Opinion

JOANNA WEISS

Calling politicians to end the obesity crisis

There are plenty of presidential candidates out there now, pitching the same proposals, give or take a phrase or two. Shaking up Washington  . . .  somehow. Replacing Obamacare with  . . . something. The new big idea — Donald Trump’s call to close loopholes on hedge fund managers — scratches a populist itch, but won’t bring fundamental change.

But I know of a tax proposal that could. It has to do with food. And it’s laid out in a piece that ran last year in the Journal of the American Medical Association, by three Boston-area experts in nutrition and economics. They call for an across-the-board tax, in the range of 10 to 30 percent, on processed foods — basically, anything that comes with a nutrition label — plus fast food and large chain restaurants.

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They’d use the proceeds to subsidize food that is actually good for us: fruits, nuts, beans, seafood. The ultimate goal: to make it cheaper for an inner-city mother to buy her kids apples than potato chips.

“There are very few simple things that could completely alter the medical and economic challenges the country faces,” said Dr. David Ludwig, the Boston Children’s Hospital child obesity expert who coauthored the piece.

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Simple, of course, is not the same as easy. In Massachusetts, we can’t even get our act together to eliminate a tax break on sugar-sweetened beverages. That’s partly because of a powerful beverage lobby, but it’s also because of a powerful idea: that people should be able to choose what they eat without the nanny state reaching into their pantries.

But that’s where Ludwig says we need a reality check: The government is deeply involved in food policy already. We spend $20 billion per year to subsidize corn, wheat, and soybeans — overwhelmingly used for products like cheap animal feed, processed snacks, and high fructose corn syrup.

“We’re dumping cheap junk food, massive amounts, into the food supply,” Ludwig said.

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So the current price of food doesn’t reflect the real cost. By 2030, we’re due to spend $1 trillion per year on obesity-related diseases, including diabetes, heart disease, and cancer. Diet now leads to more preventable illnesses than tobacco. And we’re comfortable with taxing tobacco to the hilt. As Ludwig points out, you’re still free to buy cigarettes. You’re just paying in advance for the lung cancer you might get.

Meanwhile, our current approach to the obesity crisis — reminding people to eat healthy and exercise — only goes so far. There are too many distractions and perverse incentives, marketing dollars used to lead teenagers to soda and kids to sugared cereals, supermarket practices that put junk foods front and center on the shelves.

“In 100 or 200 years, they will look at us the way that we look at the Romans and think, ‘How could they live like that?’ ” said Kenneth Rogoff, a Harvard economist who coauthored the piece. (The third author is Dr. Dariush Mozaffarian, a cardiologist who is dean of the Friedman School of Nutrition Science at Tufts.)

So far, their proposal has gotten little traction. It’s too simple, too broad, too insurmountable, it seems, to anyone with a passing knowledge of Washington lobbying interests.

Ludwig says he needs a coalition: medical and public health professionals; budget hawks; advocates for children and the poor; businesses fearful of soaring health insurance premiums.

He also sees a ray of hope in  Donald Trump — not the candidate so much as what his popularity represents. In a time of political paralysis, Ludwig suggests, there’s room for radical thinking — an incentive for boldness, as a way to break through. Everyone is looking for a non-absurd candidate with an eye-catching, meaningful idea.

So to the hordes in New Hampshire: Who’s willing to take this one on?

Joanna Weiss can be reached at weiss@globe.com. Follow her on Twitter @JoannaWeiss.

Related:

One proposal could make a real difference: a tax on processed food.

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The Issue of Food

Evan Horowitz: Obesity comes as a side order to cheap food

Editorial: Puerto Rico’s proposed fines won’t help obese children

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