Tackling Obesity

HEALTH CARE

May 19, 2010

by Faiz Shakir, Amanda Terkel, Matt Corley, Benjamin Armbruster, Zaid Jilani, Andrea Nill, and Alex Seitz-Wald

Last week, First Lady Michelle Obama and several administration officials unveiled Solving The Problem of Childhood Obesity Within A Generation, a report produced by the White House Task Force on Childhood Obesity. The goal, first articulated by the First Lady's Let's Move! campaign, is bold: "Solve the problem of childhood obesity in a generation." But the goal is so ambitious only because the crisis of childhood obesity is so grave -- with the current generation of Americans is "on track to have a shorter lifespan than their parents." Obesity "is estimated to cause 112,000 deaths per year in the United States, and one third of all children born in the year 2000 are expected to develop diabetes during their lifetime." Each year, obese adults incur "an estimated $1,429 more in medical expenses than their normal-weight peers," and overall, the nation spent up to $147 billion on obesity-related costs in 2008. At last week's unveiling, the First Lady seemed humbled by the magnitude of the problem but also confident that the Task Force's recommendations, if fully implemented, could begin reducing the nation's obesity rates. "For the first time -- this is the key -- we're setting really clear goals and benchmarks and measurable outcomes that will help tackle this challenge one step, one family and one child at a time," she said.

A MULTI-PRONGED APPROACH: The administration's report provides a comprehensive approach that seeks to tackle the obesity epidemic from all angles and with a broad coalition of stakeholders (an approach the Center for American Progress has stressed as necessary for effective implementation of the obesity initiative). The report focuses on ways government, together with the private sector, can work to create a healthy start on life for children, empower parents with the ability to make healthier food choices, upgrade the nutritional quality of school lunches, eliminate so-called "food deserts" in urban and rural America, and encourage children to get more physically active in their schools and communities. For instance, noting that "approximately one in five children are overweight or obese by the time they reach their 6th birthday," the report recommends informing women about the importance of conceiving at a healthy weight and encouraging breast feeding, which could lower the risk of becoming overweight by as much as 22 percent. The Task Force tackles the multi-billion business of food marketing to children and provides ways in which the food industry can use market as "a powerful tool to drive the purchase of healthy products and to communicate important information about healthy eating choices." The use of licensed characters "to market foods to children is particularly effective and pervasive," the report notes. "When preschoolers were asked if they would rather eat broccoli or a Hershey's chocolate bar, 78% of the children chose the chocolate bar and only 22% chose broccoli. When an Elmo sticker was placed on the broccoli, however, 50% of the children chose broccoli." The report commends the industry for taking steps to reduce advertising of poor quality foods to children, but warns that voluntary industry efforts "had not substantially shifted advertising for children towards healthier products" and argues that "the FCC could consider revisiting and modernizing rules on commercial time during children's programming." Moreover, citing the growing problem of limited access to healthy food choices that forces millions of low-income Americans to live in "food deserts" that "lack convenient access to affordable and healthy food," the report recommends that the federal government provide grants to community development financial institutions, "nonprofits, public agencies and businesses to promote interventions that expand access to nutritious foods," and "support regional planning systems that ensure greater access to healthy food in underserved areas." Providing economic incentives to farmers to "increase production of healthy foods" and taxing unhealthy foods like soda may also impact consumption, the report notes.

HOW HEALTH REFORM WILL HELP: The new health care law makes significant inroads in addressing the obesity epidemic. As Ellen-Marie Whelan, Lesley Russell, and Sonia Sekhar point out in a recent report released by the Center for American Progress, the newly enacted comprehensive health reform law "contains a number of provisions to address childhood obesity in the context of health care and public health." Several studies have indicated that, when presented with calorie information and recommendations, people on average consumed meals with almost 100 fewer calories. The law improves nutrition labeling in fast food restaurants by requiring all chain restaurants "to provide clear labeling of the calorie counts by March 2011." By that date, restaurants must "display a succinct statement on the recommended number of calories individuals should consume each day as well as provide written nutrition information when requested." Vending machines will soon have to meet a similar requirement. The law also promotes breastfeeding by mandating that "employers with more than 50 employees must provide break time and place for breastfeeding mothers to express milk," gives grants to community based obesity intervention programs, invests in broader population-level obesity intervention efforts, and promotes primary care and coordination efforts that emphasize prevention. Still, none of this alone can significantly lower obesity rates. For that, policymakers must do much more to enact the Task Force's recommendations and look beyond health care into the nutrition of food in school cafeterias, the physical education programs, America's agricultural policies, and the food options in lower-income neighborhoods.

CONSERVATIVES ON THE ATTACK: Unfortunately, some in the conservative media are using the Task Force to further the meme that the administration is undermining personal freedoms and liberties. Last week, for instance, Matt Drudge ran a headline saying, "White House seeks controls on food marketing." On the May 11 edition of his Fox News show, Sean Hannity said: "An Obama government obesity task force." "Does every American family need a dietitian appointed by the government to tell them that this food is going to make you fat and this food is not?" he asked. Conservative blogger Michelle Malkin also turned the Task Force into a hit, saying that her "problem with the Obama administration is that it's more concerned with policing grocery aisles and our refrigerators than it is with our borders." "And we'd be heck a lot better off if they got their priorities in order." Only former Governor Mike Huckabee, who himself has struggled with obesity, warned conservatives against mischaracterizing the report. During a discussion in February about Obama's campaign to fight childhood obesity, Huckabee explained that the initiative is not a "nanny-state solution" or a "leftist position" and warned that conservatives would engage in reactionary attacks against the program. Speaking of Obama, he concluded, "She does not believe that it is a government solution and that government should dictate what size cheeseburger you eat."