In the latest attempt to gain ground against the nation's epidemic of obesity, the Food and Drug Administration proposed rules Friday that require restaurant and fast food chains to post the calorie content of standard items on their menus.
But the rules, which would also apply to vending machines, coffee shops and convenience and grocery stores but not to movie theaters, bowling alleys and airliners, underscored the herculean challenge in helping Americans reduce their calorie intake: Despite decades of trying, the United States has made little or no progress against one of its biggest public health challenges.
As a result, while most public health and nutrition specialists welcomed the new rules, few suggested they would make a substantial difference in the epidemic of overeating that adds an estimated $150 billion a year to the nation's medical bill.
"Nobody thinks that calorie information by itself solves the problem, but it's part of the tool kit," FDA deputy commissioner for foods Michael Taylor said in a brief interview. "We see this as part of the overall effort to fight obesity."
The exemption of movie theater refreshment stands is a win for the National Association of Theater Owners, which argued to be left out of the disclosure rule.
It's also an example of the fierce lobbying – and the potential cost – of imposing even seemingly simple requirements.
"All of these individual battles are exhausting...If you can address issues like food marketing, labeling, tax subsidies and farm programs, then you've got the war on obesity. But in the absence of that, you've just got all these skirmishes" -- and that favors continued high levels of obesity," said Thomas Sherman, a Georgetown University biochemist who studies' nutrition and obesity.
Certainly the record of such efforts is not encouraging. Public health officials have lectured against over-eating. They've pulled soda pop out of school vending machines and re-engineered school lunch menus. Doctors and nutritionists have devised countless diets and pharmaceutical companies have spend hundreds of millions of dollars researching weight-loss drugs – so far in vain.
Meanwhile, the rate of obesity has more than doubled over the past 40 years. In 1971, an estimated 14.5 percent of adults in the US were obese compared to some 35 percent in 2008.
The rules, which are subject to another round of public comment before they take final form, would apply to food-selling chains with 20 or more locations, meaning customers at McDonalds, Burger King, Denny's, and other iconic fast food shops would see calorie counts next to sandwiches, fries, shakes and other offerings on those above-the-counter menu displays.
Generally, the rule applies to businesses which either define themselves as restaurants or devote more than 50 percent of their floor area to the sale of food.
Chain eateries are the focal point because they serve standardized products which can be readily measured for caloric content, unlike individual restaurants which may change offerings daily.
The National Restaurant Association endorsed the publication of the proposed rules, but said it "anticipates there will be many questions" and promised "detailed comments to the FDA to ensure that restaurants are provided adequate time and are able to comply with the regulations effectively, as well as provide information to consumers in the most usable way."
An FDA spokesman said the agency hopes consumers will be able to compare calorie counts by the end of the year.
Calorie counts would have to be displayed prominently on all menus and menu boards, including at drive-through locations, and next self-service foods, such as items in a salad bar.
Fast- food companies say they may have to shrink the number of items they put up on menu boards in order to make room for the calorie data – costing them sales. Fast food franchising executive Craig Culver, who said the lost space would have cost each outlet in his chain $82,000 last year.
The menu provision was part of last year's health care overhaul law, which also was slated to have a tax on sugared beverages aimed at combating obesity – until it was knocked out after lobbying from the soft drink industry.
In another illustration of industry maneuvering, key food trade groups earlier this year announced a plan to put nutrition information on the front of grocery story food packaging, where consumers could more readily see it.
Food groups said they were responding to a request by First Lady Michelle Obama, an outspoken anti-obesity advocate -- for more helpful labeling. But critics say the plan may actually confuse consumers and undercut a planned federal labeling scheme.