Yesterday, a New York State Supreme Court Judge struck down the first attempt in the U.S. to fight against obesity by legally regulating portion sizes. A day before a law was due to take effect that would limit the allowed size of sugary drinks sold in restaurants, food courts and movie theatres to 16 ounces, Judge Milton A. Tingling called the limits “arbitrary and capricious,” and stopped the implementation of Mayor Bloomberg’s most heralded, but also most debated initiatives.
What stood behind the initiative?
Mayor Bloomberg explains it best himself:
[youtube=http://youtu.be/VD6U5ppL_RE]
In public health literature, the “supersizing” of serving sizes, including of sugary sodas, had increasingly been linked to the rise of chronic diseases, in particular obesity-related diseases such as adult-onset diabetes and cardio-vascular issues. The increase in consumed calories is especially subtle and unnoticeable when consumed in liquid form – when you drink a super-size coke, say – because your body doesn’t register them as “food” and doesn’t regulate your hunger cues accordingly. And yet, even the 16-ounce serving, which would have been the largest size allowed, contains the equivalent of 12 packages of sugar and 10% of an average person’s caloric needs for the day.
In addition, researchers believe that the average person subconsciously applies rules of thumb in their decision-making in order to cope with our daily avalanche of choices. Such a rule of thumb could be, for example, “always eat up your plate”, or “always only consume 3/4 of what I was served.”
Thus, behavior economics and medical research have found a psychological bias in consumption decision-making depending on the size of the serving vehicle – most people will eat or drink more if they are faced with a larger bowl of soup, say, than with a smaller one.
These reasons are why public health specialists and nutritionists for the most part stood squarely behind Mayor Bloomberg’s initiative, arguing that making it “just a tiny bit harder” to make the same (unhealthy) choices – for example by buying 2 16-ounce bottles or adding sugar to your coffee yourself – would already be a first step in moving to a “default” healthy option, without limiting individual choice all that much.
Image by Bonnie Natko, via Flickr Creative Commons.
But. The proposed law also had a mountain of opposition, arguing that it was paternalistic, ineffective or even discriminatory. Interestingly, the obvious opponents – big soda companies such as Pepsi-Co and Coca-Cola – were joined by minority-advocacy groups, who argued that the law unfairly discriminated against bodegas and other small neighborhood stores while leaving supermarkets and other retailers exempt. In other cases, similar organizations had opposed taxes on sodas, arguing it would be a form of regressive taxation – targeting the poor more than the rich, since they spend a larger part of their income on food.
An interesting New York Times article highlighted that African-American and Latino community organizations often rely on sponsorship or philanthropy grants from large beverage companies; these charitable givings are apparently in the millions of dollars. Does that mean they are in the pockets of the big organizations and captive in their opinion on public health initiatives? It’s a question that is hard to answer, especially since this statement by Jose Calderón, the president of the Hispanic Federation, seems to reflect a common viewpoint in society:
“I don’t think we move the needle by legislating what people ultimately eat or drink,” Mr. Calderón said. “Our experience has been that you educate folks, empower folks — meet them where they are, basically.”
According to a New York Times poll, 60% of New York residents opposed the measure, with Bronx and Queens residents more likely to answer that they thought Mayor Bloomberg’s idea was misguided than people living in Manhattan.
On the other hand, the financial relationships between soda companies and non-profit groups go back decades and are extremely important for the non-profits to fund the programs they implement, so it is very possible that, according to the NYTimes, “the money has effectively muzzled organizations that might otherwise be on the side of regulation.“
Mayor Bloomberg has pledged to appeal the case, but it is unclear whether that will happen in time before he leaves office – and his successors are less likely to pursue the public health fight with the same fervor as him, leaving the trajectory of U.S. public health legislation as of yet open.
What is your view? Is legislation required to make the healthy choice the easy one, or are such initiatives taking away people’s freedom to decide and insult their rationality?
This is an interesting issue… psychologically, I wouldn’t want to think my rights are being infringed upon by the government making choices for me on my own consumption patterns. I also know lower income individuals and families need to rely on unhealthier foods because they don’t have access to or cannot afford the fresher, healthier alternatives, and so a ban like this, without simultaneously addressing the access to food issue, does imply a disregard for the situations of millions of Americans. (Although one could argue banning soda doesn’t eliminate the unhealthy eating options available, it is more the mentality, in my opinion). However… obesity and chronic illness plagues the US (and other) health systems, costing everyone millions of dollars – so by that argument, shouldn’t we be fighting to eliminate the causes any way we can? When I think about it in a vacuum, it infuriates me that peoples own choices to live unhealthy lifestyles will cost me money – whether it be eating poorly, smoking, excessive drinking, what have you. But we’re not in a vacuum, and a lot of these problems reflect deeper issues with poverty, stigma, lack of education… so many things.
I almost always err on the side of education and empowerment. Let’s remove soda and unhealthy snacks from schools, sure, but as a whole, we should be teaching kids (& adults!) about healthy eating and the problem with huge portion sizes. But more importantly, the government should also be working to provide the alternatives they promote, so healthy and affordable food is available to everyone, regardless of where they live and how much they make. Until we work to provide alternatives, it won’t really matter whether bad foods are banned, because while it might stop people eating them, they’ll just be going hungry–and will be unhealthy either way.
Great blog Janina! Very thought provoking.
This is very thought provoking! I can understand the uproar response to the government’s decision as it would infringe on the rights of the American people to decide for themselves. But at the same time, the law will only regulate portion sizes and not the entire product of soda itself. The reason behind the opposition is fueled by these big sugar drink companies, as you’ve stated, and should only prove the point that they are economically, and not health, driven. I also feel that the people have been given the ‘chance’ (for lack of a better word) to choose healthier alternatives for a while now. I see it as a ‘parenting’ tool but for a nation, or in this case, a city, parallel to what we call ‘tough love’. In the end it is in the benefit of the people themselves (for both their mental, in regards to self esteem, and physical health). Still I will always believe that education regarding unhealthy vs. healthy eating (and more so policies on junk-food advertising!) should be more enforced and used as a main initiative to curb the obesity rise, especially in younger children and in schools. Rather than taking something away, as we will always want what we can’t have…
A very good blog post! It’s made me think.