by Marion Nestle
Jan 9 2012

New York CIty Health Department launches portion-size campaign

The amazing New York City Health Department, almost unique in its interest in public health and willingness to do what it can to improve the health of New Yorkers, adds another campaign to its collection of hard hitters.  This one is on the need to reduce portion sizes.

The subway campaign posters in Spanish and English.  Here’s an example in Spanish.

I especially like this campaign because much of the work on increasing portion sizes in the food supply was launched by my former doctoral student, now Dr. Lisa Young.  See:

Larger portions do three things:

  • They have more calories, obviously.
  • They induce people to eat more calories
  • They induce people to underestimate the number of calories they are eating

All of these induce people to eat more than they need or should.

The expansion of portion sizes alone is sufficient to explain rising rates of obesity.

The Health Department’s campaign makes sense.  Let’s hope it helps.

Update, January 10: The American Beverage Association doesn’t like the ads much, according to Crain’s:

Portion control is indeed an important piece of the solution to obesity,” said said Stefan Friedman, New York spokesman for the American Beverage Association, in a statement. “But instead of utilizing scare tactics, the beverage industry is offering real solutions like smaller portioned containers and calorie labels that show the number of calories in the full container, right up front, to help people chose products and sizes that are right for them and their families.

And if you think the New York City ads are tough and hard-hitting, try these “Strong4Life ads from the state of Georgia.  Shocking people out of complacency?  Or just shocking?

Update, January 25: The New York Times reports that the shocking photograph of an overweight man with a leg amputation was “photoshopped” from a stock photo.

This is unfortunate, as it opens the Health Department up to unnecessary criticism:

The American Beverage Association, which opposes the city’s efforts against sodas and fast food, called the advertisement overwrought. “This is another example of the ‘What can we get away with?’ approach that shapes these taxpayer-funded ad campaigns,” Chris Gindlesperger, the association’s director of communications, said in a statement.

  • Sarah

    What’s with the use of a mildly plump person in a wheelchair to advertise an anti-obesity initiative? That person obviously isn’t in the chair because of obesity– and even if that was the case, the ubiquitious “headless fatty” is demeaning. I’m all for reducing portion sizes (along with prices, one would hope) but the way the ad is framed is really problematic.

  • Michael Bulger

    Sarah,

    I share a concern regarding the stigmatization of individuals, but I thought I might offer some information.

    Research literature suggests the risk of mobility disabilities increases with obesity.

    http://aje.oxfordjournals.org/content/169/8/927.short

    http://www.ncbi.nlm.nih.gov/pubmed/20059707

    Further, type 2 diabetes is correlated with obesity and poor diet. There are several complications that can arise in diabetics that too often lead to mobility disabilities.

    http://www.ncbi.nlm.nih.gov/pubmed/20059707

    Mobility disabilities are just some of the unfortunate health outcomes that the NYC Health Dept. is trying to address. I hope they can spread the message and prevent an even broader range of problems, such as strokes and heart disease.

  • lisa

    The woman in the scooter is not “mildly plump.” She’s obese. Our culture has grown delusional and self-serving in excusing what is considered fat.

  • Michael

    Sarah: I don’t know that woman’s BMI, but I am pretty sure she is obese, not ‘plump.’ I’m afraid this may be a case of the same ‘portion distortion’ happening to human body shapes, as polls and formal studies keep showing — eg, just recently:

    “As Americans’ actual weight has increased, so has their ideal weight.”
    http://www.gallup.com/poll/150947/Self-Reported-Weight-Nearly-Pounds-1990.aspx

  • Margeretrc

    I think serving smaller portions is a great idea–as long as there is a drop in price to go along with it. Good luck getting restaurants, etc. to go along with it, however.
    “The expansion of portion sizes alone is sufficient to explain rising rates of obesity.” Sufficient? Perhaps. Actual cause? Not likely. One needs to remember that portion sizes reflect what the venders have found their customers want. The question one needs to ask is why do we want ever increasing portion sizes? Solve that problem and the portion sizes will take care of themselves. I’m skeptical that, even if this campaign is successful, it will make a significant dent in the obesity epidemic, because it does not address the root cause.
    Personally, I don’t want a large portion and, if served one, will share or take home part of it.

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  • Sarah Too

    Heightening awareness of portion sizes is one thing, coupling it with images of obese folks… doesn’t that feed into the corporate personal responsibility spin? There has to be another way.

  • http://foodforlunch.org jennie cook

    Could we start in the public schools please, and start teaching healthy habits before our addictions are raging for processed food as young adults?

  • Susan of Litttle Ladies Who Lunch

    Jennie Cook in the comment section makes perfect sense. Other than that, I am fully willing to pay more money to get REAL FOOD even if there is less of it.

  • Joe

    First, who gets to decide how much a person needs to or should eat? Is that the NYC HD’s next campaign?

    Secondly most restaurants do offer smaller portions for a lesser price its called the childrens menu.

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  • kathleen nolan

    Wow- people sure are touchy. A co-worker just about the same size as the model looked at this column and said “Yes, she’s fat- just like me. That’s why she’s using that scooter – I use them too. In the market, when I go to Disneyland or anytime having to walk alot would get in the way of me having fun. That’s real life.”

