by Barbara Berkeley, MD
It's the debate du jour. Should the government step in to control health behaviors or do such measures represent the dreaded "Nanny State"? In the past week, Mayor Michael Bloomberg announced his latest front in the battle on obesity. First it was the banning of trans-fats from restaurant kitchens, then menu labeling. Now Bloomberg is going after liquid calories with a ban on sugary drinks that exceed 16 ounces. This has raised many concerns, among the fear of continued banning. Clearly there are endless unhealthy products in the marketplace. Once the precedent for food bans is set, the possibilities are infinite. While this is a point worth debating, it is not the issue I want to speak to today.
The response to government intervention in eating behaviors always comes down to a defense of individual freedoms, a sacred cow to most Americans. Can we force people to do things that are healthy or are we abridging a basic right to live freely in doing so? If the issue were simply this, the answer would be an easy one. Individual rights are paramount. But the issue is not simple at all. Unhealthy behaviors are turning us into a sick, obese, diabetic society with health care costs that are untenable. We all suffer the burden of these costs, so the issue is no longer individual, but collective. The very future of our nation is impacted. This,too, is an important point for discussion.
But I want to talk about something else.
Has if occurred to you that the food freedoms we so long to protect may be something quite different?What happens if we are actually NOT free to choose at all, if in fact the freedom we believe we are protecting is simply the defense of a gripping addiction? Suddenly, the argument changes. Should we protect the right to choose something that is, in fact, not freely chosen? This is how I see this issue and it is a perspective that I have not heard discussed.
An increasingly significant line of research confirms the fact that sugar and the things that become sugar after digestion (i.e. grains and starchy carbs) are addictive. In a recent segment on 60 Minutes, Dr. Sanjay Gupta subjected himself to an MRI while sipping Coca Cola. The MRI shows an immediate hit to the brain's pleasure centers, the very areas which are stimulated by drugs. Animal behaviorists confirm the fact that animals will choose to overconsume pleasurable substances both in the lab and in the wild. Like other species, we are suckers for a food high. Once hooked, we can't figure out why we keep going back for more. Our world has started looking alot like a lab in which we are drenched in a bath of addictive foods and observed by those who create them. The foods are then tweaked to provide further "irresistibility". It is the "right to choose" these foods that we fight for. Is it really a choice? Is free will really involved?
I am always struck by the following observation: suggest that people become vegetarian and they are quite willing to consider it. This eating style eliminates an entire food group, yet it falls within the range of possible diets for most people. On the other hand, ask someone to eliminate carbohydrates other than fruits and vegetables and you will be accused of nutritional extremity. A life deficient in bread, cake and pasta seems like a punishment. I submit that the inability to imagine life without carbs testifies to the degree of pleasurable addictive response created by these foods. The problem is not that we need freedom to choose any foods we like, it is that foods we like choose us..and addict us....to our great detriment.
I don't think we need worry that wholesale food bans will pop up across the nation like so many McDonald and Burger King franchises. I do think we need to worry, however, that we will go on blissfully ignoring the damage being wrought by addictive pleasure foods, and even fighting to defend our right to eat and be consumed by them. Mayor Bloomberg's gutsy initiatives are important and to be commended. Individually they will not solve the obesity problem of course. But they call national attention to the degree to which we have fallen under the spell of modern sweet and starchy food. They give cover to companies like Disney who has now called for a ban on the advertising of junk food on its cable channel. They get headlines and start conversations. And perhaps they open a few eyes to the idea that the foods that are killing us have so seduced us, that we may need a "nanny" to remind us of the truth.