Administration/Board of Trustees/Influential on-staff Heart Surgeon: "We want a major healthy foods initiative in our hospital retail food services program. After all, we are a health care organization and we had better set the proper example!"

Chief Financial Officer: "Retail food sales have to be increased and net revenue improved. The new health care environment is creating significant financial challenges and your department can make a contribution! And, oh, about that staff reduction program we were discussing…"

Customers/Visitors: "We're adults and and we'll eat and drink what we want. If you won't offer it, we’ll get it across the street!"

Food and Beverage Industry – "We put billions of dollars into advertising campaigns and political contributions and our marketing techniques are down to an exact science. We also have star power—from Beyoncé to Michael Jordon, Elton John and Bill Cosby."

Sure, the eat healthy-be healthy drum has been beaten many times before.  But is it real this time?  There's no question that an obesity crisis is looming in the U.S. (with 30-35% obesity rates), and that there is good justification for the view that the  healthcare industry should pay more attention to how its service offerings might complicate its own mission.  

This is also an issue that is becoming increasingly global. The same obesity issues are now showing up in countries that previously were held up as examples of moderation in food intake and healthful living habits:  France (9.4%), Italy (8.4%), and Switzerland (7.7%). They, too, are concerned about the rise of obesity in their countries, and what can or should be done about it.  

Many think that New York City's current efforts to ban large high-calorie soft drinks in some settings (and in healthcare systems, almost completely in their cafeterias and patient service) as an extreme approach.  But it is not alone. Britain is discussing a tax on sugar drinks and the borough of Westminster plans to cut benefits to those who refuse to follow doctor’s orders to exercise and lose weight.

Even Japan, often thought of as having a national population apparently immune from obesity (3.2%), is concerned enough about rising healthcare costs to pass laws prescribing waistline measurements, among other metrics, for adult citizens.

Are such initiatives the wave of the future? Will they take hold, or fade as other well-meaning initiatives have? 

More importantly, how should hospital FSDs—trying to walk the razor thin line— respond?