Obesity and type 2 diabetes mellitus are epidemic in the developed world. Exhorting our patients to eat better and exercise more is necessary, but insufficient, to reverse these trends. We need additional methods for decreasing caloric consumption and increasing energy expenditure.
One strategy that has been receiving increased attention is the use of surcharges (added taxes or fees) on sugar-sweetened beverages to discourage their use and/or to fund interventions that promote alternative beverages.1- 3 Several lines of evidence support focusing on sugared beverages. First, experimental, cross-sectional, and longitudinal studies have demonstrated that increased consumption of sugar-sweetened beverages is associated with energy surplus, weight gain, obesity, and diabetes.1,4,5 Second, the increase in the prevalence of obesity in developed countries has occurred in parallel with an increase in the consumption of sugar-sweetened beverages.1 Third, the direct and indirect social costs of sweetened beverage consumption is substantial and not incorporated in beverage costs and therefore in consumer decision making. Indeed, annual obesity-attributable medical expenditures may be as high as $147 billion.6 Fourth, not only has the price of soda not increased to incorporate the increasing costs of obesity, but, as demonstrated by Duffey and colleagues7 in this issue of the Archives and by others,2 the price of soda during the past 20 years (after adjusting for inflation) has decreased, while the price of milk has increased. Finally, also demonstrated by Duffy and colleagues,7 when the price of discretionary commodities such as soda increases (in real dollars), consumption decreases.