An unprecedented move to tackle obesity in New York

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Recently New York City Mayor Michael Bloomberg proposed a ban on sales of sugary drinks larger than 16 ounces in restaurants, delis, sports arenas, and movie theaters in New York. His proposal has no precedent; New York is the first city in U.S. to directly attempts to limit sugary-drink’s portion. At a public hearing about this proposal the health experts, politicians and soda supporters squared off.

American beverage association, their advocacy group: New Yorkers for beverage choices, local council men and some consumers strongly object the idea. Aside from the obvious reason that it will reduce profit, the soda companies claim it will limit people’s choice which is a violation of civil right.

On the other hand, groups like Center for science in public interest (CSPI) said, in the wake of obesity epidemic it is about time to address the issue of increasing portion size of sweetened beverage which has increased many folds over the last fifty years. Besides, Dr. Walter Willett, chairman of epidemiology and nutrition of Harvard Medical School, pointed out that sugary drinks are now the single greatest source of added sugar in American diet. Therefore he supports the idea of attacking the number one target in the fight against obesity.

Although anybody can easily circumvent this ban that is if someone wants to drink 32 ounces of soda he or she can just buy two 16 ounce sodas.  But there is a behavioral economics called “default bias” behind this proposal which is: If a choice is offered where one option is seen as a default, most people will go for that default option.  For example, in countries where people have to choose to be an organ donor, most people aren’t donors; whereas in countries where people by default are organ donors unless they actively choose not to be, most people are donors.  The soda ban makes size 16 ounce or less the default option for the consumers. If they want more they will have to make an extra effort for that.

Researchers have shown that people does not have a fixed perception about portion size, they tend to consume food in the size a bag, box or bottle it comes with, a phenomenon known as “unit bias”. In 1974, the biggest container size for soda was 21 ounces in McDonalds and today the biggest one is 32 ounces. Therefore, the fact that now the largest soda in McDonalds is 32 ounces makes a 21 ounce soda feel sensible. The proposed ban is designed to flip this effect in people’s mind; if the largest soda people can buy is 16 ounce, a 12 ounce soda may start to seem normal.   

Although public opinion polls show a majority of American oppose this plan, the doctors treating the casualties of the obesity epidemic say even this unpopular proposal to soda portion should be just the beginning of stricter regulation of unhealthy foods in the country. Therefore, this proposal is the first bold step to fight against the big and powerful beverage companies who are spending billions of dollars marketing these large sugary drinks which are directly related to obesity. For the past forty years people have been the subject of social-science experiments, conducted by beverage and fast-food companies which only made these companies richer. And now they will again be the subject of such an experiment, conduct by the Department of health and Hygiene of New York City. But this time it will be for their benefit that is to reduce obesity epidemic in New York.  Plus there is good chance that this unprecedented experiment will be successful.     

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3 Responses to “An unprecedented move to tackle obesity in New York”

  1. meghanrimelspach Says:

    I agree that obesity is a problem and find this to be a very interesting approach. To some extent, I like the idea of changing the environment and making it harder for people to make the unhealthy decision, but I am not sure about the long term effectiveness of something like this. I wonder what the break down is of where people get/consume the beverages. For instance, if a majority of pop is purchased at grocery stores, the impact of this policy is likely to be minimal. Also, many restaurants have free refills on beverages, so the size of the cup might just make more work for the servers and not curb consumption. I can understand why beverage manufactures would be upset about this policy, since there are certainly a lot of other foods that are unhealthy which are not being targeted. There are so many factors that impact health, I hope this is part of greater comprehensive strategy.

  2. sbf2012_jonf Says:

    Thanks for posting this interesting article on the soda ban in NYC. Whenever I read articles on soda taxes or bans, I always picture myself at the movie theatre deciding between the regular (but still humongous) fountain soda, versus the ridiculously-sized large “for only 25 cents more!” (of course, I always choose the larger size because it’s relatively cheaper — what does that say about the key determinants for obesity??)

    I’ve always been a proponent of broader-level interventions that change the environmental context to make the default decision a healthier one. Banning the sale of oversized portions may indeed make it harder for someone to consume the same amount of calories from a sugar-sweetened beverage – i.e. individual effort will be required to seek these extra portions. So this is an interesting idea for a public health intervention, and may signal a broader shift in social norms relating to obesity prevention.

    I think this also relates closely with the proposed soda taxes (e.g., Richmond, CA) as an intervention to reduce consumption of sugar-sweetened beverages. I tend to agree with taxes as good public health interventions for reducing consumption of certain unhealthy goods (effectiveness ranks high in my personal ranking of decision criteria, and there is substantial evidence for effectiveness and cost-effectiveness for alcohol and tobacco taxes). However, “effectiveness” is just one of the many criteria for deciding whether or not to implement an intervention at the population-level. Social acceptability, for example, can make or break the successful implementation of a public health measure. Indeed, taxes are always controversial among the population, and raise questions on individual liberties and government involvement. Moreover, some people may argue that those who consume the unhealthy product are the ones responsible, and thus we should not penalize society as a whole with a tax.

    However, I would tend to argue that obesity is society’s problem (e.g., the costs and burden of obesity is shifted to society as a whole), and that in some cases, consumers cannot always make fully-informed and rational decisions about consumption of junk foods (see http://www.theendofovereatingbook.com/), thus constituting a market failure and necessitating government intervention via taxes. Also, one cannot ignore the public good that arises from these types of interventions, such as reduced obesity at the population-level and increased revenue for public programs.

    Either way, I’m hoping that this will form just a part of a comprehensive obesity prevention strategy that targets individual behaviours and national-policies (and everything in between) through the use of health education, promotion of physical activity, policy changes, environmental changes, manufacturer changes, and changes to social norms. I’m also hoping that NYC and other jurisdictions are conducting rigorous process and outcome evaluations to provide evidence for effectiveness, cost-effectiveness, uptake, public perception, etc.

  3. mkamau17 Says:

    I find it perplexing that Americans would be opposed to the ban on large sugary drinks even though the country is struggling with the obesity epidemic. I even find it more perplexing that some Americans consider the ban a violation of their civil rights. Not only do i support the ban, i also support a move that would begin to hold soda companies liable and would somehow discourage their profit driven motives that endanger the health of Americans. The absurdity of large sugary drinks available in the U.S. is more evident when one travels to Europe and other countries in the world. In addition, let us also not ignore the fact that the American taxpayers will have to incur the costs of providing healthcare to millions of Americans who are suffering from chronic conditions like diabetes due to obesity as a result of massive consumption of large sugary drinks.

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