The average obese American consumes a beefy 42% more in medical costs than his normally-weighted neighbor. So says an article published today in the journal Health Affairs. Last year, such avoidable avoirdupois boosted health care spending by a corpulent $147 billion. That’s enough to buy comprehensive health insurance for more than a million uninsured families.

America’s infatuation with “weight loss” (I got 107 million Google hits on the term.) is exceeded only by its obsession with successfully avoiding it. In the mere eight years between 1998 and 2006, the obesity rate distended from 18.3 percent of the population to 25.1 percent. This progression of portly proportionality gives every indication of continuing until we all resemble the ponderous passengers on the movie spaceship in Wall-E—but without the anodyne of zero-g.

What can be done? Taxes on Twinkies? Measuring the obesity rate in “porcint”? Mandating spandex halter tops and sweatpants for Wal-Mart shoppers? No? Then how about a market-based solution?

I suggest we make a small change in how people are charged for their health insurance in any health care reform proposal. Then we can all just shut up and get out of the way as ingenious entrepreneurs emerge with real solutions for the aggravation of America’s adipose addicts. All we need to do is allow health insurers to charge lower premiums to anyone who periodically proves that his or her body mass is within a normal, healthy range. Above that, the higher your body-mass index, the higher your insurance premiums. Want to lower your premiums? Then lower your weight.

Such a system is inherently fair. It entitles people who choose not to reduce their rotundity to tell the rest of us to go engage in anatomically-improbable acts. They’ll now be paying for their god-given right to become One with the smorgasbord. Others will find it financially compelling to invest in programs with money-back guarantees that they’ll actually earn those big insurance savings. With the acknowledgment that there are indeed some folks who cannot safely lose weight by any medically-appropriate means, they would get either medical exemptions from paying the higher premiums or premium subsidies to cover the differential.

Of the tens of thousands of entrepreneurs responding to the challenge, a few will discover techniques that are effective, fun, easy, and cheap. They will all die rich. Doctors will spend more time treating medical problems that aren’t self-inflicted. Health care cost savings will be huge. And I’ll let my insurance company bribe me into finally losing the ten pounds or so that stand between me and the government’s definition of “normal weight.” As an added bonus, I promise I’ll never again afflict you with fat puns—alliterative or otherwise.