Book excerpt: Because of these powerful underlying circumstances, America's strongest policy response, both to climate change and obesity, will be adaptation rather than mitigation. As the damaging consequences of climate change become manifest, America will not impose adequate measures to reduce fossil fuel consumption, attempting instead to protect itself from storms and sea-level rise through costly infrastructure upgrades. In response to the damaging health consequences of obesity, America will opt for medical interventions and physical accommodations, rather than the policy measures that would be needed to induce better diets or more exercise. These adaptation responses will generate serious equity problems, both at home and abroad. Responding to obesity with medical interventions will fall short for those in America most prone to obesity - racial minorities and the poor - since these groups have never enjoyed adequate access to quality health care.