Dr Thomas Farley, of the New York City Department of Health and Mental Hygiene, said governments should consider regulating portion sizes to avoid ‘needless deaths’ caused by obesity.
The DH has favoured voluntary industry agreements through a 'responsibility deal', encouraging measures such as salt reduction and calorie labelling on menus.
In a JAMA editorial, Dr Farley said these measures alone were less effective than regulation as manufacturers primarily respond to shareholders’ demands, and larger portions are more profitable.
Instead, alongside voluntary deals and advice, governments must regulate food products that harm the largest numbers of people, he said.
In New York City, a $0.01-per-ounce tax on sugary drinks reduces the financial incentive to market large portion sizes.
The city’s authorities have also proposed a cap on the portion size of sugary drinks served at restaurants.