Soda Tax — The Philadelphia Story


In Philadelphia, Pennsylvania, former mayor Mike Nutter used to keep a bottle of soda on his desk, and another container with 17 teaspoons of sugar in it, to illustrate the point that swallowing the one implied ingesting the other. He even took the props to public meetings, and once asked a journalist, “Who in their right mind would ever put this much sugar into something you’re going to drink?”

Insane or not, across America, many voters are against the whole “sin tax” concept. They resist taxes with a “moral subtext” imposed by the “nanny state.” Even politicians who are pretty much on the same side may disagree. During last year’s presidential campaign, both Hillary Clinton and Bernie Sanders made headlines by weighing in on the city’s soda tax controversy.

One man reconsiders

Back when Mayor Nutter wanted a 2-cents-per-ounce soda tax, Jim Kenney was one of the city council members who opposed it. But after becoming mayor himself, Kenney switched sides, acquiring a new, supportive, and exclusively revenue-based attitude.

Mayor Kenney did not tell voters that drinking less sugar would be good for them and their children, but pointed out that $400 million in the next five years would be a sweet little nest egg to finance preschools, and to renovate public spaces, including parks and recreation centers, which at least have some connection with obesity prevention. Still, the mayor’s endorsement was unabashedly “based on the idea that a soda tax is just an untapped source of revenue,” as journalist Zeeshan Aleem put it.

How much difference does it make? A public official’s genuine attitude is a difficult variable to influence or control. Nothing can make them care about children’s health. But all public officials are supposed to care about spending tax revenues sensibly, and about bringing in more money. If they favor the soda tax for that reason, how much should their motivation matter, as long as the thing gets done?

A false equivalency

People wondered why passing a soda tax was so difficult. After all, Berkeley, California, had managed to do it. But Berkeley is a smallish city on the West Coast, while Philadelphia is big, tough, and sits on a lot of history.

Their situations are not the same, as Jacob Sullum explains: What initially appeared to be an altruistic effort to “save poor people from their own bad habits” was in Philadelphia admittedly only a money grab. He writes:

Unlike Berkeley, where voters approved a one-cent-per-ounce tax on sugar-sweetened drinks in 2014, Philadelphia will tax low-calorie and zero-calorie beverages at the same rate as regular soda. In fact, the tax of one-and-a-half cents per ounce could perversely encourage consumption of more calories, especially since it does not apply to juice products loaded with naturally occurring sugar.

How did this happen?

(To be continued…)

Your responses and feedback are welcome!

Source: “The Philadelphia soda tax experiment,”, 08/04/16
Source: “Philadelphia’s Mayor Proposes the Highest Soda Tax in the U.S., But Not to Improve Health,”, 04/15/16
Source: “Philadelphia’s New Soda Tax Has Nothing to Do With Obesity,”, 06/17/16
Photo credit: Shardayyy via Visualhunt/CC BY

Obesity Villain Suspect — BPA


A while back, Childhood Obesity News looked into phthalates, a group of related chemicals that seem very useful for a number of human purposes, but which might contribute to obesity. The really enormous problem here is that there is no really dependable way to find out. Phthalates are so ubiquitous, there is probably no control group of un-phthalated humans anywhere on earth. Everyone is saturated with these substances, so without a basis for comparison, how can we really know what they are doing to us?

Another problematic substance is Bisphenol A, nicknamed BPA. Studies of BPA provided the first instance where the science bore out the suspicion. The case against it is so convincing, all 28 of the European Union’s member nations have classified it as an endocrine disruptor and “a substance of very high concern.” says:

The expert panel of scientists agreed on findings of probable causation for EDCs and a number of human diseases, including IQ loss, autism, ADHD, childhood obesity, adult obesity, adult diabetes, cryptorchidism (undescended testes), male infertility, and mortality associated with reduced testosterone.

Like estrogen, BPA is said to make fat cells larger, and is very strongly associated with impaired glucose tolerance, elevated insulin, the metabolic syndrome, and, of course, increased body weight. In one study, researchers found that girls between 9 and 12 years of age with higher BPA levels in their urine had about twice the likelihood of being obese.

