Obesity, Prevention in Childhood

Why is Obesity Different?

There is a striking difference in public opinion on how to prevent childhood obesity compared with preventing other threats to child safety. For example, unintentional injury is the leading cause of death of children between ages 1 and 15; hence, there are public education, policy, and legal measures to protect children (e.g., public education campaigns about choking hazards of small toys, warning labels on toys with small parts, manufacturer's recall of dangerous toys). [Page 758]In contrast, the prevention of childhood obesity is considered the sole responsibility of individual children and their parents.

One reason is that obesity does not have one simple cause, and so there is no one problem to address to prevent obesity. Childhood obesity is the result of a complicated interaction of genetic, biological, behavioral, and psychological factors, many of which are still not fully understood. In addition, obesity is associated with negative character traits, such as being greedy, selfish, and lazy. The powerful societal stigma against obesity interferes with public health efforts. The prevailing attitude is that people are overweight due to their own behaviors and therefore must take responsibility for change. The push toward personal responsibility, however, has not resulted in improvement in the weight status of children. Rates of childhood obesity have increased despite powerful social stigmatization of obese children.

Public Policy

The way food is developed, marketed, and sold in our society contributes to the epidemic of obesity and needs to change. At the present time, economic and convenience factors pressure consumers to eat foods that are prepackaged and readily available. Typically, these foods are not fresh, lack many nutrients, and contain high levels of calories and fat. Snack foods, soft drinks, “children's menu” items at restaurants, and sugared breakfast cereals are aggressively marketed to children. If breakfast cereals are ranked from least to most healthy (by any definition, e.g., amount of fiber, sugar, or fat), the cereals marketed most often to children tend to be the least healthy and are most likely to be associated with cartoon or movie characters.

To change the economic structure of the food industry, one idea is to tax unhealthy foods and use the revenues to subsidize healthy foods. Some research has found that when healthier foods are offered at lower prices, consumption increases. This idea has been controversial, but it represents the type of dramatic policy change that may be necessary to alter the current food environment. Other broad-scale approaches are to regulate food advertising aimed at children and to devise ways to encourage children to be physically active.

...