Anti-obesity forces eye small chains, independents

Given new CDC reports showing the U.S. obesity epidemic continues unabated, even the prestigious Journal of the American Medical Association is saying it’s time to try a new direction. Among the ideas being floated: increased scrutiny of independent and small chain restaurant menu offerings and downsized portions for all.

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“The obesity epidemic in the United States is now three decades old, and huge investments have been made in research, clinical care, and development of various programs to counteract obesity. However, few data suggest the epidemic is diminishing," write JAMA editors Dr. Jody Zylke and Dr. Howard Bauchner in their June 2016 issue. “Perhaps it is time for an entirely different approach, one that emphasizes collaboration with the food and restaurant industries that are in part responsible for putting food on dinner tables."

The word “collaboration” sounds ominous to restaurant operators in the wake of menu labeling. That’s the federal rule requiring chains with 20 or more locations to provide nutritional labeling for standard menu items by May 5, 2017. Even before this rule has been fully implemented, studies have shown that menu labeling has little net impact on how much food restaurant customers order and eat. 

Hence the search for new methods. 

“What is the next step in addressing the epidemic of obesity?” Zylke and Bauchner ask. “Much research and attention have been directed toward the treatment of obesity, but the development of new drugs and procedures will not solve the problem. Perhaps genetics will unlock some of the mysteries of obesity, but this will take time, and more immediate solutions are needed. The emphasis has to be on prevention, despite the evidence that school- and community-based prevention programs and education campaigns by local governments and professional societies have not been highly successful.”

So are fat fighters out of viable options? Not quite. “The food and restaurant industries may be the sector of society with the greatest potential to affect the obesity crisis,” Zylke and Bauchner say.

Hmmm. . . "immediate solutions needed”. . . "restaurants”. . . ”greatest potential to affect obesity crisis.” We already know menu labeling at large chains isn’t getting the job done. That leaves independent restaurants and smaller chains—those under the 20-unit threshold of the menu labeling rule—as potential targets. 

Obesity researchers have already found these restaurants—typically full-service or fast casual—wanting. One study last year found that, from a caloric standpoint, eating at full-service restaurants is roughly as bad as consuming a fast food meal. But full-service is worse is terms of salt and cholesterol.

Another study that appeared in the Journal of the American Academy of Nutrition and Dietetics this January found that meals from restaurants not required to put calorie and nutrition information on menus serve food that’s just as bad for customers as that of chain restaurants, particularly fast food chains. 

“Non–chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy,” the study concludes, “Restaurants in general, rather than specific categories of restaurant, expose patrons to excessive portions that induce overeating through established biological mechanisms.”

Lead researcher and Tufts University prof. Susan Roberts found that 92 percent of meals provided by restaurants ranging from large chains to local full-service spots contain more calories than people need. The solution: “require restaurants to let customers order half portions or one-third portions and price it proportionally.”

“I would eat out 10 times as much if I could order a half or a third of whatever I want, instead of being left with the miserable healthy options, which are low in calories but not as interesting either,” Prof. Roberts tells Time. “Restaurants would hate it, but they would adapt by charging more for their portions or reducing portion size,” Roberts says.

She’s right. Restaurants would hate it, although probably not as much as customers asked to pay more for less.  

Obesity drives public health officials crazy because it is a complex problem that has no single cause and no single solution. Fixing it matters because obesity is linked to heart disease, hypertension, diabetes and other health issues whose personal and societal costs are staggering. Restaurants would like to help, but let’s hope that ideas like this one remain suggestions instead of becoming mandates or federal rules.