My wife bought some cherries the other day, which were $15.99 for 2 pounds, or 8 bucks a pound. That’s pretty expensive, no? Here's what we could have bought instead for that 16 bucks: A 370 g bag of Doritos ($5.22), a 270 g box of Oreos ($3.65), a two litre bottle of Pepsi ($3.05) and a large frozen pizza ($3.97), all of which adds up to $15.89. The two pounds of cherries are about 572 calories. Here are the calories for the other items, in order as listed above: 1942, 846, 840, 1000, for a total of 4628. So you get 800 percent more caloric intake for the same price. What do you think a poor person on a tight budget is going to do, buy cherries or all that junk food?
You might think I cherry picked (bad pun intended) these examples and you’d be right. Inflation has hit all food items hard, with grocery bills up roughly 21 percent since the end of the pandemic. But the bigger problem is that our grocery stores are full of ultra-processed food that is slowly killing millions of people. As prices rise, more people opt for this junk food over real food, because as you can see from my example above, junk food is a lot cheaper. The items I substituted for the cherries are all things that are contributing to the epidemic of obesity we are seeing in both Canada and the US. The data is mind-blowing: 73 percent of Americans are overweight or obese. Obesity is defined as a body mass index (BMI) of over 35, and around 42 percent of Americans are above this number. Seven percent - roughly 18 million people - have a BMI over 45, a level at which a person’s health is likely already severely compromised. The numbers in Canada aren’t really much better, with 35 percent overweight and an obesity rate of 30 percent.
Obesity kills; it dramatically increases your risk of diabetes, heart disease, stroke and cancer. It leads to back, knee and hip problems that result in chronic pain and limited mobility. It has a huge adverse impact on your quality of life. Severely overweight people are also stigmatized and often ridiculed. You might think they just lack will power, but science says otherwise. Ultra-processed foods are filled with chemicals that are designed to make you not feel full. You know the Lays potato chip ads that said “Betcha can’t eat just one”? This was a rare snippet of accidental honesty from the food industry. Chips are a diabolical combination of salt, fat and simple carbohydrates (which the body converts into sugar) that leaves you craving more. Think of a natural food that contains all three of these things - you can’t because it doesn’t exist. Fructose, sucrose and glucose, which are the sweeteners found in all sugary treats like soda and cookies, alter the transmission of certain brain chemicals including endorphins, dopamine and serotonin. The end result is that many people are unwittingly addicted to junk food.
But now the pharmaceutical industry has swooped in to the rescue with a magic pill. Wegovy, Ozempic and other new drugs are allowing people to lose a lot of weight very quickly. These drugs are semaglutides, which in a nutshell means they alter the body's chemistry so that people feel satiated much more quickly, causing them to eat far fewer calories and thus lose weight. There are several problems with these drugs. They are expensive and they can have severe side effects.( 5-10 percent of people have to stop taking them because of extreme reactions.) And once people stop taking the drugs, they gain weight again, which means you'd likely have to take them for the rest of your life. Long-term use raises a couple of serious unknowns. Will these drugs maintain their effectiveness over time? Will they create new health problems / side effects in the future?
There's a lot of excitement around these drugs but it's highly dubious whether the euphoria is warranted. As a society, do we want to spend a few trillion dollars over the next 40 years on these pills, further enriching Big Pharma and their executives and shareholders? There are myriad serious issues with our food supply - how livestock are raised, food waste, soil destruction, climate change, overuse of chemical additives (there are over 6,000 food additives currently in use), our reliance on chemical fertilizers, etc. The weight loss pills don't fix any of these issues. We need these drugs in the short- to -medium term because they will improve the health of hundreds of millions of people worldwide. But we also need to fix our food issues for the long run, and the only way to do that is by using our collective strength through government to force changes.
We have a road map on how to do this from recent history. In the early1980s, almost two-thirds of the population smoked. You couldn’t go anywhere and not breath it in- bars, restaurants, hockey arenas. Doctors would smoke while examining their patients. In hindsight this all looks monumentally stupid but at the time, most people thought smoking was acceptable. The reduction in smoking was done with a combination of education, government intervention and taxes. The various levels of government spent a lot of time and money running ads on TV explaining the dangers in no uncertain terms. They also forced the cigarette companies to put dramatic warning labels on their packaging and severely curtailed the industry’s ability to advertise their products, particularly to young people. Governments also banned smoking in almost all public places, which made it much more inconvenient. But it was probably the taxes that were most effective. Governments continually kept raising the taxes on tobacco until it simply became too much for most smokers. A pack of cigarettes now costs roughly $18 in BC, of which $12.14 is taxes.
Some folks (conservatives, mainly) reacted just like you would expect - stupidly. When smoking was banned in bars, I remember there was this Calgary radio DJ, Gerry Forbes, who would go on daily moronic rants about how most bars would have to close down because of the new law. Never happened. There was a lot of crying about “government overreach” and the “nanny state” and the ever reliable nonsense about “freedom.” (Am I free to demand that people don’t blow cancerous smoke into my face?) But the measures worked like a dream; only 12 percent of the population smokes today, a huge drop that has literally saved millions of lives and hundreds of billions of dollars in health care expenses. Lung cancer cases have decreased by 42 percent since the 1980s, and continue to drop every year.
Cigarettes are not exactly like food, since everyone has to eat. With so many of our aggregate calories coming from ultra-processed food, we can’t simply eliminate them all overnight. But we can at least give our kids a better diet and mitigate the impact on the people most at risk, those whose systems make them crave this junk. Ban advertising directed at kids. Things like soda, chips and candy bars shouldn't be sold at schools. Put prominent warning labels on packaging. Run public service ads. But most importantly, tax the worst offenders - chips, sodas, sweets, fast food. Of course, we can't tax any food to the point it's unaffordable. But taxes, combined with education and other measures, can be used to diminish the consumption of ultra-processed foods and give real food a more equal footing in terms of cost and market share.
I know the first reaction many people will have is that this will all be too hard and too expensive. Here's some math for you: The direct cost of obesity to our health care systems Canada-wide is close to $10 billion per year (that doesn't include all the economic and social costs). Right now Wegovy costs a person about $4800 a year; the average Canadian is 42 years old and has a life expectancy of 82. So multiply $4800 by 40 years and you get about $200,000. Now take that and multiple it by the 13 million people (a number that is rising every year) who are overweight and obese and you get an astounding $2.6 trillion as a rough estimate. Even if the drug costs come down significantly over time, and even factoring in the money we save from deceasing the number of overweight people, we are looking at an expense that will crush our health care system. And if we opt not to cover the drugs, we are likely condemning millions of people to an unhealthy life and an early death.
The weight loss drugs give us a quick and easy fix to one problem, while ignoring or making worse a host of others. The easy way is usually the wrong way.
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