A WebMD page says:

One explanation for the results may be that girls who are entering puberty are uniquely vulnerable to the effects of hormone-disrupting chemicals, said study author Dr. De-Kun Li, an epidemiologist at Kaiser Foundation Research Institute and the Stanford School of Medicine, in California.

In another 2012 study, around 22% of the kids with the highest BPA levels were obese, compared with 10% of the subjects with lower levels. The Food and Drug administration banned the chemical from items that babies drink from.

The first alerts about BPA appeared for that very reason. Babies and toddlers were spending a lot of time sucking and gnawing on objects made of plastic, which has BPA in it because the chemical is very good at hardening polycarbonate plastics.

Chemory Gunko notes that BPA was developed “as a form of artificial estrogen […] originally created to be a female contraceptive,” and goes on to write:

Over the years, various studies into BPA have shown that it causes changes in genitalia and tissues, changes in maternal behaviors, disruptions in ovarian development, is carcinogenic, and reverses the normal sex differences in brain structure and behavior.

Does this sound like something that babies ought to be ingesting? But even the most careful parents cannot prevent their children (or themselves) from sopping up BPA like a sponge, because it’s found in metal can linings, bottles, food packaging, pipes, sports equipment, digital storage formats like CDs and DVDs, dental sealants, and a whole bunch of other places.

Every day, we all eat a little bit of synthetic estrogen. Gunko writes:

Now throw in the fact that both infertility and obesity are hugely on the rise, and you have to ask yourself if we can really afford to keep on ignoring the potential health effects of consuming these kinds of chemicals in our water and food?

Your responses and feedback are welcome!

Source: “European Chemicals Agency Classifies BPA as an Endocrine Disruptor,”, 06/29/17
Source: “Study ties BPA in cans and bottles to childhood obesity but doesn’t prove it’s a cause,”, 09/18/12
Source: “More Evidence Links BPA to Childhood Obesity,”, 06/12/13
Source: “Could plastic be making you infertile… or fat?,”, 05/09/17
Photo credit: oksun70/123RF Stock Photo

More About Berkeley’s Soda Tax


Yesterday, we were discussing how Berkeley instituted a soda tax, and whether it was working. Apparently, good things proceeded to happen. One year ago, journalist Michael McLaughlin wrote:

Consumption of soda, energy drinks and other taxed items fell by 21 percent in some neighborhoods after the tax took effect, according to research published Tuesday in the American Journal of Public Health… Shoppers reported drinking 63 percent more water, according to surveys from a team led by University of California-Berkeley researchers.

McLaughlin went on to say:

At the same time, consumers in Oakland and San Francisco increased their consumption of soda and other sweet beverages by 4 percent, researchers found.

Did they? Or is that statistic attributable to Berkeley tax protesters, willing to travel to save money on their sugar-sweetened beverages (SSBs) and/or to make a point? A study published by PLOS Medicine, says Bruce Y. Lee, “found that one year after the SSB tax was introduced, SSB sales fell in Berkeley by 9.6% and rose in surrounding areas by 6.9%. Meanwhile, sales of water in Berkeley jumped by 15.6%.”

Keeping their word

Berkeley voters had been told that the soda tax revenues would be spent on children’s health programs, especially in areas where economically deprived kids were succumbing to obesity. Some doubted that, and for good reason. Although the soda tax was new, Americans in many states had been told that the profits from a “sin tax” on tobacco, liquor, gambling, etc., would be used for excellent publicly-approved purposes. These rosy promises had not always been honored, which gave rise to skepticism.

But a panel of nine experts was assembled to vet the proposals made by various groups, and Heather Knight was able to report that Berkeley had kept its word regarding the soda tax proceeds. Last fall, Knight wrote:

So far, the soda tax there has raised about $2 million — and sure enough, about $2 million has been spent. Of that, 42.5 percent has gone to the Berkeley Unified School District for cooking, gardening and nutrition programs. An additional 42.5 percent has gone to community groups, including Ecology Center, Healthy Black Families and the YMCA for their health-related programs. The rest has gone to fund the administration of the program.

One of the experts, Xavier Morales, told the journalist of his satisfaction in knowing that noone could point a blaming finger or claim that Berkeley wasn’t doing it right. For instance, an organization called the Ecology Center trains youth to work at farmers’ markets and produce stands in economically distressed parts of town. They also had water bottles printed with information about the harmful effects of SSBs, and distributed them to all the Berkeley freshmen.

When investment counselors advise clients to “play the global fight-against-obesity theme,” it’s a cynical observation and a piece of self-serving advice that feeds into the endless greed of the corporate monster. It is also an admission that two different worlds coexist, one in which dollars matter more than anything, and another in which people want to keep their children and themselves out of the hospital and the morgue.

It may be a grudging admission on the part of Big Soda, but business leaders are being forced to realize that we will not simply continue forever to buy the crap they put in front of us.

Your responses and feedback are welcome!

Source: “Big Soda Spends Millions On ‘Unethical’ San Francisco Area Ads Fighting Drink Taxes,” HuffingtonPost,com 08/24/16
Source: “Berkeley kept its word on soda tax proceeds,”, 10/22/16
Photo credit: William Newton (Wnewton1948) via Visualhunt/CC BY-SA

Berkeley and Its Soda Tax


The financial entity known as Bank of America Merrill Lynch advised its constituents of the many juicy opportunities for entrepreneurs and investors who wish to “play the global fight-against-obesity theme.” Many countries around the world have instituted, or at least talked about, taxes on fat, sugar, and high-calorie foods. However — and this is the message — even without selling sweetened fizzy water any manufacturer who is savvy enough to jump on the health bandwagon can still make a killing.

As we have seen, the Coca-Cola Company led the way in demonstrating adaptability to the health movement. Coke pioneered such workarounds as peddling sugar-laden drinks in smaller containers. The strategy turned out to be even more profitable than what they had been doing before. This, by the way, is a perfect example of what a money-worshipping corporation means, when it talks about creating choice for the consumer.

If results are any clue, people are already offered more choice than is good for them. What is the benefit of having 1,500 kinds of soda if they are all equally damaging to the health?

Shots fired

The idea of a soda tax popped up sporadically, here and there across the country, but never quite caught on, until the West Coast showed leadership. Journalist Lizzie Wade wrote:

In November 2014, Measure D, a one-cent-per-ounce soda tax, was passed by Berkeley, California voters with a 76 percent plurality, becoming the first soda tax referendum to be implemented in the U.S.

As always, opinions differed. A lot of academically-oriented people had a horse in this race, and so did the corporate-minded ones.

Marion Nestle, who literally wrote the book on this issue — titled Soda Politics — would have been better pleased if the social experiment of taxing fizzy drinks could have more defined edges. As it was, soda consumption had been going down anyway, especially in Berkeley, so the effect of the new tax would not be clear cut.

There was also the matter of “leakage,” which is what happens when tax-avoiding consumers simply go to a nearby city (like Oakland or San Francisco) to stock up on soda pop. Bruce Y. Lee pointed out that Berkeley is a smallish, not-major city with “a much smaller lower-income population and potentially fewer people who use cost as a deciding factor of whether to drink soda.” For these and other reasons, proponents worried that whatever data eventually emerged from Berkeley’s experiment would not have much bearing on the possibilities for other cities.

Even the American Beverage Association weighed in with a warning that Berkeley was too small to base any conclusions on, and besides, its “high median income and low baseline consumption rates make it a challenging place to determine the true impact of a beverage tax…” As the old saying goes, even the Devil can quote scripture.

(To be continued…)

Your responses and feedback are welcome!

Source: “A fat investment opportunity,”, 04/16/15
Source: “Mexico’s Soda Tax Is Working. The US Should Learn From It,”, 07/13/15 Source: “In a devastating blow to the beverage industry, four cities passed soda taxes,”, 11/09/16
Source: “In Berkeley, Soda Tax Is Doing What It’s Supposed To Do,”, 04/18/17
Photo credit: Kai Schreiber (Genista) via Visualhunt/CC BY-SA

A Johnson, a Jackson, and a Journey


To the dismay of some and the applause of others, prominent men are often willing to talk about their decision to resort to bariatric surgery. One example is EJ Johnson (son of basketball star Magic Johnson), who has been in the cast of the reality TV show, Rich Kids of Beverly Hills. The latest news is that a much slimmer version of him will soon have his own series, EJ and the City.

It was on Rich Kids that Johnson announced his intention to lose some of his 360 pounds.
Speaking of his planned gastric sleeve procedure, Johnson told newsperson Carrie Dilluvio:

A lot of people think it’s the easy way out, but it’s not. It’s a step in the right direction, just a big push. I feel very mature, kind of in the right place for it and I’m very ready to look cute. The surgery is a huge deal for me and it will certainly be a positive change.

It has now been three years since the momentous decision. During the first post-op year, Johnson lost 180 pounds, and was inspired to show up during New York Fashion week in some very avant-garde outfits that featured his slimmer frame. When reporters asked what else he was doing besides surgery, he credited the Pilates physical fitness system for his ability to maintain the original weight loss.

The following year, when another reporter checked in to see how EJ was holding up, he was still doing Pilates four days a week with his own trainer. He described his eating routine as nibbling throughout the day, which makes sense in his particular case, because gastric sleeve patients should not, and cannot without bad consequences, eat regular-size meals.

Johnson told E! News:

Find a workout that’s something you love to do. For me it’s not even working out it’s just having fun. We dance a lot, we sweat and at the end of it I’m like, “Wow! I burned all these calories and I didn’t even know because we were just having a blast.”

For TV personality Randy Jackson, who was an American Idol judge for a dozen years, the magic number was 350 pounds. Coincidentally, that seems to be the red-alert benchmark for a lot of men. They get to up 350, 360, and start taking it seriously. Following a 1999 diagnosis of Type 2 diabetes, Jackson modified his diet and his exercise habits, and four years later opted for gastric bypass surgery which led to a loss of more than 100 pounds.

When he started gaining weight back, Jackson spoke to the press of cultural influences:

I grew up in the South, where food and good times were king. For the old Dawg, a holiday party was a chance to have something to eat, drink, and be merry, but the new Randy does not drink or eat at parties.

None of it is easy, he hastens to add, describing the need to resist the snacking urge as “a constant battle.”

Your responses and feedback are welcome!

Source: “EJ Johnson Receives Weight Loss Surgery,”, 09/28/14
Source: “Rich Kids’ EJ Johnson Shows Off 180-Pound Weight Loss in a Sheer Shirt—See the Pic!,”, 9/14/15
Source: “RichKids Star EJ Johnson Reveals How He Maintains His 180-Pound Weight Loss, Shares Fitness & Diet Tips,”, 03/17/16
Source: “Randy Jackson,”, 05/30/17
Source: “How Randy Jackson Lost 100 Pounds,”, 10/12/16
Photo credit: Michel Curi via Visualhunt/ CC BY

Celebrity Weight Loss — Al Roker


A reader of Childhood Obesity News once communicated that her barrel-shaped figure was a comfort, because she felt anchored to the earth, and indeed could not imagine losing weight, because she would feel insubstantial and in danger of blowing away. This almost happened to TV weatherman Al Roker, who in 2005 was filmed struggling to stay upright as a cameraman tried to hold him down and Hurricane Wilma tried to blow him away.

It was ironic, because the career of the beloved television personality, known for decades of Today show appearances, was plagued by weight issues. When the hurricane arrived, he had succeeded in shedding a large amount of excess weight.

Even in the college years, Roker weighed in at nearly 300 pounds. In adulthood, it crept up to 340. Divorced from his first wife in 1994, Roker married Deborah Roberts the following year.

Journalist Michelle Tauber reported:

In 1999 Roberts interviewed singer Carnie Wilson, whose frankness about her own gastric bypass surgery put a famous face on the procedure. “When I came home after doing the interview with Carnie, I just casually mentioned it to Al,” she recalls. His response? “He shut me down right away,” she says.

But the incident remained in Roker’s memory bank, and he later spoke of how his terminally ill father set him straight:

We’d talk and joke, and then one day he got serious and said, “Look, we both know I’m not going to be here to help you with my grandkids, so you gotta promise you’re going to lose weight.”

Shortly after his father’s demise, Roker and Roberts learned that a child was on the way. He recalls his reaction as, “Okay, I’m going to have to do something.”

That something was gastric bypass surgery, whose results he spoke about with Tauber:

All of a sudden, I just wasn’t hungry… I went from consuming maybe 3,000 calories a day to 300 calories a day.

Years later, going over the same ground with another reporter, he warned:

I am not advocating gastric bypass surgery; you can eat through a bypass. I did — I lost 140 pounds and gained 40 back.

When Roker’s mother became ill, everything started to spiral and he went back to the old binge-eating, self-medicating ways. He told interviewer Bonnie Taub-Dix:

When you’re in the midst of it, whether an alcoholic or a drug addict, that secondary voice inside you is not loud enough. It almost feels like the “devil and angel” sitting on your shoulders…

After the surgery, Roker had gone through some required post-op therapy, but realized much later that he should also have joined the support group that was available. He fought back and managed to bring his weight back down again, arriving at the conclusion that “Nothing tastes as good as skinny feels.” However, he admitted that maintenance is always a problem, because it is all too easy to revert to old habits.

Roker loves to cook and has even published cookbooks. He told Taub-Dix that cooking at home had never been the real problem, because preparing good meals for the children, and setting a good example for them, were always priorities. Restaurant dining was always his downfall, along with unrealistic notions about food portions.

He said:

I used to look at a pint of Häagen-Dazs and call it a serving size. Now I know that I can have a couple of spoonfuls and I’m done. I’m more in control — and I’m controlling food.

If so, it is a miracle, because very few people are able to play with fire in that way. Dr. Pretlow has found that total abstinence from certain problem foods is what works best.

(On this page, Roker is shown at a Kids’ Kitchen event with Michelle Obama.)

Your responses and feedback are welcome!

Source: “100 & Counting,”, 11/18/02
Source: “Al Roker’s Diet Revealed on Today Show With Debut of His Book ‘Never Goin’ Back’,”, 01/03/13
Source: “A Stormy Relationship With the Scale: An Interview With Al Roker,”, 02/07/13
Photo credit: USDAgov via Visualhunt/CC BY

Soda Tax, Sin Tax


We have seen how the citizens of Boulder, Colorado were reluctant to institute a soda tax without a firm idea of where the money would go. On the West coast, San Francisco voters were told the same thing — pass the tax first, stash the money in the city’s general fund, and then a soda tax committee would be formed to decide where to supply financial relief. Last fall, San Francisco, two other California cities, and Boulder passed their soda tax laws at around the same time.

For, Julia Belluz summarized the hopes of a few different places:

In Britain, revenue from the drink taxes will fund childhood obesity interventions, such as sports programs in primary schools. In Berkeley, the money goes to children’s health programs in low-income areas that are battling particularly high rates of childhood obesity. Philadelphia’s tax will fund an array of community and education initiatives, including universal pre-kindergarten classes, building new community schools, and improving recreation centers, parks, and libraries throughout the city.

In February of this year, Philadelphia cardiologist Kenneth Margulies described the new program as a “game-changer” that enabled 2,000 children to enroll in pre-kindergarten classes. This was quick action, considering that the soda tax only went into effect on January 1.

When citizens can see immediate beneficial effects, it naturally influences their willingness to try other new things. The plan is to accommodate another thousand pre-K children this fall, and to eventually bring the number up to 6,500.

But that’s not all. Philadelphia’s soda tax is expected to bring in about $90 million per year, which will be used for school construction and expansion, parks and recreational facilities, and library improvements.

Seattle’s planned soda tax would be collected at the distributor level, with the increase then, of course, passed along to the customers. According to supporters, the tax might generate as much as $140 million of income each year, which could be used to “fight childhood obesity and fund other public health programs.” If it passes, 2018 is expected to bring in $23 million, but some city council members are unhappy because only 14% of that projected income is earmarked for public health programs.

Last year, pollsters verified that when citizens consider whether or not to support a soda tax, the final destination of the revenues is very much on their mind:

For example, support for a soda tax in New York was higher when pollsters said the money would go towards health care, children’s education, or parks and recreation.

Just to confuse things and make life more difficult, the industry will jump in there and lie to the people. When Oakland was deciding, voters received slick propaganda pieces in the mail claiming that the soda tax would be spread out over all groceries, and thus cost everybody more whether they drank fizzy sugar bombs or not.

When pondering the usefulness and consequences of such tariffs, people have philosophical and political responses, like the three economists who collaborated on a paper based on the assertion that the costs of implementing a sin tax will always outweigh the benefits. They suggest that “the limits of what defines a sin steadily are being expanded,” which is correct.

Public awareness campaigns to promote the soda tax concept are intentionally modeled after the effective anti-tobacco paradigm. The co-authors say:

Taxing sin might be reasonable if the revenue from these taxes was used to address the underlying negative consequences of consumption. In the real world, however, money generated by the tobacco settlement financed general spending and not smoking cessation programs or treating smoking-related diseases.

If nobody exhibited any of these behaviors, society as a whole would be much better off. Intellectually, most people would probably agree. But emotionally, not so much. The writers contend that sin taxes don’t affect, to any significant degree, what people actually do on a day-to-day-basis.

Consumption might decrease a bit, “but bad habits are hard to break.” That is the problem. Ideology is one thing; adjusting one’s own behavior is another.

The authors included a snarky question that exemplifies one objection to the soda tax concept:

What better way to raise revenue than to find something that your neighbor buys or an activity he engages in that you don’t like and tax it?

Your responses and feedback are welcome!

Source: “Soft Drinks Make For Bitter Election Year in Three Bay Area Cities,”, 11/03/16
Source: “In a devastating blow to the beverage industry, four cities passed soda taxes,”, 11/09/16
Source: “Commentary: Philly drink tax means a healthier, better educated city,”, 02/21/17
Source: “Soda Tax Update: Santa Fe Rejects, Seattle Considers,”, 05/05/17
Source: “PepsiCo: The Soda Tax Is The Opportunity,”, 05/14/17
Source: “‘Sin Tax’ Costs Outweigh Benefits,”, 02/25/13
Source: “Big Soda Spends Millions On ‘Unethical’ San Francisco Area Ads Fighting Drink Taxes,”, 08/24/16
Image by scanrail/123RF Stock Photo

Sin Tax, Soda Tax


Some officials and many citizens see taxation as the most effective way to deter behavior that is inimical to the individual or society. Others see any form of “sin tax” as overreach, an annoying intrusion by the “nanny state.”

Depending on location, a sin tax might be levied on alcohol, tobacco, casino gambling, the lottery, video gaming, horse racing, and now cannabis. According to

While they’re not a major source of revenue in most states, some do rely on them much more than others. Sin taxes account for the largest share of tax revenues in Rhode Island, Nevada, West Virginia, New Hampshire and Delaware.

The public can be inveigled into believing that other burdens, like property tax or sales tax on non-sinful consumables, might be lifted. All they have to do is accept the idea that a sin tax can be any exorbitant amount whatsoever, like more than 50% in some cases.

Still, looked at purely as a revenue-generating apparatus, the schemes rarely play out as advertised. As a bureaucrat or a corporate representative might phrase it, and as a spokesperson for the Illinois Beverage Association actually did say, “These models consistently conflict with real-world results.”

In one recent year, tobacco tax brought in almost $17 billion nationwide. As the old joke almost goes, “A billion here, a billion there, and pretty soon you’re talking about real money.” All kidding aside, sin taxes pay for a lot of public good. Unless they don’t.

Plans go awry

In Cuyahoga County, Ohio, a news story began:

You’ve been paying a sin tax in Cuyahoga County since 1990. And you’ll be paying it for at least another 19 years…

The county’s sin tax covers alcohol and tobacco, and brings in maybe $13 million per year, which legally has to be spent on professional sports facilities, and only for capital repairs costing more than half a million dollars. Apparently, this intention has been carried out in a straightforward manner, with the money “used toward construction of the Q, Progressive Field and the plaza between the two facilities.”

The author of the article Karen Farkas goes on to say:

Cuyahoga County taxpayers still are paying millions of dollars a year for the facilities because of cost overruns and team leases that have failed to generate as much money as originally promised.

Also, various issues around the whole project continue to cause dissent in the community.
When a “sin tax” is proposed, the public can be convinced to vote for it on the promise that revenues will go into a certain budget column, often the one headed “public schools.”

When Boulder, Colorado, discussed instituting a soda tax, voters were told that revenues would go to support public health, “particularly programming that targets kids and minorities, who are disproportionately burdened by diabetes and obesity.” But a group of citizens balked at the general nature of that promise, wanting first to know specifically what programs would be funded when the tax money started rolling in. The City Council said, no, let’s pass the thing first, then we will put together a task force to make recommendations about how to spend it.

Your responses and feedback are welcome!

Source: “Illinois soda tax could cut health costs, raise $561 million in revenue annually,”, 04/25/17
Source: “Sin Tax Revenues by State,”, 2014
Source: “What is Cuyahoga County’s sin tax and what does it pay for? 8 questions and answers,”, 12/12/16
Source: “Harvard: Sugary drink tax would cut disease rates, health care costs in Boulder,”, 10/27/16
Image by Visualhunt

Lessons Learned


Back in 2003, the state of Arkansas embarked on an exceptional project whose object was to really do something about childhood obesity. Laying the groundwork was a huge job in itself. It required the cooperation and coordination of the legislators, their advisory body, school administrators, teachers, nurses, Phys Ed teachers, and cafeterias. And parents, of course, and definitely the students. The ambitious goal required everyone to be on board.

The idea of tracking such a project from its inception was music to the ears of the Robert Wood Johnson Foundation (RWJF). Here was a solid and irresistible opportunity to chart the progress of big, wide-ranging program, right from the jump.

RWJF funded “an evaluation of the process and impact of the law’s implementation.” They wanted to know in real time whether the blueprint was viable, and whether it was working. A research team scrambled to design the paradigm and parameters of the evaluation, and take care of all the other preparatory steps that result in a useful study.

What was proposed?

Act 1220’s original intention was to provide body mass index screenings for all students every year, and to have the parents notified of the BMI scores. Seems pretty straightforward. But resistance was immediate, vehement, and multi-faceted. The press contributed to misunderstandings and mistrust, with headlines seemingly designed to trigger the “Don’t tread on me” American.

The concept was to have the BMI score hand-carried home by the kids, and it met with objections on privacy grounds. It would be too easy for a bully to snatch a chubby kid’s report card and flaunt it around. Consequently, money had to be found to pay for postage to mail the reports, and the Arkansas Center for Health Improvement stepped up. Some critics felt that every year was too often, and that requirement was changed for older kids.

A belief that BMI scoring was mandatory angered many parents. The report explains:

The original legislation did not speak of parents’ ability either to opt in or out of their children’s participation in the school-based BMI assessment program; thus, parents and students always had an implied ability to opt out of the program. However, because the Commissioner of the ADE had issued several advisory letters to school district superintendents instructing them to comply with the mandates of Act 1220 and assess all students, there was at least some perception that participation was mandated.

In practice, parents who did not want an assessment and students who refused to participate were allowed to make that choice without consequence.

A number of school districts developed parental consent forms, which were completed by parents as a part of the annual registration at the beginning of each school year. However, a minority of school district officials and parents remained opposed and vocal in their dissatisfaction with the lack of a specific ‘‘opt out’’ provision in the statute.

This is the kind of roadblock the anti-obesity efforts ran up against, and it illustrates how complicated the quest for change can become. Even in one basic, seemingly unquestionably necessary part of the program, there was a lot of stuff to wade through. The example shows why it is so beneficial to have reports like this one.

(To be continued…)

Your responses and feedback are welcome!

Source: “Evaluation of Act 1220 of 2003: Lessons Learned, 2004-2012,”, Feb 2014
Image by Robert Wood Johnson Foundation

Obesity, Quality of Life, and China’s One Child Policy


China’s One Child Policy was introduced in 1979, technically applying only to ethnic Han Chinese, and with a gradually-increasing number of exceptions permitted. The government decided that making women give birth without anesthetic would encourage compliance, because who wants to go through that twice?

The carrot-and-stick approach included both incentives for people who obeyed the law, and punishments for those who did not, including forced sterilizations and late-term abortions. A couple of years ago, the law was changed to allow two children.

Are Chinese singletons obese?

A study of the influence of China’s one-child policy, by researchers from four universities, was released recently. Its conclusions are summarized by these points:

Being single-child was associated with high risk of childhood obesity.

Single-child status and childhood obesity association became stronger over time in China.

Single urban children were more likely to have excess energy intake than those with siblings.

The obesity trend was exacerbated by other cultural factors, like a suspicion toward fresh groceries that lingered for a while after a series of contamination scandals and scares. Despite being laced with sugar, salt, and chemicals, processed food items were perceived as more healthful.

As the country’s prosperity increased, people shunned the traditional bicycles for cars, and burned fewer calories. Rather than doing farm work, millions of Chinese found themselves sitting at desks to earn their livings. When families were forced to limit the number of progeny, attention became focused on a limited pool of children eligible for spoiling, and a sort of competition took place among relatives to see who could most successfully fatten up a lone child.

Are obese Chinese kids miserable?

That depends on how you define misery. Millions of kids have enjoyed sumptuous early childhoods of being treated like “little emperors,” overfed by both their parents and grandparents, showered with gifts of computers, play stations, and other gadgets that foster a sedentary existence.

Inevitably, it all caught up. “Internet addiction” became a genuine concern, as grownups blamed online gaming for the extra pounds the kids became encased in. This resulted in the establishment of harshly administered “fat camps” and of specialized institutions for treating internet addiction with methods as extreme as electric shock.

Despite the fact that many concerned parents made efforts to encourage contact with other children, the outcome of the One Child Policy was found to be negative by a 2013 study by researchers from three universities:

Results indicated that individuals who grew up as single children as a result of China’s OCP were significantly less trusting, less trustworthy, more risk-averse, less competitive, more pessimistic, and less conscientious individuals.

Those qualities seem destined to create a life experience which, while it may not reach the “misery” benchmark, is nonetheless unhappy.

Hong Kong footnote

In 1997 Hong Kong became one of China’s Special Administrative Regions. Although it was exempt from the One Child Policy, Hong Kong faces its own obesity epidemic. Presently, about 40% of adults are overweight or obese, along with about 20% of the school-age kids, and this is definitely considered a public health problem.

Your responses and feedback are welcome!

Source: “9 things you didn’t know about China’s One Child Policy,”, 08/17/16
Source: “Are single children more likely to be overweight or obese than those with siblings?,”, 07/21/17
Source: “China confronts problem of obesity,”, 01/01/13
Source: “Effects of China’s One Child Policy on its children,”, 01/10/13
Source: “Quality of life in overweight and obese young Chinese children,”, 03/06/13
Photo credit: robot42 via Visualhunt/CC BY-SA

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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