too much salt or a full meal more than 600 calories.
Disney’s rules, which take effect in 2015, closely follow a proposal by New York Mayor Michael Bloomberg to take supersized drinks over 16 ounces (500 ml) out of convenience stores, movie theaters and restaurants to stop people from having too much of a bad thing.
Predictably, the outraged public said that this time, Bloomberg had gone too far. Banning smoking in public places and artery-blocking trans fats in food was bad enough, but stopping them from guzzling comfort drinks by the litre was almost a human rights violation. It seems most people are not just happy choosing their own poison. They also want it in supersized doses guaranteed to kill sooner than later.
For, after tobacco use, obesity is the biggest public health bugbear that triggers more avoidable diseases and death than malnutrition. Overweight and obesity are the leading risk for global deaths, killing 2.8 million adults each year. In addition, 44% of all diabetes, 23% of heart disease and between 7% and 41% of certain cancer are linked to overweight and obesity, says the World Health Organisation.
Worldwide, obesity has more than doubled since 1980. In 2008, more than 1.4 billion adults were overweight, with over 200 million men and nearly 300 million women being obese. In 2010, more than 40 million children under five were overweight.
So it is pretty obvious that left to themselves, people are choosing wrong and something needs to be done to make them stop and think.
The reasons for poor lifestyle choices are many, with almost all driven by socio-economic causes such as low education and limited income. Like killer infections, obesity and the resultant type-2 diabetes, affect the poor more than the affluent, largely because processed and fast foods are cheaper and take less or no time to prepare than healthy home-cooked meals.
Limiting food choices, however, is not enough. Paediatricians at the American Diabetes Association’s 72nd Scientific Sessions in Philadelphia this week underlined the need to get children off their chairs and into the playgrounds. Too much screen time, largely social-networking, followed by online and video gaming and television, are making healthy children fat and putting them at risk of type-2 diabetes in the second decade of their lives. The lifestyle disease that interferes with the way the body metabolises glucose typically affects people in their fifties and sixties, and is linked with a host of complications that can potentially cause heart disease, kidney disease, blindness and amputations over time.
The official measure for obesity in adults is body mass index (BMI), which is calculated by dividing a person’s weight in kilograms by the square of his height in meters (kg/m2). The WHO definition is a BMI greater than or equal to 25 is overweight, a BMI greater than or equal to 30 is obesity, but the cut-offs for south Asians are 23 for overweight and 25 for obesity.
Physicians, of course, have a role in alerting their patients that they may soon be tipping the scale but I find it amazing that people still need to be told that size XXXL is not all right. Large is still okay, but supersize is not. And if it takes the bullish New York City mayor to hammer the message home, then so be it. For choosing dessert over carrots or facebook over homework is okay just once in a while.