Tacoma, what happened? You have become the fattest city I have ever seen. Every part of town I visited was full of obese men, women and even children. I rarely saw a normal-sized individual.

How can you thrive as a city if the majority of people are terribly out of shape? Stop blaming the government and take a good look in the mirror. You can’t expect to rebuild Tacoma’s economy if the majority of the city is overweight and out of breath.

Insurance companies want to make sure that the services they cover will be the most effective and have the greatest chance of a successful, long-term outcome. Otherwise, the service will simply add to the high cost of health care with nothing to show for it. That is why insurance companies use guidelines when deciding to cover weight loss surgery: Sometimes it works, sometimes it doesn’t.

There are a number of logical reasons why a conventional, medically supervised weight-loss approach and psychological evaluation should be documented first, the most important of which (in my opinion) is that it demonstrates the patient’s ability to adapt to a lifestyle that will be important to long- term success. Reversing obesity requires some sort of behavior modification.

While there have been many well-documented successes with weight-loss surgery, there also have have been failures. I know a few of them personally. These are people who initially lost weight after surgery but eventually gained it back again because they did not maintain a healthy lifestyle.

Weight-loss surgery should be used as a last resort, not a first. And it should only be used on those who truly need it, not by those who simply view it as a cure-all for years of bad behavior.

Over the last 15 years, $246 billion in taxpayer subsidies have helped to artificially reduce the price of unhealthy food. According to an analysis of U.S. Department of Agriculture records, the top 10 percent of agricultural subsidy recipients received 74 percent of those payments, and the subsidies have disproportionately supported a handful of commodity crops led by corn and soy.

These subsidies have driven down the cost of commodity crops, including corn and soybeans, making processed foods cheap to produce and market, and making animal feedlots cheaper to maintain.

Overproduced corn is cheaply converted into sugars, leading to an explosion of various forms of corn syrup, and soy adds cheap, unhealthy fats to processed foods. Over the past 20 years, real costs for soda, sweets, fats and oils have declined, while prices for fruits and vegetables – grown with relatively little government support – have increased nearly 40 percent.

What can be done?

We’re urging Congress to establish caps on the amount of direct payments and limit the income eligibility for such payments. Taxpayers should not subsidize already profitable enterprises and certainly should not provide direct payments to landowners who no longer use the land for farming.

(Breaux is an advocate with the Washington Public Interest Research Group.)

Government subsidies for corn and soybeans make sugars and fats some of the cheapest foods to produce, and Big Ag has used its clout in Congress to ensure that billions in taxpayer subsidies continue going to high fructose corn syrup, hydrogenated oils and other products that are tied to obesity.

For our physical and fiscal health, we must reform agricultural subsidies to reduce or eliminate the subsidies for commodity crops that artificially lower the cost of unhealthy foods; our tax dollars shouldn’t be used to subsidized foods that we know are harmful to our individual and collective health.

As Congress reviews the federal budget and reauthorizes the Farm Bill, we have the opportunity to cut these wasteful subsidies.

For more information, visit WashPIRG’s “Stop Subsidizing Obesity” page.

(Breaux is a public-interest advocate for the Washington Public Interest Research Group.)