Obesity Prevention Policy Options

1. Obesity Prevention Policy Options By: James Onisk

2. Background • 60 million Americans are considered obese¹ • 43 million American Adults are considered overweight¹ • Totaling 100+ million Americans who are overweight/obese, and 33% of the adult population² • Currently, 45% of adults say eating at restaurants is an essential part of their lifestyle³ • Restaurant foods are known to be high in fat, sodium, and sugars while providing non-nutrient dense foods

3. Background • Medical costs associated with obesity are $147 billion annually 2 • Third party payers paid $1,429 more, annually, for those who are obese than those who are not2 • Medical conditions associated with obesity are: • Heart disease4 • Hypertension4 • Stroke4 • Cancers4 • Type 2 diabetes4

4. Obesity Related Policy Options • 1.) An excise tax of one penny per ounce on sugar sweetened beverages (sodas, artificially flavored juices, etc.) • 2.) Mandatory menu labeling of calories, fat, sodium, etc. at fast-food restaurants • 3.) A national ban on trans-fats

5. Major Stakeholders • National Restaurant Association • American Beverage Association • National Grocers Association • American Heart Association • Center for Science in the Public Interest • General Tax Payers

6. Evaluating Policy Options • Each policy option will be evaluated by the following criteria: • Cost- How much will implementation of these policy options save state/federal governments? How much will these policies cost tax-payers or involved parties? • Political Feasibility- Do interest groups have the ability to interrupt implementation of these policies? Have policy makers supported these types of policies in the past? • Public Support- Does the general public show interest and support for these policies? • Effectiveness- What percent of the population will decrease in obesity as a result from the policy implementation?

7. Option 1: Tax on Sugar-Sweetened Beverages • Average person consumes 10-15% of their daily total calories from sugar sweetened beverages5 • An excise tax would encourage people to consume less due to financial burden5 • Better than a sales tax because a sales tax would only encourage cheaper beverages being purchased5

8. Option 1: Tax on Sugar-Sweetened Beverages • Effectiveness- expected to reduce consumption by 13%, or two servings per week per person.5 It is also expected to reduce caloric intake by approximately 8,000 calories a year and result in trimming 2.3 pounds of extra weight.6 • Costs/Savings- would raise at least $14.9 billion in the first year of implementation alone7 • Public Support- Some poll results show support for a beverage tax ranging from 37-72%, 5 Low income populations may disagree with the tax because they are major purchasers of sugar sweetened beverages • Political Feasibility- This policy can be interrupted by threats from beverage companies and lobby groups. PepsiCo threatened to move its corporate headquarters out of New York State when a possible 18% tax on sugar-sweetened beverages was proposed7

9. Option 2: Mandatory Menu Labeling • Menu labeling makes information regarding calories, fat, carbohydrates, and sodium content of foods served available on menus in restaurants8 • Better choice • As of 2004, only 54% of chain restaurants provided nutrition information9 • In a study looking at the knowledge of calories and fat content of restaurant foods, 73% of consumers underestimated the number of calories in “light entrees” by 43, while 90% of consumers underestimated less healthy entrees by an average of 642 calories9

10. Option 2: Mandatory Menu Labeling • Effectiveness- Of studies analyzed, there have been mixed results from whether menu labeling has a positive, negative, or no impact on lowering caloric and fat intake. 9 • Cost-Signs= $6400 per restaurant per year; nutrient analysis= around $50,000 for all menu items • Public Support- Surveys show that 62-87% of consumers support requiring restaurants to list nutrition information8 • Political Feasibility- Two bills have already been purposed to congress regarding menu labeling policies, both have been stalled, as well as California and New York City have implemented menu labeling policies. 9

11. Option 3: Banning Trans-Fats • They are used in commercial food processing for an increase in flavor, saving texture, increasing shelf life, and for deep frying10 • 2% of all calories consumed are from trans fats; as intake is recommended under two grams per day, most American adults eat 5.8 grams daily10 • Trans fat is more dangerous than saturated fat, having an anywhere from 2.5 to 10 times greater risk at causing cardiovascular disease- which has costs of $431.8 billion yearly10

