A Supersized Problem: America's Losing Battle Against Soft Drinks

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Overweight Americans place a massive burden on the US health care system, a problem New York Mayor Michael Bloomberg hopes to help solve with a ban on supersized soft drinks. But the highly publicized offensive against sugary sodas has erupted into a debate about personal freedom.

Photo Gallery: Fighting Obesity One Cup at a Time Photos
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Lloyd Winnecke, the slim mayor of Evansville, Indiana, often watches the "Today Show," a breakfast show broadcast from Manhattan. There is one episode, in particular, that sticks in his mind. It was June 1, and New York Mayor Michael Bloomberg was sitting in the studio looking cornered. It was the day after Bloomberg had announced a plan to ban supersized soft drinks, and now he was on live TV to celebrate National Donut Day, of all things, as the city's official patron.

To commemorate the event, the baked-goods maker Entenmann's was giving away some 2.2 million calories in the form of 7,500 donuts. The irony of Bloomberg's duel involvement with the soda ban and the donut bonanza was just too tempting for "Today Show" host Matt Lauer to pass up: He made the mayor look like a ridiculous hypocrite.

In Evansville, a city in southern Indiana on a bulgy horseshoe bend of the Ohio River, a two-and-a-half-hour flight west of New York City, Mayor Winnecke began his day a little amused and even gleeful. It was yet another day in America's confused war on obesity.

It's clearly a war worth fighting. The enemy is deeply entrenched in the country and wreaking havoc on the civilian population. In Indiana, 65 percent of all adults are overweight or truly, even dangerously obese, and some 30 percent of young people aged 10 to 17 weigh too much or even far too much. Since these extreme numbers coincide with the national average for the United States, they describe a national crisis that is likely to expand to disastrous proportions. In 2030, an estimated 110 million Americans will be obese, an increase of 32 million over current figures. Indeed, some believe that the obesity epidemic could lead to the collapse of the American health care system.

Evansville is a case in point. A Gallup poll conducted last year ranked the city as the most obese in the nation. According to the survey, 37.8 percent of people in Evansville are obese, with a body mass index (BMI) of 30 or more. That's a lot: With a BMI of 30, an 8-year-old boy, 1.3 meters (4'3") tall, weighs more than 50 kilograms (110 lbs), a 40-year-old man, 1.8 meters (5'11") tall, weighs almost 100 kilos (220 lbs), and a 20-year-old woman, 1.7 meters (5'6") tall, weights 87 kilos (191 lbs). In Evansville, these statistical types go by names like Shirley and Steve or Peter and Mary, overweight people made of flesh and blood -- and far too much fat.

A Dubious Distinction

Although it's a very serious issue, and one that government authorities have dubbed an epidemic, it's hard to not chuckle a bit over some aspects of the matter. For example, when some Evansville residents wanted to break the world record for collective pushups, only 165 people showed up, instead of the required 251, out of a population of 120,000. And a video showing the mayor, police officers, firefighters and local ice-hockey stars working out while singing might also make you laugh. But none of this is funny.

"The subject of obesity is toxic in Evansville," says Winnecke, a 52-year-old moderate Republican who has only been in office for six months. The Gallup poll ranking Evansville as America's obesity capital came out in the middle of his election campaign.

Evansville is a respectable and relatively prosperous city. There is a noticeably large concentration of industry in the surrounding area, including a plastic-goods manufacturer with 2,200 employees and a Toyota plant with 4,600. There is a huge sports and entertainment center in downtown Evansville, and the city has an orchestra, a casino, two large hospitals and a wide belt of shopping malls and commercial zones along its periphery. "We always have companies interested in moving here or building new facilities," Winnecke says. "The scouts are constantly coming here to look for good locations. Being called the 'most obese city' doesn't exactly help."

Appearances vs. Reality

To offset that dubious distinction, the city is trying to polish its image. But there is little hope of coming to grips with the underlying problem. "I myself never take the elevator," Winnecke says three times during the course of a Friday morning in mid-July. "I always walk up the stairs." After our meeting, he makes a show of visiting the small farmers' market in deserted downtown Evansville, a forlorn-looking collection of a dozen vendors next to an urban wasteland.

Posing in front of the cameras of local TV stations, Winnecke buys fresh vegetables and fruit, squeezes tomatoes and melons, raves about the smell of fresh basil and thanks the farmers and vendors for being there in the first place. "It's all about raising awareness," Winnecke says, borrowing an expression that you hear a lot in the United States these days. It means believing in the healing powers of a drop on a hot stone and behaving as if there were no reason to despair in the face of a seemingly unsolvable problem.

Signs have gone up at a few intersections in Evansville showing the number of steps to various locations in a city where hardly anyone walks anymore. The fitness video "Go, you chicken fat, go," filmed at Bob's Gym and published on the mayor's YouTube channel, received 3,400 clicks, equal to about 3 percent of the city's population. Winnecke says that there are 65 small and large parks in the city, "plenty of space for all kinds of activities." But when you look around in Evansville, you don't see much physical activity going on, except in the evening along the banks of the Ohio, where the homeless get drunk, and during the day at the main bus station, where a lot of very fat people sit in the waiting room drinking sugar-saturated drinks from cups the size of flower pots.

