Cheese curds, chicken tenders, macaroni bites and French fries thrown onto one bun and covered in Ranch. That was the “fat sandwich” I chose last week, one of the many absurdly caloric offerings at the recently opened Fat Sandwich restaurant on State Street. Nothing could sound more Wisconsin, or more like a shortcut to morbid obesity. As I devoured my creation with pride last week the question I asked was how closely the two — Wisconsin and obesity — were related.

But before I address that question, it is important to establish why it matters. At the most critical level, the problem of obesity is clearly an issue of individual health and quality of life — that much has been established. Hopefully by now we have all seen the eye-opening statistics on how efficient and prevalent a killer obesity and its resulting diseases are (in fact, they are the runaway most common killers in the U.S.).

However, the burden of obesity on public health is nearly matched by its burden on the economy. It is in this context that the problem is all too often ignored. A study released this summer in the Health Affairs policy journal showed medical spending averages $1,400 more per year for someone who is obese than for someone who is at a normal weight. With increasing costs and percentages of the population becoming obese, medical spending to treat obesity related diseases has risen to 9.1 percent of all health care spending, up from 6.5 percent in 1998. Eric Finkelstein, a health economist working with the research group which published the study put the effects of this best: “Unless you address obesity, you’re never going to address rising health care costs.”

Yet there is no way to explain away or justify this prevalence of obesity. So many, eager to seem compassionate to those with a weight problem, claim this is largely a problem of genetics. They are right, but not in the sense they intend. Prior to the advent of food surpluses and Twinkies, the constraints of natural selection favored human beings with a talent for the storage of fat. Food was scarce and surviving seemed like the best option. Then McDonalds moved into the neighborhood and we decided it would be easier to drive there than walk. Quite predictably, human genetics, which had taken tens of thousands of years to evolve, didn’t quite catch up. The result was way too many Americans got fat.

And yet, populations and cultures with surpluses of food exist throughout the globe without the slightest hint of an obesity problem, and many more with only a minor one. I hope you are catching my drift. For all the times you have heard someone say a friend is fat because of their personal genetics, only a few times has that actually been true.

While it’s important we address the issue of obesity delicately and with due respect to peoples’ self image, it is also important to look at the problem realistically. Most obese people are simply making irresponsible choices risking their own health and unnecessarily costing all of us a lot of money. And if the presence of the issue of affordable and inclusive health insurance on the national scene for the past two decades is any indicator, it is costing a lot of unnecessary money in the worst of places.

Which brings us back to our own state. A report on obesity published in 2008 showed that Wisconsin, at 26 percent, has the 25th highest rate of adult obesity in the nation. Not bad, but certainly not exempting us from the problem. More importantly, consider the sheer numbers here. If one in four residents make you middle of the pack, consider the kinds of prevalent obesity at the top of the list. Tack on $1,400 of increased medical costs per person in such states and you begin to get a picture of the economic burden of this unnecessary problem.

The public sector certainly has a role to play in addressing the problem, most notably as it relates to children and schools. Some close to the debate have gone as far as suggesting that the federal government should institute a “fat tax” to help offset the costs of health care reform. While the argument for such a tax would be as simple as recycling the arguments for cigarette taxes, a “fat tax” would also seem to be completely politically unfeasible and strikingly regressive.

This problem, like so many modern ones, is most effectively addressed at the individual level of choice. In the absence of altered personal choices on a large scale by Americans, either someone is going to have to pay up for part of the populations’ irresponsibility or health insurance will continue to be far too exclusive.

Neither option sounds fair.

Alec Slocum ([email protected]) is a senior majoring in philosophy and legal studies.