Diabetes Forecast

Can the Obesity Battle Be Won by "Default"?

By Craig Williams, PharmD, Associate Editor ,

The mayor of New York recently created a lot of debate when he declared that the city would ban the sale of sugary drinks larger than 16 ounces in size. While most people would not miss these larger sizes, most of us also do not like being told what we can or cannot drink. A judge blocked the mayor’s soda limit; the city is appealing the decision. The fizz over soda raised broader questions about the role of government in our lives, and pretty soon people were picking sides and digging in their heels. But let’s take a small step back and look at an interesting aspect of the debate that got little attention: “default conditions.”

What are default conditions? The following example illustrates: In some countries, the default condition for organ donation is that organs are donated when a person dies unless that individual has specifically opted out. In other countries—such as the United States—the default condition is that organs are not donated unless one specifically opts in for donation. In countries where donation is the default condition, the rates of donating are about 98 percent. In countries where not donating is the default condition, donation rates are about 15 percent. Yet, when people in all countries are surveyed, they feel similarly about organ donation (overwhelmingly that organs should be donated).

How does this apply to large sizes of soda and New York?

Whatever we individually think about sugary soda, we all can probably agree that it is not healthy. In citing the reasons for the ban, the mayor of New York listed the sobering rates of obesity in the city.

As we consider the ban on soda within the context of fighting the increasing rates of obesity, the lessons of default conditions are relevant for the following reason: Soda is cheap to produce, and soda companies are competing for our dollars. Therefore, from a marketing standpoint, it makes sense to offer us more and more soda to compete for our cash. Multiply that effect by many competing soda companies, and suddenly it can be difficult to find even a 12-ounce soda anymore as 16-, 24-, and even 36-ounce bottles become the default condition on convenience store shelves.

Further, the lessons of default conditions teach that if I want an 8- or 12-ounce soda, but all I can find is 16 or 24 ounces, then I will buy the larger size. While I may not finish all of that soda, I will drink more than I would have if I had picked up a smaller size.

So, what should we do with this information? I believe that the battle against obesity will be won in small increments. There is no easy cure waiting to be discovered. Paying attention to which default conditions we set for ourselves is part of winning that battle. Maybe what we can do for now is just tip our hat to the mayor’s office if we’re in New York and enjoy a 12-ounce soda rather than reach for a 24-ounce one.



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