentage of the human population — it’s gone entirely digital.

Fat people modeling beautiful clothing — beautiful fat people modeling beautiful clothing — real beautiful people, unaltered, in a state beyond the most zealous proponent of Photoshop’s liquefy tool — is amazing. Courageous. Powerful. Perhaps Freedman and her ilk realize how powerful it is, and feel threatened? How dare us fatties perform beauty? How DARE we? Don’t we know that’s not for us?

Cannold’s statement is a classic attempt to undermine something she sees (or perhaps only feels on a visceral level) as powerful and threatening. How should we respond?

Feel good about ourselves. We’re making a difference. Our courageous fatshion is shaking the foundations of their exclusive club, and they don’t like it.

What should we do now? Cower down, strip out of our gorgeous maxis and slink back into some polyester tent?

No. SHAKE HARDER!

Photoshop Used to Make People Skinnier

This should be required watching for all size activists. This is what we’re up against — it’s so, so easy to do this, it’s considered as standard in photo editing as removing blemishes or an unwanted seagull from the picture. Blargh.

TRIGGER WARNING: It’s not as extremely fat-hating as I’ve heard, but it’s not fat-friendly. A lot of ‘hurr-hurr-ing’ about making her butt look smaller and so on. I suggest those who are sensitive to that kind of thing mute the volume. It’s visually self-explanatory, anyway.

On the 1% increase of obese and overweight in the US

If you haven’t yet seen the article from Reuters: More than 70 million US adults obese, US agency says

And here’s a link to the actual CDC report

Hey look, the obesity level in the US is remaining steady!

Oh wait, the article didn’t say that? The carefully timed flood of press releases on a ‘report’ from the CDC, an agency already over-reporting the levels of ‘overweight and obesity’ as well as stocking their site with all sorts of scare-graphs and claims of an ‘epidemic’ (and not to mention the same folks that claimed 400,000 deaths per/year were ‘attributable’ to obesity when it was found later that the figure was closer to 30,000 deaths/year) seemed to say:

WE’RE IN AN EPIDEMIC FATTIES OMG OMG CHILDREN WILL DIE ETC!

Or, what the CDC actually said:

Over the past decade, obesity has become recognized as a national health threat and a major public health challenge. In 2007–2008, based on measured weights and heights (1), approximately 72.5 million adults in the United States were obese (CDC, unpublished data, 2010). Obese adults are at increased risk for many serious health conditions, including coronary heart disease, hypertension, stroke, type 2 diabetes, certain types of cancer, and premature death (2,3). Adult obesity also is associated with reduced quality of life, social stigmatization, and discrimination (2,3). From 1987 to 2001, diseases associated with obesity accounted for 27% of the increases in U.S. medical costs (4). For 2006, medical costs associated with obesity were estimated at as much as $147 billion (2008 dollars); among all payers, obese persons had estimated medical costs that were $1,429 higher than persons of normal weight (5). In 2001, the Surgeon General called for strong public health action to prevent and decrease overweight and obesity (3). [EMPHASIS MINE]

A few things:

  1. Correlation doesn’t equal causation. The public health dollars scare tactic was calculated by taking the sum of ALL diseases ‘correlated with’ obesity and adding them together. That means there was a crapload of thin people with heart diseases, diabetes type II, certain cancers, and who suffered strokes that have been lumped in with all the fatties to make that percentage look as high as possible. Misleading.
  2. I don’t see a margin of error stated in the report, except a very narrow confidence interval of 0.7 – 1.4 percent. Really that — that — is what’s getting shouted from the rooftops of every science news agency and crappy local evening news station in the country? Really?
  3. Again, it bears repeating: A 1% increase over two years does not an epidemic make. Nor are we currently in an epidemic by any reasonable definition of the term. The fact that the CDC is bearing down on us with these imprecise scare-words means this is about politics and keeping themselves in the green, NOT about the actual fucking health of Americans. Anyone who hasn’t read Greg Bear’s brilliant Darwin’s Radio, please do.
  4. How is obesity a major public health threat again and, if this is true, how in the world has it just ‘become’ so, given that obesity rates have been leveling off for the last few years (isn’t it something like 5 or 6 years now, since 2004)? I smell a press release.

