Fight obesity by putting calorie counts on menus

When New York City passed legislation requiring restaurants to post calories next to menu items, it took a step toward obesity reduction that Baltimore and the rest of the nation should follow.

We have seen the obesity epidemic grow to epic proportions over the last three decades. Skinny people are becoming an increasingly slim minority; more than one-third of Baltimore adults are medically obese, and another third are overweight. We pour millions of dollars into the health care system to treat obesity-related disease, and all the advances we have made researching drugs to lower the risk of heart attacks, strokes and diabetes are counteracted by the deleterious impact of obesity.

At first glance, it may seem that people are motivated to fight against the epidemic. There has been a big increase in the number of gyms over the last few decades. Industries like Jenny Craig and Weight Watchers have blossomed with the message that they can help you lose weight by limiting your daily calories and sponsoring active behaviors. The solutions are simple. And yet, the obesity epidemic continues to rise.

The problem is not the availability of outside help. The problem is that our motivation to commit to these programs is weak because it is contrary to our natural set point. If we were able to go to the gym regularly, or stay in Jenny Craig for long periods, we would be able to rein in our expanding waistlines. However, these programs take time, money and — perhaps most daunting of all — effort.

Our brains do not accurately compute the risks to our health because the health consequences of our decisions are years away, whereas that burger is right there in front of me. And, I can always start my diet tomorrow. Or maybe the day after.

We need help in making healthy food choices. Healthy eating campaigns are underfunded and lack the charisma to influence behavior. Taxes on unhealthy foods are a powerful disincentive, but such efforts — Baltimore's controversial "bottle tax" is a prime example — are few and far between. Propose a junk food tax and opponents will decry a "nanny state," arguing it violates freedom of choice, a core American value.

We might do better, as a nation, to follow New York's example. The policy there is simple: Restaurants must indicate the caloric content of menu items right next to the item on the menu. The information will be difficult to avoid, and disclosing that information at the point of purchase makes it compelling.

Many companies list calorie counts on their websites, but this does not go far enough. Few people read the nutritional information online, and a distant tidbit of information is easily forgotten when one is perusing a restaurant menu. We need the calorie content right there in front of us, weighing on our decision right up until the moment the waiter takes our order. We need that constant feedback every time we go to a restaurant, so that every time we don't make the healthy choice, we remember it and we can let that feeling guide future healthy decisions.

The restaurant industry would probably not support this measure. Apart from the cost of printing new menus, restaurants make more money when we buy huge portions. Large meals require a decreasing marginal cost of production, yet people have been willing to pay more for additional portions of food, and restaurants use this to maximize profit.

Restaurants would still be able to sell large portions, but they would be selling to better-informed customers. Adam Smith's model of capitalism holds that rational decisions are made in the presence of accurate information about all available products and the expected costs and benefits of each product.

We must do our best to educate the public about the long-term risks of excessive calorie consumption. In the meantime, customers must be presented with point-of-purchase information about calorie content. This alone will not thwart the obesity epidemic, but it is a smart policy with little cost that will make good headway.

Thomas Hanff is a medical student at the Johns Hopkins University. His email is

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