12/20/2013 05:11 EST | Updated 02/19/2014 05:59 EST

Will We Ever Eat Healthy?

Anti-obesity advocates take note: one of your favored strategies is a bust. Last week the Ontario Auditor General's Report concluded that banning junk food in schools in that province has been a clear failure.

Why? For several reasons but a main one is that kids are voting with their feet. Many schools are close to convenience stores and other outlets and the kids take themselves there to buy goodies instead of what is on offer in the school cafeterias and vending machines subject to the ban.

The result will be disheartening for those, including myself, who want children to eat more nutritiously in the name of weight control but even more importantly to improve health generally. What's to learned from this failure? A lot. Here are four points to ponder:

First, bear in mind unintended consequences. What happened in the Ontario schools is an example of a well know phenomenon: unintended consequences. Policymakers want to achieve certain goals yet their policies produce outcomes at odds with those that are intended.

Another recent example is the 2011 Danish junk food tax which was also a big bust and has now been repealed. The Danes drove to neighboring countries to buy food and beverages, at lower prices, than those subject to the levy in Denmark. Such unintended consequences often occur when the law at issue can be easily evaded; something that was the case for both the Ontario school ban (just go to nearby convenient stores) and the Danish tax (cross over to nearby countries that don't impose the tax).

Second, formulate on overall strategy with a mix of interventions. The ban on junk food was part of the Healthy Schools Strategy of the Ontario government. It did contain a number of tactics. But to have a reasonable chance to succeed they have to be part of an overall strategy that encompasses what goes on at school, at home and in the community.

There is no silver bullet. Progress will be made by adopting a mix of interventions. This overall strategy needs to be about healthy diets but also focused on much more physical activity. All levels of government should be involved, including a beefed up Children's Fitness Tax Credit run through the federal Income Tax Act.

Third, emphasize health not weight. All aspects of the overall strategy need to focus on health with weight a secondary consideration. Weight is not irrelevant but our individual and collective obsession with it should be sidelined. We also need to be much more accepting of bodies in a variety of shape and sizes even as we promote healthier diets and greater amounts of exercise.

Fourth, be persistent and patient. A certain amount of failure in this area is to be expected. Trial and error should be the order of the day not exaggerated expectations regarding any of these tactics either alone or in combination. A collective and individual turning away from junk food and sitting on the couch will be no easy task and will take some amount of time.

The battle against smoking is instructive in this regard and provides a hopeful, if inexact, comparison. We have more than halved the rates of adults who smoke. But that achievement took something like four decades, a lot of revamping in terms of various legal interventions and - importantly - drastic change in public attitudes. The school ban shouldn't be scrapped but revamped and combined with other measures promoting healthy diets and exercise. A tall order.

Pass the salad, please.

Proposed Campaign From Ontario Medical Association