by Marion Nestle
Sep 18 2012

Today’s debate: The Wall Street Journal asks who’s responsible for preventing obesity?

Betsy McKay of The Wall Street Journal organized and moderated a debate on this question.  I was a participant along with Brian Wansink , the John S. Dyson professor of marketing at Cornell University and Michael D. Tanner, senior fellow at the Cato Institute.

The debate is lengthy—you can read all of it online—but here are my initial responses to the two questions asked of me.

WSJ: What role should government play in addressing the obesity epidemic?  

DR. NESTLE: The government is up to its ears in policies that promote obesity. To name only a handful: supporting production of food commodities, but not of fruits and vegetables; permitting food and beverage companies to deduct marketing expenses from taxes; permitting SNAP benefits [food stamps] to be used on any food, thereby encouraging food companies to market directly to low-income groups.

Research on the prevalence of obesity shows that after decades of remaining at the same level, it began to increase sharply in the early 1980s. Our sense of personal responsibility did not change then. What did change was the food environment, transformed by food industry imperatives to increase sales, to one that increasingly urged people to “eat more” by making it socially acceptable to eat anywhere, anytime, and in very large amounts. In this kind of food environment, all but the most mindful eaters overeat. Few of us are in that category.

The food, beverage and restaurant industries collectively spend roughly $16 billion a year to promote sales through advertising agencies, perhaps $2 billion of that targeted at children. Marketing to children is well established to encourage kids to want advertised products, pester their parents for them, and believe that those products are what they are supposed to be eating. The “I am responsible” argument does not work for children (I’m not aware of evidence that it works well for adults either). Because regular consumption of junk foods and sugary drinks is linked to obesity in children, marketing these products to them is overtly unethical.

To expect food and beverage companies, whose sole purpose is to increase sales and report growth in sales every quarter, to voluntarily stop marketing to children makes no sense. On ethical grounds alone, government intervention is essential.

Given the personal and economic costs of obesity—currently estimated at $190 billion a year—governments have many reasons to promote the health of their populations. Just ask the military.

WSJ: Let’s talk about some specific initiatives. Will Mayor Bloomberg’s cap on soda sizes reduce soda consumption? What about the proposed municipal tax of a penny an ounce on sugary drinks in Richmond, Calif.?

DR. NESTLE: If only education and personal responsibility worked to improve eating behavior. Brian Wansink’s research clearly shows that his own students, diligently educated to understand the effect of large food portions on eating behavior, will still eat more when given more food—and, more seriously, they will underestimate the amount they have eaten.

Education must be backed up by a supportive environment. So why not create a food environment that makes it easier for people to eat less? Mayor Bloomberg’s idea of capping soda sizes at 16 ounces is an interesting approach to doing just that. A 16-ounce soda is not exactly abstemious. It is two standard servings, 50 grams of sugar and 200 calories.

To suggest that food laws will not change behavior makes little sense. For one thing, anti-obesity initiatives have scarcely been tried. For another, the history of anti-smoking interventions suggests quite the opposite. Attempts to get smokers to quit by invoking personal responsibility made little headway. Smokers quit when the government made smoking so inconvenient and expensive that it became easier to stop than to continue.

The intense response of soda companies to Mayor Bloomberg’s cap on soda size is testimony to the effectiveness of regulatory approaches. The companies would not be putting this kind of effort or spending millions to oppose an action they expected to fail.

  • alex

    Education must be backed by a supportive environment. I believe that making these small changes will make a difference. It is just so difficult for these changes to be accepted. I don’t think the shift that favors an obesogenic lifestyle was difficult for the US to adapt or that there was any sort of uproar about more fast food locations. Why is the opportunity for a healthier life that will improve quality of life through less chronic disease complications so shunned?

  • http://www.drsusanrubin.com Dr. Susan Rubin

    Mayor Bloomberg is missing a huge opportunity to leave a lasting and sustainable legacy in NYC. Instead of this jumbo soda silliness, why not support the BEST healthy drink out there? WATER.

