by Marion Nestle
Sep 19 2012

JAMA publishes theme issue on obesity

Yesterday, JAMA released a theme issue on obesity with several articles of particular interest, starting with New York City Health Commissioner Tom Farley’s Viewpoint.  About portion sizes, Dr. Farley notes:

As publicly traded companies responsive to the interests of their shareholders, food companies cannot make decisions that will lower profits, and larger portion sizes are more profitable because most costs of delivering food items to consumers are fixed….The sale of huge portions is driven by the food industry, not by consumer demand….The portion-size studies strongly suggest that, with a smaller default portion size, most consumers will consume fewer calories.  This change will not reverse the obesity epidemic, but it can have a substantial effect on it.

Lots of interesting food for thought here.  Take a look:


Viewpoint

The Role of Government in Preventing Excess Calorie Consumption:  The Example of New York City
Thomas A. Farley, MD, MPH
JAMA. 2012;308(11):1093 doi:10.1001/2012.jama.11623

The Next Generation of Obesity Research:  No Time to Waste
Griffin P. Rodgers, MD; Francis S. Collins, MD, PhD
JAMA. 2012;308(11):1095 doi:10.1001/2012.jama.11853

FDA Approval of Obesity Drugs:  A Difference in Risk-Benefit Perceptions
Elaine H. Morrato, DrPH, MPH; David B. Allison, PhD
JAMA. 2012;308(11):1097 doi:10.1001/jama.2012.10007

Cardiovascular Risk Assessment in the Development of New Drugs for Obesity
William R. Hiatt, MD; Allison B. Goldfine, MD; Sanjay Kaul, MD
JAMA. 2012;308(11):1099 doi:10.1001/jama.2012.9931

Original Contribution

Exercise Dose and Diabetes Risk in Overweight and Obese Children:  A Randomized Controlled Trial
Catherine L. Davis, PhD; Norman K. Pollock, PhD; Jennifer L. Waller, PhD; Jerry D. Allison, PhD; B. Adam Dennis, MD; Reda Bassali, MD; Agustín Meléndez, PhD; Colleen A. Boyle, PhD; Barbara A. Gower, PhD
JAMA. 2012;308(11):1103 doi:10.1001/2012.jama.10762

Association Between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents
Leonardo Trasande, MD, MPP; Teresa M. Attina, MD, PhD, MPH; Jan Blustein, MD, PhD
JAMA. 2012;308(11):1113 doi:10.1001/2012.jama.11461

Health Benefits of Gastric Bypass Surgery After 6 Years
Ted D. Adams, PhD, MPH; Lance E. Davidson, PhD; Sheldon E. Litwin, MD; Ronette L. Kolotkin, PhD; Michael J. LaMonte, PhD; Robert C. Pendleton, MD; Michael B. Strong, MD; Russell Vinik, MD; Nathan A. Wanner, MD; Paul N. Hopkins, MD, MSPH; Richard E. Gress, MA; James M. Walker, MD; Tom V. Cloward, MD; R. Tom Nuttall, RRT; Ahmad Hammoud, MD; Jessica L. J. Greenwood, MD, MSPH; Ross D. Crosby, PhD; Rodrick McKinlay, MD; Steven C. Simper, MD; Sherman C. Smith, MD; Steven C. Hunt, PhD
JAMA. 2012;308(11):1122 doi:10.1001/2012.jama.11164

Health Care Use During 20 Years Following Bariatric Surgery
Martin Neovius, PhD; Kristina Narbro, PhD; Catherine Keating, MPH; Markku Peltonen, PhD; Kajsa Sjöholm, PhD; Göran Ågren, MD; Lars Sjöström, MD, PhD; Lena Carlsson, MD, PhD
JAMA. 2012;308(11):1132 doi:10.1001/2012.jama.11792

