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Caroline J. Cederquist, M.D.

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A Misguided Mandate: Is Banning Sugary Beverages the Answer to the Obesity Epidemic?

Posted: 10/10/2012 12:40 pm

New York City's ban on sugary 20-ounce beverages has certainly caused its share of controversy, and of course, questions about why other beverages like fattening milk shakes or ice cream sodas are exempt from the law. As a bariatric specialist, I am always preaching "Don't drink your diet," but what does that really mean?

For someone who is trying to stay away from soda but doesn't really understand why it's bad for them (too much sugar in the diet, empty calories, spurs further hunger cravings, etc.) they may opt for a large "juice" drink. Chances are that juice drink is just that: a drink that tastes like juice. It isn't fruit juice packed with vitamins imperative to our health, it is just a sugary drink with high fructose corn syrup, lots of useless calories and little or no nutrition.

With fall upon us, pumpkin lattes and apple ciders are starting to raise their colorful and tasty profiles in full force, and the unaware consumer is pretty much trapped by lots of scrumptious advertising! What are they unaware of, you may ask? They don't know that not only are these beverages increasing their calorie count in what we call empty calories, they are also causing a spike in their blood sugar, which leads to more sweet cravings and ultimately weight gain.

When guiding bistroMD members or my patients at the Wellness Center, I urge people to drink water. Yes, water and only water is what the body actually needs. If you're looking for a little more flavor, we suggest flavored waters that still help you get your calories from chewing nutritious food, not swallowing sugary liquids.

New York's supersize soda ban is Mayor Bloomberg's latest effort to combat obesity in the heart of the Big Apple. I applaud the mayor's dedication and willingness to take a stand against opponents to the ban and all the name calling criticism he has received. There's no doubt his courage in the line of fire in the battle against obesity is deserving of praise simply because he has brought national attention to bear on this critical issue.

At the same time, banning supersize soda alone misses the point. If the real goal is to help people lose weight and live healthier lives, soda shouldn't even be in the equation. Diet drinks must be included in the soda prohibition; they can be even more dangerous for dieters because although caloric intake may be zero, they often lure people into craving something sweet -- super sweet. Recent studies have found diet soda consumption to be linked with weight problems. Some speculate that, "of course overweight people will choose a diet soda," but this may not explain the association. Diet sodas are often drunk in the absence of food, and while they are not thought to invoke a release of insulin, for some people they actually do. The body is anticipating sugar from the sweet taste of the diet drink and none arrives. It responds with a hormone and metabolic cascade that may actually increase hunger shortly thereafter. I have had countless patients who describe a history of drinking diet sodas all day, avoiding eating much for most of their waking hours, having a reasonable dinner every night, yet constantly gain weight despite these efforts. What's worse, diet beverages are loaded with artificial sweeteners, which in some studies have been linked to a variety of maladies, including cancer.

Although I fully support Mayor Bloomberg's efforts to combat obesity, enactment of the new law is in the last analysis both misguided and misdirected. However, I'm delighted that he has called attention to obesity among New York City's adults and children. He is a champion for getting the media to scrutinize the obesity issue again and again, and for raising awareness of the need for people to make smarter, more educated choices.

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