    NYC has some of the cleanest water in the country (at least now, before the fracking starts…)
    The 100 Fountains project would bring a drinking foundtain revival to the city. To learn more, click here:
    http://100fountains.com/

  • Steve

    Marion,
    I disagree with several of your comments, but probably the one I disagree with the most, is that our sense of personal responsibility hasn’t changed. Not only has it changed, it has changed dramatically. I am disturbed by the number of people who claim everything they don’t bother to control, is an addiction or is somebody else’s fault. And as long as you look for somebody else to blame, your problems will most likely continue, until you determine that your best option is your own will power.
    As I see it, children born from the mid 70′s and after (I am in my early 50′s), were growing up in a time when video games were popular. I went to many friends houses and watched their kids play video games literally for hours on end. For that reason my wife and I never allowed any video games in our home. Now in addition to video games and television, we have movie rentals, personal computers and facebook, cell phones and texting, and even games on cell phones. We are a much more sedentary society, and I think that has created a greater problem than the food industry, not that many people couldn’t eat healthier. I use to spend hours playing basketball in my spare time, because we were allowed 1 hour of TV.
    But if an example is not set in the home, of personal responsibility, healthy eating, and adequate exercise, I don’t think the government can legislate health by making laws restricting soda size or anything else for that matter. What we need is education, and if the parents don’t provide it in the home, then it should be in the schools. Children today are “addicted” to media of every type, and many families are convinced that they could not live without it. I am not sure what the answer is to break that notion, but I believe that is the bigger problem.

  • Mario

    Marion,
    You may be correct in saying that there is a bigger problem to be solved, however, you do not have a solution to this “bigger problem”. No one can have a solution to this problem, it has been brought on by so many factors all which cannot be taken on and changed simultaneously. While Mayor Bloomberg’s cap on soda sizes is not necessarily the best solution or the perhaps not even the right solution, it is an attempt, and right now that’s what our population needs.

  • http://www.how2loseweight.net/ Vijayraj Reddy

    Hi Marion,

    A very loaded question. I am sure nobody can answer this straight. Government’s hands are tied down most of the time because of their commitment to the national industries for various reasons. They would receive funds for endorsing new entrants in food chains and similar concepts. In such cases, they cannot vocally promote any cause which can be a double edged knife.

    Regards,
    Vijay

  • Joe

    What if obesity is not preventable? We are all of different heights, eye color, hair color and texture, skin colors, etc which makes us unique. Why is it that obesity is different? It seems to me that some are going to be thin and some are not. That is why two people with the same diet can have vastly different outcomes. Am I the only one that has noticed this?

    The first step in many government obesity programs is to reduce the consumption of soda (CDC, NYC). What about those fat or thin whose weight is unaffected by soda or other sugary drinks? When government singles out the soda industry as a main culprit in the so called obesity epidemic are they not villifying one specific sector of the economy/country. Isn’t that unfair because soda may or may not be the cause of obesity. The notion that it is is purely conjecture.

    What role should government play in addressing the issues of obesity? None at all because it is not the role of government to tell me what and what not to eat. And by the way the analogies to smoking are apples compared to oranges in this debate. Smoking contributes nothing to better health. Cigarettes and soda are not the same.

  • Anthro

    @Joe

    What does soda contribute to health?

    Obesity is an actual epidemic–not a “so-called” one.

    Prior to the 1980’s, as Marion points out, obesity was not much of a problem on a population-wide basis. She lists the factors that changed the food dynamic.

    No one is telling you what to eat. The efforts being made are aimed at unrestricted marketing to children.

  • grrljock

    Dr. Nestle, seeing as you had to “balance” the discussion against a professor of marketing and a Cato Institute fellow, I’m glad you got the last word to remind people what public health is (and the perniciousness of the personal responsibility argument).

  • http://burningbird.net Shelley

    Oh my god, talk about an uneven debate.

