According to the Center for Disease Control and Prevention (CDC), more than one-third (36.5%) of U.S. adults are dealing with obesity. With around 250 million adults in the U.S., this issue affects a large portion of the population.

Our diet—what we eat and drink and the amount—plays a significant role in managing our weight and health. Obesity-related conditions include heart disease, stroke, type 2 diabetes and cancer, and the estimated medical cost of obesity in the U.S. is over $150 billion a year.

America has always been about individual freedoms, but at what point do we recognize a public health crisis and start enacting regulations and publicity campaigns to generate awareness and combat adverse health effects for the greater good?

The War on Smoking and Its Effects

The issues surrounding obesity caused by unhealthy food and beverage consumption, as well as large portion sizes, is not unlike our realization that smoking causes adverse health effects.

In the 1960s, more than 40% of the U.S. adult population smoked cigarettes and other tobacco products. Even with studies over the previous decades suggesting a link between smoking and cancer, heart disease and other adverse health effects, many people did not know or care about the dangers.

However, as more evidence pointed toward the health hazards from smoking, public health advocates began pushing for government review. In 1964, the first Surgeon General’s report on smoking was released to the surprise of many. The report recognized the link between smoking and lung cancer and the increased mortality of smokers vs. non-smokers.

This awareness and recognition incited a strong response from the government and public health officials. While it took much time and effort, we started seeing change.

1966 – First health warnings enacted on cigarettes.

1971 – Cigarette commercials banned from TV and radio advertising.

1974 – Connecticut passes the first state law to apply smoking restrictions in restaurants.

1988 – Surgeon General’s Report states that nicotine is a “powerfully addicting drug.”

1992 – Legislation requires states to enact laws prohibiting the sales and distribution of tobacco to minors.

1998 – California becomes the first state to ban smoking in bars and restaurants.

1998 – Master Settlement Agreement signed by 46 states to settle lawsuits for billions of dollars in costs associated with the treatment of smoking-related illnesses.

2009 – The largest federal cigarette excise tax increase goes into effect.

Today, over 50 years later, cigarette smoking has gone from over 40% of the population to 15%, saved around 8 million lives and billions of dollars in healthcare costs.

Big Food, Big Profits, Big Incentives

Similar to Big Tobacco and the enormous profits they wanted to protect, Big Food has a lot at stake when it comes to their businesses and continued growth. From a profit standpoint, the main focus is to keep product costs low and have people buy and consume as much as possible.

Scientific Research—or Propaganda?

In 2016, the Journal of the American Medical Association (JAMA) released a report that looked into the scientific research on the link between sugar and coronary heart disease (CHD). Even though, starting in the 1950s, there was emerging data that indicated CHD risks from sugar consumption, Big Food sponsored a research report that singled out fat and cholesterol as the dietary causes of CHD. It was published in the New England Journal of Medicine in 1965 and downplayed sugar as a culprit for CHD.

Big Food also sponsored a research program in the 1960s and 1970s that successfully cast doubt on other health hazards from sugar consumption. These findings were eventually included in federal dietary guidelines. In the U.S. Dietary Guidelines for Americans (1980)—while it recommends avoiding too much sugar—it states:

“The major health hazard from eating too much sugar is tooth decay. Contrary to widespread opinion, too much sugar in your diet does not seem to cause diabetes. There is also no convincing evidence that sugar causes heart attacks or blood vessel diseases.”

These types of sponsored scientific studies continue today, and lobbying—purchasing influence through campaign contributions—to government officials who sit on food regulation oversight committees was $30 million in 2016 (not including state and local levels).

Big Food also partners with organizations committed to public health. The Academy of Nutrition and Dietetics (formerly American Dietetic Association) is the world’s largest organization of food and nutrition professionals, and it is “committed to improving the nation’s health.”

The Academy of Nutrition and Dietetics receives millions of dollars from Big Food corporate sponsors. A recent investigative report helped publicize its relationship with industry and create more awareness, but it has yet to be seen what kind of changes, if any, may occur. A list of corporate sponsors from the recent past, which can be found through a web archive search, included Coca Cola, PepsiCo, Unilever, General Mills, Kellogg’s and Mars Incorporated. They also allowed Big Food to sponsor “Nutritional Fact Sheets.”

Example Nutrition Fact Sheet – What’s a Mom to Do? Healthy Eating Tips for Families (sponsored by Wendy’s)

While the site has changed over the years, they still generate significant revenue through their advertising and sponsorships. In their 2016 media kit, one advertising option includes a “Sponsored Educational Supplement.”

