As I was growing up, I had often heard New York City associated with gangs, drugs and violent crime. Today, by most standards, the city is rated one of the safest in the country. Improving trends are the result of a sustained commitment by New York’s mayors, daily efforts of a dedicated police force and meaningful engagement by concerned citizens.

The devastation of the World Trade Towers on Sept. 11, 2001, left not only the skyline, but also the inhabitants of Manhattan forever changed as they again came together to rescue, salvage and heal their broken lives and damaged property. Today the people of New York City shine once more with courage and resolve as they emerge from power outages and widespread damage wrought by Hurricane Sandy just assessed to be as high as $70 billion. New York City has, time and again, proven to be an inspiring model for all Americans.

Mayor Michael Bloomberg now leads the way in tackling another immense problem plaguing the citizens of NYC: obesity. Beginning in March, a ban on the sale of many sweetened drinks in containers larger than 16 ounces goes into effect.

Fully two-thirds of American adults and one-third of children are either overweight or obese, according to the Institute of Medicine. The nation now spends 1 in 5 health care dollars on obesity-related illnesses. Absenteeism from obesity alone is estimated to cost businesses $4.3 billion each year. This epidemic is so profound it has the potential to adversely affect national productivity and the federal budget.

In the current edition of The Economist’s "The World in 2013" publication is an article titled "The World Is Fat." Obesity is an international problem, and governments are choosing differing strategies to address it. Japan, for example, has placed limits on the weight of its citizens, and employers face fierce fines if their workers exceed designated weight allowances. Other governments such as Denmark have begun to levy additional taxes on foods high in cholesterol. Bills to add a tax on sugary drinks have been recently voted down by the Hawaii state Legislature, but The Economist argues that this is less intrusive than laws requiring seat belts that are now widely accepted. Oddly, the Hawaii Legislature continues to tighten up on laws requiring the use of helmets on motorcycles and mo-peds.

The Economist proposes "soft paternalism," which is favored by "behavioral economists." "The idea is not to limit choice but to make it easier to choose carrots over french fries. Governments can’t force people to eat broccoli but can provide incentives to make it cheaper," The Economist said. The Australian government has been successful in incentivizing its fashion industry to design sun wear that protects its population from damaging ultraviolet exposure.

The Institute of Medicine has identified the following recommendations:

» Integrate physical activity every day in every way.

» Market what matters for a healthy life (transparent labeling is critical).

» Make healthful foods and beverages available everywhere.

» Activate employers and health care professionals.

» Strengthen schools as the heart of health.

The challenge is in implementation. Not long ago several of my esteemed colleagues secured funding for research trials on healthful school lunches. School officials reported that hearty salads and green vegetables were thrown in the trash, and students had gone home complaining to parents that their hamburgers and hot dogs had gone missing.

Behavioral change begins when we change our relationship to the food we eat. Michelle Obama’s initiatives to support school gardens have changed lives. When children raised in an urban setting have an opportunity to grow food, bring it home and feed their families, the entire community benefits.

New Yorkers are demonstrating an increasing demand for locally grown produce, defined as food that has come from within 400 miles away. New York City schools spend around $125 million annually to feed 860,000 children per day, according to OnEarth magazine. The schools already have begun to buy local apples, cabbages and onions.

Hawaii is already engaged in addressing obesity in myriad ways, yet we would be well served to keep abreast of efforts in the Big Apple.

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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.