America has the highest rate of obesity in the world. A third of American adults are defined as obese (meaning they have a body mass index score of 30+). And three times as many children (17%) are obese as three decades ago.
And yet, America has generally resisted aggressive approaches to dealing with obesity. We don’t have the sugar taxes of Mexico or Finland (unless you count Berkeley’s soda tax). Measures like New York Mayor Michael Bloomberg’s oversize soda ban are defeated in the courts and in the bureaucracy. And even relatively minor ordinances–like Santa Clara’s idea to ban toys in unhealthy meals–are met with laughter and derision. (Jon Stewart called it the “Crappy Meal” plan.) Americans don’t like being told what to eat, even if that food is bad for them and the consequences are wider than themselves. Obesity-related health care costs are $147 billion to $190 billion a year–costs that we all, one way or another, end up paying.
In a new paper, Stanford legal professor Deborah Rhode weighs the costs and benefits of 10 anti-obesity policies, including bans on certain marketing to kids, increased public education, and litigation against food manufacturers. She concludes that “public education, or access to parks and quality PE programs” are the best approach, especially if they’ve paid for by taxes on sugar-sweetened beverages.
“Such taxes have the double benefit of raising revenue and deterring consumption, and polling data suggests that they become more politically acceptable if the funds raised are targeted to obesity prevention,” Rhode says.
Several studies have shown that demand for sugar-sweetened drinks is strongly linked to price–which is probably why drinks manufacturers have aggressively resisted such new laws. One paper says a 10% tax on soft drinks could reduce purchases by 8% to 10%. Many people point to tobacco: When we increased the price through taxes, people stopped smoking so much.
Despite her legal background, Rhode says litigation isn’t likely to help with obesity. Plaintiffs have a high bar they have to meet in linking harm to manufacturers’ products, even when they can prove that those manufacturers manipulated the truth of what was inside those products. “Although litigation can help raise public awareness and deter misleading marketing practices, it is unlikely to play a major role in obesity prevention,” she says.
Rhode is more optimistic about zoning for obesity–that is, restricting fast food (and unhealthy foods) allowed in “sensitive” areas, like around schools. She also describes restrictions on marketing unhealthy foods to kids (including bans on toy promotions and school advertising) as “cost-effective ways of changing the environment in which food choices are made.” Meanwhile, more calorie information in more places would also be useful (although the evidence for that is mixed).
Where you stand relates to whether you think the government has the right to intervene. Some people will always see eating decisions as a matter of personal choice. Others say we have a responsibility to reduce the scale of the problem, collectively if necessary. The problem is that obesity (and food) neatly exposes the usual Right-Left rifts. But we do need to do something more than what we’ve done so far: whatever that was isn’t working.