Wednesday, June 13, 2012

Portion Creep

(Photo Credit: Reuters, by way of Tenured Radical.)

Portion size has been on the nation's mind lately in the wake of New York Mayor Michael Bloomberg's proposal to ban the sale of sugary drinks over 16 ounces from restaurants and movie theaters (but not from stores that sell, you know, Big Gulps).

Portion size has been on Moose's mind lately, too, as she approaches the one-year anniversary of her success on her Lifestyle Adjustment Program. (She reached her official target weight in mid-July, though she dropped another ten pounds during her first couple of months on maintenance.) I think we'll let her weigh in, as it were, on the whole issue of nutri-nannyism, since healthy, happy eating and drinking are kind of her beat these days. Take it away, Moose!
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Thanks, Rox. Let's cut right to the chase. Does Mayor Bloomberg's proposal make sense as a matter of public policy? Does the state -- or, in this case, the city -- have a right to set limits on consumer choice in the interest of combatting obesity and the health risks associated with it? (NB: The Department of Lifestyle Adjustment here in Roxie's World disapproves of phrases like combatting obesity, because we don't like war metaphors or eliminationist rhetoric. We use the term here because it shows up all the time in coverage of weight and public health. See for example the lead paragraph on this story about Bloomberg's proposal). Our good buddy Tenured Radical did a post the other day that argued in favor of the proposal as an appropriate use of the government's power to regulate trade, promote health, and protect consumers from the food and beverage industries' efforts to boost profits by pushing ever larger portion sizes off on the hungry, thirsty public. Go read that post for TR's excellent links and for yet another example of just how nasty commenters over at The Chronicle of Higher Education can get when their dander is up, which it generally seems to be.

It's easy to see why Bloomberg's proposal raises hackles. It reaches right into the heart of the great American ambivalence about government, activating our knee-jerk inclination to condemn anything that appears to limit a freedom that we like to pretend is or should be absolutely unfettered. It also underscores the tendency in our market-dominated world to assume that consumer sovereignty is the only form of sovereignty there is. Law prof (and current head of the White House Office of Information and Regulatory AffairsCass Sunstein argues in his book Republic.com 2.0 that consumer sovereignty -- i.e., the freedom to buy and consume whatever we want -- is not nearly as important or robust as political sovereignty -- i.e., our right and responsibility to participate in democratic self-government. Our tendency to overvalue consumer sovereignty and to confuse it with political sovereignty helps to explain why knickers get wadded over any perceived threat to our inalienable right to have whatever the heck we want whenever the heck we want it.

Philosophically, I stand with Bloomberg, TR, and others who say government has the right to set the kind of limits on consumer choice that the sugary drink proposal would set. I mean, look, I'm as freedom-loving as the next gal, but I fail to see a threat to the American Way of Life in this idea. I know, if it turns out Starbucks won't be able to sell the 24-ounce (and 510-calorie) version of its Caramel Frappuccino we'll be in a different ballgame and New Yorkers will be justified in fighting back with all they've got. For now, though, I'm thinking Bloomberg's proposal represents a significantly smaller threat to liberty than, say, state-ordered transvaginal ultrasounds.

I can also personally vouch for the effectiveness of limiting portion size as a way to manage weight. A year ago, people were constantly asking me how I lost more than fifty pounds. These days, they're asking me how I've succeeded, so far, in keeping it off. Portion control is an important part of the answer to both questions. (The other part of the answer is physical activity, but that would be the subject of another post.) Day in, day out, the single most important adjustment I've made to my lifestyle in the past year and a half is represented in the picture below:


On the left is the plate we used to use for most of the (non-entertainment) meals served in Roxie's World. It's 11-1/4" in diameter. On the right is the plate we started using in January of 2011 when I started trying to lose weight. It's 9-3/4" in diameter. The switch to a smaller plate has been enormously helpful to my efforts to eat mindfully and well. The smaller plate looks full with less food, and that look of abundance is a powerful visual cue that I am getting enough to eat. I'm not starving or denying myself the pleasures of the table. When the plate is empty, I am finished eating, though I'll admit to still taking the occasional bite or two off of Goose's plate. (Her eyes are bigger than her stomach. Also: I am not perfect.) I don't go back for seconds, which I think is the logic of Bloomberg's proposal: Limit portion sizes to 16 ounces, and the vast majority of people aren't going to go back for more. They'll be satisfied with less and the risk of damage to their health from the garbage-laden calories in sugary beverages will have been lowered. (By the way, science backs me and the mayor up on the benefit of using smaller serving dishes. Check out this fascinating study on how even a group of nutrition experts were fooled about how much food they were getting when they ate out of larger bowls.)

So, I agree that government has the right to set such limits and acknowledge that fighting portion creep has been essential to my own efforts to reach and maintain a healthy weight. Why, then, do I nonetheless find myself doubting the wisdom of Mayor Bloomberg's proposal? It's partly, I suppose, that the idea seems so vulnerable to the kind of mockery that has in fact greeted it. It's just too easy to make it sound ridiculous, which aids and abets conservative efforts to depict all government regulation that doesn't involve women's wombs as nanny-like intrusions into the lives of citizens. More importantly, though, I'm also not convinced that the plan, well intended as it is, would have a significant effect on the problem it hopes to address. People who want to consume ridiculous amounts of sugary beverages will still be able to do so by ordering several of the 16-ounce servings available in restaurants and movie theaters or by stopping off at 7-Eleven for a Big Gulp. (Grocery stores are exempt from the proposed limit on serving sizes.)

