How do we provide our growing global population with healthy diets, in ways that don’t harm the planet?

Extra large is the problem. The trick is convincing Americans to think about food in a new way: Extra large isn’t extra good.

For a long time, the health dictum to “eat in moderation” has been an easy one for Americans to echo. It’s a simple, memorable rule of thumb. But people have trouble actually practicing it, and overconsumption of calories—especially nutrient-poor calories—is believed to have contributed to the rise of several deadly diseases in the United States.

Up against a noisy ecosystem of fad diets and a complex array of nutrition science, a new group hopes to bring fresh meaning and substance to that age-old adage. And because of the people involved, it’s a movement worth noting.

The Portion Balance Coalition wants to reshape how people think about food portioning, an attempt to align the disjointed approach to nutrition that gets marketed to Americans. Never has a group this broad and diverse come together to tackle the issue of obesity through portion control, bringing to one table Nestlé, PepsiCo, the American Beverage Association, the US Department of Agriculture (USDA), the Center for Science in the Public Interest (CSPI), the American Heart Association, and several others.

That might sound like a staid list of institutions and businesses, but behind each one is a person (or multiple people) with a fierce set of interests that are very often at odds with the others. The group is still in its early stages, but it’s looking to launch a US consumer education campaign around portion balance, and also to engage with restaurants about the portion sizes they serve. A timeline for this rollout is still being developed.

Wrangling and getting groups to coalesce around the same goal hasn’t been easy, but the woman behind the effort, Diane Ty, says she believes it’s imperative.

“The solution here can’t be solved by one sector alone, we’d all be talking past each other,” says Ty, who works at Georgetown University’s business school as the coalition’s project director. The group’s diversity makes it uniquely powerful among previous efforts; it’s also a powder keg. Still, members of the coalition think it’s worth a shot.

Why portion control?

In the US, a combination of consumption and activity patterns is contributing to the country’s stubborn obesity problem.

“We have an epidemic and it really hasn’t changed except among young children,” says Mary Story, a Duke University nutrition science professor and member of the coalition. “Otherwise, obesity has increased in spite of many funders.”

Obesity, in many instances, is code for increased risk of a pernicious suite of acute health problems—harmful for any one person, and expensive for the national health system. Obesity has been linked to type 2 diabetes, heart disease, and hypertension, among other conditions. Those have an estimated combined annual economic cost in the US of about $495 billion, according to the US Centers for Disease Control and Prevention (CDC).

In February 2010, America’s then-first lady Michelle Obama announced the Let’s Move! campaign, an effort to reduce childhood obesity by 5% over 20 years. It was a valiant effort, with stakeholders from government, research institutions, and the business world promoting exercise and other strategies for healthy living. But exercise alone isn’t a silver bullet for the obesity epidemic.

In contrast, “we’ve never really had a mega-campaign that really would look at portion control,” says Story.

At the foundation of the new coalition is the idea that people are eating too much. The idea may seem simple enough: Larger portions of food mean you’re eating larger amounts of calories. But the relationship between portion size and overeating is actually a lot more nuanced.

As New York University nutrition science professor Marion Nestle has put it, larger portions encourage people not just to eat more, but to underestimate how much they’re eating. It’s as much a mental game as it is a mathematical one.

The impacts of portion size psychology multiply when restaurants serve massive portions and food manufacturers create jumbo-sized products. Between 1993 and 2013, the average bagel got 100% bigger; burgers got 78% bigger; cinema popcorn bags 120% bigger; and fountain sodas 207% bigger, according to the CDC. Meal planning (and sizing) is complicated by a thicket of nutrition science and fad diets that push eaters to prioritize the consumption of macronutrients over food that simply sates them. Amidst the confusion, portion sizes continue to grow: Studies from 2002, 2003, 2010, 2011, and 2015 have shown as much.

What makes those larger sizes even more troublesome is that they’re marketed and sold as bargains. When people learn to equate massive amounts of food with a good deal, it becomes an even more Herculean task to change their behavior, Ty says.

Ty points to celebrity chef Guy Fieri’s Food Network show, “Diners, Drive-Ins and Dives,” as an emblem of the problem. In it, Fieri travels across America, visiting classic restaurants that often serve up heaping portions for cheap.

“That’s our culture, that’s what we’re up against,” Ty laments. Members of the coalition have noted that quick-service and sit-down restaurants, particularly chain restaurants, play an outsized role in promoting the idea that more food is a good thing.

To change that culture, it will take successful collaboration from groups that often have competing interests. It won’t just be about physically reducing sizes of portions, but effectively communicating to people a new way of thinking about the value of food: Bigger isn’t always better.

Strange bedfellows

The effort to change the conversation around portion control came from within the food industry. In late 2017, Wendy Johnson, a policy representative from Nestlé, the world’s biggest food manufacturer, approached the Georgetown University McDonough School of Business with an idea.

“Nestlé came to Georgetown asking to host a roundtable in January 2018 to spark a conversation around portion and portion control,” Ty said. A 2014 McKinsey white paper (pdf) about the importance of portion control when combatting obesity fueled much of the early interest, she says.