Shopping malls surround the city like the camps of a besieging army. The malls, connected by multiple-lane highways, are the focal points of public activity. The obesity epidemic is in full view at the large Eastland Mall on Green River Road, which has a floor plan in the shape of an elongated cathedral. Chunky parents walk around holding the hands of their bloated children, while shoppers in tightly fitting XXL T-shirts sit around on benches consuming generous portions of fried chicken, soft-serve ice cream and smoothies.

Wanting Change

Of course, all of this sounds like a tired cliché, a well-worn caricature of America. But, sadly, it is actually a snapshot of reality.

In Evansville, it feels almost unreal when Shirley Smith arrives in a taxi at the Walmart supercenter on North Burkhardt Road. She is 47, not very tall and weighs 350 lbs (159 kilograms). It takes a while before she's extracted herself from the car, and then, supporting herself with crutches, she gets into an electric wheelchair that's intended for people in frail health and is much too small for her. Folds of her soft flesh hang down from both sides of the seat, and she's perspiring heavily. She's suffering, a lot, she says.

She says she has diabetes, high blood pressure, poor liver function, water in her shapeless, swollen legs, trouble sleeping and digestive problems. She's also worried about cardiovascular disease and missing her incisors because she says she can't afford to visit a dentist. But she has lost weight, she adds, 15 kilograms in a year, and she now eats lots of fruit and vegetables "and all that other stuff." Then she rolls away at a walking pace into the aisles of Walmart, where the package sizes for ice cream and ham, soda and potato chips, cheese and popcorn erase any distinction between wholesale and retail.

Mayor Winnecke pauses for a moment when asked if he's ever thought about taking his awareness-raising campaign to shopping malls and fast-food chains. Perhaps he thinks the question is naïve. Perhaps he's asking himself what he, the mayor of a small Midwestern city, could do against major corporations. "I know perfectly well that they can't make their rolls big enough," he says, "and I don't understand why you have to drink soda out of buckets." But, in the end, he adds, everyone in America has to be able to decide for themselves what they do or don't want to eat or drink.

"That's not going to change," Winnecke says. But it sounds more like he's saying it can't change.

A Mayor's Crusade

But change is exactly what Americans have been arguing about since New York Mayor Bloomberg made headlines with his soda ban. The ban, which is expected to go into effect in September, is part of a 23-page "Task Force Plan" that seeks to "reverse" the obesity epidemic. It affects movie theaters, restaurants, delicatessens, food vendors and fast-food chains of every stripe. Bloomberg wants to prohibit them from selling beverages in cups larger than 16 ounces, which is about half a liter. As mundane and ineffective as it sounds, the move is actually a revolution and a rejection of the quintessentially American "bigger is better" culture.

Of course, many only see it as a threat to freedom. Can McDonald's and Burger King be prohibited from selling soda in giant cups? And what about America's other, less well-known fast-food chains? At White Castle, for example, a 21-oz. (0.6-liter) beverage is still considered "small," while a large beverage is 44 oz. (1.25 liters) and iced tea, usually sweetened, is sold in cups that hold up to a gallon, or 3.8 liters. Kentucky Fried Chicken sells soda in 65-oz. "Mega Jugs," each containing 210 grams of sugar and almost 800 calories. At the AMC Empire movie theater on Manhattan's West 42nd Street, the smallest drink size is 32 oz., or twice as big as the limit Bloomberg wants to impose.

To justify the ban, City Hall is quoting thousands of studies and rattling off frightening statistics. For example, obesity costs the United States $200 billion a year in hospital and doctor costs. Every year, 5,800 New Yorkers die of the consequences of obesity, and 700,000 are diabetic. According to the mayor's office, "sugary beverages" are the most important cause of the crisis, and the aim of the ban is to force consumers to think about their consumption habits.

It isn't Bloomberg's first coup. The multibillionaire has already imposed extensive smoking bans on his 8.2 million fellow New Yorkers and used taxes to drive up the price of a pack of cigarettes to $13 (€10.5). In 2005, he banned the use of harmful artificial trans fats in food and, in 2008, he forced all restaurants in the city to list calorie counts on their menus. In 2010, Bloomberg saw to it that welfare recipients could no longer use food stamps to buy soda, but he failed in an effort to impose a soda tax that would have been pegged to drink sizes.

Bloomberg's messages, including warnings about drinking too much soda, and his appeals to live a healthier life are all over the city's subway system. The mayor makes such a fuss about health issues that cartoonists at the New Yorker can hardly keep up. On one of the magazine's covers, Bloomberg is depicted as a narcissistic dandy staring adoringly into the mirror, and soon he'll undoubtedly be caricatured as a health tyrant.

But even if vanity is his driving force, it would be very hard to find another politician who is staging such a large-scale, frontal assault against the interests of multiple major industries and their suppliers.

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