06/27/2011 02:05 EDT | Updated 08/27/2011 05:12 EDT

Obesity Is Not the New Smoking, and Fat Is Not Our New Tobacco

God how I hate seeing those quotes.

Smoking is a singular behavior.

Now I don't want to minimize the difficulty of nicotine addiction, or the impact of factors such as poverty, advertising and culture on the decision to start smoking, but it is important to recognize that starting and stopping smoking involve one single behavior -- lighting or not lighting a cigarette. One behavior, governed by choice.

Obesity is not a choice, nor is it the consequence of one singular behavior.

People don't choose to become obese, and while choice and free will are involved in lifestyle design, they're certainly not lifestyle's only determinants.

Genetics, co-morbid medical conditions, psychology, pace of life, socio-economics, environmental obesogens, governmental failings in the provision of evidence-based nutrition and energy balance/caloric information, the unregulated self-help quackery of the commercial weight management programs, the confusion and contradictions of over 60,000 diet books, glossy magazines that promote quick fixes, reality television that promotes inane, non-sustainable and frankly dangerous treatment, crop subsidies that allow highly processed, hyperpalatable, hypercalorific foods to be sold for pennies, front-of-package labeling that confer health-halos to junk food, the demise of the family meal and the fall of cooking, predatory advertising targeting adults and children alike, a culture that promotes the provision of food at every event however small, super-sizing of restaurant portions, lack of caloric information at point of sale, medications which cause weight gain, juice and chocolate milk being promoted as healthy choices, public health messaging that wrongly suggests exercise is sufficient to "balance" calories consumed, epigenetic changes that occur in the womb, eating as a defense or a reaction to emotional, physical or sexual abuse.....

Honestly, I could go on.

Of course there are choices involved in personal weight management, but the playing field is anything but level. Go back through that list up above and consider life 60 years ago, when obesity was a rarity rather than a norm. Most of the list would be gone. Also consider the fact that none of that list reflects the failings of people as individuals, but rather it reflects our collective failing of protecting our environment. What we're dealing with today is a state sponsored, massively un-level playing field, superimposed on our most powerful physiologic survival drive. Go figure we've got a problem.

So no, obesity is not the new smoking and fat is not the new tobacco. The folks who say they are, whether they realize it or not, are part of the problem, as the notion that obesity's the new smoking fuels the hateful bias that dealing with it is as easy as butting out.

If it was as simple as pushing away from the table, everyone who wanted to be would be slim.

Dr. Yoni Freedhoff, MD is known as a "nutritional watchdog" for his advocacy efforts for improved public policies regarding nutrition and obesity. He is the founder and Medical Director of the Bariatric Medical Institute, dedicated to the (nonsurgical) treatment of overweight and obesity since 2004, and his personal website, Weighty Matters, is ranked among the world's top health blogs.