Whose responsibility is childhood obesity?

With the obesity crisis in America, one of the major reasons for increasing health costs, the issue of the causes inevitably arises.

There seem to be two sets of causes postulated by a growing crowd of experts. Unfortunately, each set is aligned in our current polarized political climate with the right or the left.  Each set of causes has some basis in reality, but neither fully explains the problem.

On one side of the argument are those who claim that the core problem is a set of interconnected large corporate entities that control food production from the planting of crops to either the grocery or fast food outlet.  As a nation, we produce far more calories than we need per person to survive, so it is in the corporate interest to encourage us to consume those excess calories.  In addition, with the heavy emphasis on certain crops, such as corn, we have too many foods that are high in calories, low in nutrients and sweetened, which are aggressively marketed to children and families.  To listen to these critics, American families are awash in a sea of high fructose corn syrup, and forced too often by the fast pace of life to consume convenience products and fast food.   In some food deserts in the cities, there are no grocery stores, no places to buy fruits and vegetables and no healthy choices. In these places, families have few options.

On the other side of this debate are the personal responsibility advocates.  Their message is quite clear and simple.  What we eat, and what we feed our children is our choice.  If families choose wisely, their children will eat nutritious food, grow up healthy and not have weight problems.   It is parents who feed children, not corporate America, and it is parents who need to change their behavior.   Whenever the discussion of children and obesity arises in some of the more conservative media outlets, the pundits shake their heads sadly and point to parents as the cause of this looming health crisis.

Perhaps there is a middle ground, and with some thought, there could be compromises that would help children.   First, we should recognize that children need healthy foods.  Indeed, childhood obesity should not be considered a problem by itself but rather a symptom of a larger problem of how we value and raise our children.  An obese child is not a healthy child; obese kids are, in fact, often frequently malnourished because they are not receiving appropriate nutrients from their food. They are overweight not just due to too many calories, but because they’re eating low quality foods.  So, perhaps as a community, a state, a nation, we can agree that children need access to healthy foods, just as they need clear air to breathe and clean water to drink.   If we start with that assumption, we can than make the needed changes in all the places where children are fed – at home, in school, at child care, at camp.

Second, it is time that we all take the personal responsibility for this effort seriously.  That means the adults need to look at home and where they work and ask if they are being personally responsible for the health of children.  Some corporations have already started down that difficult road.  Wal Mart, for example, has a policy now of attempting to competitively price healthy foods in their stores.  Others have not yet risen to the challenge.  A recent stockholders meeting at McDonald’s indicated that shareholders insist on the right to market unhealthy products to children with Ronald McDonald.   If we are being personally responsible, we need to take it everywhere with us.  Our schools need to be healthy.  Our child care settings need to be healthy.  Those who work in the food industry should examine what they are doing.  Stockholders of larger food related corporations should ask themselves if they are being responsible to their customers.

It’s easy to talk about personal responsibility and point the finger at the parent of an overweight child.  It’s much harder for us in society to look at our own role in this issue and ask what we have done to change things.  All children are entitled to healthy food, clear air and clean water. It’s going to take passion and purpose to change the environment for kids. We all need to stop pointing fingers and get to the task of achieving that goal.

Doug Tynan is an Associate Professor of Pediatrics at Jefferson Medical College.

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  • Anonymous

    I appreciate your article, but still argue that >90% of the responsibility lies with the parents. Perhaps I am considered “right wing,” but I see it as common sense. Frequently, overweight children are the spawn of overweight parents. This isn’t genetics, it’s bad parenting – “If it’s OK for me, why isn’t it okay for little Timmy?” And I DO agree that corporate greed will take advantage of EVERY fiscal opportunity, good or bad (see 2008 financial collapse). However, we have a FREE market, and the ability to choose our foods, however convenient. If the lunchroom serves poor food cvoices, pack your kids a lunch. Take responsibility for your kids! If this is too much for a parent to handle, perhaps they shouldn’t have any more kids. Unfortunately, advocates such as you always give these parents an out. I guess when all of the government funding runs out, we won’t be worried about childhood obesity anymore. But that’s just sad…and call me “right wing.”

