Hastings Cent Rep. 2018 Jan;48(1):5-7. doi: 10.1002/hast.804.
It is staggering to observe the new normal in America: 37.9 percent of adults are obese, and 70.7 percent are either obese or overweight. One out of every five minors is obese. The real tragedy, of course, is the disability, suffering, and early death that devastates families and communities. But all of society pays, with the annual medical cost estimated at $147 billion. The causal pathways are complex, but if we drill down, sugar is a deeply consequential pathway to obesity, and the single greatest dietary source is sugar-sweetened beverages (SSBs). The copious amount of sugar in the American diet is no accident. Industry practices and regulatory failures have fueled this explosion. Yet there are sensible, effective interventions that would create the conditions for healthier behaviors. What are the key interventions, and how can we overcome the social, political, and constitutional roadblocks? Tobacco control offers a powerful model, suggesting that success requires a suite of interventions working in concert: labeling, warnings, taxation, portion sizes, product formulation, marketing restrictions, and bans in high-risk settings such as schools and hospitals. Each intervention deserves detailed analysis, but I'm kick-starting scholarly and policy conversation by systematically laying out the major legal tools.
令人震惊的是，如今美国已经出现了一种新常态：37.9%的成年人肥胖，70.7%的成年人超重或肥胖。每五个未成年人中就有一个肥胖。当然，真正的悲剧是这种残疾、痛苦和早逝给家庭和社区带来的毁灭性影响。但整个社会都为此付出了代价，据估计，美国每年的医疗费用高达 1470 亿美元。其因果关系很复杂，但如果深入研究，糖是导致肥胖的一个重要因素，而含糖饮料是糖的最大单一来源。美国人饮食中含有大量的糖并非偶然。行业惯例和监管失败助长了这种现象的爆发。然而，有一些合理且有效的干预措施可以为更健康的行为创造条件。关键的干预措施有哪些？我们如何克服社会、政治和宪法方面的障碍？烟草控制为我们提供了一个强有力的模式，表明成功需要一整套协同作用的干预措施：标签、警示语、税收、份量大小、产品配方、营销限制以及在学校和医院等高危场所的禁令。每个干预措施都值得详细分析，但我通过系统地列出主要的法律工具，为学术和政策讨论开了一个头。
