Why warning labels on sugary beverages will not impact obesity

California might be the first state to mandate “warning labels” on some sugar-sweetened beverages. SB 1000 would require some sugar sweetened beverages that contain more than 75 calories per 12 ounce serving to carry a warning label that says “Drinking beverages with added sugar(s) contributes to obesity, diabetes and tooth decay.” The legislation is widely supported by those who are concerned about the obesity epidemic. However, while many proponents have an academic understanding of the relationship between overeating, weight gain and diabetes, few seem to have little direct experience in counseling those who are struggling with expanding waistlines.

The causes of obesity and diabetes are multifactorial and more complicated than simply drinking soda. People may become overweight because they eat for comfort, coping or emotional reasons; others may have a genetic or hormonal issue. Most are not physically active. The problem with warning labels is that they enforce the assumption that all obesity is caused by overeating. This is not true. Having directly counseled obese adults and children from all socio-economic classes, it is clear that obesity is caused by numerous factors. Each individual’s struggle with weight gain is a personal journey. Effective behavioral change and weight management involves more than a warning label.

Soda warning label advocates claim that consumers have a right to know about the health problems related to sodas and other sugary drinks. From clinical experience, we know that obese people are not ignorant; many are aware that certain foods contribute to overweight and even diabetes. Labels characterize obese persons as mindless gluttons who are unaware of the nutritional value of certain foods. Moreover, warning labels may encourage others to make value or moral judgments about what and how someone eats.

Many overweight and obese persons are already targets of discrimination. Consider a recent UK proposal to show “pictures of fat people” on junk food (Parry) or a 2008 Mississippi proposal to ban “fat people” from restaurants or a clothing company who didn’t want plus size people wearing its clothes. Warning labels may further encourage “fat bullying” and cause people to make moral judgments about what and how someone eats. Many of my adult obese clients have been publically shamed and chastised by misinformed food police who point out the “sins” of eating or drinking certain foods or beverages.

Overweight and obese children are not immune to discrimination either and warning labels are unlikely to change behavior or curb childhood obesity. Overweight and obese children, like adults, may have a genetic predisposition to obesity; a disease that causes weight gain; and oftentimes issues with emotional overeating patterns (Butor PM) or lack of physical activity. In fact, a recent study of 42,316 Americans (Welsh et al NHANES 1999-2008) showed that consumption of added sugars and sugar-sweetened sodas has declined particularly in children. Now kids are swapping soda for coffee beverages (Branum et al). Interestingly, barista-made coffee beverages loaded with shots of sugary syrups and caffeine are unlikely be emblazoned with the “warning label.”

Instant Diabetes: Just add soda?

Blaming soda for the obesity epidemic is short sided and misguided but such opinions are not widely regarded by the popular press. Critics of the soda warning label legislation have been characterized as child hating, big industry zealots who are misinformed of the scientific facts. Nothing could be further from the truth. Many of us are scientists and clinicians that have worked with, listened to and counseled obese persons. We also know that legislation sold to the public on the basis of mistruths such as “Sugar in liquid form is ingested much faster than sugar in solid food, overloading the liver and pancreas, making it a direct cause of diabetes,” (San Jose Mercury News) harm the scientific integrity of any argument and insults the intelligence of anyone with common sense…consider that an estimated 99% of Americans have consumed a sugary beverage… are all 99% diabetic? The development of diabetes takes time and is strongly associated with genetics. Chances are you know people who routinely consume regular soda and are not obese, diabetic or in ill health.

So if soda warning labels won’t work to fight the obesity epidemic, what will? Easy solutions are elusive, but from a practical and educational perspective: Bring back home economic classes; start an elementary school garden and educate children about portion sizes; get parents involved in nutrition education and work with those from lower socioeconomic groups on strategies that incorporate healthier foods and extend their food budgets; revamp the SNAP program to provide vouchers for specific foods (like the WIC program) and provide nutrition education to recipients (Ly); commit public funds to facilitate lasting habit change—similar to smoking cessation classes. Many of these strategies have been successful, but dependent on implementation of tailored programs and individual commitment to change.

Real behavior change begins with addressing the root cause of the poor dietary habits and empowering people to make individual changes that work for them, not coercing through fear or shame. This means focusing on education programs that provide tools for effective habit change instead of investing in another ineffective government mandate that treats everyone the same.

This article originally appeared in Psychology Today.