The fact is that similar tactics were used by Big Tobacco to try and dissuade Americans from the truth about its products and the adverse effects. A study by UC Davis and UC San Francisco also shed light on how Big Tobacco funded and presented scientific research to position their products as safe and discredit negative reports.

We Know Nicotine Is Addictive, but What About Sugar?

Through significant research and published studies on nicotine, it is now a widely known and accepted fact that nicotine is addictive. In recent years, research is showing the addictive effects of sugar. A 2013 study identified that sugar and sweetness can induce reward and cravings that are comparable in magnitude to those triggered by addictive drugs such as cocaine.

In a 2015 publication, MIT neuroscientists attempted to study and understand sugar addiction. Senior author, Kay Tye, who previously developed novel techniques for studying brain circuitry in addiction and anxiety, said:

 “For the first time, we have identified how the brain encodes compulsive sugar seeking and we’ve also shown that it appears to be distinct from normal, adaptive eating.”

In reviewing the research, the scientific director at the National Institute of Drug Abuse, Antonello Bonci, stated:

“While there have been many excellent studies in the past, looking at the compulsive drive of substance-use disorders, this is the first time that a study goes very deeply and comprehensively into the same aspects for compulsive feeding behavior. “

With more research finding similarities in the way that our bodies respond to sugar and addictive substances like nicotine, there is certainly cause for us to look at how we can combat the rising obesity rates in America and our dependence on unhealthy food and beverages that are high in sugar. This is particularly important as we have also seen portion sizes in America increase substantially over the last 40 years.

Big Food and Big Tobacco Advertising

Marketing and advertising play a large role in creating perception and demand for products. One of the tools used to fight against tobacco use was limiting how cigarettes could be advertised.

Examples of cigarette advertisements claiming to be endorsed by doctors:

• 20,679 Physicians Say “Luckies Are Less Irritating”
• This Is It: “L&M Filters Are Just What the Doctor Ordered!”
• More Doctors Smoke Camels

Smoking is addictive, and one of the key tactics for tobacco companies was advertising its products to youth who would become customers for years—if not a lifetime.

With sugar producing a similar addictive response, it is worth looking at how Big Food advertises their products to youth. In 2008, the Federal Trade Commission reported that the food industry spends almost $10 billion per year marketing food and beverages in the U.S. that appeal to children and adolescents, including $1.6 billion to target youth directly with soft drinks, fast food and cereal promotions.

Marketing and advertising unhealthy food and beverages are practically unchecked. In a resource on Harvard’s School of Public Health website, it states that two-thirds of Big Food companies have no policy whatsoever on marketing to children. From a federal standpoint, the Federal Trade Commission has attempted to develop voluntary nutrition standards for food and beverages marketed to children, but it has met strong resistance from industry and made no progress through Congress.

The Fight Against Big Food: A Long Road Towards Change

Similar to Big Tobacco, creating awareness and change in the types of food and beverages that we consume will take time. However, public awareness and regulatory action may very well be able to help spur change and combat our growing health crisis.

A 2017 study in Australia simulated the effect of taxes on foods with saturated fat, salt, sugar and sugar-sweetened beverages in addition to providing subsidies on healthy alternatives. The study concluded that taxing unhealthy food and beverages, as well as subsidizing fruits and vegetables, can potentially be combined to achieve substantial improvements in population health and healthcare cost savings.

A study conducted by the Rudd Center for Food Policy and Obesity (Yale) concluded that a modest tax on sugar-sweetened beverages could both raise significant revenues and improve public health by reducing obesity. If some of the tax revenues were invested in obesity prevention programs (similar to tobacco taxes), public health benefits could be even more pronounced.

However, similar to the fight against tobacco, efforts to change the status quo will be met with resistance from industry and consumers. When former mayor Michael Bloomberg attempted to ban oversized sodas in New York, he was met with stiff resistance from the State, and the ban was eventually rejected by the New York Court of Appeals.

But again, it takes time. Berkeley, California passed the first soda tax in 2014 and preliminary research suggests it helped cut soda consumption by up to 20%. However, soda is only one aspect of unhealthy food and beverages that impact the U.S.

Unfortunately, unlike smoking, food and beverage consumption is required to sustain life. If healthy food and beverages continue to demand premium pricing, while unhealthy alternatives remain inexpensive, it will be difficult to fight against the obesity epidemic that we currently face.

There is a long road ahead, and only time will tell if we’ll be able to win the fight against obesity and Big Food—especially since it’s a more difficult and complex opponent than smoking and Big Tobacco.