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Why The AMA's Obesity Ruling Is Bad Medicine

Hank Cardello

The American Medical Association’s announcement this week that it regards obesity as a disease is terrible news for food companies, public health advocates, and, most of all, the very people it intends to help, obese Americans. It could ignite new wars between the food industry and its antagonists; provide destructive new tools to hardcore food activists; derail the progress that the food and restaurant industries already have made in introducing healthier and lower-calorie options; and give consumers one more reason not to care about what they consume.

It’s still too early to tell how the disease badge might ultimately affect medical research, treatments, insurance payouts, and public policy, since the AMA has no legal power. But like a promising new medicine, the decision is likely to have unintended side effects.

For one, calling obesity a disease gives health activists and policymakers a new blunt instrument to use against the food industry. Food and beverage companies are already bedeviled by accusations in a 2013 bestselling book by New York Times reporter Michael Moss (Salt, Sugar, Fat: How the Food Giants Hooked Us) that they purposely concoct addicting products. The accusations have helped revive calls for such measures as Twinkie taxes, soda cup size bans, and restrictions on full-fat pizza.

These newly ignited brushfires, fanned and fed by social media and zealous lawmakers, could cost the food and restaurant industries enormous time and money to fight. If the activists were to claim that the industries are selling products that worsen a disease called obesity, they would have no choice but to lawyer up and defend themselves. As the decades-long tobacco wars proved, this would only greatly delay getting both parties to come to an equitable agreement. In the meantime, obesity would continue to shorten more lives, including children’s, than it should.

Moreover, new outbreaks in the food wars could divert food and restaurant companies’ resources from developing the healthier, lower-calorie foods that consumers increasingly demand. Leading food companies have already begun shifting their product portfolios to lower-calorie items. The momentum is building as many firms have discovered that these products can boost sales and profits. In fact, a recent study by the Hudson Institute for the Healthy Weight Commitment Foundation, a group of more than 230 major food, restaurant, retail, and other companies that have pledged to reduce the calories in their product lines, showed that lower-calorie items drove 82% of sales growth for the foundation’s consumer packaged goods members between 2006 and 2011. That was four times the growth rate of higher-calorie products. And lower-cal offerings accounted for two-thirds of the new products that had sales of at least $50 million.

A number of food companies have already reduced their “calorie footprints,” the average calories sold per capita. The Coca-Cola Company and PepsiCo have cut theirs by roughly a quarter in the U.S in the last decade by expanding their low- and zero-calorie beverage and bottled water businesses. General Mills has improved the nutrition content of more than two-thirds of its products and commands the highest operating profit margins among its peers, according to an earlier Hudson report.

Even in the slower to change restaurant industry, lower-calorie options are boosting sales at chains like Taco Bell and the Cheesecake Factory. In short, many food companies are already moving in the right direction, cutting calories in their product lines.

They are changing their ways not only because it’s profitable but also because they have made commitments to improve their products and have struck effective working partnerships with the public health community. One example is the HWCF, whose members’ efforts trimmed 1.5 trillion calories from their products this year, three years ahead of schedule.

Another is the Partnership for a Healthier America, a coalition of businesses, health advocates, and obesity experts dedicated to reversing childhood obesity. PHA’s member companies have added vegetables to children’s menus, funded fitness programs, and opened up more places to buy healthy foods in areas of the country that lacked them. Such partnerships demonstrate how health advocates and industries should work together to solve the obesity problem. Efforts to demonize the food industry as purveyors of disease would poison this well.

Labeling obesity as a disease also ignores the almost taboo subject of personal responsibility. Describing obesity as purely a disease overlooks the complex role of a person’s psychological profile and attitudes. A study led by Angela Sutin of the National Institutes of Health highlighted that the most disciplined consumers had lower rates of obesity while larger weight gains were linked to personality factors such as impulsiveness, low conscientiousness, and a willingness to take risks. The authors concluded that any obesity solution must address these psychological factors, which general practitioners cannot.

Research conducted by the Natural Marketing Institute further highlights the differences in obesity rates across consumer segments. NMI data shows that two consumer segments comprising 52% of adults exhibit the highest obesity rates. More importantly, NMI found that people in these segments either don’t care about what they eat or believe that supplements or medicines will cure any weight problem, rather than watching what they eat. To top it off, these consumers were the least likely to exercise. Declaring obesity a disease absolves many who practice deliberate eating and lifestyle behaviors that contribute to obesity.

In short, calling obesity a disease gives a hall pass to many who either don’t care or who struggle with their food and lifestyle choices. It could cause even more of them to backslide into obesity.

Food and restaurant companies, lawmakers, and public health advocates will be watching intently the fallout of the AMA ruling. We can only hope that cooler heads will prevail. We applaud companies that have already incorporated healthier, lower-calorie foods into their product lineups and menus. We press others to jump on the bandwagon because it’s good for their business and shareholders as well as responsible to society.

Most of all, with signs that obesity rates might be tempering, we celebrate those who are tackling an obesity problem by changing their lifestyles and eating habits. Let’s hope that the momentum continues, without the “disease” crutch.

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