Reducing Obesity: Policy Strategies from the Tobacco Wars

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Urban Institute

The first challenge for the 100-plus people who flowed into Urban Institute's Washington offices last week to talk about a new study on strategies to combat obesity was to keep their hands off the cookies, sugary snack squares and soda laid out on a table for the lunch-time panel discussion. The irony alone might have been worth an extra mile on the treadmill that night, but most went with the vegetable wraps, tuna sandwiches, fruit and even water.

The mixed nutritional offerings were an appropriate warm-up for the 90-minute discussion, where the overriding message was that Americans are not about to let go of their junk food.

The event was built around a new institute study that seemed to raise hope: "Ousting Obesity: Strategies from the Tobacco Wars." You'd think the successful efforts over the past decades to reduce tobacco use would offer some lessons to combat overeating.

You'd be right - but you'd also come away feeling that getting movement on this issue is like overhauling health care: There are too many vested interests to allow significant change quickly. This despite the fact that the percentage of 12- to 19-year-olds defined as obese rose from 4.2 in 1963 to 17.4 in 2003, according to the new study.

Two panelist - Arthur Garson Jr., one of the three study authors, and Matthew Myers, president of the Campaign for Tobacco-Free Kids - cited several tactics in reducing tobacco use that might be applied to fighting obesity. Raising taxes on tobacco products made them more expensive, and cut down on use. Better labeling (mandated by the federal government) produced "virtually no dramatic affect on consumption," Myers said. But the labeling increased knowledge about tobacco and changed people's intentions for use, and helped to build public and political support for legislative changes. Restrictions on advertising and marketing also helped.

Based on those findings, and efforts by other countries (such as Great Britain and the Netherlands) to tamp down on unhealthy eating, the study makes several recommendations, including:

* Impose a 10 percent tax on fattening foods (to be defined).

* Limit advertising of certain foods to children.

* Add "traffic light" nutrition labels to the front of food packages and list calories on the menus at chain restaurants.

The trouble is obvious: These ideas would cut into profits at companies that make and sell the targeted products. The other two panelists - John Calfee, resident scholar at the conservative American Enterprise Institute, and Judith Thorman, senior vice president of government affairs at the American Beverage Association - dismissed the ideas as ineffective and unfair.

Among their objections: While you can encourage people to quit smoking, you can't tell them to quit eating and drinking. The beverage industry can be trusted to do the right thing on its own because it has already taken voluntary steps to reduce the availability of soda in schools. The effort shouldn't be "about vilifying one food or beverage," in Thorman's words, because it's not the food that matters; it's the total calories you take in vs. how many you burn. She favored "teaching people how to balance their calories."

Of course, relying on ourselves to balance potentially harmful behavior against temptation is why we have prisons, abortion clinics, laws against text-messaging while driving - and panel discussions about how to fight the obesity epidemic.   

As panel discussions go, this one was substantive and interesting. But the setting and the make-up of the experts was too typically polite for a frank verbal brawl. Myers displayed the most passion for reform, contending that you can't trust big corporations to be honest and do the right thing without regulation. He also stressed that he was no expert on obesity or nutrition.

The bow-tied Garson is a soft-spoken, polite researcher who set out to find common ground. He praised those who opposed his ideas for telling him some things he didn't know, and implored Thorman to make suggestions based on the admirable work of the beverage industry.

About that work: On the way to the elevators, I asked Thorman about the agreement in 2006 by the beverage industry to limit soda sales in schools. Why didn't the industry do the same in non-school youth settings, like recreation centers, after-school programs and teen centers?

Thorman didn't know. She mentioned that the focus of the negotiations, which were brokered by the William J. Clinton Foundation, was on schools only.

That's true: The agreement came during a period of growing public and media backlash against junk food in school vending machines. Without public pressure, there was no reason to go any further. 

The report (73 pages) and a recording of the event are free at (202) 261-5687.