Coffee Without Sugar

A Distracting Debate About Taxing Sugar

After two decades of fighting obesity, policymakers are still guessing about what will work. The polarized debate about taxing sugar provides a vivid example in the BMJ this week. A debate continues because evidence about the real world effects of such a tax is inadequate.

But for people with obesity, such debates are, at best, a distraction from urgent needs for evidence-based options to reduce the considerable impact of obesity on health and quality of life. These debates serve as a reminder of how the lives of people with obesity are often given little consideration.

Taxes to increase the cost of foods and beverages that are deemed to be problematic might arguably steer families unaffected by obesity away from such foods. However, there is little evidence to support a claim that taxes would have a therapeutic effect for families already living with obesity. Obesity disproportionately affects people with limited financial resources. So the potentially regressive effect of taxing disfavored foods and beverages is an important concern.

Enormous energy goes into the formulation of obesity prevention strategies that effectively discount the lives of people with obesity. Sugar taxes are a case in point. Relatively little effort goes toward strategies to actually improve the health and quality of life of people with obesity. They find themselves routinely encountering healthcare providers who dismiss their condition as a self-inflicted injury that should be cured through self discipline. Meanwhile, access to more aggressive, evidence-based treatment is often severely limited.

So, from the perspective of people with obesity, the debate about taxing sugar is moot. Evidence to settle the question is lacking and no one is suggesting that these taxes will benefit people who are already living with the disease. More heat than light emanates from this debate. The energy consumed by the debate should go into collecting evidence to answer the question. It should not be tolerated as a distraction from improving health and quality of life for people who are living with obesity.

Obesity is a disease that is at least partly transmitted through families and social networks. Preventing obesity in the next generation will not happen without addressing it in the current generation. Thus, taxing sugar — even if good evidence for a prevention effect emerges — will be no more than a small part of what is needed to reverse the impact of obesity.

Coffee Without Sugar, photograph © Bertalan Szürös / flickr

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August 7, 2015