Ontario doctors waging war on fat

The Ontario Medical Association is taking off the gloves, and shoes, in recommending a multifaceted attack on curbing the over-consumption of junk foods in an attempt to reproduce the success of the movement against smoking in the fight against obesity.

Here's an excerpt from the OMA's press release on the initiatives they recommend

• Increasing taxes on junk food and decreasing tax on healthy foods;
•  Restricting marketing of fatty and sugary foods to children;
• Placement of graphic warning labels on pop and other high calorie foods with little to no nutritional value;
• Retail displays of high-sugar, high-fat foods to have information prominently placed advising consumer of the health risks; and
•  Restricting the availability of sugary, low-nutritional value foods in sports and other recreational facilities that are frequented by young people.

The recommendations put forward today build on the actions Ontario’s doctors have already called for including:

• Legislation that would require calorie contents to be listed adjacent to the items on menus  and menu boards at chain restaurants and school cafeterias;
• An education campaign to help inform Ontarian's about the impact of caloric intake on weight and obesity; and
• Making physical activity/education mandatory throughout high school.

Of course I'm all for actions that can help reverse and prevent obesity.  I think this hit 'em from all sides initiative is a good idea.  

If you sense a "but" coming, your intuition is impeccable. 

First, I agree with the marketing, calories on menus, education, and physical activity ideas presented by the OMA.

I'm not 100% sold on the increased tax on junk food and decreased tax on healthy foods, but not because the concept lacks academic validity, rather because it isn't as practical or as potent as it seems. 

You all know I love researchers and doctors.  I love those who have true altruistic motivation to do good for humanity.

I have a bit of a problem though, with impractical idealism's that may sound intuitively good at first wash, but once you get the shine off and get down to the wood you may find a few knots and maybe even a bit of rot.

There is currently no tax on most basic groceries, including fruits and veggies, in Canada.  

Maybe the Ontario Medical Association would benefit from reading about food product taxation in the province of Ontario.. http://www.fin.gov.on.ca/en/guides/rst/500.html 

Some of the foods not taxed in Ontario (identical for the rest of Canada)

Fruit

Vegetables

Yogurt

Nuts

Bread

Eggs

Dairy

Vitamins and minerals

Meats

Cereal

Some of the foods that are taxed

Alcohol (not really a food..)

Candy

Chewing gum

Ice cream

Snack food (like potato chips) 

Um.. zero tax on healthy food, and tax on junk food.  Am I missing something here?

Junk food is already taxed and is already significantly more expensive than healthy food.

A grapefruit will cost you around $2.80/ kg with no tax, and a bag of potato chips will cost $9.80/ kg plus tax.

It is an urban myth that people buy junk food over healthy food because junk food is cheaper.  People buy junk food because they like it more.

Read my post where I did a grocery store price comparison of healthy food vs junk food:

Healthy food cheaper: Potato chips 1134% more $$ than potatoes

You buy a banana, orange, or apple from a grocery store and you're out of there for under 50 cents, no tax.  Tell me what junk food you can buy for 50 cents.  Exactly.  People aren't buying oranges at the same rate as they're buying potato chips because people want the potato chips more, even though a bag of chips is a few dollars and an orange is bought with nickels and dimes.  People will pay more for what they want. Significantly more.

How many times have I bit my lip in a grocery store line up witnessing a person on a very tight budget put back the healthy items and keep the pop and chips to stay within their spending ability?  Too many times.  I've seen down on their luck mothers with kids in tow put back milk and keep the pop.  I'm not talking about putting back $5.00 worth of milk and keeping $2.00 worth of pop and chips, I'm saying there are many that, in spite of their tight budget will opt to favor displacing $5.00 of milk in favor of $6.00 of chips and pop.

It isn't as though most people are complaining about how they can't afford healthy food; it's that most people complain that they don't prefer healthy food as much as they prefer unhealthy food.  Remember, healthy food is already cheaper than junk food.  People preferentially buy unhealthy food because they like it more.

When I was a smoker and hurting for cash and managed to make a few extra bucks I didn't think, "wow, now I can buy some broccoli".  Nope.  I thought, "Players Special Blend, king size". The smokes were a reward, a treat, much more so than healthy eating.  I wasn't the only nicotine fiend making the same delusional decision.

This is reality.  This is what happens right now and has been happening for decades.  Many low income people smoke.  In fact smoking decreases as income increases.  For many adding more tax to cigaretts and junk food would result in even less of their income going towards healthy choices as many will put aside the healthy choices in favor of the more appealing unhealthy choices.  We need to help people change their reward associations so healthy choices feel intrinsically more appealing than unhealthy choices, and cost alone wont make this happen, and wont have as much of an influence as other more socially and emotionally compelling reasons will.

So if healthy food is already significantly cheaper than junk food and has zero tax, what's the point of raising tax on junk food, and how can you reduce tax on something that already has zero tax?  How about a tax refund for making healthy choices?

Although currently more expensive, maybe junk food isn't yet prohibitively expensive.  Maybe that's what they are thinking.   There is some research showing that tax on unhealthy food reduces spending on the taxed food, and that making healthy food cheaper increases the sales of healthy foods.

