Opinion

The obesity epidemic is too complicated for simplistic fixes like fast-food bans

Surprise: South L.A. has fewer fast-food chain outlets per capita than other neighborhoods.

Limiting the number of standalone fast-food restaurants in a neighborhood can improve its looks, but no one should be surprised when such a policy doesn’t do much about obesity.

For many reasons, it was silly to think that it would. The 2008 ban on new standalone fast-food joints in the neighborhood of Baldwin Hills, Leimert Park and parts of South and Southeast Los Angeles was mainly intended to give the neighborhood some of the planning oversight that neighborhoods in such areas as the Westside enjoy. Long vistas of gaudy signs don’t make for the kind of neighborhood most people want. As a side advantage, supporters talked up the effect they presumed this would have on residents’ health through reductions in obesity rates (though The Times editorial board cast doubt on that assumption at the time).

Seven years later, along comes a RAND Corp. study that blasts such dietary myths out of the water as though they were so many fish in a barrel. Despite claims by the nonprofit Community Health Councils that the ban had reduced obesity by three percentage points, obesity rates actually rose from 2008 to 2012, the period covered by the study, as they did citywide. And in the affected area, they rose very slightly more. The ban did nothing to change quick access to junk food.

And here’s the eye-opener: Despite everyone’s assumptions, there weren’t more chain fast-food joints per capita to start with in the affected neighborhoods, but actually fewer per capita. "There was a complete disconnect between the justification and the policy," the report says.

What there were and are a lot more of, the study found, are small retail food stores, the type where people stop by for a soda, chips or sweets—quick, calorie-laden treats with little nutritional value.

Of course, the ban didn't actually reduce even fast-food stores. They could continue to open as long as they were in shopping centers rather than built as drive-through, standalone outlets. Unfortunately, the hoped-for supermarkets with arrays of healthful food didn’t open—but then, RAND economist Roland Sturm, who produced the report, found three years ago that so-called food deserts do not contribute to obesity, either.

In other words, food and eating are complicated. The obesity epidemic is going to resist simplistic solutions. Policy decisions are made based on what makes sense in theory, but fail flat in the face of reality. Nutritional science has fallen prey to the same well-intentioned thinking that if it makes sense, it must be true. Fat has more than twice as many calories per gram than carbs or protein, so it was theorized that a very low fat diet must be the best way to lose weight. Such thinking failed to take into account blood sugar spiking and satiety factors. Egg yolks are high in dietary cholesterol, so doctors assumed they must cause high blood cholesterol.  But it turns out that dietary cholesterol has little effect on blood cholesterol, and the federal government no longer considers it a matter of concern.

When it comes to restaurants, the sit-down places might give an area more of an aura of class, and many of the items offered might be more healthful--though not all of them, by any means. But with their generally huge portions, it's worth questioning whether they do anything for people’s waists. Even when it comes to that fast-food staple, the burger, eliminating fast food doesn’t necessarily mean a lower-calorie way of eating. A Whopper with mayo contains 650 calories, compared with 740 for a basic burger at the International House of Pancakes.

One bright spot, Sturm wrote, is that soda consumption in the neighborhoods with the ban fell, though consumption also fell citywide. It’s good that people are drinking less of a product so devoid of nutrition, assuming they haven’t just replaced it with something equally junky. But that lowered consumption hasn’t made any difference in obesity levels, which are headed in the wrong direction.

Perhaps time will paint a more promising picture. It would be hard to believe that a mere five years under the fast-food growth ban would make any kind of difference. Restaurants don't turn over all that quickly. It's also unknown what effect the recession may have had, perhaps encouraging people to eat cheaper, less nutritious food.

Still, the information in Sturm's report is disconcerting, if not downright depressing. It implies  that reversing obesity trends will require more time, fewer assumptions, a lot more research and some piercing questions about the meaningful, comprehensive strategies needed to combat a very tough foe. Would it make a difference if people cooked more of their own foods at home? If that’s true, how do they get the time to do it, when employers demand longer hours and many people work two jobs to make ends meet? How can more nutritious food be made more affordable?

Would it make a difference if workers did less sitting at desks and had both the opportunity to move around more in the workplace, and more time to be physically active generally? If so, what steps must society take to make sure those opportunities exist? What can be done to make streets and parks safe enough for outdoor activity, especially in the evening? Are we even asking the right questions about what might reverse this unhealthy situation? This is going to be a lot more challenging than banning a particular kind of restaurant.

Follow the Opinion section on Twitter @latimesopinion and Facebook

Copyright © 2016, Los Angeles Times
57°