Prevention

Prevention of obesity and overweight has become a major concern of public health officials and policy makers throughout the United States as statistics about the health and financial cost of the obesity epidemic have emerged. State and local panels have convened across the country to devise strategies and develop initiatives to reduce the unhealthy eating patterns and sedentary lifestyles that are widely believed to be the cause of the unprecedented weight gain of the past three decades among American children and adults. In addition to those health initiatives aimed at individual behavior change, policy makers are intervening in both the public and private sectors to address factors in the community, in schools, and in the food industry that may contribute to the rise in obesity. Legislation has been passed and laws have been put in place that will make it easier for the public to engage in healthful behaviors, such as limiting the public's exposure to harmful trans fats, and prohibiting the dissemination of free baby formula in public hospitals to increase the chances that mothers breast-feed their infants.

While there is general agreement that the public has to eat healthier foods and get more exercise, there is some disagreement in the health community over how to best accomplish this. Important new research is helping professionals understand the complexities of weight gain and weight loss, and the emotional consequences of societal pressure to change such a fundamental aspects of human beings: their bodies. New insights and understanding are being used to evaluate prevention initiatives so that the intense pressure that is heard in the media and elsewhere about the importance of being thin does not inadvertently result in unwanted consequences such as increased rates of depression, isolation, low self-esteem, and suicidal thoughts and ideation. The focus is shifting from an emphasis on weight loss to an emphasis on increasing healthy behaviors in an attempt to ensure that adoption of healthy lifestyles is supported. It is generally agreed that increasing blame and bias toward obese people will not help improve health outcomes or the quality of life of the targeted population.

Traditional Public Health Approach

The traditional public health approach to overweight and obesity aims at changing individual health behaviors, such as eating more nutritious, low-calorie foods, instead of sugary, high-fat, and fast foods, and in choosing active behaviors instead of sedentary ones. These initiatives might consist of public health announcements in the form of television, print, and radio campaigns, as well as asking pediatricians and schools to focus on the problem with both children and parents.

There has been some concern in the health community that the zeal with which some sectors are tackling the problem may cause new problems. Requiring school districts to send notes home to parents indicating their child's body mass index (BMI) is highly controversial because of the emotional distress it can cause. These letters, which are becoming more frequent in locales around the country and have become known as “weight report cards” or “fat report cards,” can further stigmatize children who may already be teased and excluded by peers because of their body size. Furthermore, they have the effect of making parents feel shamed and stigmatized. School districts argue that this is a legitimate way of improving health outcomes because it calls attention to the problem and it pressures parents to act.

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