The proposal seems doomed to fail if it isn't accompanied by an education campaign aimed at moving consumers toward healthier choices and then assuring they have access to healthier products. It's great to give consumers some measure of protection from the relentless, well financed, and government subsidized efforts of soda makers to "drive more ounces into more bodies more often," as a former marketing executive for Coca-Cola put it at a "National Soda Summit" held in Washington last week. It's just as important, however, to go about this work in a way that doesn't make overweight people feel judged, ostracized, or condescended to, and Michael Bloomberg doesn't always come across as someone whose cup, whatever its size, runs over with empathy. I'm not a nutritionist or a public health expert, but here's a link to some constructive ideas from a bunch of folks who are on how we might more effectively help the public to achieve a healthy weight. Go check out their ideas and then come back here and we'll chat about portion creep, public health, or whatever else might be on your mind. I've just taken a big gulp of cool, refreshing tap water, and now it's time to go take the sweetest girl on dog's earth out for an evening stroll. That sounds like a healthy, happy choice, doesn't it? See ya later, kids. Peace out.

6 comments:

  1. The weird things is... I know exactly where this idea is coming from. It's Libertarian Paternalism which is a (sexy new) way of changing behavior that is *less* intrusive than regular government interventions such as taxes, mandates, etc. (See Nudge, also by Cass Sunstein.) You can still get your 64oz of sugary soda, you just have to realize it's 4 cups worth, that's all. You get to choose, at little to no additional cost. Yet people seem like they'd be happier if the gov't imposed a soda tax... somehow that would be less intrusive even though technically it's more intrusive. I guess the lesson is to stick with government interventions that people understand and distort even rational behavior rather than ones that let them make up their own minds by providing full information.

    OMG, thank you for the comparison to women's reproductive rights. What a tempest in a teapot (or sugary fizzy drink in a large cup?) this soda thing is comparatively. And yet... even the Daily Show seems to be spending equal time on the two topics.

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  2. LOVE the term Libertarian Paternalism, which seems just right for describing Bloomberg and Sunstein. (There's a lot I don't love about Republic.com, but I do find his distinction between consumer and political sovereignty really useful. Hadn't heard of Nudge, so thanks for mentioning it.)

    People probably would prefer soda taxes to limits of the kind Bloomberg is proposing -- but of course the beverage industry has effectively bought off Congress, so that ain't happening. WaPo had a good article on the issue of soda regulation when Bloomberg's proposal first came out. Here's the money quote: Sodamakers “have indicated they will spend as much money as it takes to kill a tax because tens of millions [of dollars] is nothing compared to the sales they would lose if a stiff tax were adopted.”

    Ya gotta admit, Bloomberg's proposal is genius for the end run it makes around that mountain of money. The article is here.

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  3. I find it interesting that thepeople who are going berserk-o on my blog about Nanny Bloomberg regulating the Soda Gulps don't worry about the kinds of surveillance that have been routine in NY for a long time. We know, for example, that the NYPD has drones, and engages in the kind of undercover work that used to be the province of Mother Hoover and her boys. In another vein, children are tested constantly in school, which is long-term surveillance at taxpayer expense.

    But let's talk weight loss. Inspired, in part, by Moose (yes, her influence is everywhere) I decided to lose the twenty pounds that make me feel old. Oh yes, other things make me feel old too, but this one I can do something about. I read about an app (yes! an app!) called Lose It which is, pure and simple, a calorie counter.

    You simply enter the weight you want to lose and the rate you want to lose it (I decided to go for 1 lb a week, which I had heard somewhere was reasonable) and the app gives you a daily calorie count. You then enter what you eat, and the exercise you do (which then gives you more calories to spend!) and all you have to do is stay under that number.

    I was surprised when I started about how little I knew about the calorie counts of all my foods, and it was a terrific learning experience. A lot of things I thought were low cal were not; and many things I really like are pretty modest in the calorie department (vodka, blueberries, quinoa.)

    You can do the Fat is A Feminist Issue thing too -- do I want ice cream for dinner? Then I shall have ice cream! Screw the dinner. Of course, then you go to bed hungry because of the sugar surge, which makes that dinner dramatically less attractive on subsequent days and you don't do that again.

    So this is all to say that even for those of us who think we eat pretty healthy, know a lot about our bodies, and are of moderate build, there turns out to be a big learning curve.

    And BTW -- the outcry over Bloomberg reminds me of the water floridation and vaccination debates, not to mention everything going on in the raw milk world nowadays. Put all of them together, and someone's got an article at least.

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    1. If you eat high fat premium ice cream, it's glycemically balanced, so you don't get the sugar surge and crash. It's only the low-fat high sugar stuff that causes the glycemic problems. (I had ice cream for dinner last night...)

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  4. Just a little flavor or context or what have you: Here's a 1960s commercial that touts Pepsi's new 16 oz. "half quart" as giving three, yes THREE servings: http://www.youtube.com/watch?v=9FfBQIv53Bo

    Portion creep indeed.

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  5. There is some interesting public interest advertising already going on in New York City. We have a series of ads in the subway, in both English and Spanish, about "pouring on the pounds." What makes them more interesting than your average "gosh these drinks are full of sugar" messages is that they quantify the calories with exercise: "You'd have to walk the 3 miles from Union Square to Brooklyn to burn off the calories from one 20oz. soda."

    http://www.nyc.gov/html/doh/html/pr2011/pr026-11.shtml

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