Itemizing obesity

April 10, 2002

AS IF THE agony of filing taxes weren't complicated enough, the annual trek through the numbers of our lives could now involve one more awful calculation: that of our body mass index, the measure of how much fat we're carrying around.

The social engineers at the Internal Revenue Service have just ruled that obesity, like smoking and alcoholism, is a disease. So, if a doctor says you're obese, then the cost of weight-loss programs could be tax deductible -- even if your extra pounds haven't yet made you sick.

The IRS ruling prompted a predictable flow of knee-jerk jokes. (Late-night TV comedian Conan O'Brien couldn't resist one about claiming two or more chins as dependents.) But there's nothing funny about our national weight problem.

Half of all American adults are overweight or obese. So are millions of kids. Diabetes, heart disease and high blood pressure are just a few of many diseases commonly traced to too much weight, resulting in more than $100 billion in health-care costs and an estimated 300,000 deaths a year. (More on this later.)

Ordinarily, we look a bit askance at the modern trend of medicalizing -- let alone granting a tax loophole for -- problems that in some cases are deeply rooted in our culture's excesses. In an all-you-can-eat age, there's little question what our society demands: Super-size it, please.

Moreover, weight-loss programs aren't renowned for working. When dieters lose weight, many tend to regain it all too quickly. Established players, such as Weight Watchers, are already licking their chops. Marketers of the latest belly busters also must be salivating, though it appears their gimmicks, as with most diet foods, won't be deductible. And you can be sure that the rich will find a way to write off their spa sojourns.

But for almost all of us, this won't be such a lavish deal. To cash in, you'll probably need a lot of other medical deductions -- at least 7.5 percent of your income -- and you'll already need to be close to itemizing your taxes. Last-minute tax filers, for whom all this is particularly fresh with the rapid approach of Monday's filing deadline, know that involves good old IRS Schedule A, home of our cherished mortgage-interest, property-tax and charitable-donation deductions.

The real problem is that the new write-off for weight-loss programs may miss the point. Among some health professionals, there's still debate over whether extra weight is a medical problem by itself and whether obesity is directly linked to those 300,000 deaths a year. Some say pinpointing weight as the sole problem is a product of diet-industry hype and dovetails nicely with our society's widely tolerated bias against heavy people.

In many cases, of course, weight and medical problems go hand in hand, but it's also true that the source of the problem often is a lack of exercise -- rather than too many pounds, per se. A recently released federal survey found almost 40 percent of us lead very sedentary lives, hardly getting any physical activity. Another 30 percent of us get some exercise, but not vigorous or regular. So instead of a new deduction for weight-loss efforts, perhaps the IRS should have simply instituted a new tax -- one on couch time.

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