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Should the government pay for our bad food choices?

Posted by Dr. Claire McCarthy  January 2, 2013 11:04 AM

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We don't have to buy healthy foods if we don't want to. We can go to the store and fill our cart with soda and chips if we feel like it.

But should the government have to pay for our bad food choices?

No, says a commentary in the Journal of the American Medical Association (JAMA) written by David Ludwig MD, the head of the New Balance Foundation Obesity Prevention Center at Boston Children's, along with Susan Blumenthal MD and Walter Willett MD

They point out that the highest rates of obesity are found in people with the lowest incomes. And the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps, is part of the problem.

When it comes to fighting hunger, it's not just about getting enough calories--getting good calories matters. Not all calories are created equal; some simply offer better nutrition, and keep us full longer. As the authors write:

Research suggests that if a child consumes 20 oz (600 mL) of a sugary drink, she will become hungrier more quickly than if she ate a large apple and a heaping tablespoon of peanut butter, even though both have about the same number of calories. Thus, the present lack of focus on food quality in SNAP may simultaneously exacerbate hunger and promote obesity.

See, you can buy any food or beverage you want with food stamps--except alcohol, tobacco, vitamins or hot prepared items (not sure I get the last two, but whatever). You truly could fill your shopping cart with soda and chips. 

Now, I am all for personal choice. Being poor is hard enough without the government telling you what you can and can't eat, right? Right...except that empty calories can leave you hungry, and the point of SNAP is to fight hunger. Actually, empty calories make you not just hungry but fat, the weird paradox of all this. And if the government is going to be paying for your health care, I think it's fair that they have some say in your diet. As it says in the commentary:

The public pays for sugary drinks, candy and other junk foods included in SNAP benefits twice: once at the time of purchase, and later for the treatment of diet-induced disease through Medicaid and Medicare. 

It's not like there isn't precedent for regulating what foods the government pays for. The WIC program (Special Supplemental Nutrition Program for Women, Infants and Children) only pays for a defined and healthy food package, and in 2010 legislation was passed to improve the quality of school breakfasts and lunches (we could argue that they haven't improved it much, but at least they are trying).

I was surprised to read in the commentary that half of the population will be enrolled in SNAP at some time by age 19 years. As a pediatrician, that really makes me want the program to only cover healthy foods. It's one thing if you're a grownup making bad choices for yourself. It's entirely another thing to make bad choices for children--choices that could doom them to lifelong poor health.

After the government fixes SNAP, they need to fix the agricultural subsidies. Because they, too, are contributing to our obesity epidemic. 

Taxpayer money should go toward making us healthy, not unhealthy. It's that simple.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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