Relationships and Health
 
by Jhon Wlaschin, Ph.D.

Michael Bloomberg, the mayor of New York City is proposing a ban on sugar-sweetened beverages larger than 16 oz.  The mayor has made progress as a public health advocate by being among the first in the nation to enact a total ban on smoking in bars and restaurants and later restricting the use of trans-fats for restaurants serving fried food.  

Has the Mayor gone too far?
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Photographer: Chang W. Lee/The New York Times. Click the photo to read more about Lee's work.
Some serious debate is going on among the city’s residents and although some obesity researchers like Kelly Brownell from Yale support the idea, others like Cornell’s Brian Wansink who’s book “Mindless Eating” describes how most of us consume far too many calories without realizing it, believe the proposed ban is too confrontational and “doomed to fail.”

Reading comments posted on the NY Times website attached to the news stories, I am struck by the passion people have for this issue on both sides.  Part of the emotion comes simply from a well known phenomenon called reactance.  People do not appreciated and become angered when limitations are made on their freedom to choose.  that spouses who try and control their partner’s health behavior such as a weight loss attempt often fail and harm the relationship if done in a way that makes the person feel bad about their behavior.

People also feel that this removes value from the way money is spent on drinks.  It is certainly cheaper to buy the extra large sizes.  Food companies and others who sell soft drinks such as movie theaters have relied heavily on the profit margin that come from selling sweetened water.  Gas stations and fast food establishments use the lure of the giant soda as a way to keep customers coming back for what seems to be a good deal for the pocket book in the short term but the quickly consumed excess calories pile up and contribute to weight gain in the longer term.

Many people feel the Mayor  would be wiser to educate his citizens about the hazards of excess soda consumption or spend more on programs like subsidizing gym memberships.  One opinion writer in the Times criticizes the mayor for not creating programs to help people to make better choices and then offers examples such as the changes school lunch programs have made by offering lower calorie drinks, and salad bars.   Aren’t these the same type of environmental controls the Mayor is prosing with the large size soda ban?

The problem is that unless you are living in a cave, you already know that drinking too much soda can lead to weight gain and in fact there has been a substantial decline in soda consumption over the last 15 years.  and other’s have pointed out, size matters, and people will consume most of what is given them without thinking.  Once smaller soda sizes become standard, people will not likely pine for the “Big Gulp” and they may be thinner for it .

The Mayor cannot throw money at this problem.  Making gym membership cheaper will not cause enough people to exercise.  More informational public health campaigns are welcome but do little to change behavior long term.   It is the environment that we as a society have constructed in the name of capitalism and instant gratification that has had the unfortunate consequence of making the population fatter.   We were smart enough to create such a system to solve the problem of hunger and now we should attempt to build a new culture that feeds people responsibly. 

Unless we don’t really care about our children becoming obese before they reach middle school. 

Limiting the size of soft drinks is a cost-effective nudge at encouraging people to make better choices.  New Yorkers hated the idea of a smoking ban in bars when it was first proposed and now breathing cleaner air on a night out in the city is universally accepted and applauded.    Bloomberg is not saying you can’t drink soda, he is just putting a speed bump in your way to get you to slow down.

 


Comments

Sarah
06/01/2012 10:30

Great post! I've been so disappointed to see the extreme negative reaction to Bloomberg's move (e.g., http://latimesblogs.latimes.com/showtracker/2012/06/jon-stewart-stephen-colbert-bloomberg-soda-ban-.html). I guess it's an easy target, but all of the opponents are essentially defending the right to buy soda by the bucket-full, as though bucket-sized sodas were worthy of defense. When I teach this topic in health psych, I link it to normalization of deviance. Huge portions became acceptable gradually, and perhaps a subtler, more gradual shift is needed to reverse the trend. I think you're right about psychological reactance being the driving force of the backlash, and that people can react just as negatively when healthy policies are introduced by loved ones as by politicians (thanks for the link to my paper!). I'm impressed that Bloomberg stuck his neck out on this one to try to bring more conscious thought and attention to the ubiquitous "portion distortion" (even if it is the neck of a lame-duck mayor). It may fail as a policy proposal, but it started the conversation and presented an alternative to Brownell's much-embattled soda tax proposal.

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06/22/2012 04:10

It is not something that a mayor can control but yes he can make decision to help people to understand and control themselves.

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06/29/2012 06:11

I just wanted to leave a quick comment to say that your blog was nice. I found it on Google search after going through a lot of other information that was not really relevant. I thought I would find this much earlier considering how good the information is.

