Doctors have killed tobacco. So why can’t they beat obesity?

Today, tobacco is on the run in Canada and the U.S., and in Ontario, it’s even against the law to smoke in your own car if there’s passengers under the age of 16 with you.

What did it take to turn tobacco from something everyone did to something only social pariahs dare keep doing? Timely whistle-blowing, a well-funded and strategic anti-tobacco lobby, huge litigation settlements in favour of state governments who promptly turned that money back into anti-smoking initiatives, enthusiastic media coverage, de-glamorization by role models in the sports and entertainment fields – and lest we forget, the moral leadership of doctors.

So why don’t doctors stand up and decry the much more lethal and expensive plagues of obesity and its cousin, diabetes? Both of them keep growing despite the fact that medical science knows so much more about their causes and effects than it did even just a decade ago.

Why? A couple of big reasons. But not insurmountable ones. First, while people are used to demonizing “Tobacco,” nothing will ever convince them to do with same with “Food.” Or even “Too much food.” That’s because without food, we die. Not trueof tobacco. And while we’re often told to cut down on our consumption of food, no one thinks that reducing your use of tobacco is really going to help you much. So it’s hard to articulate in a short, sharp accurate way what the problem is.

The second big reason is that the forces lobbying our governments for stronger, most transparent labeling on processed food are puny compared to the armada of advocates the food industry has lined up against them. The only North American government that has not succumbed to the interests of making calorie counts practically invisible at food counters, or making 100-calorie-a-can soft drinks practically mandatory in our schools is …the City of New York.

It took Michael Bloomberg, a billionaire Mayor who feels strongly about health and fitness and who is immune to financial blandishments, to pronounce in 2008 that fast-food chains have to post the calorie count of everything they serve. Last year, the New York Daily News reported that research by the city Health Department found that 15% of the people who see the calorie information eat an average of 106 fewer calories per fast-food meal. The article also notes this could add up to 26,000 fewer calories during the year, enough to lose 7.5 pounds.

But while New Yorkers ad those who visit The Big Apple may benefit from convenient and visible calorie labeling on fast foods, the battle to control how much we eat and how healthy our food is, is much more diffuse and complex. Not many of us know how many calories is ‘normal’, i.e. enough to keep your weight steady, let alone what that food’s sodium and cholesterol counts should be. But that will come. What’s missing from the battle against obesity and diabetes is a concerted campaign by doctors to stand upas a single, unified profession against the powers that fight
for less open and complete food labeling.

We are said to live in an age of transparency. It’s high time that clarity came to what should be medicine’s next great war, and the one it has both the obligation and the opportunity to lead.

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