POLICY BRIEF
TARUN SINGH
CHILDHOOD OBESITY IN THE US -
EATING OURSELVES TO DEATH?
YR: 4 SEM: 2 TF: ANKUR PANDYA
Overview
• Childhood Obesity in the US is alarmingly
high and trends show that these rates have
increased over the past few decades.
• There are tremendous health risks associated
with obesity, including heart disease and
diabetes.
• Genetics, physical inactivity and dietary
patterns all contribute to elevated obesity.
• In order to ensure that children today do not
die younger than the generation before them,
we will need to institute an intervention. That’s
why I recommend that we provide parents with
the tools needed to instill healthy eating and
physical habits at home while increasing the
physical activities offered by public schools.
Why Should You Care?
Childhood Obesity Over Time
Source:http://nccic.acf.hhs.gov/afterschool/
fitness_nutrition.html
• Almost one out of every three children in the
US is either overweight or obese, that comes
out to over 23 million children and teenagers.1
• Obesity in children leads to higher rates of
high blood pressure, type 2 diabetes, heart
disease, sleep apnea, stroke, asthma,
depression and even cancer.2
• There are also psychosocial risks associated
with childhood obesity, such as low self-esteem
and societal discrimination. These risks can
impact academic performance and societal
functioning.3
• Obese children have a higher risk of becoming
obese adults, so preventing obesity at an early
age is crucial.4
• The financial burden that comes with
childhood obesity has a large impact on the
economy of the entire nation. It is estimated
that $14 billion are spent each year on direct
health care costs stemming from childhood
obesity.5
Defining Obesity
• The CDC defines childhood obesity using the
Body Mass Index (BMI). The BMI measures
weight in relation to an individual’s height to
determine if they are overweight or obese. The
BMI is the preferred metric since it is
correlated with body fatness while being non-
invasive.6
• In order to be classified as obese an individual
must have a BMI in the 95th percentile or
higher for children of the same age and sex.7
Current Status and Trends
• Estimates of obesity in children and
adolescents range from 16% to 33%.8

• Obesity rates vary by income, region and race.
Typically, the southern US has higher rates of
obesity. Up to 24 percent of Hispanic and
African American Children have a BMI
considered obese.9
• Hispanic boys, and African American girls
have the highest prevalence of childhood
obesity.10
• Obesity rates for children ages 6-11 have more
than quadrupled in the last four decades.11
Geographic Obesity Prevalence Among Low-
Income, Preschool-Aged Children 2006-2008
Source: http://www.cdc.gov/obesity/childhood/
lowincome.html
Factors leading to Childhood Obesity
• Genetics contribute to being overweight –
children with obese parents are twice as likely
to become obese. Yet, genetics don’t entirely
explain the increase in obesity over the past
few decades. Genetic characteristics of the
population have been relatively similar over
time but obesity has increased.12
• Having a sedentary lifestyle, marked by
physical inactivity, increases the risk of
obesity. 43% of adolescents watch more than
two hours of television per day.13
• Environmental factors such as the availability
of unhealthy foods at home and at school make
children more likely to become obese.14
• While physical inactivity has increased, the
average daily food intake of children has
increased. Consumption of fast food has
tripled in the last 30 years and children are
bombarded with commercials about unhealthy
foods like candy and soda.15
Possible Barriers to Change
• Changing people’s behaviors such as the level
and quality of food consumed as well as
moving away from a sedentary lifestyle is
difficult and takes time.
• Our target audience here is children, and
children don’t make their own decisions –
parents make many of the decisions and they
may see any advice about how to raise their
children as being paternalistic.
Possible Solutions and their Pros/Cons
Intervention 1: Healthier foods in US schools
• Many children eat one to two meals a day in
schools. Children aged 2-19 get 46% of their
vegetables in the form of French fries despite
the amount of oil and fat.16 Ready access to
sugary drinks such as flavored milk and soda
vending machines is also a contributing factor.
Thus, I recommend a nationwide ban on high
sugar drinks and a complete overhaul of school
menus to focus on fresh, and healthy options
instead of precooked, fried foods.
• An advantage to this approach is that it can
instill children with good eating habits early on
which can carry over to later in life.
• A problem with this intervention is that it
doesn’t control what children do when they are
not in school and it will be expensive to switch
to fresh food that is not precooked, which
 many school districts may not be able to
afford, and it also doesn’t ensure that parents
will teach their kids how to make healthy
decisions outside of school. In fact a review of
obesity interventions showed that interventions
focussed on changing school food were not
efficacious without additional interventions. 17
Intervention 2: Tune out when school is out
• The growth of media such as television, video
games, and computers has led to fewer hours
of physical activity. Furthermore, television
and other media provides parents and
babysitters with an easy way of supervising
children, thereby exacerbating the problem of
inactivity. Therefore, it would be worthwhile
to increase physical activity in schools by
enacting programs like subsidized after-school
programs such as school sports teams for
elementary and middle school children.
• This program would directly encourage
participation in physical activities like sports
and would provide parents who cannot afford
little league fees to have healthy options for
their children.
• Two major problems with this program are the
costs associated with establishing such a
program and that there is no guarantee that
parents will have their children participate in
these after-school activities.
Intervention 3: Going back to School
• Children belonging to lower socioeconomic
levels are more likely be obese, and this is
partly due to parents buying cheap, unhealthy
food and not encouraging enough physical
activity. Thus, mandating employers offer a
seminar program designed to educate parents
on how to provide their children with healthy
and affordable food, physical activities to take
part in and how to teach their kids to make
healthy decisions on their own would be
worthwhile.
• This program would be effective since parents
wouldn’t have to take time off from work to
take part in the seminar, as it would be a part
of their employer’s requirement. Employers
would also have an incentive to take part in
this program because it would lower the health
care premiums they pay for their workers.
• Ultimately, there could be some small costs
associated with such a program and it still
comes down to whether parent implement
what they learn in the seminars, at home.
Recommendations:
• If given the choice to implement one program,
I would choose intervention 3 since it focuses
on parents who are the main food purchasers
of a family. Providing parents with practical
tips on how to shop/cook healthy and how to
incorporate physical activities into family time
would instill children with the necessary
values moving forward. Some studies have
shown that educational programs targeting
parents is more effective at reducing childhood
obesity than only targeting children,
suggesting interventions like this one would
work.18 Also, the impact on insurance costs
makes the program a win-win for parents,
children and employers.
• If I had to choose a second intervention, I
would implement intervention two because
increasing physical activity can help burn the
calories children are consuming from
overeating or poor eating choices. The
intervention also gives parents with limited
monetary resources a means to have their
children involved in activities that promote
active lifestyles. Physical activity can not only
limit obesity but probably has other health and
social benefits as well. Not only does this
intervention make sense logically, expert
committees have recommended increasing
school based physical activity to lower obesity
rates. 19
Addenda
Resources for More Information:
http://www.surgeongeneral.gov/obesityprevention/index.html
http://www.cdc.gov/obesity/childhood/index.html
http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolescents.htm