12. Option 3: Banning Trans-Fats • Effectiveness- In one study, overweight women who increased their calorie intake by 1% from eating tran’s fats gained an additional 2.3 pounds per year. 9 • Costs- Virtually no cost to restaurant owners in switching to non-trans fat cooking oils; and Possible negative impact on restaurant food sales due to a potential change in taste.10 • Public Support- Many fast food restaurants are voluntarily removing trans fats 10 • Political Feasibility- 18 states have already considered or passed trans-fat bans. 10

13. Evaluation Using a Decision Matrix

14. Policy Recommendation • Implementing a federal excise tax of one cent per ounce container on sugar sweetened beverages is the best policy method for reducing obesity rates. • Both very effective and can raise money to fund other obesity or health related programs

15. Implementation of the Policy • Tax will be paid as customers purchase products at grocery stores • All current state taxes must be dropped and replaced with a flat rate • States will receive 20% of tax revenue from these purchases (rest goes to the federal government) • A new IRS subdivision must be created to monitor tax reporting

16. Monitoring and Evaluations • At the end of each fiscal year, calculations of tax revenue will reveal how much funding was raised to support other health programs. • With these numbers, the quantity of sugar-sweetened beverages can be calculated and analyzed to recognize any behavioral changes in the purchasing of these drinks. • Combined with reports from the CDC, the effect of an increase, decrease, or no change in sugar-sweetened beverage purchases can be correlated with a rise or fall in obesity in the next decade.

17. Questions, Comments, Concerns? Do you have any questions or comments? Thank you for attending this presentation

18. References • 1. The President’s Council on Physical Fitness and Sports. Physical Activity Facts. 2011. http://www.fitness.gov/resources_factsheet.htm. Accessed November 8, 2011. • 2. The Centers for Disease Prevention and Control. Overweight and Obesity: Data and Statistics. 2011. Available at: http://www.cdc.gov/obesity/data/index.html. Accessed November 8, 2011. • 3. Robert Wood Johnson Foundation. Menu Labeling: Does Providing Nutrition Information at the Point of Purchase Affect Consumer Behavior?. 2009. Available at: http://www.rwjf.org/files/research/20090630hermenulabeling.pdf . Accessed November 8, 2011. • 4. The Centers for Disease Prevention and Control. Overweight and Obesity: Health Consequences. 2011. Available at: http://www.cdc.gov/obesity/causes/health.html.Accessed November 8, 2011. • 5. Brownell KD, Frieden TR. Ounces of Prevention- The Public Policy Case for Taxes on Sugared Beverages. N Engl J Med. 2009; 360(18):1805-8. Available at: http://www.yaleruddcenter.org/resources/upload/docs/what/industry/SodaTaxNEJMApr09 .pdf • 6. Public Health Law Center. Taxing Sugar Drinks: A Tool for Obesity Prevention, Cost Savings, and Health Improvement. 2011. Available at: http://www.publichealthlawcenter.org/sites/default/files/resources/Taxing%20Sugar_Drinks _Public%20Health%20Law%20Center%20%20May%202011.pdf . Accessed November 8, 2011.

19. References • 7. Brownell KD, Farley T, Willet WC, Popkin BM, Chaloupka FJ, Thompson JW, Ludwig Ds. The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages. N Engl J Med 2009; 361(16) 1599-1605. • 8. Rudd Center for Food Policy and Obesity. Menu Labeling in Chain Restaurants: Opportunities for Public Policy. 2008. Available at: http://www.yaleruddcenter.org/resources/upload/docs/what/r eports/RuddMenuLabelingReport2008.pdf . Accessed November 10, 2011 • 9. Robert Wood Johnson Foundation. Menu Labeling: Does Providing Nutrition Information at the Point of Purchase Affect Consumer Behavior? 2009. Available at: http://www.rwjf.org/files/research/20090630hermenulabeling. pdf. Accessed November 8, 2011. • 10. Public Health Law Center. Trans Fat Bans: Policy Options for Eliminating the Use of Artificial Trans Fats in Restaurants. 2009. Available at: http://www.publichealthlawcenter.org/sites/default/files/resou rces/phlc-policy-trans-fat.pdf Accessed November 8, 2011.