IN THE MIDST of the season when Americans are settling in to rationalize an extra slice of fruitcake, or consume more cookies than they ever expected to eat, along comes the surgeon general to wag his disapproving finger. In a long, specific, and worried report, Dr. David Satcher tells us that Americans are too fat, and that obesity kills an estimated 300,000 of us every year.

As it happens, the surgeon general is nearing the end of his tenure and, grasping the pulpit that will soon be snatched away, has taken to making a series of pronouncements. A few months ago, Dr. Satcher warned us that we are deficient in our knowledge of human sexuality (does he ever watch television?) and called for more, and more detailed, sex education in the schools. Now he has deployed the prestige of his office to warn Americans to lose those extra pounds or else.

On the one hand, it is difficult to take issue with Dr. Satcher's formula. Anyone who walks down a city street, visits a swimming pool, or lurks in the vicinity of a buffet table, is aware that many Americans are heavier than they ought to be. The question is: Does anyone dispute this, or believe that it is smarter to be stout than slender? Even the stalwart members of those "fat acceptance" organizations must realize that physicians don't lecture them about their weight for aesthetic reasons, but because obesity promotes a host of dangerous conditions: heart disease, diabetes, etc.

On the other hand, it is worth wondering what motivates Dr. Satcher.

Part of the problem, I suppose, involves his professional status. A generation ago, the surgeon general was head of the U.S. Public Health Service, and clad in the standard gray flannel of the species, labored in near-anonymity in the capital.

All of that changed with the invention of Dr. C. Everett Koop, a pediatric surgeon from Philadelphia, with strong anti-abortion views and a flair for publicity. Dr. Koop discarded his scrubs and donned the dress whites and blues of the PHS's crypto-naval uniform, complete with gold braid and ribbons, and transformed himself into the nation's "top doctor."

Instead of consulting on morbidity statistics or lobbying Congress for more research funds, Dr. Koop took to the airwaves and the hustings, subjecting us all to periodic checkups, and lecturing the country on the perils of AIDS. Since his retirement in 1989, Dr. Koop's successors have all dutifully outfitted themselves like ships doctors, and chosen a particular crisis to address as a prelude to legislative and regulatory action.

The problem with Dr. Satcher's latest pronouncement is not its obviousness but its implications. In 1964, Surgeon General Luther Terry issued his famous report on smoking and health, and the rest is history.

Dr. Terry may have regarded his work as educational, and intended for his report to be taken as advice: Smoking, after all, is a choice, not a pathogen, and people must decide whether to take up the practice. But it formed the basis for what would later become the federal government's war on a lawful industry, with draconian legislation, bans on smoking in public, ever-higher taxes, and colossal lawsuits that have largely served to enrich the tort bar.

No doubt, Dr. Satcher is merely deploying his prestige to give his fellow countrymen some sensible counsel. So far, no plump taxes are contemplated, or regulation of the confectionary industry, or tariffs on sweets, or bans on the advertisement of doughnuts.

But don't laugh. Just as the I'm-fat-and-I'm-proud crowd complain that Americans are bombarded with commercial imagery of junk food and anorexic fashion models, we can hear the opening salvos of the next great movement to restrict our freedom to live life as we see fit.

In a recent column in The Washington Post, two journalists shrieked that "we are surrounded by tasty, cheap, high-fat food, while fruits and vegetables are comparatively more expensive and less readily available." This may be true at the local carnival, or McDonald's franchise, but is less obvious at the grocery store, where most Americans buy their food. Still, say the authors, there is only one solution: The federal government must step in and make Americans eat right.

Should it? No one disputes the fact that it is better to eat a healthy, balanced diet, to consume junk food sparingly, to trade the chocolate for the salad, and to keep one's weight to a reasonable level.

But to grow obese is a failure of will, not a symptom of the absence of federal regulation.

It is both a strength and weakness of our system that people are free to decide how they treat themselves, and accept the consequences.

We cannot expect laws restricting the consumption of greasy hamburgers, or bans on sugar, or confiscatory taxes on starches and fat, to impose the self-discipline we require to stay healthy. That's the missing ingredient in Dr. Satcher's formula.

Philip Terzian writes for The Providence Journal. Contact him at: The Providence Journal, 1325 G Street NW, Suite 250, Washington, D.C. 20005.

　　From Healthy.net