Obesity in America: Policy Solutions and Public Health Action

Introduction

Obesity is a critical issue in the United States, and the problem appears to be worsening both domestically and globally. According to recent estimates, about 34 percent of American adults and 15 to 20 percent of American adolescents and children suffer from obesity. Every demographic of the American population is affected by the condition, and one of its most alarming features is that it significantly increases the risk of multiple chronic conditions in both adults and children. Given its widespread prevalence, obesity is now considered an epidemic by public health authorities.

To address the problem of obesity in the United States, public health officials need to develop targeted programs and policies. However, significant efforts remain insufficient at present. Because of how complex the problem of obesity is, it will likely prove to be a very difficult public health challenge to solve (Mitchell, Catenacci, Wyatt & Hill, 2011). Reducing obesity will require all levels of government and relevant agencies to work together. There is also a need for regulations, policies, laws, and campaigns to trigger social changes that will sustainably reduce the incidence of obesity in the long term (Swinburn, 2008).

What Is Being Done?

The United States federal government identified reducing the incidence of obesity as one of its top health priorities approximately a decade ago, launching long-term programs to turn the tide against the condition. Early in 2010, the nation's top medical officer, the Surgeon General, issued a report titled Vision for a Healthy and Fit Nation. Within the report, the Surgeon General highlighted the growing public health crisis of obesity, detailed its causes and effects on society, and — most importantly — offered recommendations for steps that various parties, including communities, doctors, schools, parents, and ordinary consumers, can take to fight obesity (AAFP, 2010).

Between 2004 and 2006, a national action plan against obesity was developed by the Commonwealth Government of Australia. The plan was intended to provide a roadmap for fighting obesity across the country. While no significant study has comprehensively reviewed the success of the action plan, available reports suggest that implementation has been far from impressive. The portion of the plan that has been most consistently implemented is the section calling for television advertisements against obesity; both federal and state governments have run many such advertisements on popular stations with nationwide viewership. Community-level programs against obesity have also been widely implemented and have demonstrated better potential for making a lasting impact on the issue.

In New Zealand, community-level programs have similarly shown a measurable impact on obesity rates. The New Zealand government also introduced a school food policy designed not to promote obesity. This initiative carries the long-term potential of cultivating healthier eating habits in children and, by extension, reducing the incidence of obesity among future adults in that country (Swinburn, 2008).

What Is Not Being Addressed?

Many regulations and policy options against obesity around the world rarely get adopted because they face opposition from certain sectors — most notably the food and beverage industry. For example, a policy that bans the advertisement of junk food and sugary drinks to children will almost inevitably face opposition from the manufacturers of those products and their industry associates. Furthermore, state and federal governments have over recent years tried to reduce bureaucracy and deregulate, making policies that seek to ban or restrict the sale of certain products to segments of the population appear counter to broader government goals of reducing red tape.

The general public has also opposed some policy measures previously adopted by governments, such as measuring the BMI (Body Mass Index) of children and reporting those results back to families — a practice that has raised concerns over stigmatization and privacy (Swinburn, 2008). Opposition from parents and certain economic sectors is therefore among the primary reasons why certain evidence-based policies against obesity have not been fully implemented.

Proposed Ideas

If the fight against obesity is to succeed, all levels of government must collaborate and exercise leadership. The President ought to direct the Secretary of the Department of Health and Human Services (DHHS) to form a task force — including senior officials from other departments and agencies — to create policies, programs, and budgets to fight obesity within a unified policy plan. Federal and state government support for existing anti-obesity efforts should also be strengthened. Specifically, governments should:

• Provide more funding for research into obesity prevention and treatment, including studies developing or evaluating community-based obesity prevention programs.
• Provide more funding for research into the prevention of childhood obesity, particularly studies focused on environmental and social approaches.
• Support physical activity and nutrition grant programs, especially in states with a high prevalence of childhood obesity.
• Increase support for obesity monitoring research studies such as the National Health and Nutrition Examination Survey (NHANES).
• Develop and scale programs that promote healthy diets and physical activity, building on initiatives that have already proven effective (Institute of Medicine, 2007).

Conclusion

Obesity is an epidemic in America. A significant percentage of both American adults and adolescents are overweight or obese, and many programs have been implemented to try and reduce obesity in the United States to no avail. The problem is now correctly perceived as a crisis — and a dangerous one (Swinburn, 2008). Federal and state governments need to act decisively to prevent the problem from worsening and negatively affecting every dimension of American life.

The most effective approach is to significantly increase support for research into obesity prevention, especially among children. Governments must also develop laws or policy documents to guide both their own steps and those of all stakeholders in the fight against obesity, ensuring that efforts are coordinated rather than competing or contradictory. Community-based programs have demonstrated particular promise in terms of sustainability, cost-effectiveness, and overall impact. These programs deserve closer examination and scaling at local, state, and regional levels to realize their full potential.

References

AAFP. (2010). Federal government takes bigger role in combating obesity. Retrieved from

Institute of Medicine. (2007). Progress in preventing childhood obesity: How do we measure up? Washington, DC: The National Academies Press. https://doi.org/10.17226/11722

Kumanyika, S. K., Parker, L., & Sim, L. J. (2010). Bridging the evidence gap in obesity prevention: A framework to inform decision making. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK220174/

Mitchell, N., Catenacci, V., Wyatt, H., & Hill, J. (2011). Obesity: Overview of an epidemic. Psychiatric Clinics of North America, 34(4), 717–732. https://doi.org/10.1016/j.psc.2011.08.005

Swinburn, B. (2008). Obesity prevention: The role of policies, laws, and regulations. Australia and New Zealand Health Policy, 5(12). https://doi.org/10.1186/1743-8462-5-12