So the group assembled. The participants—including Kraft-Heinz, CSPI, DC Hunger Solutions, Unilever, and nutrition researchers like Duke’s Mary Story—walked away feeling the weight of the moment. It was the first time groups had assembled around portion control in a meeting that wasn’t driven by a research institution or trade association.

“Everyone was honest,” Johnson recalls. “Reserved at the beginning, but I think at the end we had the commitment that people wanted to continue this dialogue.”

That meeting was purportedly so productive that Ty was brought aboard just three months later, tasked with gluing together a coalition. Nestlé provided an undisclosed amount of seed funding, and some organizations have since chipped in with more funding and low-cost services.

The set of industry folks, consumer advocates, nutrition experts, and government representatives Ty has assembled are far from natural partners. Throughout its history, the nonprofit CSPI in particular has gone head-to-head with food industry lobbying groups.

Consider this brief rundown of the soda industry’s efforts to beat back against public health initiatives across the last few decades:

In 1979, the USDA proposed a rule that would bar schools from selling sodas and other sugar-laden junk foods until after kids had eaten during the final lunch period of the day. Pepsi organized a letter-writing campaign opposing the idea. In 1980, the rule was approved anyway, and the National Soft Drink Association promptly filed a lawsuit. The group lost its case, appealed it, and then won in 1983.

For decades the soda industry found itself at odds with CSPI over whether its marketing of sugary products to children should be regulated. It wasn’t until about 2008, after the US Federal Trade Commission revealed the industry was spending about $1.6 billion annually to target kids, that the soda companies committed to stop buying ads aimed at children under 12 years old.

In 2013, mayors from 18 cities across the US wrote to Congress asking lawmakers to reassess whether the federal food stamp program should prohibit recipients from using their benefits to buy sodas. It’s an idea that’s been backed by CSPI, and predictably reviled by the soda industry. In a letter of its own, the American Beverage Association wrote: “It’s not the government’s job to grocery shop for our families; it’s ours…[politicians] don’t need to tell us what to put in our shopping carts.”

And finally, for the last decade, soda companies have been locked in a protracted battle with cities around the country as voters have sought to approve soda taxes. In some cases, the tactics used by the companies to thwart these attempts have been downright sneaky.

Ty says that progress will likely be incremental at first. Striking a balance between fierce consumer advocates, researchers, and industry players is a tough tightrope to walk. Still, industry is showing a willingness to engage.

“Beverage companies have been partnering with public health groups and advocates for years now to help consumers maintain a good dietary balance,” says William Dermody, spokesman for the American Beverage Association, a group that represents the interests of companies including Coca-Cola and PepsiCo. “That’s why we are pleased to join with other partners in the Portion Balance Coalition.”

Dermody points out that the beverage industry has worked with the Obama White House during the Let’s Move! campaign and in the Robert Woods Johnson Foundation’s Healthy Weight Commitment initiative to reduce calories in products, among others.

Skeptics of the food industry understandably will wonder: If a company’s profit-driven mindset is to make more money, what is the incentive for being involved in this effort?

It’s an interesting question, especially in light of recent news from a group of leading US CEOs who collectively announced (paywall) that shareholder value isn’t the end-all-be-all of corporate life. They say they’re committing to focusing more on other elements of their businesses, such as consumers, communities, and people up and down the supply chains.

It’s a mindset that’s been infused into Nestlé for some time. The Swiss food behemoth has spent the last decade repositioning itself to be a health and wellness company as much as a food company, spending billions to redesign product labeling, rework its ingredients, and acquire pharmaceutical-adjacent firms for future research and development.

“If we want to do well in business, we have to do well for the communities we serve,” Johnson says. “We want consumers with us for a long time, and obesity is threatening the longevity of consumers and communities.”

To be sure, much remains to be seen.

Every five years, the entire food industry engages in lobbying wars in Washington, DC when the federal government convenes a panel of nutrition experts to update the nation’s official dietary recommendations. That’s happening right now, and the idea that all these interest groups can sit around a table and suddenly make harmonious, substantive change is a folly. There will be tension. Concessions will have to be made. The question is whether the groups can strike a balance.

The biggest threat

No matter the number and diversity of groups, and no matter the financial resources at the coalition’s disposal, the biggest threat is moving too slowly, Story says.

The coalition cites on its website one case study that might serve as a model for success: Getting Taco Bell to abandon its 40-ounce (1.18 liter) fountain drink cups. That decision was announced by the fast food chain in 2017.

The issue: It took three years of work to convince Taco Bell to make the change. And even when did, the chain still offers an objectively large 30-ounce cup size. The coalition’s members acknowledge that incremental changes are inevitable. But with nutrition-related health problems getting worse in America, food industry participants will have to make more sweeping changes than Taco Bell’s.

Ty says that the coalition does not yet have “that silver bullet” for how to best communicate the importance of portion control. She suspects, though, that the most effective message will at once empower people and also demolish the idea that more food is equivalent to value.

Even the language around portion needs to change. While “portion control” is a common phrase, Ty is working to usher in the idea of “portion balance.” That might seem silly at first glance, but the underlying message to everyday eaters is that they have the autonomy to make their own choices; eating can’t simply be dictated by scientific institutions and governmental bodies.

“I think we do need to have different sectors working together,” Story says. “We can’t as a society afford to wait.”