Methinks the CDC is working to ramp up anti-obesity fervor for something. To garner more support for the “Let’s Move” anti-obese kids program? To garner more support for some kind of new, wider initiative (since my guess is that “Let’s Move” hasn’t been generating any real results, surprise surprise)?

And then there was this lovely gem from the NY Times busting open the current HHS anti-obesity funds and focus: Antismoking Efforts Lose Ground to Obesity Fight

Shortly after the first lady kicked off the “Let’s Move” program, the administration awarded more funds to fight obesity than tobacco through two big new money sources for preventive health. The funds, totaling $1.15 billion, came from economic stimulus and health care reform legislation. They still provided more than $200 million for tobacco-use prevention, but much more to grapple with obesity.

Scary. Nice that part of the economic ‘stimulus’ package was funds to stimulate hate! Oh, dearie. It’s so funny I forgot to laugh.

Scarier still: apparently the Robert Wood Johnson Foundation is involved. For extensive analyses of some of their anti-obesity initiatives, check out this link.

What do you think of all of this?

The Mia Freedman Debacle, or, Why Moral Panics Need Strawmen

Bri King of Fat Lot of Good, fellow Fat Acceptance blogger and general advocate, recently came under fire as she found herself daring to push back against a so-called body image activist allowing virulently anti-fat comments on a recent post about feederism.

Bri has since been asked to comment for articles in several Australian news outlets. (students of sociology, pay close attention to the language used in the titles of each of these articles—five extra brownie points for some analysis, if you wish to provide it!)

1. Herald-Sun: Body blogger Mia Freedman gets heavied

2. Today/Tonight: Heavyweight fury

3. A Current Affair: Mia’s fat fight

The article is the fairest, though uses some cheap fat-mocking ‘colorful’ descriptive language here and there. Both of the other segments I watched briefly without the sound so that I could get a sense for the kind of imagery they put forth, and it’s immediately problematic — headless and legless fatties, thinner people who get attractive straight-on headshots, and so forth. But I think others can go through the segments with a bit more of a detailed analysis, what I want to talk about is what really went down, here, and why this is an example of how the strawman effect is the most powerful foundation block of a moral panic.

For Bri’s explanation and links to Mia’s post and its comments, please see her posts here (ordered by date):

1. This Angry Fatty won’t just shut up and go away…

2. still Angry Fatty

Freedman has since come back to explain that, in fact, she wasn’t talking about fat people in general but was highlighting the feederists, which we can all agree are bad, bad, bad! And why don’t us regular fatties just shut up about it, what, do we think that kind of behavior is good or something? Of course, the arguments being made against Bri are chock full of logical fallacies (extra points for those who list which ones!). And it shows either a great deal of ignorance or intellectual dishonesty on the part of a so-called body image advocate to claim that highlighting feederism in the midst of a moral panic where fat people are the folkdevils isn’t harmful to fat people in general.

Here are a few facts to chew on, in case you’re still not convinced:

  1. Feederism wouldn’t seem as horrifying if society wasn’t already panicked and disgusted by fat people in general. The natural bigoted question being, “Can you believe there exist people who not only like being fat but want to get fatter?”
  2. Feederism wouldn’t seem as horrifying if the common wisdom wasn’t erroneously that people with few exceptions have the ability to control their body weight. The natural bigoted question being, “Can you believe these people want to be fat when they could be thin if only they got their priorities straight or were sufficiently shamed, and further, that they want to be so very fat indeed?”
  3. Feederism wouldn’t seem as horrifying if the nanny-state wasn’t continually making its version of ‘health’ a public responsibility (thus placing people’s bodies into the black box of common ownership and hence critique). The natural bigoted question being, “Can you believe these people are irresponsibly choosing fatness when it’s my wallet on the line?”

