Public Policy and Obesity: The Need to Marry Science with Advocacy

To review federal, state, and local antiobesity policies and to assess their relationships with obesity growth rates.

We performed a literature review, acquired data from governmental Internet sources, and assessed the statistical correlation between state antiobesity policies and the concavity in obesity growth rates.

State-by-state antiobesity policies in 3 categories—taxation of sugared beverages and snacks, physical education and physical activity in schools, and funding for bicycle trails—were found to have no significant immediate correlation with the change in obesity growth rates.

Ineffective antiobesity legislation may be attributable to shortcomings in policy implementation. Behavioral economics and addressing large-scale cultural issues may have critical roles in promoting more healthful lifestyles. We propose that a systems-based paradigm evaluating complex interactions among pathophysiological, cultural, political, economic, and behavioral components can improve antiobesity policy implementation and should therefore be a research focus. (Endocr Pract. 2012;18:737-744)

This longitudinal study identified common summer care arrangements for adolescents and examined whether those arrangements predicted risk for obesity (Body Mass Index (BMI) ≥ 85th percentile for age and gender) the following school year. Participants were a nationally representative sample of 1766 adolescents ages 10–18 from the Panel Study of Income Dynamics–Child Development Supplement. Results showed that, beyond measures of BMI taken before the summer and several demographic aspects known to predict obesity, youth whose summer arrangements involved regular participation in organized activities (e.g., sports) showed significantly lower risk for obesity than other youth. This was most evident during early adolescence. Youth whose regular summer arrangement was predominated by parent care without organized activity participation showed the greatest risk for obesity.

The continued rise in obesity rates in most countries suggests that current programs and initiatives designed to combat obesity have not been successful in reversing the obesity epidemic. Obesity rates are increasing because of a gradual weight gain in most populations. There has been little long-term success in treating established obesity through lifestyle change, perhaps because of the large permanent changes in diet and physical activity required to keep weight off. An alternative strategy to address the obesity epidemic involves not focusing on weight loss but promoting small changes in diet and physical activity to initially prevent further weight gain. With the use of this strategy, obesity rates could first be stabilized in most populations and then, over time, decrease gradually. Supporting data show that small reductions in conscious energy intake and increases in physical activity can reduce excessive weight gain. The opportunity exists to use the small-changes approach to bring different stakeholders together to create a national initiative to address the global epidemic of obesity. The Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council believe that a small-changes framework, aimed at helping people make conscious small changes in lifestyle behaviors, in combination with efforts by the private sector to gradually “ratchet down” some of the environmental factors that have contributed to excessive energy intake and the declining rates of physical activity, can be successful in reducing obesity rates. Such an initiative would benefit from the support of educational and social marketing campaigns developed with governmental input and support.