Setsuko Hara in No Regrets for Our Youth

Woulda Coulda Shoulda Prevented Obesity

Another experiment in preventing obesity just got added to the list of what woulda coulda shoulda worked. Seven years ago, Los Angeles banned new fast-food restaurants in South LA, where obesity was seen to be a critical problem. In a study just published in Social Science and Medicine, Roland Sturm and Aiko Hattori found no impact from the ban. They found that:

Fast-food consumption and overweight/obesity rates have increased from 2007 to 2011/2012 in all areas. The increase in the combined prevalence of overweight and obesity since the ban has been significantly larger in South Los Angeles than elsewhere.

At the time this ban was passed, Councilwoman Jan Perry said, “I believe this is a victory for the people of South and southeast Los Angeles, for them to have greater food options.”

Now Councilman Bernard Parks, who wrote the zoning restriction with Perry says, “We never believed it was going to be an overnight situation where all of a sudden the community was going to be healthy.”

Sorting through the merits of obesity strategies can be contentious. Writing in the Atlantic, Adam Chandler observes that:

The subtext here is that policy should be dictated for poor people the way it is for children. Unless the tenor of the conversation about obesity gets a little less paternalistic, it’s going to be a challenge to get anyone to the table.

Learning from experimentation like this ban is what’s most important. Obesity is the result of a complex, adaptive system of human behavior, food distribution, physical environment, and human biology. More often than not, prevention efforts have unpredictable effects.

So objectively figuring out what works, what doesn’t, and why is essential. Getting stuck on what woulda coulda shoulda worked doesn’t help.

Pragmatism, not dogmatism, will move us ahead.

Click here to read more from NPR, here to read more in the Atlantic, here to read more from ConscienHealth, and here to read the study.

Setsuko Hara in No Regrets for Our Youth, public domain film frame from Wikimedia Commons

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


4 Responses to “Woulda Coulda Shoulda Prevented Obesity”

  1. March 25, 2015 at 6:15 am, Joe Gitchell said:

    Thanks, Ted. And so “cherish those who seek the truth, doubt those who have found it!”

    Heck, maybe ConscienceHealth should do an annual (more frequently?) Voltaire award for those who advance public health science in the face of dogma/white hat bias, etc?? Good on these researchers for asking and answering the tough questions!

    And, yes, I’m available any time for unsolicited suggestions!

    • March 25, 2015 at 6:45 am, Ted said:

      Thanks, Joe! Good idea.

  2. March 27, 2015 at 8:47 am, Prof Jack Winkler said:

    Good to see you end with the strong and realistic conclusion: “Pragmatism, not dogmatism, will move us ahead.”

    On that score you might be interested in a paper from the British Medical Journal entitled “Brutal Pragmatism on Food”. It is available at
    BMJ 2013;346:f3728 doi: 10.1136/bmj.f3728

    • March 27, 2015 at 9:20 am, Ted said:

      Thanks for sharing the reference, Prof Winkler. I’m certainly hoping for “an outbreak of pragmatism.”

      For anyone who has trouble accessing this reference on the BMJ site, you can find open access to it at: