Balancing Hope and Facts in Childhood Obesity

Hope and facts live together in an uneasy relationship. We have an excellent example before us as we digest the latest trends in childhood obesity. Specifically, we’re looking at the prevalence in children between the ages of two and five. In new statistics for 2016, the number reached a new high: 13.9%.

Perhaps you recall this headline from 2014:

Obesity Rate for Young Children
Plummets 43% in a Decade

A Cherry-Picked Statistic

At the time, ConscienHealth and others pointed out that this number was misleading. It was pointing to a statistically unreliable trend. More likely, the number was just noise in relatively thin data.

But hey, this number felt really good to people who wanted to prove that their pet projects for childhood obesity prevention were working. HHS asked for a press release “skewed to highlight the good news.” It was neatly timed to help celebrate the Let’s Move! program’s five-year anniversary.

Soon, folks in the obesity prevention industry also started touting their success. In 2015, the Robert Wood Johnson Foundation issued a progress report and CEO Risa Lavizzo-Mourey said:

We feel like there’s a real momentum going at the moment. We’ve turned the corner on this obesity epidemic.

Swatting Away Doubters

Naysayers are a nuisance. When new data came out in 2016, Asheley Cockrell Skinner and colleagues carefully analyzed the trends and concluded:

The significant decline previously reported in prevalence for 2- to 5-year olds for 2003–2012 is not evident in our results, for girls or boys, when using all data from 1999 to 2014.

In a commentary published simultaneously, Bill Dietz dismissed those doubts, saying, “It all depends on how you look at it.” He went on to say:

The declines in the consumption of sugary drinks, fast food, and pizza observed over the past decade would lead us to expect a plateau in the prevalence of obesity in 2- to 19-year old youth, as well as declines among younger children in whom the caloric gap necessary to return prevalence levels to those of the 1970s is so small.

Wishful Thinking, Obvious in Retrospect

In retrospect, wishful thinking and confirmation bias are rather obvious in how public health officials look at these data. We’re all hungry for good news.

It’s very possible that the rate of growth in childhood obesity is reaching a limit. At some point, all of the children who are susceptible to obesity under current conditions will have it. The growing prevalence will slow down. Maybe that’s already started. But when the slowdown happens, counting it as a success would be a triumph of self-deception. Success will come only when we reduce the health burden of obesity.

Hopefulness need not compete with objectivity. Obesity in general and childhood obesity in particular is a wickedly complex problem. Our scientific understanding of the problem is far from complete. We are making progress. But wishful thinking gets in the way of progress.

Our hope lies in scientific curiosity and faith in objective inquiry to solve this problem.

For the latest CDC report, click here. You can find further perspective here.

Hope, fresco by Giotto / WikiArt

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October 17, 2017