The widespread promotion of high-calorie, low-nutrient foods and drinks has been identified as a major contributor to the global obesity crisis. Now that much of the world no longer faces widespread famine or infectious disease, some public health advocates suggest that today’s “vectors of disease” are multinational food corporations that market salt, fat, sugar, and calories in overwhelming amounts.
Criticism has been directed toward policies that appear to prioritize the interests of the food industry, which is often described as the largest industry in the world. Processed food manufacturers alone may generate trillions in revenue. As one senior director at the George Institute for Global Health put it, the commercial success of the food industry is contributing to what could become one of the most serious public health crises of our time.
However, it's important to remember that corporations operate to maximize profit, not necessarily to promote unhealthy diets. Their aim isn’t to make people overweight — it's to make money.
But why not market apples instead of Apple Jacks, or oranges instead of Orange Crush? The answer lies in basic economics. Fresh, whole foods spoil quickly. Shareholders prefer products like snack cakes that can sit on shelves for weeks.
On top of that, real food lacks branding power. A broccoli farmer isn’t likely to pay for advertising when their product is indistinguishable from a competitor’s. The current system simply doesn’t reward the sale of healthy food.
And growing fresh food is expensive. Investors are more interested in cheap ingredients like corn syrup, especially when they benefit from taxpayer subsidies. That’s how soda and Dollar Menu burgers stay so affordable — federal subsidies help keep animal feed and processed ingredients cheap.
Using the Anti-Tobacco Playbook
Too often, profit is prioritized over public health. Businesses may choose disguise over disclosure, sales over safety, and money over morality. This raises tough questions: Who knowingly puts the public at risk to increase profits? Who sees illness and death as acceptable costs of doing business?
The fight against Big Tobacco is considered a major public health victory. Smoking rates dropped from 42% in 1965 to 15% today. That’s from about five in twelve adults to fewer than two. This decline has helped reduce deaths, though cigarettes still kill around 500,000 Americans a year — fewer than those who die from poor diets, which are now considered the leading cause of death in the U.S.
Could we use the same strategies that worked against Big Tobacco to fight unhealthy food marketing? Possibly. Three of the most promising policy tools include:
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Taxes on unhealthy foods and drinks
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Front-of-pack labeling
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Restrictions on advertising to children
Death and Taxes
Taxation played a key role in reducing smoking. A 25-cent-per-pack tax was linked to a 9% drop in smoking. The World Health Organization has estimated that a 70% increase in cigarette prices could prevent up to 25% of tobacco-related deaths worldwide.
The idea of taxing food isn't new. Adam Smith, in The Wealth of Nations (1776), wrote that sugar, rum, and tobacco — though not essential to life — were widely consumed and ideal for taxation. The logic is this: people can choose to smoke, drink, and eat poorly, but they should also help offset the public healthcare costs of those choices.
For example, a penny-per-ounce tax on sugary drinks could generate over a billion dollars annually in large states like Texas and California. A nationwide 10% tax on unhealthy foods could raise half a trillion dollars over ten years. Even if some of that revenue went to lower the cost of fruits and vegetables, the net gain would still be in the hundreds of billions. But would that actually change behavior?
Even small price differences can make a big impact. Just a 10% price gap between unleaded and leaded gasoline helped phase out lead in fuel. Similarly, could a modest price shift lead more people to choose apples over apple pie?
Studies suggest that financial incentives work. When fruits and vegetables are cheaper, people buy more. When unhealthy foods are taxed, people buy less. A tax on saturated fats (found mostly in fatty meats, dairy, and processed foods) could potentially save thousands of lives per year.
Would this kind of tax be unfair to low-income families? Yes — but perhaps in a good way. Lower-income groups tend to experience the worst health outcomes, so these policies could bring them the greatest benefits. Just as with tobacco taxes, the burden may fall more heavily on the poor — but so does the burden of chronic disease. In that sense, it's the disease that's truly unfair.
The tobacco industry fought aggressively against taxes, forming front groups and lobbying politicians, which shows how effective taxation can be. Still, much of the food-related research so far has relied on simulations, not real-world data.
In virtual supermarket studies, a 25% discount on fruits and vegetables increased purchases by about two pounds per week. But buying virtual produce doesn’t improve health — so what happens in real life?
One example comes from South Africa, where the country's largest private health insurer offered up to 25% cash back on healthy food purchases. Households could earn the equivalent of nearly $800 per month. The insurer expected to save money by reducing disease through higher intake of fruits, vegetables, and whole grains, and lower consumption of sugar, salt, and fat.
Why not just pay people to lose weight? Studies suggest this can work — but only if the incentives are meaningful. One study that didn’t find benefits offered just $2.80 a day, which may not have been enough to make a difference. For kids, even a nickel or a sticker can work short term — but the effect ends as soon as the reward disappears.
Still, even permanent incentives might pay for themselves. In the U.S., every $1 spent taxing processed foods could save $2 in healthcare costs. Making vegetables cheaper could yield $3 in savings per dollar spent. Subsidizing whole grains might provide a 1,000% return on investment. Even a 1% price drop on all fruits and vegetables could prevent nearly 10,000 heart attacks and strokes every year.
- How Not to Diet book by Michael Greger, M.D., FACLM