Surgical vs Conventional Therapy for Weight Loss Treatment of Obstructive Sleep Apnea:  A Randomized Controlled Trial
John B. Dixon, MBBS, PhD, FRACGP; Linda M. Schachter, MBBS, PhD; Paul E. O’Brien, MD, FRACS; Kay Jones, MT&D, PhD; Mariee Grima, BSc, MDiet; Gavin Lambert, PhD; Wendy Brown, MBBS, PhD, FRACS; Michael Bailey, PhD, MSc; Matthew T. Naughton, MD, FRACP
JAMA. 2012;308(11):1142 doi:10.1001/2012.jama.11580

Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults
Ian J. Neeland, MD; Aslan T. Turer, MD, MHS; Colby R. Ayers, MS; Tiffany M. Powell-Wiley, MD, MPH; Gloria L. Vega, PhD; Ramin Farzaneh-Far, MD, MAS; Scott M. Grundy, MD, PhD; Amit Khera, MD, MS; Darren K. McGuire, MD, MHSc; James A. de Lemos, MD
JAMA. 2012;308(11):1150 doi:10.1001/2012.jama.11132

Editorial

Progress in Filling the Gaps in Bariatric Surgery
Anita P. Courcoulas, MD, MPH
JAMA. 2012;308(11):1160 doi:10.1001/jama.2012.12337

Progress in Obesity Research:  Reasons for Optimism
Edward H. Livingston, MD; Jody W. Zylke, MD
JAMA. 2012;308(11):1162 doi:10.1001/2012.jama.12203

Comments

Fascinating that a cross-sectional study would be included in a special issue – of JAMA, no less! They are of limited value in obesity studies, which the authors admit but no less will get media play, I imagine, with this important study limitation being lost to readers. We shall see…

  • Steve
  • September 19, 2012
  • 9:18 am

That paragraph strikes me as a total misunderstanding of economics.

Yes, the marginal cost of making a meal slightly larger is very cheap. That doesn’t mean that meal size isn’t driven by consumer demand. If consumers weren’t driving portion sizes, why aren’t they bigger than they currently are? After all, the marginal cost of giving more french fries would be very cheap.

The answer: It’s only profitable to increase marginal portion size as long as that larger portion size increases your profits by at least as much as the marginal cost. In other words, you can only increase your portion size if customers are willing to pay more money for your product because of the extra food on the plate.

The fixed cost nature of restaurants does make them more able to serve larger portions at a lower price, but it doesn’t actually reward them for serving those larger portions unless customers demand it.

  • Sam
  • September 19, 2012
  • 1:20 pm

The most expensive thing when you buy a processed food is not the food, but the packaging it comes in. The larger the package, the smaller the package surface area compared to the volume of food. So I spend less in packaging to pack a larger amount of food. Also, particularly with glasss, it also means lower weight per amount food shipped and this lowers my shipping/energy costs. The savings from the packaging and shipping is always more (if it not the company doesn’t make the change) than the cost of the extra food, so the company makes more money on the larger package.

Now a consumer may not go to the store saying, geez I wish I had bigger bag of chips, but when they see the pricing $1 for a 100 chips vs $1.15 for 125 chips (25% more!!!), they’re going to buy the 125 chip bag, not because they want more chips, but because it looks like a better economic deal…and hey it might last longer. Of course, as Marion pointed out in a recent post, the 125 chips do not last longer than the 100, studies show that when people are presented with more junk food, they eat more of it, not less. So the 125 chip bag goes just as fast the 100 chip bag and the consumer goes back to the store and stil buys the 125 chip bag because it’s still a monetary deal and we are bad at gauging our food consumption and those trade offs with money(which of course Food Companies know through market research), so the the food company makes more money on the big bag and the consumer gets fatter. Then the food company figures out how to make a bigger cheaper bag, and the cycle repeats itself.

http://www.fosteringwellness.net/doctor/chiropractor/550S/chiropractic-Rutland/the-french-paradox.htm

Look at this interesting paradox regarding wine, fats, and dietary habits.

Leave a comment