    Cato Institute? A professor of Marketing?

    I almost threw my computer out the window.

  • http://www.vitasanas.ch Leoluca Criscione

    ……and what about the responsibility of the obesity scientists? As obesity scientist and former researcher, I must shamefully state, that we scientists are co-responsible for the increase in obesity rates worldwide! We create and feed daily confusion and insecurity in people’s mind!
    Some of our sensational “discoveries” are often questionable and conflicting with each other. They generate therefore more confusion and uncertainty… even among scientists!
    This situation is co-driven by the interested industry with grants and sponsorships! We, the scientists, must more and more condemn these ways of malpracticing science, misinformation and “half-truths”.

  • https://twitter.com/#!/fredkzk Fred

    All one needs to curb obesity is a little education (from both schools and parents) and much less laziness at home!!
    The same junk food has been around in Europe yet people at not as obese thanks to an ongoing early education from our parents who are not so lazy to cook at home.

  • Courtney

    @ Joe – the notion that soda contributes to weight gain and obesity, including in children, is NOT conjecture. There is plenty of research to back this up.

    @ Steve & @ Fred – As Dr. Nestle stated, if education was enough to overcome this obesity epidemic, there wouldn’t be an epidemic anymore! It is well known by now what obesity and all of its co-morbidities does to us at an individual and national level – physiologically as well as economically. Perhaps you don’t want the government “to tell you what you can and can’t eat.” But the facts are that the majority of this country is overweight or obese and that it is affecting not only our health but our pocketbooks. The amount of money our government spends on healthcare for preventable conditions is astronomical and only getting worse which in turn affects our economical stability as a country. This affects ALL of us, even those who are not overweight or obese but still have to pay for it, and for that reason, the government should intervene.

    And Fred, just because you’re cooking at home doesn’t mean that you’re cooking HEALTHFULLY at home…

  • Michelle

    It is really insulting to say that it is purely a matter of parental responsibility when in so many ways society is working against us. I am a mother. I am not overweight and am in good health. I cook. I garden. We talk about nutrition and staying healthy way more than I remember my parents talking about it when I was small.

    In our house, soda is limited to special occasions. I enroll my kids in sports programs outside of school to keep them active, and insist that they play outside every day. And yet, it is a real struggle to keep my kids at a healthy weight. Why? Here are some of the things I’ve identified as challenges for us:

    1) The house we can afford is in the suburbs. There are very few places that we can walk or bike to – most trips require a car.
    2) With two working parents, there is very little time during the week for physical activity. If he kids get 30 minutes outside before dinner, we consider it lucky.
    3) With more and more academic requirements placed on our children’s schools, gym class, recess time and lunch time have all been cut back drastically. The children in our community have about 15 minutes to eat their lunches. This encourages them to eat too quickly and overeat.
    3) Additionally, to save money many of the smaller schools in our area have been closed. This means that the children’s schools are further from home, and it is less likely that the children can walk to them.
    4) Finally, portion sizes are a real issue. When we go out to eat, the meals off the children’s menu generally are more than enough food for me, and far larger than what my kids need. Recently, I took my children to a movie theater and (as a treat) ordered them each a small soda. Imagine my surprise when the clerk handed me two 32 ounce sodas!

    It isn’t just about lazy parenting or kids who just want to play video games all the time. For many of us, we’re just swimming against a really strong tide.

  • Patrick

    The key question in this debate is the role of government. Today it is 16 oz. sugary drinks, tomorrow will there be a ban on Big Mac’s or any other meal that contains too many calories? Logic dictates that those will be next in line. You ban high calorie soda, why wouldn’t donuts, rich sauces and more be next?

    NYC wants to improve the health of its citizens because NYC has to pay for a lot of its citizen’s healthcare. There are two arguments here, one is to improve health by improving diets, and the other is to stop paying for healthcare for people that make bad decisions.

    Where is Charlton Heston when we need him to come out and state “I’ll give you my soda when you take it from my cold, dead hands”

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