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Nick Michalak
07/02/2012 13:51

Hey Jhon

So I was reading this article (http://www.bbc.co.uk/news/health-18393391), and I immediately wanted your thoughts. Question: how different would the West be right now if the advertising campaigns in the 70s focused on "low sugar" instead of "low fat" ? I instantly thought, "Well, if HFC/sugar is the problem (probably is), how do we reduce its consumption (assuming we want to, and we do)." You cited one opinion was to increase information--we both know information campaigns effects on behavior are marginal to zilch. I liked your use of the word 'nudge' (great book), but is banning (limiting) the most effective nudge, if it's a nudge at all? I think reactance was another good thing to note. Yes, people reacted to smoking bans and eventually welcomed them (I think), but has smoking decreased? Attitudes have certainly changed, but...A-B gap..I need to do some 'research', but I'm interested in what are the effects of trans-fat and smoking bans, as opposed to taxing them or demonizing them with nudge-like advertising ("make it large for an extra 50 cents!, note: a large soft-drink has X grams more sugar than a medium, and research suggests diets high in sugar...etc, etc."). My opinion leans toward marketing: make "low-sugar" the sexy/buzz label, because it seems to have worked with fat over the past 40 years. Anyway, sorry for the stream of consciousness. Good article Jhon, keep writing!

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jhon wlaschin
07/18/2012 14:22

Hi Nick,

I suppose that if ad campaigns in the 70s focused on low sugar rather than low fat we would have seen a parallel marketing response from the food companies promoting their low sugar products. To some degree this did happen with all the sugar substitute products out there. We live in such a consumer culture that the response to any problem has been simply to consume something else rather than consume less. That is why I can't fault Bloomberg for stepping in and attempting to help establish a new norm for what is an appropriate size soft drink.

Government regulation for drink sizes may seem radical now but perhaps will become more common place once there is data to support that the policies are effective in reducing consumption and perhaps obesity rates. I can't think of a more effective "nudge" simply because leaving it up to the consumer doesn't work. Banning smoking in public places has by far been the most effective way to reduce prevalence rates. Taxation also is effective but to a lesser degree.

I think it is too soon to know how much the trans fat ban has been on obesity rates in NYC. Again, people howled when it was first introduced but once the law is in place, people adapt and will soon not care or will rarely complain. The key thing is that government does have the power to shape social norms through enacting laws. Those laws that benefit the overall health of the public seem to be a fair tradeoff for whatever temporary losses there are in the marketplace. The cost of health care is rising at an astonishing rate and will soon overwhelm our economy if we don't figure out how to manage the health of the society.

It is in the interest of government to see consumption of unhealthy products go down. Businesses, for all their good intentions, will never advocate anyone to use their product less. Most people who try to capitalize on health research by creating the next sexy health product for consumption (e.g. acai berry juice) simply over claim the benefits to sell a product. They know little of the long term effects or lack of them. Turns out that the big push toward low fat diets may have been in the end a bad idea.

I think companies can try all they want to make low-sugar sexy but in the end taste will rule. No one has come up with a better tasting sweet substitute than sugar. In the end people will get what they want. It simply will help a little if government can create standard portions that demonstrate what is appropriate and healthy.

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Nick
07/18/2012 17:09

I agree that, in the end, no company would advocate using their product less (e.g., think Pepsi and Coke hiring sustainability consultants, so bottling uses less plastic/biodegradable plastic, but the bottom line is selling bottles of pop).

I also agree that intervention could work. That Bloomberg, or any policy-make for that matter, wants to implement regulations and bans to curb sugar-consumption and (hopefully) obesity is great. Governments can engineer social change to an extent.

However, I say could because we don't know. How could we find out, or at least infer, that banning certain sizes of drinks would cause the desired reduction in beverage consumption? We could hire a good social scientist and run a randomized trial. Some parts of the city can't order too big a size, other parts of the city are incentivized to order small sizes, other parts receive "no treatment."

We could infer from previous studies and data. I wish I could just type "Elliot Aronson" or "Robert Cialdini" and all the links to their relevant studies would pop up. However, take this one (http://bit.ly/Lt6Lk5), where they eliminated caloric beverage consumption, but it was only the higher BMI groups, not the group overall, that reduced BMI. It's these kinds of things that I don't think the Bloomberg group had in mind (or maybe they did, I dunno, I wasn't on the panel).

I guess I'm not arguing that they shouldn't intervene--they should just have good ol' randomized trials to back themselves up .

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08/06/2012 10:47

I think you're right about psychological reactance being the driving force of the backlash, and that people can react just as negatively when healthy policies are introduced.

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