Propaganda, taxes, and cashback for physical education: how to fight the nation's obesity?

What is terrible about obesity and what COVID-19 has to do with it

In our country, 55% of the population is obese or overweight to some extent. More than half of the country's population is a huge number! It is terrible because excess weight is not only a problem of the mirror or the choice of clothes. Over time, it can cause serious illnesses. Their number is legion — arthritis, arthrosis, hypertension, cardiovascular diseases, fatty liver hepatosis, type II diabetes and many others. Among them — the overwhelming mass of diseases from which people die. This means that we can conclude that obesity is a mediated factor in the death of most people in our country.

Not only we but also the WHO and the scientific community say that overweight is a real scourge of our time. Many countries have already realised this and are fighting this phenomenon in various ways.

The medical community and relevant committees of the State Duma have been talking about the problems of obesity and all that it causes for a long time — but the problem remained “unhighlighted”. But right now, during the coronavirus pandemic, we are seeing the following: most of those who cope with the disease with difficulties, who die from it — these are people with exactly the same concomitant diseases that are caused by excess weight. The risk group, for example, includes people with diabetes, people with cardiovascular disorders, people with hypertension, and people who are just obese. So we can say unequivocally: the coronavirus crisis has once again affected the problem of fighting excess weight. Perhaps, it will become a catalyst for decisions that need to be made long ago.

We need a state programme

The main thing at the first stage is for everyone to agree that obesity is a big problem, and it is at the state level. This should be realised not only by deputies and representatives of the upper echelons of power — the idea should firmly capture the minds of society, just as everyone is aware of the harm from alcohol and nicotine.

I believe that the fight against obesity requires a fundamental, comprehensive, federal programme to combat this evil. It can include various areas — medical, social,economic, and educational.

• First, a separate branch of the programme should be the fight against endocrine diseases — we know that obesity does not always depend on nutrition, but can be the result of hormonal abnormalities.
• Second, very serious preventive work of doctors and teachers is required.
• Third, the promotion of healthy lifestyle is more important than ever. Yes, this trend is now in Russia, it is stronger than ever, but it is not enough.
• Fourth, prevention of physical inactivity is important — motivation for sports, including financial motivation. Some of this work is already underway — for example, a draft bill on cashback for paid sports has already passed the first reading, and if it comes into force, there will definitely be more people choosing this path — we will see a statistically significant increase.
• Fifth, when developing the programme, it is impossible to do without the economic component. The thing is that one of the most serious factors of obesity is junk food. We need to motivate people to eat healthy, first of all, by persuasion, but if it does not work out — the tactics of persuasion with money are inevitable.

Excise taxes: how is fast food and soda better than alcohol?

Again, the cornerstone of human health is nutrition. In most cases, unhealthy eating habits, laid down from childhood, are to blame for being overweight. Fast food and sweet carbonated drinks are, perhaps, the leaders among the recognised harms in our diet. If you look at how much sugar is in bottled lemonade, it becomes clear why for a year of daily use, you can easily add ten kilogrammes. Meanwhile, unlike alcohol (which also harms the social functions of a person, and therefore is recognised by everyone as a harmful product), the average person does not perceive sweet soda and hamburger as a formidable enemy.

Therefore, I am deeply convinced that we cannot do with exceptionally soft, “vegetarian” measures (propaganda, persuasion, motivation with cashback) alone in the fight against obesity of the nation. Over time, we need to introduce financial measures to curb the expansion of harmful products.

I'll go back to the example of alcohol. What does the state do to make people drink less? It controls the price of alcohol, introduces excise taxes, and sets the minimum cost of a bottle of vodka. To make a person think about whether he should buy this bottle for this price. The same is true with nicotine, and serious excise taxes are imposed on it. By the way, I have heard a lot of people say: “I have calculated how much I spend on cigarettes a year — and I see that with this money I could buy something useful for myself.”

But let's think about junk food in the same way. Why is sweet soda considered more harmless (after all, nothing will come from a bottle) than cigarettes? Because nicotine and alcohol are addictive. But sugar can also cause dopamine dependence, this has already been proven. And as for fast food, the huge food industry is looking for exactly the combination of tastes that will almost chemically affect the brain, constantly make you want to go to this particular network and buy this particular burger. And this is not a science fiction story, but a very advanced modern food technology.

That is why I am deeply convinced that the turnover of such products must also be regulated financially. If you introduce the notorious tax on fast food or lemonade, it will cause an increase in the retail price of them, which means that they will buy less.

Red or green light for the product: the idea of labelling

There is another suggestion that I have not yet voiced — I think this will cause another wave of criticism in my address. It would be very effective to introduce some kind of labelling, gradation of products according to the degree of harm to health.

An example: a store has a shelf of approximately uniform products — I suggest that each of them be assigned a color-graded label. For example, products that do not contain harmful substances or are prepared in a healthy way can be marked with green marks, and their more unhealthy “counterparts” — for example, red. Between them, you can also enter several degrees of harm (or utility). The customers will immediately see what they are putting in their shopping cart.

Yes, I understand that technically separating a harmful product from a useful one is not an easy task. But in our country there is a whole research institute that deals with nutrition, there is an army of scientists and nutritionists. They can help to develop a method for such labelling, come up with its algorithm, and put it on stream. Yes, this will require costs, but all of them will be paid off in a big way — the health of our citizens.

Let's discuss

I often object to this topic: they are afraid that the initiative to introduce a “fast food tax” will stifle the core business.

But for some reason, few people are outraged by the way the state “stifles” the nicotine and alcohol business. But why can't you touch the business of sweet soda producers or fast food chains? What is the difference if both products cause harm to the body, and this is a proven fact? Yes, there is a very serious business behind harmful products, which, of course, will be against it. We see that fast food restaurants are inexorably taking over not only large and small cities — they are now at every turn. It is unlikely that a “fast food tax” can do anything fatal to them: in the US, the so-called “fat tax” has been in effect for a long time, and everything is still fine with their fast food chains.

Another popular argument of my opponents: people with low incomes will not have the opportunity to eat properly if additional factors are introduced to increase food prices.

But healthy food doesn't equal expensive food, and you can buy healthy food with the amount you buy fast food. I assure you, the percentage of people with obesity is about the same in all segments of society — it is equally susceptible to those who do not think about prices when buying food, and those who know exactly how much a packet of the cheapest milk costs. This means that the question is not in the price, but still in the preferences of people.

Finally, another popular point of view — the proposed measures will require enormous costs at the state level, and this will negatively affect the economy.

But if we do nothing now, then in ten years we will come to what is now in the United States, where the percentage of people who are overweight reaches 70%. And society will lose much more money on this than on these measures. It's simple: people will get sick, which means, first, they will not be able to contribute to the country's economy, and second, their treatment will require funds from the federal budget. And these costs will more than cover the costs of the state programme.

There are a lot of questions about these proposals, and I already face a storm of criticism when I talk about it. But I'm sure I'm right because I have the truth behind me. Certainly, we can't just introduce, for example, a tax in one day. First, we need to convince the public to notice the problem. This is a serious and painstaking effort to make sure that everyone understands the essence of this proposal, discusses it comprehensively, and offers their own initiatives.

There are no quick solutions, this is a lengthy process which requires serious decisions and routine work. The result will not be visible today, tomorrow, or even in a year. It will be visible to our children and grandchildren!