If you're obese, whose fault is it? Are you to blame, or can a finger be pointed at the huge portions served at local restaurants, the glut of fast-food joints in your neighborhood, or perhaps the lack of parks or other spaces to work out?
A commentary published today makes a firm case that the environment plays a significant role in obesity and calls on governments to do more to help halt and reverse the epidemic. The paper is by the man who is leading the way on government involvement, New York City health commissioner Thomas Farley. Farley is the guy who recently encouraged the city to enact a ban on restaurant sales of sugary soft drinks in containers larger than 16 ounces.
New York City has also taken the lead in recent years in passing laws requiring restaurants to cut trans fats from foods and post caloric information on menus and menu boards.
Obesity "is not a problem. It's a crisis," Farley said today at a news conference in New York City. His editorial is part of a special issue in the Journal of the American Medical Association focusing on obesity. "People's genes haven't changed. People haven't fundamentally changed. What has changed is our food environment. It is clear that an increase in calorie consumption is the major cause of the obesity epidemic."
About one-third of U.S. adults are obese and another third are overweight, according to government statistics. Those figures alone make this a public health issue. About 100,000 Americans die each year as a result of obesity, Farley says, and the epidemic costs the nation about $150 billion a year.
Americans want to lose weight and raise healthy children, he says, but heavily marketed, sugary foods placed in stores to encourage impulse buying can sabotage people's good intentions. Since the 1970s, Farley notes, caloric intake has increased between 200 to 600 calories per person per day.
Americans have tripled their consumption of sugary beverages over the last four decades with the average size of drinks increasing from 6.5 to 8 ounces in the 1960s to as high as 64 ounces today (containing about 50 teaspoons of sugar). While other scientists have hemmed and hawed about the causes behind the obesity epidemic, Farley lays a large share of the blame on sugary soft drink consumption.
"Sugary drinks are probably the largest single driver of the obesity epidemic," he says. "We should regulate the few marketing practices that harm people the most."
Farley and other government and public health officials have been criticized for over-reaching with anti-obesity regulations. Many people argue that individuals should have the right to choose what foods they purchase without the government slapping their hands.
"We see the problem of obesity as rising from the environment in which we all live," he counters. "We think [people who are obese or overweight] are victims of an environment that makes it too easy to consume calories and too hard to prevent it."
The new portion-size soda regulation is an effort to make it harder for consumers to over-consume. Under the law, restaurants (including food vendors in movie theaters and stadiums) cannot sell soft drinks larger than 16 ounces (about 200 calories), but customers can purchase as many drinks as they like and refills are allowed.
The regulation, which goes into effect in March, 2013, gives consumers a choice and makes them think about portion size, he says.
"It doesn't restrict what people can drink. It doesn't restrict how much restaurants can sell," Farley says. "We think this is reintroducing human-size portions."
Government regulations on unhealthful food marketing, he says, are not much different than laws concerning smoking or texting while driving. Few people look back at successful public-health initiatives—such as seatbelt laws or smoking bans in restaurants—and complain, he says.
"No one has yet come up to me and said, 'Please put trans fats back in my food. Please put second-hand smoke back in my restaurants,' " Farley says.
Governments, he says, should step in with laws targeting the most egregious unhealthful practices while encouraging food manufacturers to make voluntary changes and educating consumers on how to eat healthier. New York City officials have also proposed prohibiting consumers on the Supplemental Nutritional Assistance Program from using program funds to purchase sugary drinks.
But companies that want to move in the direction of healthier fare haven't always been supported for their efforts. PepsiCo's recent plans to promote healthier products was criticized by industry analysts and investors because of the potential impact to the company's bottom line, Farley says.
"Publicly traded companies cannot make decisions that will lower their profits," he says. PepsiCo officials "were reminded by their investors and shareholders that they should not go too far in that direction."
Do you think there should be more or less government intervention regarding the foods we eat? Let us know in the comments.