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Will Taxes, Regulations, Lawsuits and Advertising Bans Prevent Obesity?
By Elizabeth M. Whelan, Sc.D., M.P.H.
The New England Journal of Medicine (NEJM) has now officially morphed from a scientific publication into an advocacy organ for big government. An article and editorial in the current NEJM call for what amounts to a government takeover of the food industry in the name of reducing obesity, especially childhood obesity. But there is even more to this agenda than meets the eye.
Americans—both adults and kids—are too fat and, as a result, our health is in jeopardy. The problem is quite real and quite serious—there is little controversy about that.
But what should we do about it? Is this a personal matter of individual responsibility and choice? Or is it a problem of such national significance that government intervention and even coercive actions can be justified?
Two very distinct philosophies about effective solutions to the obesity problem are now emerging. On one hand there those of us who view obesity as a personal health issue, one to be addressed by individual patients (or their parents) and their physicians. These influences may also be supplemented by increased public health education on how to define caloric needs, as well as on keeping the number of calories ingested in balance with expenditures in the form of exercise.
On the other hand there are those who believe that obesity in America has reached a crisis level that necessitates a full spectrum of government interventions to protect people from their own actions--namely over-consumption of calories. Scientist-lawyers associated with the Department of Health Policy and Management at the Harvard School of Public Health starkly outline this approach to obesity in the current NEJM. Their commentary calls on government agencies and attorneys to play a more aggressive role in combating obesity by, among other things, slapping taxes on so-called junk foods and banning or restricting food advertising
I have a number of concerns about this proposed government assault on obesity—and so should you:
First, in determining which foods to tax and which ads to regulate, how would officials distinguish between "junk" and "healthy" foods? Would all foods high in sugar be labeled “junk”? If so, would that include fruit juices? Would all foods high in fat be labeled "junk", and if so would that include avocados, butter and cheddar cheese? Or would a food be considered "junk" if it were low in nutrient density, for example a can of soda or beer? If the beverage were fortified—say with vitamin C and calcium—would it shed its "junk" label and thus be free from tax and regulation?
The problem with viewing food in a simplistic dichotomy—bad versus good—is that eating is more than a biological experience. Eating is a pleasure of life. There is no sound scientific reason to justify the claim that everything we eat must be bursting with nutrients. In an otherwise well-balanced diet, there is room for moderate intake of soda, cupcakes, potato chips—and even that ultimate form of adult junk food, alcohol.
Second, placing a punitive tax on certain foods will do nothing to curb obesity. It will only serve to raise a family's weekly grocery bill, an impact that will hit poor families the hardest as they spend a relatively higher proportion of their income on food. It will not teach them which foods might be better for them, only those that are cheaper. Those who advocate for a tax to discourage the consumption of certain "bad" foods argue in vague terms about how this revenue can be used to educate people about healthy eating. But surely there are other ways of beefing up educational efforts about calories, exercise and striking a daily balance. Further, our history with such allegedly designated taxes (like those on cigarettes) teaches us that all such taxes are ultimately hi-jacked for general government revenues.
Third, the Harvard authors give short shrift to the role of individual responsibility in making dietary decisions and the importance of parental guidance in shaping the diets of children. They characterize consumers as gullible and vulnerable to the manipulative actions of the food industry—and perceive a need for government to intervene as our protector. This "consumer as victim" mentality flies in the face of the reality that we voluntarily purchase the foods we want—not because we are brainwashed by advertisements. Adult consumers are not puppets that are manipulated at will by advertising, and parents must help their children distinguish between ads and educational information. They will be seeing all kinds of advertising throughout their lives, and will have to make such distinctions continually.
Fourth, the authors and other advocates of the use of laws, regulations and taxes to restrict food advertising and discourage the purchase of "bad" foods overlook one very obvious recommendation: physicians and scientists should be encouraging the food industry to use the science of food technology to reduce the caloric content of food—while maintaining quality and taste. For example, techniques of biotechnology now allow the modification of potatoes to raise starch content to a level that reduces the amount of fat absorbed during deep-frying. Given the nation's passion for French fries, this application of biotechnology could shave substantial calories off a fast-food meal—much more than a "bad food" tax would. Similarly, use of fat substitutes (like the unfairly maligned olestra) would increase the number of available reduced fat, lower calorie foods.
Government intervention in the form of mandated vaccinations, water chlorination and similar measures have been very successful in reducing the burden of infectious disease. That is a proper role of government—in the interest of public health. But when it comes to obesity the matter is not amenable to such mandates. Providing accurate, unbiased information about the importance of a healthful lifestyle, including moderate dietary choices and appropriate activity levels, can be a useful government activity—without draconian taxes or restrictions on food availability. Before we turn over the responsibility of weight management to Uncle Sam, M.D., we should scientifically evaluate proposed solutions to learn if they are likely to work and consider the unintended consequences of interventions that raise prices and curb freedom of choice.
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