THE BLOG
02/18/2014 03:48 pm ET | Updated Apr 20, 2014

Can a Hat Trick Reverse Obesity?

I joined the medical staff of the Kaiser Richmond Medical Center in 1981. Much in medicine has changed since then. We're better at preventing smoking and in controlling high blood pressure, but we have witnessed the development of an obesity epidemic that threatens to bust the bank of U.S. health care. Current national health expenditures related to obesity stand at a staggering $150 billion yearly and are expected to top $200 billion by the end of this decade.

When I started practicing medicine, no one foresaw the need to offer bariatric surgery. Now 160,000 such surgeries are performed every year in the U.S. at a cost of approximately $30,000 each. Bariatric surgery is the medical profession's euphemism for stomach stapling and various other procedures aimed at reversing obesity by vastly decreasing the stomach's capacity to accommodate food.

What has happened? Why have we gotten fatter? What should we be doing about it?

For decades the medical profession has recommended that we reduce our fat intake. We have. We lowered our fat intake from 40 percent to 30 percent of total calories. Why then have obesity, and the diabetes that often accompanies it, become so prevalent?

It appears that the advice we as doctors gave, and in most cases are still giving, was wrong.
The main culprit is not fat, but excess sugar. We made the huge mistake of swapping sugar for fat. We doubled our fructose consumption and we have reaped a whirlwind.

Excess added sugar consumption has now been linked to obesity, diabetes, heart disease, heart disease deaths, fatty liver, and some cancers. The latest research shows that sugar's negative health impacts occur even in those who are of normal weight.

While sugar's predominant role in the nation's obesity and diabetes crisis is now established, if not well appreciated, science is pointing an even more damning finger at sugar in liquid form. More than 40 percent of the additional calories we have been consuming over the last 30 years have come from sugary drinks. That is enough, all by itself, to explain the obesity epidemic.

Our bodies respond differently to sugar, depending on the form it comes in. Cake with sugary frosting makes us feel full, and we reduce the amount we subsequently eat. Digestion takes hours, allowing our bodies time to deal with the sugar load. This doesn't happen when we drink a soda.

For eons, human beings have quenched their thirst with water. That's still what our bodies expect. When we add 15 teaspoons of sugar to that glass of water, as we do when we drink a soda or other sugary drink, we override our finely tuned and long-evolved system. Obesity, diabetes, heart disease and cancer have all been linked to sugary beverage consumption.

The strategies emerging to decrease sugary drink consumption have been informed by past successful tobacco prevention efforts. These emerging strategies aimed at reversing obesity by lowering sugary beverage consumption include: a soda tax, warning labels on sugary drinks, and removing sugary drinks from health care facilities.

Mexico recently made history by passing a soda tax in an attempt to lower its world leading obesity rates. The American Heart Association took notice and called on, "U.S. states and communities to enact the (soda) tax as well." The cities of San Francisco, Berkeley, and Seattle and the state of Connecticut are all considering levying a soda tax in order to reverse the obesity/diabetes epidemic.

A new and creative strategy in the fight to lower sugary drink consumption was recently unveiled in Sacramento, Calif. SB 1000, proposed by CA State Senator Bill Monning, would place warning labels on sugary drink bottles and cans. The science supports such an effort. An expert panel of medical researchers designed the warning label, which if passed, would read: STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.

A third strategy is to remove sugary drinks from medical center cafeterias, vending machines and inpatient units. St. Luke's Hospital in Duluth, Minn., the Baylor University Health Care System in Dallas, Texas, Vanguard Health Systems in Chicago, the University of Michigan Health System, and Indiana University Health Center in Indianapolis and many other medical centers nationwide have removed sugary drinks from their cafeterias and vending machines. By taking such actions, health care leaders are helping to get the message out to the public that sugary drinks are unhealthy, just like cigarettes.

Can a combination of all three strategies, a hat trick, if you will, help reverse the obesity/diabetes epidemic? I believe so, but to be truly effective we need these strategies to go viral. Clearly, Big Soda believes that their sales will go down if these strategies are adopted. That's why they spend so much money fighting to defeat these measures.

Ask your elected representatives to consider both a soda tax and placing warning labels on soda bottles and cans. Ask your medical center leaders to promote health by joining those hospitals that have already signed the "Health Hospital Challenge" and have gone "soda-free." The future health of our children and of our communities may well depend on it. For resources to get a campaign started in your community go here.