Government should impose limits on portion sizes as part of its strategy for combatting America’s obesity epidemic, argues Thomas Farley, Commissioner of the New York City Department of Health and Mental Hygiene in an article written for the Journal of the American Medical Association. “Americans consume many more calories than needed, and the excess is leading to diabetes, cardiovascular disease, and premature mortality,” writes Farley in the piece — published in this week’s issue of JAMA. More than one-third of adults in the U.S. ages 20 and older are obese, according to estimates from the U.S. Centers for Disease Control and Prevention. A 2007 JAMA study found that obesity is associated with approximately 162,000 excess deaths each year — 120,000 from cardiovascular disease, 15,000 from cancer and 35,000 from other obesity-related conditions. While the link between physical activity and obesity is still unclear, says Farley, “it is quite clear that this increase in calorie consumption is the major cause of the obesity epidemic.” That’s why a government cap on portions of “food products that harm the most people” would be an effective strategy for reducing the obesity rate, he argues. One food category that has been singled out as a leading contributor to obesity-related disease is sugary beverages, which studies have linked directly to weight gain and higher rates of type II diabetes. Last week the New York City Board of Health approved a proposal to limit the size of sugar-sweetened beverages served at restaurants, street carts and movie theaters to 16 ounces. The idea of reducing soda consumption either by taxation or portion caps has been met with strong resistance by the beverage industry. “Singling out one item as the cause of obesity completely misses the mark,” Susan Neely, president and CEO of the American Beverage Association said in a 2010 press release. “If we really want to solve this national public health challenge, we must focus on educating Americans through comprehensive approaches that include nutrition education based in fact and focusing on total diet and exercise – not efforts that are simplistic and will be ineffective.” Farley includes education in his editorial as one strategy for combatting obesity. While the piece focuses on capping portion sizes of “risky” foods, it also recommends that government encourage industry to cut back on junk food marketing and work to educate consumers on how to make nutritious choices. “The balanced and most effective approach is for governments to regulate food products that harm the most people, simultaneously encourage food companies to voluntarily produce and market healthful products, and then provide information to consumers in ways that facilitate their choosing healthful products,” he writes. Farley also addresses New York City’s recent super sized soda ban in the article, noting that “studies strongly suggest that, with a smaller default portion size, most consumers will consume fewer calories. This change will not by itself reverse the obesity epidemic, but it can have a substantial effect on it.”