Emergency Life Saving Equipment

Is Childhood Obesity a Public Health Emergency?

Epidemic, pandemic, syndemic, crisis, emergency: well-meaning people attach these words to obesity in general and often to childhood obesity in particular. Two decades ago, Cara Ebbeling, Dorota Pawlak, and David Ludwig proclaimed in Lancet that childhood obesity was a “public health crisis” and prescribed a “common sense cure.” But a new perspective published yesterday in Pediatrics tells us that this type of crisis mentality has brought little relief to the problem.

Instead of throwing around words that might conjure a moral panic, Eric Bomberg, Ted Kyle, and Fatima Cody Stanford write that actions can be far more meaningful:

“Specifically, it may be time to more effectively address the pediatric obesity epidemic with broader and more immediate actions. The most important first step toward this end is to increase advocacy to empower youth and families living with pediatric obesity.”

A Crisis of Behavior?

Bomberg explains that public health efforts likely have been ineffective because they presume childhood obesity is a crisis of unhealthy behaviors:

“Many of the previous public health efforts to reduce or prevent obesity largely focus on changing behaviors. However, focus only on this without addressing other forces [biological, environmental, social, and economic] is less likely to lead to any meaningful effects on reducing or preventing this disease.”

In short, we do not have more childhood obesity because children behave differently today or because parents are somehow failing to protect their health. Coaching or pressuring them to do better has not and likely will not reduce obesity prevalence.

Respecting Autonomy

Bomberg et al also point to the importance of respecting personal autonomy. People value and will vigorously defend their right to make personal decisions about their lives and their health. Forgetting to respect autonomy in the name of public health can clearly cause setbacks that outweigh any gains. COVID offered us some vivid lessons about this.

Urgent Words Versus Effective Actions

Ultimately, labeling childhood obesity a public health emergency without offering families effective options for improving their lives and health is counterproductive. Policies that reflect respect and care for the children and families living with obesity are far more important than words of panic and crisis.

Click here for the new perspective in Pediatrics and here for more from Dr. Bomberg.

Emergency Life Saving Equipment, photograph by Dietmar Rabich, licensed under CC BY-SA 4.0

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September 14, 2023