New York City Mayor Michael Bloomberg recently announced a plan to forbid the sale within the city of sugar-sweetened drinks larger than 16 ounces. The limit, which excludes juice-based, artificially-sweetened, and alcoholic drinks, as well as drinks sold at convenience or grocery stores, is his latest contribution to the effort to combat obesity and associated chronic diseases. Fines of $200 may be instituted as soon as March 2013.

Critics maintain that this approach will not decrease obesity because nothing will prevent those who desire from simply stopping at a local convenience store to purchase the drink of their choice before proceeding to their destination. 

These people miss the point. Mayor Bloomberg is not saying you can’t drink as much soda as you want. He’s saying it can’t be your default setting when you make a stop for a fast food meal. He’s saying you can’t buy it all in a single cup.

This reminds me of the time my two young sons threatened to eat white bread at school. I listened solemnly, and replied that they could still eat anything they wanted anywhere they wanted, like at school or a friend’s house. I was not saying they could no longer eat white bread. I was saying was that they could count on the fact that the available options in our home would consist of nutritious, whole foods. Of course my new plan would simultaneously decrease opportunities for choosing empty calories. 

I have heard people say that Mayor Bloomberg’s policy interferes with their freedom to indulge personal appetites (that will significantly increase their risk of becoming sick and/or handicapped). So many years later, I still remember the sign that hung on the front wall of my ninth grade Civics class: “The right to swing my fist ends where the other man’s nose begins.” – Oliver Wendell Holmes. 

Are buckets of soda the only cause of obesity?  Of course not. Insufficient activity, giant bagels, overwhelming stress, chronic exhaustion, gargantuan servings of chips and fries in place of fruits and vegetables, and triple-sized burgers all contribute their fair share, not to mention smoking and trans fats.

The obesity epidemic is no longer just an epidemic, but rather a catastrophe. Either we invest in prevention or we pay the consequences. One issue at a time. All roads lead to Medicare, and we will fund the consequences. We’re all in this together.