Let’s further the analysis, for those who still aren’t clear on the connection between these points — demonizing feederism in the context of a moral panic where fat people play the part of folkdevil — and why such a blog post, made by a so-called body image advocate, furthers general sizism and worsens general hate of all fat people.

Feeders/Gainers, and those who are seen as clearly choosing to get fatter, are the strawmen of the ‘obesity epidemic.’ Because one of the fundamental lines of reasoning behind the moral panic of fat is that the vast majority of fat people choose to be fat. Hence, in the common-wisdom narrative of the ‘obesity epidemic’ all fat people are, to some degree, feeders/gainers.

So demonizing feeders/gainers in the context of the ‘obesity epidemic’ moral panic is the same as demonizing the vast majority of fat people.

And the comments on Freedman’s site prove this point to be true, as do many of the comments on the Herald-Sun article linked above. Those commenters don’t care if Freedman was talking about feeders/gainers in particular — to them regular fatties aren’t really that different from feeders/gainers. So what Freedman has written has the effect of only reinforcing the bigoted notions of fat put forth by the common-wisdom narrative, reinforcing people’s disgust over fat people. What Freedman has written reinforces their horrified sensibilities concerning what and how it is proper to consume food or think about wellness and how they believe ‘proper thought’ to be inextricably tied to a particular ‘proper’ size. What Freedman has written reinforces the idea that it is okay to hate and ‘be against’ this behavior, which to them is only an extreme version of what they believe all fat people do.

Freedman, a so-called body image advocate, is doing nothing more than promoting the ‘proper’ body — one that isn’t too fat — by means of what she surely believes is well-placed concern about feederism.

Still don’t believe me? Take the tenor of the comments on any article which treats this debacle (including comments on Freedman’s blog). The high level of outrage and disgust signify rage and panic over someone daring to be an outspoken member of a deviant class. This is traditionally how moral panics police their deviant classes. If most of these commenters came in with honest curiosity or concern over health, I can say beyond a shadow of a doubt the level of emotion would be quite a bit lower.

In conclusion, I would like to reiterate a comment I made on Bri’s blog about this whole debacle, in particular the backlash against her take on the situation.

Remember, the ‘obesity epidemic’ is a moral panic, and by being an outspoken member of the deviant class you threaten the status quo and that’s obviously ruffling some feathers.

In fact, congratulations are in order: it seems you’ve advanced your particular message to the third stage of activism. For as Gandhi said, “First they ignore you, then they laugh at you, then they fight you, then you win.”

They’re definitely fighting you. Cheers, Bri, keep on!

EDIT (5/13/10, 11:30p EST): Please also take a look at Spilt Milk’s current Freedman post. She replies to a comment Mia Freedman made to Spilt Milk’s blog—it’s really fantastic, please read it!

NOTE: If you have come to submit the comment, “But don’t you know that feederism is bad? What, are you promoting feederism or something?” I might actually publish it, just to get laughs. But I request in any case that you re-read this post — and again, if you’re still scratching your head — and if you can’t get it after that, congratulations! You’re a bigoted pawn of the moral panic. Or should I say, I send my deepest regrets to your friends and family.

Ashley Graham on Jay Leno

Ashley Graham, the model whose Lane Bryant ad was banned from ABC and Fox for — being too racy? Showing too much ‘flesh’? No one really knows for sure — was interview on Jay Leno the other evening.

The news is that the commercial is back on (I guess being showed by NBC in the 9 o’clock hour?).

Part 1 of the interview, in which there is a very positive reaction to her concisely-put size acceptance messages:

Linking, having problems embedding on WordPress at the moment.

Part 2 of the interview (short):

Link

Note that you can click on the videos in my VodPod sidebar widget.

Predictions: American Health Care and Fat People

Now that the ‘reform’ of Healthcare, i.e., delivering 1/6th of the American economy into the hands of government, has passed the House and been signed by the President, I want to make a prediction or two. These predictions are nothing new for this blog, and if you’re interested in my more general thoughts of the connections between various kinds of heathcare systems and the obesity epipanic, please read:

  1. Case-building: Making Fatties the Deviants
  2. When Other People Pay for It, They Can Claim the Right to Control It
  3. Government Healthcare is Bad for Fat People
  4. Universal Healthcare and Fat
  5. Libertarians and Obesity, Take Two
  6. Eliminate Fat People?
  7. When Your Body is No Longer Yours
  8. Why Universal Healthcare Should Be Opposed By Fat Activists
  9. Universal Healthcare is Not Automatically Fat Friendly

But I’m not here to yet again debate the merits (or demerits, in my view) of a universal system. We didn’t get a universal system with Sunday night’s signing: we got more of a Delayed Trojan Horse, which lays the groundwork for the system to be pushed in the direction of going single-payer, during Democrat-controlled Congresses and Administrations. But I’m not going to explain that right now, either, though there are scads of lovely posts on it on WSJ, Econ blogs, Cato, Mises, etc.

That being said, comments are closed.

So here my predictions on how we’re going to start seeing this new law change the cultural conversation about fat people.

  • In the short term: “You mean, I have to pay for YOUR fat ass, now? This sucks. I hate fatties, but I hate government more. Damned health insurance bill.” — oh, hai evidence, relying on the new Donna Simpson Straw Fatty Model, no less.
  • In the medium term: Increase of employer/government weight-loss ‘health’ initiatives; pouring money into weight-reduction schemes (esp. in public schools) sanctioned at a higher rate, getting more general public support; general stigmatization of ‘fatties’ for being fat, but a sense of compassion. Open derision of fat people as costing ‘more’ health dollars, as premiums skyrocket even higher, choice becomes less, it’s harder to find a good doctor, waiting times for appts increase, and so forth. Talk will begin to filter down that the regulatory boards should consider charging fat people more for health insurance, or not allowing them access to certain procedures because fatties who undergo those procedures ‘cost more’ than thinnies.
  • In the long term: When the anti-obese people ‘health’ initiatives don’t work to make fat people permanently thin, more drastic measures will be taken, all at high cost (which will gain the ire of taxpayers), with the ‘reasoning’ that some high cost, drastic measure like surgery is ‘necessary’ to ‘save lives and save more, chronic health expenditures down the road.’ We might have single payer by this time, which would compound the issue. Costs aren’t going to go down, so what you’ll see instead is rather than the government take responsibility for the fact that they’re going to destroy the system and explode costs with inefficiency and regulatory schemes, they’ll point the finger at some kind of scapegoat — you guessed it, the fatty. (cough, NHS, cough) Fatties will be banned from undergoing lots of ‘elective’ procedures (like fertility treatments, knee replacements, etc) unless they lose weight. There will be no competition, no recourse: the fatty will have no ability to go to another doctor or institution and perhaps be able to get it there, since the regulatory measures anti-competitively are ‘blanket’ measures (in order to ensure healthcare ‘equality,’ you know. Less for everyone, but especially those we deem to cost more by nature of their existence!). Government-controlled research institutions will, like the Big Pharma-backed institutions of yore, churn out anti-fat ‘research’ which is carefully structured in order to support their inevitable open discrimination against fat people. And so forth, however far down this slope you feel like sliding.

On Saturday I felt like much more of a human being than I do today, in America. Now, I feel a target on my back, because my government has decided that the way to cover the 10-15 million uninsured that have fallen through the cracks of the system (the 30 million number counts those who purposefully don’t buy insurance, as well as those who qualify for assistance but aren’t utilizing it) is to redistribute a massive chunk of wealth and regulate 1/6th of the economy, all the while ignoring smaller, more market-friendly steps that could have immediately increased access and lowered costs.

Thanks for giving the obesity epipanic in America a government club. Can’t wait for this to all pan out, surely in the fatties’ favor, if other countries with government medicine are any indication.