  • http://www.facebook.com/profile.php?id=100000977601479 Melissa Gastorf

    While I will concede on the school and child care setting should serve healthy food, I hesitate to let the parents off that easy.  We have become a society where it is ok to let the child decide what is best for them.  I cannot tell you how many parents who bring their 200 pound teenager in to talk about what they are sure is a thyroid problem say their child eats a normal amount of food.  What is normal?  12 in sub from subway, a large pizza and a hungry man dinner.  That is just dinner.  The concept of portion control is gone.  I see a lot of lower income individuals, and this is not an unusual presentation after having not seen the child in 6 months to two years.  
    Exercise consists of playing on the Wii and maybe being forced to take the stairs at school.  We have a generation of adults who stopped being the parent and started focusing so much on themselves, they forget that children are not just miniature adults.
    As for the schools, while their foods have never been the epitome of good nutrition, I have yet to see a school lunch program that could be thought of as remotely healthy.  There are few choices, and many children are allowed to go back for seconds and in the case of one child thirds.  While I am all for making sure that a child does not go hungry, when is thirds ever necessary?

  • http://twitter.com/DrDrRose Dina Rose

    It is incredibly clear that parents are responsible for how they feed their children, but that the task-at-hand is made much more difficult by the current food environment.  It’s not just fast food restaurants and food manufacturers who are to blame however.  The current emphasis on nutrition has made people look inside foods for nutrients rather than consider foods as whole entities.  Once we’re looking at nutrients, not only is the food world more difficult to decipher, but it’s hard not to make food choices that seem good (chocolate milk for calcium) but which produce bad habits (increase sweetness tolerance so kids don’t like less sweet items like vegetables!).  The answer is to encourage parents to identify the lifelong habits they want their kids to adopt and then feed them accordingly.

    Are fast food restaurants a problem? Sure. Is marketing awful? Absolutely. Do school lunches need to be fixed? Without a doubt. But the research shows that preschoolers aren’t eating the way they should – more sweetened bevs and desserts than fruits and vegetables.  This doesn’t happen because parents don’t know fruits and vegs are healthier than donuts, it happens because they don’t know how to get their kids to eat fruits and veg.  One reason is that parents have stopped thinking long term habits, and started thinking nutrition. It’s counterintuitive, but true.

    Dina
    http://www.itsnotaboutnutrition.com

  • http://www.facebook.com/people/David-Brown/692744221 David Brown

    Dr. Tynan,

    You said, “All children are entitled to healthy food, clear air and clean water.
    It’s going to take passion and purpose to change the environment for
    kids. We all need to stop pointing fingers and get to the task of achieving that goal.” Agreed.

    Problem is, the fingers are pointed in the wrong direction. The government’s dietary advice is at fault(1,2) and very few health professionals know it because they’ve been misled by their educational experience. They’ve been taught to believe that saturated fats are a health hazard(3). This fallacy is reinforced by an almost constant barrage of negative publicity based on questionable assumptions regarding the interpretation of research(4). Until this issue gets resolved, food manufacturers will continue to configure their products with omega-6 industrial seed oils which are truly hazardous to our health in the quantities we currently consume(5,6).

    References
    1. http://freepressonline.net/content/what-has-government-done-our-health
    2. http://dietheartpublishing.com/25-reasons-the-2010-dietary-guidelines-are-wrong
    3. http://www.youtube.com/watch?v=vRe9z32NZHY
    4. http://hartkeisonline.com/weight-loss/will-misguided-saturated-fat-beliefs-cause-weight-gain-in-school-children/
    5. http://www.psychologytoday.com/blog/evolutionary-psychiatry/201103/your-brain-omega-3
    6. http://raypeat.com/articles/articles/fats-degeneration3.shtml

  • http://www.facebook.com/profile.php?id=826734007 David Hanson

    The parents — 100% — they decide what to buy.  There is a 12 year old boy at our church that looks like he weighs 150 pounds.  Who bought and is buying the food to get to that weight?  HIS PARENTS!

    • Anonymous

      This goes triple for a morbidly obese preschooler….who is clearly NOT using her birthday money to buy Pringles and Little-Debbies on her own trips to the store.

  • Anonymous

    Note in this bogus article, there is not one mention of the huge impact of bogus psychiatric stigmas to push lethal drugs in bed with BIG HARMA (PHARMA) THAT CAUSE OBESITY.  Atypical antipsychotics now among the #! global drug poison sellers of BIG PHARMA are useless but lethal drugs to inflict chemical lobotomies for social control, silencing and discrediting those who see through the psychopathic power elite (POLITICAL PONEROLOGY) and/or suffering from the traumatic stress psychopaths/malignant narcissists cause normal humans (WORKING WITH MONSTERS, THE SOCIOPATH NEXT DOOR, BULLY ON LINE web site, SNAKES IN SUITS, etc.). See online articles by Dr. Paula Caplan about the elephant in the living room of psych drug induced obesity and what a sadistic cruel thing to do to women experiencing life problems or social distress, abuse who already feel bad enough about themselves in a world where woman are pressured enough to be thin.  Also, obesity in children is guaranteed to cause horrible bullying, just what a child probably experiencing family problems, divorce, abuse related trauma or other social distress needs.   Remember psychopaths who can do this to people have no empathy, no conscience, no human bonds of love and friendship, so they focus on winning over and power over people, greed, status and social harm out of boredom as descibed by the world’s foremost authority on psychopaths, Dr. Robert Hare, psychologist,  in his great book, WITHOUT CONSCIENCE: THE DISTURBING WORLD OF THE PSYCHOPATHS AMONG US.   He invented the PCL-R test to diagnose psychopaths used accepted and used world wide.

