To End Childhood Obesity, a Few Modest Proposals

sh14 mustardDeborah Cohen, M.D., a RAND Corporation senior natural scientist, published a book titled A Big Fat Crisis—The Hidden Forces Behind the Obesity Epidemic—and How We Can End It. In her view, humans are “biologically designed to overeat,” and thus need to be protected from themselves. This is a job for the government, which should “apply to unhealthy foods the kind of regulations  that have been so successful in limiting alcohol consumption.”

However, and with all respect to Dr. Cohen, “success” is not always the first word that springs to mind regarding limitation of alcohol use. Regulation has succeeded in bringing in tax revenues, and that is usually what people are aiming for when they compare junk food to alcohol or tobacco. Reviewer Susannah Cahalan sums up Dr. Cohen’s recommendations:

A tax on junk food. Taking a cue from tobacco and booze taxes, “similarly, increasing the price of foods most strongly associated with the risk of obesity and other chronic diseases could lead to reductions in consumption,” she says.

Like many ideas, this one sounds good for a minute. “Tax soda like tobacco” is such an attractive concept, an entire movement has grown up around it. But a big problem lies in the following assumption: “Plus, the money levied could go to defraying health-care costs associated with obesity.”

The operative word there is “could.” Yesterday, Childhood Obesity News mentioned a couple of states where tobacco tax money is used in ways that might not have been expected by the citizens who supported the tax. Each state has its own story. We like to think that our tax will buy a low-income child an insulin pump, so she doesn’t have to stick a needle in her belly every day. But it probably won’t.

In addition to taxation, Cohen suggested a number of other changes, summarized here in our words:

  • Portion sizes would be standardized, the same in every food-selling venue, and all food must be available in a single-portion size.
  • Grocery  stores would be smaller and only open a certain number of hours. And there would be no more displays of irresistible impulse-buy candy at the check-out counters.
  • Severe limits would be placed on the number of doughnut shops, ice-cream parlors, and candy stores.
  • Sales of candy would be banned anywhere but at a food retailer.
  • Junk food would be packaged with warning labels picturing the dire consequences of obesity and its co-morbidities.

Many times, people’s well-meaning ideas have unintended consequences. For instance, any obesity solution involving an increased use of packaging material would threaten the environment and induce a backlash.

Grocery stores display unhealthful products down at eye level for just the sort of child who is likely to make a fuss in public. Maybe it would help to stock the junk food way up high, where only grownups could see it. Then, a lot of things could happen, not all of them good. Kids will insist on being lifted up to see the vile treats, which might lead to an epidemic of parental back sprains. Or maybe, to get a better field of view, kids would stand up in the shopping carts, and fall and get hurt, and the grocery store would be sued for damages.

Impractical Ideas to Reduce Obesity

Cohen is quoted as suggesting that restricted grocery store hours would “require people to make a greater effort to plan their shopping and could reduce the frequency of impulse shopping.” The unworldly assumption of this condescending moonshine is so naive, it might have been lifted from Gwyneth Paltrow’s Goop website.

Sure, if everyone planned their shopping better and restrained themselves from driving to the store for that special jar of brown mustard, it would save fossil fuel and promote cleaner air. But there is more than one reason why a person makes a single-item grocery run. Sometimes a spouse just has to get out of the house and is delighted by the chance to go and buy something.

The part about “shorter hours” is probably not feasible. It would be punitive to many customers, who perhaps live in food deserts already or work two jobs and really need for the only grocery store on the bus route to be open at night. Also, enforcing shorter grocery shopping hours would eliminate jobs, which is never a PR-friendly move.

Many people have excellent ideas that would be unenforceable, unless the entire political fabric of America were to be ripped apart and rewoven. If that happened, the country would face questions more crucial than cereal packaging.

Your responses and feedback are welcome!

Source: “Why gov’t should regulate food like tobacco & alcohol,”, 12/28/13
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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