Thursday, December 16, 2010

Fighting Obesity without a "Food War"

Obesity is the pathway to a wide range of health maladies we face, including heart disease, diabetes, kidney disease--and the economic malady of high health care costs.  James R. Knickman, Founder and CEO of NYS Health Foundation, The Huffington Post, 12.14.10
As a physician, I am always looking for treatments. But with obesity, the available treatments in no way match the size of the problem. We must find effective ways to prevent obesity.  Jeanne Clark, MD, MPH Johns Hopkins University, School of Medicine, paraphrased from  presentation at Super-Sized World Conference, NYAS, 12.09.10

What can be done about the obesity crisis? First off, we have to recognize that it is a genuine crisis and that the rates of obesity are climbing at alarming rates both here and abroad.  (Childhood obesity rates have more than tripled in the last 30 years!) Part of this recognition must be to eschew the "food wars" sniping that seems to reduce the obesity problem to a question of whether school bake sales should be "outlawed" or not. Homemade cookies, or homemade food of any kind, are not fueling these obesity rates!

Parents and families are perhaps the most important resource in the fight against childhood obesity. Rather than alienating or berating parents, we have to educate them about healthy food and lifestyle choices, being sure to promote fresh food is delicious and just as fun as "fast food." Good food shouldn't be demonized or seen as "punishment" or "medicine." This discussion should be taking place in pediatricians' offices, at PTA meetings, on the playground, and in the workplace. This is not about taking away bake sales or occasional treats; this is about creating a "norm" of what a healthy balanced life looks like and feels like. Of course, I feel like regular family dinner is an important part of what normal healthy eating looks like. Encouraging family dinner is one route to promoting healthy families.

Just as there is no single villain, no single intervention may be enough, be it better school lunches, or a soda tax, or more physical education at school. Many things must come into play in order to really see a difference and reverse this trend in childhood obesity. Family dinner is a good place to start.

Related Reading:
Obesity: We Need an All-out Campaign, James Knickman, 12.14.10

Food, Obesity, and Regulation: Simmering Culture War Boils Over, ABC News, 12.15.10

From the Academic Literature:

Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010 Sep 27;170(17):1575-7.The best current treatments for obesity include intensive lifestyle coaching, which can have short-term weight reduction. This article is the latest report in a multi-year study. Unfortunately, the treatment group regained weight, on average, in the long-term. 

1 comment:

  1. It is so important that we not demonize one aspect of this and let the complexity of it all lead to NON-action.... As you constantly outline, there are many positive, reasonable steps to take... from lots of viewpoints. You make this so clear and approachable in the blog. Keep it up!

    Responsibility seems to be at the core of all of this. Each of us is responsible... no one else to blame, but every one else to turn to for help and encouraging solutions, personally and professoinally: educators, doctors, food marketers, food producers, local shop keepers, neighbors, families of friends...and co-workers & friends!

    Our cultural media images of beauty, our societal willingness to let economics rule behaviors, our personal attachments to habits that include "comfort food" and special celebratory food as bad and indulgent rather than change our ways... each offer possibilities for us to step out of the pattern and make better choices.

    Other species spend a huge amount of their energies finding food, and almost without exception there is little likelihood of obesity. Ours seeks short cuts and external impressions, the fast and cheap, rather than taking the time to nurture the body through the foods we eat. "Nutrition" and "nurture" share a common base -- Let's put that together as a cultural priority! Family meals, fresh foods with a higher percentage of vegetables, fruits & whole grains, non-processed meats, and non-sweetened beverages!

    You are so encouraging in continuously noting that we don't have to get obsessive, judgmental or directive about it... any and all steps in that direction are good in the long run.


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