The Shiny Distraction of Childhood Obesity

Let’s face it. For policymakers, obesity is a fraught issue. The problems run deep culturally and scientifically, while the understanding of obesity is quite shallow. One solution is to focus on childhood obesity in isolation, with an ambition to prevent it. Former New York City health commissioner Thomas Farley points out in the New York Times this week that this amounts to a dangerous distraction:

Most health advocates get this. They talk about children not because they believe adults can avoid unhealthy weight gain, but because — in what has become a political battle against Big Food — declaring a goal to protect the innocent helps rally support. No one can blame them. It’s hard to win against such powerful adversaries. But, as with smoking, these calculations have trapped us in a failed strategy.

Farley is right about the failed strategy. He is also correct that food marketing plays a part in the explosive growth of this epidemic. But he is offering up a similarly simplistic solution as a substitute: tax and regulate the marketing of junk food to stop the spread obesity epidemic.

One problem with this proposal is that a workable scheme for taxing and regulating junk food marketing has yet to be found. It seems like a good idea because it worked reasonably well for tobacco. It has been more difficult to implement and deliver results in food policy. One big reason is that the definition of junk food is a moving target. When one target — sugary soda for instance — falls out of favor with consumers, whole new forms of junk food pop up to take its place.

Consumption of soda has been dropping like a rock for more than a decade with no impact whatsoever on obesity rates. We’re getting plenty of sugar and calories from “healthy” snacks like yogurt that have been loaded up with sugar to make them more appealing.

Perhaps the threat of taxation and regulation is necessary to motivate the food industry to reform its practices that contribute to obesity rates. But reform will need to come from within the industry as well. One promising approach is the Healthy Weight Commitment Foundation, which has succeeded in removing trillions of calories from the American food supply.

But that brings us to the second major problem: addressing the health of people who already have obesity, including many millions of people who are affected severely. A healthier food supply will be nice to have, but there’s no reason to believe that it will reverse severe obesity. Like it or not, millions of Americans now have a chronic, progressive disease.

Without evidence-based medical care, the burden of chronic diseases that result from untreated obesity will continue to grow. Real solutions for obesity will come with a deeper understanding of this complex disease and treatment options that really work for people who have it.

Click here to read Farley’s commentary.

Shining, photograph © Ted Kyle

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December 20, 2015