Australia should consider a healthy food rebate, tax on sugary drinks, and regulated portion sizes argue health experts, as New York pushes ahead with government regulation to address the obesity epidemic.

The New York City health commissioner behind a proposed cap on the container size of sugary soft drinks has argued government regulation of portion sizes is justifiable and could help fight America’s obesity problem.

Writing in the latest issue of the Journal of the American Medical Association, Dr Thomas Farley writes governments that do nothing about the marketing of high-calorie sugary drinks are inviting even higher rates of obesity, diabetes and related mortality.

It’s a view shared by Australian health policy experts, who say self-regulation by food groups will never be enough to address the obesity problem. In the US it’s a problem that costs 100,000 lives and $150 billion in health care costs every year.

“What it is necessary to do is to create a neutral environment for consumers, because at the moment we have an environment that is obesity-promoting,” said Bebe Loff, director of the Michael Kirby Centre for Public Health and Human Rights at Monash University.

“We don’t even give people a good sort of chance to combat the environment that’s encouraging them to buy more of these goods.”

The food and drinks industry is using the same tactics as the tobacco and alcohol industry argues Rob Moodie, professor of global health at University of Melbourne.

“There’s no way they’re going to move unless there’s regulation in my view.”

Professor Moodie said saturated advertising to Australia’s children and sponsorship of key sports created a culture where eating junk food and drinking junk drinks was the norm.

“Things won’t change until we get substantial changes to foods that have lower levels of salt, sugar and fat. That probably won’t happen until there’s regulation or the serious threat of regulation,“ Professor Moodie said.

In his article, Dr Farley details the measures taken by New York’s City Board of Health to “regulate food products that harm the most people”.

The measures include banning the use of trans fat in New York restaurants, pushing food companies to reduce the high levels of sodium in food, requiring chain restaurants to post calorie counts on menus, and imposing a 1-cent-per-ounce excise tax on sugary drinks.

The food industry continues to argue against the proposed sugary drinks portion rule, but Dr Farley said the sale of huge portions is driven by the food industry, not by consumer demand.

Kerin O’Dea, professor of population health and nutrition at University of South Australia, agreed.

“Large portion sizes are a great generator of profit. Unless there’s regulation they’re not going to change.”

Professor O’Dea said labelling of menus was critical so people knew how much they were consuming, and could make informed choices.

State governments have started to mandate for calorie counts on menus, applying schemes to fast food restaurants with more than 50 outlets. McDonalds already does this in Australia, and this week moved to do the same across America, catching up on New York where calorie counts on menus have been mandated since 2008.

Professor O’Dea said she’d like to see measures introduced that encourage people to choose a healthy diet.

“We have a diesel fuel rebate for people in the country. I would like us to have a healthy food rebate for people in isolated locations, particularly aboriginal communities… so financially people have an incentive to buy healthy food.”

But Rob Moodie said with more people dying from preventable deaths and huge strains on the health care system affecting both state and federal governments, measures akin to those imposed on the tobacco industry might be required.

“We have a particular problem in Australia with large, well organised and very aggressive junk food and drinks industries. To quote Professor Kelly Brownell from Yale, one of the leading scientists in this area: ‘When the history of the world’s attempt to address obesity is written, the greatest failure may be collaboration with and appeasement of the food industry’.”

Professor Loff said stemming the tide of disciplines dedicated to the marketing of food was a huge ask, but controlling the portion size of sugary drinks was a good start.

She added that it took 60 years, and a decision by the government to ignore its own guidelines for regulating, to see the plain packaging crackdown on the tobacco industry.

“What I would think our government would say in response to something like banning the oversized sweet drink containers is that not only do you have to show that there is this informational problem, or that the harm created outweighs whatever potential benefits there are; you would also have to show the impact that intervention was going to have on dealing with the problem, that is lowering obesity.”

Professor Loff said what’s required is restructure of both our physical and psychological environments to give everyone a fair chance to protect their health.

“I’m not suggesting it be welfare-promoting, but suggesting that it be neutral so we’re not encouraged every time we turn around when walking through a supermarket, and being bombarded with all sorts of imaginative marketing techniques.”