I very strongly disagree. Fixing our food, transit, and social systems is absolutely worth it. There are very simple measures we can take like offering a subsidy for e-bikes like we do for electric cars that would get more people outside. Taking measures to make more healthy food more accessible to people who need it would absolutely be worth it.

Cities all over the country are already assessing which roads can be converted from four lane stroads to two lane streets with protected bike lanes on either side. We can provide federal funds to encourage more of this.

Weight isn’t even the only problem with our culture. Being stuck in cars and eating unhealthy food also affects rates of heart disease and depression. Making those people lose body fat might help with those factors, but I suspect it would do so less than actually making healthier food options more accessible.

For those that really feel medication is their best choice, when we have made sure other options are available, we should also offer free medical care to all people. But that should not be the primary solution to this problem for most people!

The "simple measures" you name are things that require political will, and America doesn't have it. That's why these things are infeasible: American voters have to want them, and have to elect people who will enact them. They're not going to do that, outside of a few select municipalities (where obesity probably isn't a big problem anyway, because the people there are wealthy and educated). Even worse, America is almost certainly going to elect Trump for a 2nd term; the country is swinging conservative, so these "simple measures" you name definitely aren't happening any time soon. Look at NYC for instance: the Democratic state governor just scrapped their congestion charge program, so living in blue states and electing Democrats isn't any kind of guarantee of positive change either.

Honestly most of the stuff I mentioned is pretty in line with Bidens infrastructure plan which did actually pass! But even if you say my proposal is pure political fantasy, so is giving everyone ozempic. If we’re actually going to dream of fantasy proposals, “give everyone drugs to mask one symptom of our many problems” seems to me an impoverished fantasy.

It’s not the cars and it’s not the walking. Ignore the unique cities like LA and NYC, and daily suburban life is the same in Santa Clara or Little Rock or St. Louis or Charlotte. But some cities are full of morbidly obese people, while some (e.g. Bay Area, where you drive everywhere) have basically none of it.

Also exercise really doesn't burn as many calories as people think. You usually need to work out as much as a pro athlete or olympian to burn a noticeable amount of calories from exercise. The reality is that a lot of Americans just eat too much.

That's why the drug helps. It reduces the overeating.

And it's a relatively simple, relatively easy policy lever, unlike every other proposal.

Exercise changes your metabolism so you burn more calories no matter what you're doing.

Eat and drink! Beer, coke, more beer, more coke.

Walking is not the only option. One can easily commute by car and once home, jog around, bike, swim...

Once the demand is solid, there will be supply for bike lanes, pedestrian paths...

No need for that drama. Building walkable cities is not only perfectly possible and cheap, but most US cities were very walkable 100 years ago.

Building walkable cities (at large scale) in the US is impossible. Not because of physics or resources, but because of politics and American voters' preferences.

Sure, there's a small portion of the electorate that wants this, but they're a minority and not powerful enough to get real change outside of a few localities.

100 years ago the US had ~76m inhabitants - a fifth of what we have today - plus horses and buggies were used broadly throughout the country. The streets in our older cities weren't born from nothing but aether when cars were invented.

Your first paragraph sounds amazing.

Indeed.

I'd dig one deeper and look at the reasons why it's "not feasible" and the change that first. If people propose "national emergency" as a solution, clearly such options should be on the table.

It's not feasible for various reasons, but they mostly boil down to "political will". There's two main causes I see: food/nutrition, and lifestyle (i.e. not enough exercise, and using cars, which is caused by urban design). There simply isn't enough political will to make any significant change on either of these fronts. Don't forget, the US is almost certainly going to elect Trump for a 2nd term, so obviously there isn't going to be any positive change in either nutrition or urban design for quite some time.

So, basically the US electorate chooses to be obese? If so, the underlying question is: why do they choose this?

I can think of several reasons, but to me the most obvious cause is "runaway capitalism", where a few big corporations lobby and market and (mis)inform, to make people think this is what they want, just so they can sell more cars, sugar, processed (high marging) foods and so on.

Not to make this an anti-capitalist rant, to be clear. Just that I'm fairly sure we're seeing a clear limitation of "free markets", where people simply aren't the rational homo-economicus that many promised we'd be.

There's tons of healthy food options available to consumers these days, even in regular supermarkets. They all have "organic" food aisles now. Some Americans have become more conscious of this and have adjusted their diets. (Of course, there's also some companies trying to profit off this unfairly, like advertising "gluten free" on foods that would never contain gluten anyway, and also pushing gluten-free foods as "healthier" when there's really no evidence for that, they're healthier of course for people with a gluten allergy or sensitivity but that doesn't extend to everyone.)

In a democratic society, it's the people's responsibility to be educated about issues, so they can vote accordingly. Most Americans are making conscious choices to eat bad foods, not exercise, live in suburbs with car-dependent lifestyles, etc. They could move to inner cities and/or push locally for more density and anti-car measures, but they don't, outside of a few select places.

Instead, a large chunk of American society "educates" itself about conspiracy theories and the "importance" of guns and religion, and votes accordingly, and what you get is the society you see now.