How to Calculate Your Own BMI:

or use
http://apps.nccd.cdc.gov/dnpabmi/

Works Cited:
1 "Childhood O b e s i t y. " R o b e r t Wo o d J o h n s o n F o u n d a t i o n . 3 M a y 2 0 1 0 . <http://www.rwjf.org/
programareas/Chil dhoodObesityFramingDoc.pdf
2 "Obesity and Overweight for Professionals: Health Consequences." Centers for Disease Control and

P r e v e n t i o n . 3 M a y 2 0 1 0 . < h t t p : / / w w w. c d c . g o v / o b e s i t y / c a u s e s / h e a l t h . h t m l>.
3 Swartz MB and Puhl R. “Childhood obesity: a societal problem to solve.” Obesity Reviews, 2003; 4(1): 57–71.
4 " C h i l d h o o d O b e s i t y. " R o b e r t Wo o d J o h n s o n F o u n d a t i o n , We b . 3 M a y 2 0 1 0 . <http://www.rwjf.org/

programareas/Chil dhoodObesityFramingDoc.pdf
5 ibid
6 "Obesity and Overweight for Professionals: Childood: Defining." Centers for Disease Control and

P r e v e n t i o n . 3 M a y 2 0 1 0 . < h t t p : / / w w w. c d c . g o v / o b e s i t y / c h i l d h o o d / d e f i n i n g . h t m l>.
7 ibid
8 " O b e s i t y i n C h i l d r e n a n d Te e n s . " American Academy of Child & Adolescent Psychiatry: Facts for

Families 79 (2008). 3 May 2010. <http://www.a ac ap.org/galleries/FactsForFamilies/

79_obesity_in_chil dren_and_teens.pdf>.
9 " C h i l d h o o d O b e s i t y i n t h e U n i t e d S t a t e s : F a c t s a n d F i g u r e s . " Institute of Medicine of the National

Academies ( 2004). 3 May 2010. <http://www.act ivelivingresources.org/assets/

Childhood_obesity_fact _sheet.pdf>.
10 ibid
11 " C h i l d h o o d O b e s i t y. " R o b e r t Wo o d J o h n s o n F o u n d a t i o n . 3 M a y 2 0 1 0 . <http://www.rwjf.org/

programareas/Chil dhoodObesityFramingDoc.pdf
12 " C h i l d h o o d O b e s i t y i n t h e U n i t e d S t a t e s : F a c t s a n d F i g u r e s . " Institute of Medicine of the National

Academies ( 2004). 3 May 2010. <http://www.a ct i vel ivingresources.org/assets/

Childhood_obesity_fact _sheet.pdf>.
13 " T h e S u rg e o n G e n e r a l ' s C a l l To A c t i o n To P r e v e n t a n d D e c r e a s e O v e r w e i g h t a n d O b e s i t y. " O ff i c e o f

the Surgeon General, 01 Jan 2007. 3 May 2010. < http://www.surgeongeneral.gov/topics/obesi ty/
calltoaction/fact_adolescents.htm >.
14 " C h i l d h o o d O b e s i t y. " R o b e r t Wo o d J o h n s o n F o u n d a t i o n . 3 M a y 2 0 1 0 . <http://www.rwjf.org/

programareas/Chil dhoodObesityFramingDoc.pdf
15 " A f t e r s c h o o l I n v e s t m e n t s P r o j e c t . " A d m i n i s t r a t i o n f o r C h i l d r e n & F a m i l i e s , A u g 2 0 0 6 . 3 M a y 2 0 1 0 .

<http://nccic.acf.hhs .gov/afterschool/fitness_nut ri tion.html>.

16 ibid
17 Bautista-Castano, et al. “Effectiveness of Interventions in the Prevention of Childhood Obesity.” European Journal of

Epidemiology, 2004; 19(7): 617-622.

18 Golan, M. & Crow, S. “Targeting parents exclusively in the treatment of childhood obesity: Long-term results.” Obesity

Research, 2004; 12, 357-361.

19 Barlow, S.E. & Expert Committee. “Expert committee recommendations regarding the prevention, assessment, and 17

treatment of child and adolescent overweight and obesity: Summary report.” Pediatrics, 2007; 120: S164-S192.