    @Joe – no one “gets to decide how much a person needs to or should eat” …. it’s simple biology. You can oberve it for yourself. People who today who might be considered “plump” or “heavy” would have been in the circus 150 years ago. Check it out. Our culture – especially the “Food Industry” is normalizing fat folks (BTW, I am unfortunately one of them, being 30-lb overweight). This is seriously to our detriment.

    Wake up, people!

  • Joe

    I am losing confidence in the argument that our history was better and more pure. It is a flimsy premise on which to build arguments. It may be true that fat people were fewer in number years back but there were fat people. It is also true that in times past those who carried more body weight were considered part of the upper class by society. What chance would Chester Arthur have of becoming President today simply based on his appearance. The answer is slim (pun intended) to none.

    All I contend is that the discussion of weight, diet, fast food etc all too often smacks of one group controlling what another chooses to eat however much that might be and that is an outrage that free people should be against.

    Furthermore it is not the role of government federal, state or local to engage in such programs as telling people what or how much to eat.

  • http://www.ilr1.uni-bonn.de/mafo/mafo_e.htm Gesa

    I totally agree to Sarah´s comment, it´s stigmatization of individuals´s. Overweight indivuals do what they are expected to do, they are perfect consumers and they are perfectly adapted to an obesogenic environment. Obesity is caused by more than 100 factors as shown by the British foresight report on obesity: http://www.bis.gov.uk/assets/bispartners/foresight/docs/obesity/11.pdf
    A scare campaign focussing on the individual is just unfair.

  • http://justjuliebean.wordpress.com julie

    Joe – childrens’ menus generally consist of crappy foods. The last restaurant I ate at had cheese quesadillas, grilled cheese, or burgers, all with fries, none with veggies or salad. Adult food was not nearly such a fried starch and dairy fest. Not to mention that most restaurants won’t allow adults to order off of this menu.

    A better tactic, and one I often take, is just to eat an appetizer for dinner.

  • Michael

    Folks, no one here, nor the NY public health campaign, is bashing fat *people* , any more than showing the lungs of smokers is bashing smokers, or showing people in cancer wards is bashing cancer patients. We’re raising the alarm about the health consequences of obesity.

  • Dee

    Of course the person in the picture is clinically obese. So was I when I wore a size 12/14, walked two miles every day, and went to the gym four times a week. Now that I’m only walking about five miles a week and don’t go to the gym, I wear a 16W and am classified as “very obese.”

    The definition of obesity includes people who are quite fit and don’t look fat, let alone the person in the ad, who looks moderately fat; a size where nobody is disabled solely by their weight. Yes, anybody who’s that size and uses a scooter is using the scooter because they’re either disabled for another reason or are incredibly lazy.

    Because the focus is obviously on weight, that ad implies that the person pictured is incredibly lazy and got fat by eating oversized portions. That certainly is “bashing fat people.”

    If I saw that person on the street, I’d guess they’d put on weight after becoming disabled. Again, although I’d guess the person in the ad is clinically obese (BMI over 30), they are much, much too small to have the kind of weight-induced mobility issues that would require the use of a scooter.

  • Mitzi

    I have mobility issues at a BMI of 20 due to an inherited disorder. Unfortunately my mother and grandmother weighed more than twice what I do, and their weight caused them agonizing disability. We need to get real with people who deny that there is a problem, or that we need to do anything about it. Those of use with these conditions have to be especially vigilant as a 20-pound weight gain would cost me my knees.
    And yes, people in the past were thinner. Before my grandparents’ generation, everyone on my mother’s side was thin (one great-grandmother lived to be overweight). I have family pictures going back to the early 1900s to prove it. Now all Mom’s siblings and most of her cousins are or have been obese (until they get really sick). The hard work and periodic famine of country life really kept them thin, until constant, fatty, sugary food became available. Then bodies tuned to periodic fasting put on the pounds. I’m not saying obese people need to starve themselves or something. what I am saying is that medicine will not come up with a happy pill to take away all our food indiscretions. We need to take care of ourselves. Learning what food budget your body needs, and living accordingly, is really important.

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  • Margeretrc

    @Mitzi, “The hard work and periodic famine of country life really kept them thin, until constant, fatty, sugary food became available.” Leave out the “fatty” and you would be right. People eat less fat now than those hard working country folk, but they eat a lot more sugar and starch and therein lies the problem. That and frankenfats like partially hydrogenated vegetable oils. If people had stuck to real, unprocessed foods made the way our grandparents and great grandparents made them, there probably wouldn’t be epidemics of obesity, T2 diabetes and heart disease and no one would have to talk about portion control. Because when you eat real food, including the fat, portion control takes care of itself.

  • Ryan Ito

    I definitely agree with launching this campaign. My trip to Japan as well as my friend’s return from England revealed the complete dichotomy in proportions between the United States and the rest of the world. “Supersized meals” don’t exist elsewhere; their large meals are our small meals; the rest of the world has probably never seen a huge 7/11 cup before.

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  • Neena

    So the folks blaming ‘NYC Department of Health’ of trying to control the public eating habits and fat bashing would like the state to just stay out of it, is that it??
    How about drug control, age limits on alcohol etc.,Ohh these have harmful impact on the public health…
    Well guess what so does obesity & overeating..this may not be the only factor in obesity but it is decidedly a huge factor and people have been so desensitized to the large portions that bringing the focus that will definetely help. Do not making it such a sacred cow that can not even be discussed, What can be mentioned can be!!! managed..

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