Around one in two hardware stores sells food. This telling statistic sums up the thesis of "A Big Fat Crisis": Thanks to an aggressive food industry, nowhere are we free from the temptation to make poor dietary decisions. Deborah A. Cohen, a medical doctor and senior scientist at the RAND Corp., takes the blame for obesity away from those carrying extra pounds and smacks it on their environment. Just as cancer results from exposure to a carcinogenic environment, she argues, “obesity is primarily the result of exposure to an obesogenic environment.” She presents a credible diagnosis though her proposed cure in the form of expansive government regulation requires a big stretch of realism.
The first section of the book describes a litany of cognitive vulnerabilities. Cohen describes our susceptibility to subtle behavioural triggers that tell us to indulge. And because of an evolutionary landscape of scarce sustenance, we overeat when the opportunity presents itself. On average, Americans weigh 20 pounds more today than 30 years ago. Did everyone simply become more irresponsible? Unlikely.
The environment in which we make our food choices HAS changed in recent decades. In the second section of her book, Cohen highlights three big fattening factors: the reduced price of food, the increased availability of food, and the increased intrusiveness of food advertising. These first two sections cover a lot of already-covered ground but the book's third section presents radical, ground-breaking and, to some, upsetting policy recommendations.
Cohen’s first policy proposal involves the standardization of portion sizes; she thinks restaurants should serve food in single-portion units just as bars serve alcohol in units. Second, she argues that the government should limit “impulse marketing” by banning food from stores that aren’t dedicated to food, restricting combo meals at restaurants and keeping drive-thru windows closed outside meal times. Third, she advocates for counter-advertising that would make the downsides of fattening food more salient.
Dramatically but poignantly, Cohen compares the current obesity crisis to 1800s London, when people tossed filth out the window and left rotting carcasses in the streets, leading to widespread disease. England finally enforced sanitation standards, which required reengineering centuries-old towns to build sewers. Cohen maintains that only the same drastic reengineering will reverse the obesity epidemic. “People are suffering,” she writes, “and thus need protection.”
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