The document discusses how the rise of obesity in the US is linked to changes in dietary recommendations and food industry practices over several decades. It notes that: - The 1977 McGovern report originally warned against saturated fat and sugar but was revised under food industry pressure. - In the 1980s, the food industry marketed "low fat" foods high in added sugar, fueling demand for sweet foods and contributing to weight gain. - Choice architecture and defaults influence what people choose, benefiting some interests over public health. Nudges like placement can guide choices without restricting them.

1. Obesity and
Public Heath:
The Social Environment
of Food Choice
Image source: https://uxdesign.cc/are-you-being-nudged-60046975ef86

2. The McGovern Report and
the Rise of Obesity in the U.S.
• Until about the 1970s, hunger and malnourishment were
bigger public health concerns in the U.S. than overweight
and obesity.
• The 1977 McGovern report, issued by the Senate Select
Committee on Nutrition and Human Needs, released the
first federal dietary guidelines in U.S. history and warned
that recent changes in American dietary habits posed a
great threat to public health. The report suggested that an
improved diet would cut healthcare costs significantly by
reducing the incidence and severity of chronic diet-related
illness and disease.
• In particular, the report warned, “The American diet has
become increasingly rich—rich in meat, and other sources
of saturated fat and cholesterol, and in sugar.” It called for
largescale changes in diet to improve overall health, which
immediately put meat, milk, and diary producers, as well
as sugar and salt lobbies, on the defensive.

3. The Food Industry Response
• Under pressure from the food
industry, the McGovern report was
revised so that it no longer
recommended decreased
consumption of meat and eggs and
instead encouraged consumption of
products with reduced saturated fats.
• Perhaps more importantly, the food
industry succeeded in disbanding the
select committee, moving federal
nutrition guidance under the
jurisdiction of the Committee on
Agriculture, Nutrition, and Forestry,
which is strongly loyal to the interests
of food producers.
Above, the Cattlemen’s Association, representing the meat
industry, stated its objections to the McGovern report.

4. The “Low Fat” / “Fat Free”
Craze of the 1980s
• In the 1980s, the food industry flipped
nutrition advice to “eat less fat” and turned it
into a marketing tool, creating scores of new
processed foods advertised as “low fat” or “fat
free” and therefore offered as “healthy”
alternatives to other junk foods.
• In order to make “low fat” or “fat free” foods
palatable, food processors added lots of sugar,
an industry transition that fueled consumer
taste for sweetness and, with it, rising rates of
overweight and obesity, even (or especially)
among consumers seeking to reduce fat intake
to lose weight.
• In reality, of course, dietary fat is necessary
for the human body. Body fat cannot be
reduced by only reducing the amount of
dietary fat one consumes. Calories, especially
calories from added sugars, are central to
processes of weight gain and weight loss.

5. After four decades of this trend, about 70 percent of the U.S. population
is currently overweight or obese.

7. The Costs of the Obesity “Epidemic”
In addition to the individual health risks
associated with obesity—namely Type II
diabetes, hypertension, coronary heart disease,
liver disease, stroke, and certain cancers—there
are societal costs associated with rising rates of
obesity as well. These include higher
insurance costs, lost worker productivity due to
illness or disability, and decreased military
readiness, as nearly one-third of Americans of
military age are physically unfit to serve.
Image source: https://www.endocrineweb.com/professional/obesity/obesity-cancer-evidence-grows-supporting-link

8. Choice Architecture*
• Consumers “can be greatly influenced by
small changes in context” (pg. 639). This
means that the ways that options are
presented to a consumer are likely to
influence the choices they make by “focusing
the attention of users in a particular
direction” (pg. 640).
• This context (e.g. the ways items are
arranged in a store) can be understood as
choice architecture. The people who make
decisions about how to present various
options are choice architects. A key premise
of the concept of choice architecture is that
“there is no such thing as a ‘neutral’ design”
(pg. 640). Every design increases the
likelihood of a particular outcome. *“Selections from Nudge”
by Richard H. Thaler and Cass R. Sunstein
Image source: https://online.jessup.edu/blog/business/choice-architecture/

