Stigmatize the Obese - Even More?

File this one under candidates for Worse Ideas, Ever.  

A so-called bioethics leader, Daniel Callahan, has written an article, that according one source,  argues that 

the public health community can learn from one of the most successful public health campaigns: the anti-smoking campaign. A primary strategy has been to stigmatize smokers, he says, making it clear that their behavior is not only unhealthy for them but is also socially unacceptable. While the public health community has decisively rejected the stigmatization of obesity, Callahan directly challenges that rejection.

In original report, which you can find here, the author proposes "stigmatization lite" to exert social pressure on people by asking overweight folks question like:

If you are overweight or obese, are you pleased with the way you look?
Are you happy that your added weight has made many ordinary activities, such as walking up a long fight of stairs, harder?
Would you prefer to lessen your risk of heart disease and diabetes?
Are you aware that, once you gain a signifcant amount of weight, your chances of taking that weight back off and keeping it off are poor?
Are you pleased when your obese children are called “fatty” or otherwise teased at school?
Fair or not, do you know that many people look down upon those excessively overweight or obese, often in fact discriminating against them and making fun of them or calling them lazy and lacking in self-control?

What I don't follow is that the author fully acknowledges that the overweight are already stigmatized.  Not only to the extremely obese earn lower wages, spend more on health care, and die sooner than normal weight folk, I have yet to see the supermarket tabloids do anything but make fun of even the skinniest celebrity who has put on a few pounds.  Does anyone doubt the clear message our culture sends? Thin is cool, fat is not.  

I don't doubt that a bit more cultural shame (or stigmatization lite) might result in a few pounds being lost.  But, at what cost?  How many pounds would someone need to lose for it to be ethically justifiable to make them feel bad about themselves?  Moreover, why do I have any interest in making someone else feel bad about themselves?    And, as already mentioned, there are already many costs to being obese - why add insult to injury with even more social shame?

What one weights is a complex result of factors related to personal decisions, preferences, technology, genetics, and environmental factors like food prices and availability.  I suspect there are many obese individuals who would say they'd like to weight less, but that's just talk.  I'd like to drive a Porsche.  I don't drive one (and the obese don't weigh less) because life involves constraints and a series of difficult tradeoffs.  So, what's the use in telling me that I'm a loser because I haven't chosen to allocate my salary toward a 911 Carrera Cabriolet?   Perhaps I just need to apply some stigmatization lite to this problem: 

If you drive a Chevy, are you pleased with the way you look in your car?

Are you happy that owning a Chevy has made many ordinary activities, such as driving to work or washing the car in the drive, uncool?

Would you prefer to drive zero to 60 in under four seconds?

Are you aware that, once you buy a Chevy, your chances of every getting a Porsche are poor?