A fat tax might change the current public perception that healthy food is more expensive than junk food.  People may be buying junk food because it tastes good and is perceived as being a bargin.  Bring in a fat tax and advertise it and people may be more fiscally motivated to spend their cash on cheaper, healthier food.  Maybe, but I would think the first reaction would be simply paying more for chips and donuts because the lowly orange isn't currently perceived as all that appealing. 

There is also research showing that the more overweight you are, the less influenced you will be by the increased price of unhealthy foods.  The less overweight you are the more likely you will choose healthy foods when healthy foods are made cheaper and unhealthy foods more expensive.  This may help in preventing obesity, but it appears that once you're overweight the habit of overeating compels you spend more on what you've habitually come to feel satisfied with.

Has a national fat tax been done anywhere?  Yes, in 2011 Denmark implemented a fat tax.  Is it having an affect?  Yes, people are shopping for cheaper junk food in adjacent countries with cross-border shopping.  Denmark is now considering repealing the fat tax.

The question I have; is a fat tax likely to be a major player in reducing obesity amongst Canadians?  It will be, if the tax is so high that junk food simply costs far too much forcing people to make a decision that isn't necessarily out of careful contemplation but rather through punitive big brother influence.  That's a bit Orwellian. 

I may be jumping the gun there with suggesting that we're all smart enough to make our own correct, self preserving decisions where our health is concerned.  It doesn't appear as though this is the case.  If it were we wouldn't see an obesity epidemic. We wouldn't see the vast majority of the population wilfully living in a way that causes them to develop all the unhealthy outcomes known to be associated with being overweight.  I mean, how much sense does it make to eat ourselves into heart disease? So maybe we do need the government to tell us what to do. 

Or maybe it isn't as simple as someone telling you what to do.  Maybe once you start overeating it's hard to stop because of hormonal changes and habituated behaviors.

What is the real driver for buying junk food?

How about because it tastes good?  How about because eating unhealthy is an indoctrinated social norm?

There is still a lot of work to do on smoking.  The reason for smoking being on the way out is because of the multi-pronged approach of increased taxes, reduced advertising, education, and of course the change in how smoking is depicted in entertainment media. Except for period specific shows like Mad Men, modern depictions of smokers in movies is that of the evil character or a duffus.  Was it mainly the high taxes, or was it a change in social acceptance that provoked smokers to quit and potential new smokers not to start?

When I smoked the cost was not an issue. Sure, it was an expensive habit but my interpretation of the value of smoking was such that I justified the cost.  Out of all the X-smokers that I've spoken to, very few say they quit because it was costing too much.  Nobody has told me they quit because of the pictures on the packages, but I'm sure at least a few have.

Most quit because they came to realize that smoking wasn't a very smart thing to do, what with the self inflicted harm and all.

Smoking is now viewed as a turn off.  It stinks, it's messy, and has a "I'm not too bright, and I'm indignant towards you and your "fresh air"" stigma attached to it.  Smokers aren't cool anymore, they're a bit of a social scourge who's haplessness is often forgiven because we understand the burden of addiction. 

The habit of overeating still enjoys social support.  You have a box of donuts and you're everyone's friend.  Try that with a box of cigarettes. Or a box of carrots.  You'll get a few takers for the smokes and carrots, but you'll get a mob line up for the donuts.  Chips and donuts; we've bought in, and bought in like Bernie Madoff customers.. the deal is too good to be true, but the reward of overeating is more appealing than the health bankruptcy it will cause, so we make friends with Bernie.

Like smoking, maybe overeating needs a long time to be recognized as the health hammering waste of chewing that it is.  Maybe we do need these tax initiatives that we initially balk at but over time people will relent to the cost and the public awareness campaign.

Or maybe the tax bit is the lesser of influences and change in public perception through awareness campaigns and reduced images of and reduced support of celebrating overeating will be the winner.

I would think that less advertising of high calorie foods and more public awareness of letting people know that eating a 10 oz steak is about as smart as wanting to develop type II diabetes, would have more affect than taxing junk food (which is already taxed).

I understand the reasons for a fat tax, but this isn't the first place I'd go.  I think it's a tax grab, and not very well thought out.  It's worth mentioning again that healthy food has had zero tax for decades, and junk food has been taxed for decades.  Obesity has increased every year for decades despite zero tax on healthy foods, and tax on junk foods.  How is this a new idea, and why do people think it will work? 

We eat too much, and have put far too much social and personal acceptance into celebrating and self gratifying via eating too much.  We need a big slap in the face.  Will the OMA's plan be the slap we need?

Maybe.  I know a lot of people will jump on board with feelings of social superiority and will happily retail the idea that fat taxes and pictures of diseased bodies on bags of chips is the obvious answer, but these people wont be thinking of the person on a fixed income who already puts back the milk so they can drink pop, or the low income smoker who already chooses to pay for the death darts instead of healthy food.

I like the fact the Ontario Medical Association is getting a lot of traction in the press with this issue only in that it gets people talking about how we eat too much junk food and aught to do something about it.  I don't like the fact that the OMA didn't do their homework before presenting their ideas.

Maybe merely threatening a fat tax is the OMA's savvy strategy to get people thinking about and discussing the larger issue, and they don't actually want a fat tax. That's a huge stretch though and I'm giving the OMA too much credit for being so wise.  No, the OMA is most likely as it appears to be on this issue; hapless meddlers using their platform to show everyone how heroic they think they are.  Too bad because you'd think educated physicians would get their facts straight before going public with something so important.