NEW YORK CITY鈥橲 health commissioner announced last weekend that the rate of diabetes among city residents stands at 8 per cent, double what it was in 1994. Most of this staggering increase is due to a rise in type 2 diabetes in people who eat too much and exercise too little. The announcement is the latest demonstration that many Americans 鈥� and people from other nations 鈥� are eating themselves into an early grave. How do we tackle such a major public health problem?
With lawyers is one answer. At face value, the notion of a group of overweight people suing fast-food outlets for damages sounds like a scam 鈥� a bunch of opportunists playing the system. In fact there鈥檚 more to it than that. Fat people are commonly regarded as the weak-willed authors of their own plight, or else the prisoners of a sluggish metabolism. But what if some obese people are actually victims of the type of food sold in fast-food outlets? Absurd as it may sound, there is a growing body of evidence pointing in this direction.
A meal loaded up with fat and sugar, it seems, can unhinge the normal hormonal controls that tell people when they are full. Even more intriguing are preliminary findings suggesting that fats and simple sugars can act on the brain in the same way as nicotine and heroin (see 鈥淏urgers on the brain鈥�). Is it fair to blame people for lacking willpower if their brain circuits are craving a hit of fries and burgers, just as they might an addictive drug?
Advertisement
The research is probably at too early a stage for such arguments alone to clinch the case. But they may not need to. Even if fast food is not addictive, the lawyers will point out that it is so bad for people鈥檚 health that fast-food outlets are in effect selling a hazardous product without providing the health warnings you might reasonably expect such goods to carry. A restaurant that poisons people by selling food laced with salmonella is quickly brought to book. Is it less blameworthy to sell food loaded with calories that give people chronic disease?
A win for these overweight litigants would undoubtedly send a shock wave through the food industry. Fast-food restaurants and makers of processed foods might be forced to change their products, or at least put sensible nutrition labelling on them. Regulators might even demand health warnings on foods especially high in sugar or fat. But success in court is by no means assured. It took years for the victims of smoking 鈥� and some of those who provided their healthcare 鈥� to secure damages against the US tobacco industry. Proving negligence or culpability on the part of the fast-food industry will be harder. The case is likely to be just an opening shot in a long, bitter and potentially very political struggle.
Like it or not, however, it鈥檚 a struggle that looks necessary if we are to halt the obesity epidemic. Admonitions from nutritionists, politicians and health educators seem to have little effect. And history suggests that without the sustained pressure of a legal attack, the food industry is unlikely to mend its ways.
Better labelling would be a start. Manufacturers make much of the healthy aspects of their food on the front of the packet, while burying bad news in fine print on the back. But it is no good buying a 鈥渉ealthy鈥� low-fat yoghurt when it still contains 110 kilocalories from sugar. And if people can see their burger and fries provides all the fat they need for a day, they may think twice about opting for larger portions. Properly informed, consumer choice could act positively: pushing restaurants owners and food processors to think up lower-calorie options.
At least 18 states in the US have gone further. They are taxing such things as soft drinks, snacks, confectionary and chewing gum. There are two tactics at work here: a heavy tax can drive down demand, while a light tax could fund healthy eating campaigns 鈥� putting them on a serious financial footing for the first time. One characteristic of fast food is that it is cheap, and in many Western societies diabetes and obesity go hand in hand with poverty, a link borne out in the New York survey.
There is a lot more that could be done. But governments generally fight shy of confronting the food industry. The message 鈥渆at less鈥� does not play well with a multibillion-dollar industry whose profit margins demand the mantra 鈥渆at more鈥�. But the time is coming when the cost of treating people damaged by overeating will overtake the tax revenues and campaign funds from the food industry. We should take sensible action before then.