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A harm-reduction approach to eating out – STAT

health-and-well-being

The Hidden Costs of Oversized Portions

Several years ago, while on a road trip, I ordered the now-discontinued spaghetti and meatballs during a pitstop at Denny’s. When the plate came out, I remember thinking that it was far larger than what I had expected—and certainly more than I could finish. Yet, there was something irresistible about the abundance before me; despite my fullness, I ate almost every last bite. This experience is not unique to me and highlights a broader issue in our society: the normalization of oversized food portions.

Small Changes Can Make a Healthy Difference

Our norms toward large portions developed gradually over time. It will take time to bring us back to a level in which a 1,000-calorie entrée would be met with the shock it should get. However, the food industry has been slowly adapting to this change. By offering portion size options on their menus, restaurants can help consumers make healthier choices without feeling like they are making a significant sacrifice.

The Economic and Health Impact of Portion Sizes

One challenge is that consumers see sizing up as a way to save money: Why buy the 230-calorie fries for $4 when you can pay just $2 more to get double that amount? But the menu boards don’t convey the costs of excess weight gain. There are the physical costs, which includes increased risk for heart disease and type 2 diabetes. There are the financial costs: Excess weight doubles personal health care costs annually and, at a societal level, contributes over $260 billion in health care costs. There are also the personal costs: the difficulty of losing weight once gained, and the effects on mental health. In our study and in others, however, we found that when a reduced size is offered, people choose it even if it costs slightly more per ounce of food.

Harm Reduction Through Portion Control

What’s great about focusing on portion sizes is that it’s not about abstinence but about harm reduction. You don’t have to skip the fettuccine alfredo or the spicy jambalaya entirely. If restaurants offer those 1,000+ calorie items in a smaller size, diners can still eat what they want without sacrificing their health. In doing so, restaurants may encounter a welcome paradox: By giving their customers options to eat less, more people may show up to the table.

Sophia Hua is an assistant professor of health policy at the University of Pennsylvania. For more than a decade, she has researched ways we can change the food environment to make the healthier choice the easier choice. Her work underscores the importance of considering portion sizes as a key component in public health strategies. By advocating for responsible portion offerings and highlighting the economic and health implications of oversized meals, Hua’s research provides valuable insights into how we can collectively take steps towards better health outcomes.