anti obesity programs and policies

Few other public health issues have drawn as much attention, and garnered as much support for policy and programming as obesity. Obesity programs have been initiated and implemented at the federal and state levels, and all fifty states currently have early childhood education physical activity and healthy eating regulations and policies (The State of Obesity, 2018). All the major national public health research organizations, including the Centers for Disease Control and Prevention and the National Institutes of Health likewise inform and promote obesity-related policies and programs.

Government agencies like the Food and Drug Administration and the USDA also have distinct policies and programs. In spite of the abundance of both private and public funding for anti-obesity research, policy development, and programming, the majority—two-thirds—of American adults are overweight or obese, and more than a fourth of all healthcare costs in the nation are consumed by obesity-related issues (Levi, Vinter, Richardson, et al. (2009).

With a few exceptions, obesity policies in general have been relatively ineffective at reducing overall rates of obesity or changing public health trends. The most effective anti-obesity programs implemented in the United States have been the school-implemented ones, particularly those that combined in-school programming when they are combined with home and community involvement (Wang, Cai, Wu, et al., 2015). School-based physical activity programs have been evaluated for their effectiveness at increasing fitness levels, reducing sedentary activities like television viewing, and reducing cholesterol, but not necessarily BMI (Levi, Vinter, Richardson, et al., 2009).

Even when they are effective, program evaluation results have been “moderate” at best, and the majority of interventions have yielded few promising results (Wang, Cai, Wu, et al., 2015). The CDC has likewise proclaimed inconclusive evidence supporting its own school-based initiatives (Levi, Vinter, Richardson, et al., 2009). Similarly disappointing results have been found when measuring the effectiveness of obesity prevention programs administered through early childhood education in other countries.

For example, one UK study showed that school-based programs led to no statistically significant reduction in overall BMI scores; the results show that “schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments,” (Adab, Lancashire, Hemming, et al. (2018, p. 1). Among all populations, the most important reason why anti-obesity policies and programs have been ineffective is that they have failed to address some of the systemic issues at stake.

Some of the overarching, systemic concerns include socioeconomic class, disenfranchisement, and persistent disadvantage: social factors that are linked with higher prevalence of the disease. In almost all countries, obesity rates are higher among lower socioeconomic groups (Kornet-van der Aa, Altenburg, van Randeraad-van der zee, et al., 2017). The connection is due to a number of variables including the higher price of healthy versus unhealthy foods.

For example, the cost of fruits and vegetables has risen, whereas the price of soda, sugar, and other junk food has remained “fairly steady” over the past several decades (Levi, Vinter, Richardson, et al., 2009, p. 46). In fact, unhealthy foods cost about a tenth of the price of health foods (Levi, Vinter, Richardson, et al., 2009, p. 46).

Some states have initiated policies that reduce the taxes on healthy foods, or alternatively, impose taxes on unhealthy foods, but these policies have yet to reveal any real measurable effects in reducing overall obesity rates because they have been implemented in a piecemeal fashion (Levi, Vinter, Richardson, et al., 2009).

Other factors linking low socio-economic class status to obesity rates include community design, with low-income neighborhoods having less access to the means by which to remain physically active, such as having well-maintained and safe parks and sidewalks (Kornet-van der Aa, Altenburg, van Randeraad-van der zee, et al., 2017; Levi, Vinter, Richardson, et al., 2009). Even the state-level policies aimed at redesigning communities to encourage more physical activity have yet to reveal measurable results because they need to be combined more with other interventions. As Levi, Vinter, Richardson et al.

(2009) point out, “it’s not just what we eat and how much we exercise that affects Americans’ weight, but how we live our daily lives,” (p. 50). Current programming has tended to focus on one issue at a time, rather than expanding the anti-obesity interventions throughout multiple sectors. Targeting the private sector, such as limiting advertising for junk food, or even implementing bans on some types of obesity-causing products, may be necessary in order to reduce the overall cost burden of the disease.

The effectiveness of obesity programs and policies can also be measured in terms of public perceptions. Some school-based interventions have been deemed “controversial” for several reasons, including the fear that the programs will increase teasing, bullying, and fat-shaming, the fear that the programs will increase the rates of use of diet pills, and the fear that the programs will lead to an increase in eating disorders (CDC, 2018). The few programs that have been evaluated for public perceptions have shown that these fears are ungrounded.

For instance, Levi, Vinter, Richardson, et al. (2009) showcase at least one school-based intervention.