9. Which of these register displays is more likely to encourage a
consumer to buy an apple? A candy bar?

10. Libertarian Paternalism
• Thaler and Sunstein advance a “movement” they term libertarian paternalism,
which aims to “steer people’s choices in directions that will improve their lives”
while still allowing them to make other choices if they want to do so “because
[those other] choices are not blocked, fenced off, or significantly burdensome”
(pg. 641). Libertarian paternalism aims to guide decision-making rather than
command or direct it.
• Drawing on social science research, the authors argue that “in many cases,
individuals make pretty bad decisions—decisions they would not have made if
they had paid full attention and possessed completed information, unlimited
cognitive abilities, and complete self-control” (pg. 641). In general, people tend to
do what they have done before (maintain the status quo) or make the choice that is
suggested to them (the default option). For example, although a consumer can
request water and fruit instead of soda and fries with a fast food kid’s meal, if soda
and fries are the default option, then that is what most people will get.

11. “Nudges”
• Thaler and Sunstein advocate the use of “nudges”—“any aspect of
choice architecture that alters people’s behavior in a predictable way
without forbidding any options or significantly changing their
economic incentives” (pg. 642).
• Policies such as age restrictions (21+) or upcharges (a higher price) on
items like soda exceed the realm of mere “nudging” because those
policies measurably change a consumers’ options or the cost of
making a particular choice.
• Easy ways to nudge consumers toward healthier food choices include
putting those choices at eye-level, near the cash register, or at the
beginning of a buffet or cafeteria line.

12. Which of these floor layouts is more likely to nudge a consumer to purchase bottled
water rather than a sugary beverage?
Image source: https://jamesclear.com/choice-architecture

13. How does this display nudge consumers to buy water rather than a carbonated soft drink?

14. The Scenario: You are the Director of Food Services for a large school
system.
You are the choice architect, the person who determines how the food choices
will be presented to the students.
Options:
1. Arrange the food to make the students best off, all things considered.
2. Choose the food order at random.
3. Try to arrange the food to get the kids to pick the same food they would
choose on their own.
4. Maximize the sales of the items from the suppliers that are willing to offer the
largest bribes.
5. Maximize profits, period.
School cafeterias can encourage children subconsciously to make healthier
food choices. How? What are the benefits of “nudging”?
Adapted from Richard H. Thaler and Cass R. Sunstein,

15. How does this “choice architecture” nudge students away from choosing fries
(but maybe also apples)?

16. Studies have shown that larger portion sizes encourage people to consume more. In other words,
consumers think (consciously or not) that the amount of food or drink they are served is the right
amount for them to eat. What does this chart suggest about serving sizes of soda over time? How
does this correlate to the rise of public discourse about dieting and obesity? Note that when the
obesity epidemic took off in the 1980s, 32 ounces of soda was considered a large serving.
Serving Sizes
and
Portion Control

17. (2018)

18. Public health campaigns like this one from Los Angeles aim
to remind consumers of the importance of portion control.
Image source: http://www.choosehealthla.com/wp-content/uploads/2012/10/portion-control-tips-choosehealthla-1.pdf

19. Image source: https://www.motherjones.com/media/2012/06/supersize-biggest-sodas-mcdonalds-big-gulp-chart/
This image compares standard McDonald’s cup sizes in the U.S. and Japan.
What do you notice? What does this comparison suggest about the amount of soda
McDonald’s suggests is appropriate for a child? For useful context, consider that whereas the
U.S. has consistently ranked near the top of the world in rates of obesity, Japan has the longest
life expectancy, and by many measures the healthiest population, on earth.

20. What do these cartoons suggest about
government efforts to limit consumption of
junk food items like sodas and fries?
In what ways do they suggest that
government regulations are at odds with
consumer freedom (i.e. the “freedom” to
consume)?

21. What message do these ads offer about efforts of local
governments to encourage healthy eating?