I’m a big fan of comedian Bill Maher, host of HBO’s Real Time With Bill Maher, in large part because he is such a strong proponent of good nutrition (high-fructose corn syrup is his nutritional nemesis) and of creating a U.S. healthcare system that is focused on preventing disease before it takes hold. This was a topic Maher addressed yet again on his April 24, 2009, Real Time broadcast. I’m posting a partial transcript of the discussion here because it touches upon many of the issues NBJ has been thinking and writing about as part of our healthy kids’ market research. I found the exchange between Maher and New York Times’ ethics columnist Randy Cohen over the question of who is to blame for the current childhood obesity epidemic particularly salient for the U.S. nutrition industry.

Bill Maher: We are never going to solve this healthcare crisis unless people make the connection that most of what they buy in the supermarket is making them sick. Then the pharmaceutical companies offer relief, which makes them sicker. I know I am a broken record on this, but it is true. I mean, I read this last week that one out of four children under 4 is obese. I gotta ask the question, because kids don’t feed themselves at that age, is that not child abuse?

Randy Cohen, New York Times ethics columnist: Well, wait a second. I think you’re blaming the victim an awful lot here. There are many reasons why that kid is overweight. One reason is that there is so much car traffic that he can no longer walk to school the way we could when I was a kid. So that exercise is impossible. We’ve cut the budget at his school so there is no gym program, so he doesn’t get that kind of exercise. McDonald’s advertisements are a billion dollars a year to promote [fast food]. You’re saying this little four year old should stand up and say, “No, no! Bring on the carrots.”

Maher: No, I’m saying his parents should.

Cohen: Even when you’re asking an individual parent to stand up against the weight of massive social forces…

Maher: Well, when it’s your child, yes, you should.

Cohen: Well, it would be a lovely thing if everyone could.

Howard Dean, former Democratic National Committee chairman: I think Bill is on to something here. You know, we’re talking about healthcare reform in Washington. All we talk about is Medicare and who gets what and public and private and all of this stuff. A lot of the health problems in this country are [due to] lifestyle choices. They really are.

Cohen: I reject this. What you’re calling a choice… the reason the kids in my old neighborhood don’t ride their bikes to school is because it is much too dangerous to ride their bikes to school. There is too much traffic. Their parents are right not to let them. That is not a lifestyle choice. That is responding to the actual world that we live in.

Maher: Then go to the park.

Bethany McLean, Vanity Fair contributing editor: They had soda pop and chocolate when I was growing up, and we didn’t have it in the house because my mom wouldn’t let me eat it. She took our Halloween candy away and doled it out over the course of the year.

Cohen: Your mom is so mean [laugh]. But when McDonald’s spends a billion dollars a year to advertise to these kids, they are not doing it because it is ineffective. To suddenly say, oh, why doesn’t this working mother stand up for her kids and say no.

Dean: It’s not just the working mothers. The whole society has to say no.

Cohen: Thank you. Thank you.

Dean: We have to have a wellness society instead of an illness model.

Dana Gould, comedian: My kids are 5 and 6 and we go through this. They do want to go to McDonald’s, and it’s hard to keep the bad things… the bad things just have to be out of the house. And it’s hard. Everybody is running around, everybody is busy. But you do just have to sit down ahead of time, like we do on Sunday night, and say, “Here’s the healthy stuff. These are the healthy choices.”

Dean: Not to beat up on McDonald’s too much. Look at McDonald’s changes in the menu. They’re not perfect, but they have gotten a lot better. Why? Because people like you [points to Dana Gould] have said, “I’m not taking my kids to McDonald’s unless you start having salads and stuff like that.”

Cohen: Whenever someone starts saying, “It’s all the mother’s fault,” that is when I reach for my actually quite legal automatic gun [smiles], because you’re ignoring the tremendous social forces that lead the world to be the way it is.

Maher: Well, for the ethicist, you’re such an apologist.

Cohen: I’m not an apologist, but I think you’re blaming the wrong people.

Maher: I think you have a tremendous lack of personal responsibility… I’m not going to follow your ethics anymore, Mr. Ethicist [laugh].

Cohen: I think you’re seeing people as isolated, atomized individuals when in fact they are social creatures. They are members of communities, and people tend to behave pretty much like their neighbors. So this doesn’t eliminate our responsibility. It means we have a responsibility to create good neighborhoods, and that is politics and that is social policy and that is why Canadians are so slender and attractive. It is because of that. It is a healthier society. It is why Tuscany is so damn pretty and why no one wants their summer houses in Detroit. [laugh]

Gould: But it goes back to what we were talking about before: unlimited consumption. … [we now have] fun size Snickers bars, which are the size of support beams [laugh]. There is no cause for that. No one should eat that much Snickers. At a certain point it stops being fun. It just becomes suicide.

Maher: No one should eat any Snickers. Excuse me, but where you folks set the bar, where you set the goal post on health is going to keep us sick for the next century.

Related links:

U.S. Healthy Kids' Market Positioned to Tackle Obesity and Other Top Health Issues

Renegade Lunch Lady Takes on School Lunch Programs

Much Work Remains in U.S. Diabesity War, Author Says