Supersized Disaster

Yes, that's a 44 oz individual serving of soda!
I never recommend soda to my patients or my family members. And I cringe when I walk into fast food restaurants (only to use the bathroom, of course) or a movie theater and see single serving cups in the range of 32-44 ounces. It’s obscene. That volume of sugar devoid of other nutrients, consumed at a single sitting is crazy. Our society has a distorted sense of what normal portions are—not just for beverages, but for food as well. The only place I’ve been able to find a true juice glass, a 4 or 6-ounce size, has been at antique stores. Really. So I support NYC’s Mayor Bloomberg’s recent ban on the sale of supersized sodas, right?

Not at all. While the mayor is desperately trying to change a growing trend of overconsumption and obesity, his new policy restricting the sale of sodas larger than 16 oz is absurd on so many levels.

While I take my freedom for granted, having never lived anywhere that restricted my personal choices, including what I eat, the thought of a law limiting the size of my portions feels, well, un-American. Mark my word; if they try to restrict my purchase of cupcakes after 8 PM, for instance, I’ll start hoarding them at 7. I mean it.

Who decides what you're allowed to eat and how much?

It’s quite a slippery slope. Who decides that Sprite is out, but grape juice is fine? Or that 24 oz smoothies are ok, but soda is not?  Maybe they should halt the sale of those cardiac-inducing hot dogs sold on food carts throughout NY, instead? Sure, there’s nutritional value in the smoothy, but if the driving force behind this policy is obesity and health—why would 24 or more caloric ounces of anything accompanying a meal be appropriate?

Next, will NYC next set limits on who can buy these large caloric beverages? Will we need to weigh-in at the food carts on 5thAvenue—high BMI? You get the under 16 oz regular soda or the diet one; low BMI? Youmay choose the supersized drinks—but ONLY those drinks with calories—no diet beverages for you

Should we perhaps ban the sale of large portions of diet beverages, given that they displace the calories and nutrients desperately needed by those with eating disorders and those simply underweight?

And what about cost? Can we not buy a bottle of soda at the deli to share with others, resulting in a smaller portion and less cost per person? Bloomberg’s ruling prohibits this.

The unforseen consequences

What message does it send if 16-ounce beverage portions—regular or diet—are considered the norm? Our caloric needs vary; for some, 16 oz of juice is absolutely appropriate. For others, it’s excessive for their need. But a law stating that 16 ounces is fine or distinguishing between soda and juice as healthy versus unhealthy creates a hierarchy people will believe is valid—when it’s not. If we are talking about weight management it's about calories, and a Coke is no different than a bottle of 100% juice. 

Should those with high blood pressure be forbidden
 this heavily salted popcorn?
I understand that simply educating the public to improve health is at best challenging. We are impacted by visual stimuli and sensory prompts to eat, as well as our perception--not just information about what and how much is healthy to consume. Prompted by the suggestion that you can size up for only 75 cents more (which I overheard at the movies yesterday), most of us will go for it. If you perceive that you haven’t eaten much you will continue eating, regardless of your fullness. And if you believe that 16 ounces is appropriate--because the Mayor believes it's fine for your health-- you may be more inclined to select the 16 oz size than something smaller.

If they’re going to set rules…

Perhaps there are better alternatives than Bloomberg’s to reduce our excessive intake—if or when it is unhealthy for the individual. How about a pricing policy removing the financial incentive to size up? If ordering the 32 oz soda vs the 16 oz adds $1.20 vs 20 cents, I suspect there’d be more thought before supersizing.

Yes, this is for real. And financially more sensible that the 32 oz
 which was more expensive per ounce!
Or what about a rule allowing individuals to bring their own snacks into a movie—maybe healthier popcorn from home? Or limiting movie-theater food to a specific eating area as opposed to in front of the screen? Can we not go 90 minutes without a feeding? Why are we encouraging distracted eating, when all evidence supports mindful eating helps us better regulate our intake and our weight?

Yes, something needs to be done to improve the health of our nation. But setting arbitrary boundaries on portions, about good beverages and bad, is hardly the answer. And the fallout from this perhaps well-intended policy may only result in more problems.

And I thought I lived in the liberal Northeast...
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