One Ounce Fine Gold

Where Can We Buy an Ounce of Obesity Prevention?

Perhaps we have Ben Franklin to thank for a pervasive bias that an ounce of obesity prevention is more valuable than many pounds of treatment. But a new review of overweight and obesity prevention in children and youth concludes that only “small improvements in weight outcomes with questionable clinical importance were found. No intervention strategy consistently produced benefits.”

Certainly, we need prevention and treatment strategies for obesity that are truly effective. It’s hard not to admire the commitment to prevention, especially in childhood obesity. Borrowing our friend Yoni Freedhoff’s favorite metaphor, people are enormously busy throwing sandbags on the levee to slow the flood of obesity and its consequences. The Robert Wood Johnson Foundation recently doubled their commitment to reversing the epidemic of childhood obesity. That announcement brings their financial commitment to a total of a billion dollars.

The trouble, as the latest analysis points out, is that we need better sandbags. The most promising interventions, according to a 2011 Chochrane Review are:

  • School curriculum that includes healthy eating, physical activity, and body image
  • Increased sessions for physical activity and the development of fundamental movement skills throughout the school week
  • Improvements in nutritional quality of the food supply in schools
  • Environments and cultural practices that support children eating healthier foods and being active throughout each day
  • Support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)
  • Parent support and home activities that encourage children to be more active, eat more nutritious foods, and spend less time in screen based activities

Both the current review and the 2011 review caution that “study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs.”

This work is too important. We mustn’t continue relying upon presumptions instead of evidence for what works.

Click here to read the latest review. Click here for the 2011 Cochrane Review.

One Ounce Fine Gold, photograph © Orbital Joe / flickr

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2 Responses to “Where Can We Buy an Ounce of Obesity Prevention?”

  1. February 10, 2015 at 5:46 pm, Mary-Jo said:

    It would be great if schools could take a bold steps further and hire RDs to work with individual children (and their families) who are already struggling with overweight/obesity or high-risk and track their progress over long-term, say a few years.. Also, RDs could track and keep data on growth charts of all children. This could help track bottom-line results of school-based efforts and serve to provide epidemiological data. This type of data is missing and could be extremely useful to assess effectiveness or lack of it of our hard work and good intentioned programs and efforts.

    • February 10, 2015 at 7:09 pm, Ted said: