Law & Governance

Law & Governance 9(7) October 2008 : 53-56

Building Public Support for Anti-obesity Policy Initiatives

Bruce Silverglade


[This article was originally published in HealthcarePapers, Volume 9, Number 1.]

Solving the obesity crisis has less to do with post-partisanship and more to do with increasing public support for strong public policy initiatives that will make the healthy choice the easy choice. The government has an important role in mitigating the toxic food environment created by food manufacturers and restaurant chains. Progress to date has occurred on the state level. With greater public support in a new political environment, national progress may be possible in the foreseeable future.
"The Prevention Moment: A Post-partisan Approach to Obesity Policy" by Neil Seeman makes a welcome attempt to overcome many of the political and ideological hurdles that have acted as barriers to public health initiatives intended to help consumers improve their diets and reduce their risk of obesity and diet-related disease. The article also recognizes the severity of the problem. Obesity increases the risk of heart disease, diabetes and other chronic diseases that represent the leading causes of death in the United States and claim hundreds of thousands of lives each year. Increases in childhood obesity over the past two decades may make this generation of children the first in history to live shorter lives than their parents.

One unusually frank and forthright observation in "The Prevention Moment" is a call for the food industry, in the spirit of "post-partisanship," to disclose that its paramount concern is return on investment and delivering shareholder value. Seeman's article states that food industry executives (who often claim that they have a global commitment to improving public health) should also openly acknowledge that their company has a fiduciary duty to return profits to investors, and that this legal responsibility ultimately guides what steps any company can take to address problems related to diet and disease.

While Seeman's article recognizes the severity of the challenges before us and attempts to offer a new path toward building a consensus for improving public health, it ultimately detours into a discussion of theoretical principles that focus on personal responsibility and individual actions. In the process, it eschews the concrete public policy initiatives discussed in "Getting from Fat to Fit: The Role of Policy in the Obesity Disaster," by Suzanne Havala Hobbs. Such policy initiatives are endorsed by the World Health Organization and are broadly supported within the public health community.

In attempting to argue that such public policy initiatives are unworkable, Seeman seizes upon the political, economic and practical problems with instituting a so-called Twinkie tax. In discussing this issue, he ignores the fact that foods are taxed already. For example, more than 10 states in the United States already tax soft drinks and/or snack foods. Also, the US Department of Agriculture (USDA) administers promotional programs for the beef, pork and egg industries whereby producers pay a fee that is used for the generic advertising of their products. The point, then, is not whether or not food should be taxed but, rather, whether taxes should be based on improving the nutritional status of the American public. One such measure could call for revenues from existing sales taxes to be devoted to nutrition education programs or used to reduce the price of fruits and vegetables. Another approach could be to fund USDA (or the Centers for Disease Control and Prevention) to do more to promote fruits and vegetables.

As tacitly acknowledged in Seeman's article, corporations cannot, and will not, agree to take such steps as curtailing advertising to children of foods of minimal nutritional value, improving nutrition labelling and reformulating products unless pressured by the media or lawsuits or mandated by government. Thus, the goal seems less toward moving to a period of post-partisanship and more toward building political momentum to support policy initiatives that help make the healthy choice the easy choice. Such public policies would also help establish a level playing field for food companies trying to compete on the basis of health.

Eating better is not simply a matter of personal responsibility. While certain politicians described in Seeman's article claim significant personal weight losses, the fact is that willpower has proven to be inadequate to solve the enormous problems at hand. The government has an important role in mitigating the toxic food environment created by food manufacturers and restaurant chains promoting huge servings of soft drinks, snack chips and meals that are literally penny-wise and pound foolish. Similarly, the government has a responsibility to protect children from in-school promotions of foods of poor nutritional quality ranging from the M&M's Counting Books found in kindergarten classrooms to Pizza Hut's reading program, both of which promote "obesogenic" foods.

The prevalence of such promotions indicates that market forces are insufficient to promote healthy diets and that government intervention to facilitate healthier food choices by consumers is justified and necessary. A number of foreign governments have accepted that reality and instituted vigorous diet-health programs.

The United Kingdom, for example, has greatly reduced the advertising on broadcast television of low-nutrition foods to children. The UK Food Standards Agency (FSA) has also developed a front-of-pack "traffic light" nutrition labelling scheme that makes it easy for consumers to identify products low in saturated fat, salt and sugar. FSA has also systematically pressured companies to reduce the salt content of processed foods. France has banned vending machines from schools and requires a government-mandated nutrition education message in every food commercial on television. Companies that do not want to include the official message must pay the government 1.5% of the cost of the ad, with the revenues placed in a government nutrition education fund. Eighteen countries around the world require percentage ingredient labelling of processed foods. For example, in the European Union, Kellogg's Strawberry Nutri-Grain bars must indicate that they contain only 5% strawberries by weight. Such requirements provide valuable information to consumers and might lead companies to market more healthful foods.

While none of these steps by themselves can eliminate obesity, taken together, they can form the basis of a comprehensive public health program. That program would include the following steps:

  • Require food companies to work with health agencies to reduce the saturated fat, added sugar and sodium content of their products
  • Curtail the billions of dollars that marketers now spend on promoting low-nutrition foods to children
  • Place easy-to-decipher symbols of the fronts of food labels indicating a food's calorie, saturated fat, sugar and sodium content
  • Require chain restaurants to post calorie information for all standard items on menus and menu boards
  • Bring school lunch standards in line with current dietary guidelines, remove low-nutrition foods from school cafeterias, stores and vending machines and banning food marketing on school property
  • Require that agricultural policies undergo a nutrition impact assessment to determine their effect on public health
  • Provide economic incentives for the promotion, distribution and purchase of fruits, vegetables, whole grains and other healthful foods
  • Fund an aggressive social marketing campaign promoting healthy eating and physical activity.

Analogous tactics have been shown to work in other areas of public health, ranging from increasing seat-belt usage to reducing cigarette smoking.

Some progress has been achieved in the United States at the state and local levels. New York City, for example, requires chain restaurants to provide calorie information on menus and menu boards next to the name and price of each item. This requirement, according to media reports, is encouraging companies to offer lower-calorie fare and causing consumers to think twice before ordering that mocha latte that contains more calories than a McDonald's hamburger. The State of California also recently enacted calorie labeling legislation for chain restaurants, and limited the amount of artery-clogging trans fatty acids in restaurant food, following the lead of New York and other cities. (Denmark banned artificial trans fats back in 2006.) Parents nationwide have pressed school boards to rid schools of soft drinks and improve the nutritional quality of school lunch offerings.

Unfortunately, attempts to achieve such progress on a national level have been less successful. Last year, Congress punted on legislation that would have improved school lunches nationally. A 1980 law prohibiting the Federal Trade Commission from restricting children's food advertising remains in effect, and USDA is years behind in ensuring that the National School Lunch Program meets the nutritional goals of the its own 2005 edition of the US dietary guidelines. Clearly, the public health community, policy makers and legislators have work to do.

The ultimate solution to the obesity crisis, however, has less to do with entering a period of post-partisanship than with building public support for high-leverage government initiatives. Such programs are under way in several other countries, and it is hoped that in a new political climate and with continued activism by public health advocates, such programs can be instituted in the United States as well.

About the Author(s)

Bruce Silverglade, BA, JD
Director of Legal Affairs
US Center for Science in the Public Interest
Washington, DC


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