    See PHYSICIAN’S DESK REFERENCE for most effects of all useless but lethal psych drugs and tons of books and articles on the web.  Atypical Antipsychotics are now pushed on every vulnerable human from the cradle to the grave literally.  They not only cause drug induced OBESITY, DIABETES, HIGHER CHOLESTEROL, METABOLIC SYNDROME, HEART DISEASE, STROKE, CATARACTS, GLAUCOMA, SUICIDE, BRAIN DAMAGE, TARDIVE DYSKINESIA, NEUROLEPTIC MALIGNANT SYNDROME, DEMENTIA, EARLY DEATH BY ABOUT 25 YEARS  and other horrific damage to the human body, but a loss of the victims’ very humanity.   And most falsely stigmatized as mentally ill are not dangerous though the drugs forced on them can make them appear so while the true danger is the mental death profession knowingly inflicting bogus, life destroying stigmas to push lethal drugs they know cause violence and suicide in addition to poisoning the body.  Most if not all public shooters have been on these deadly drugs and they rank in the top 25 drugs with Chantix #1 causiong VIOLENCE!!  See Time article and others.  Now the mental death profession is pretending to have solutions to the obesity THEY INFLICT as the wolves in sheep’s clothing they are as they inflict all the above horrors on the normal people they maliciously falsely label for greed, power and status as they do for their drug induced suicide, violence and mania they use for worse stigmas like bipolar and more laws for social control.  They are even threatening to remove obese children from parents fro their own drug induced obesity just as they do when parents refuse to accept their bogus, unscientific stigmas and lethal drugs for their children.  WAKE UP WALL STREET AND OTHER PROTESTORS ABOUT THE REAL GLOBAL MENACE!!  YOUR VERY FREEDOMA ARE AT STAKE AS IN NAZI GERMANY AND STALINIST RUSSIA  WITH PSYCHIATRY USED TO MAKE DISSENTERS DISAPPEAR!  Or render them silent as in ONE FLEW OVER THE CUKOO’S NEST.

    Since any so called doctor can see the victim literally blowing up to obesity before his/her eyes after presribing these poisons, with so much evidence that these drugs only do harm with no benefit except to silence those bullies in power want silenced, anyone prescribing these drugs is nothing but a sadistic psychopathic criminal.  Plus, drug companies have been forced to put add these lethal effects to their labels and medical liturature for doctors once exposed by lawsuits, so no doctor can pretend ignorance.  Perhaps incompetence and malpractice, but not lack of information available.

    It’s time these so called health writers include one of the main causes of an explosion of obesity; the explosion of the mental death profession with its BOGUS FRAUD biological psychiatry with the latest fraud fad of bipolar disorder fueled by “Dr. Joseph Biedeman of Harvard exposed as a mere paid shill of BIG PHARMA making hidden millions with his cohorts to fuel bipolar diagnoses in children and toddlers no less among others as the fiend did for ADHD to push kiddie cocaine and now these deadly antipsychotics, and so called “mood stabilizers” like Depakote, another BIG PHARMA ploy that can cause liver damage.  The death of four year old Rebecca Riley with this bogus bipolar fraud diagnosis and on the lethal cocktail Biederman recommended for bipolar fraud as a “god” of psychiatry per his malignant narcissistic claims like many similar deaths and disabilities in children is thanks to this so called expert/god of psychiatry who also promised positive results in advance for so called studies he was paid to do for BIG PHARMA companies like Johnson & Johnson.  He is the poster boy of why psychiatry and its lethal drugs should be abolished.  Also, see lawsuits online for obestiy inflicted diabetes from atypical antipsychotics and Dr. Peter Breggin’s recent court win of SSRI antidepressant induced violence in a teen that led to a bizarre unlikely murder of a peer and many others for the many deadly disabilities like tardive dyskinesia on his web site.  The judge clearly saw this nightmare was caused by SSRI’s!  Dr. Peter Breggin is recognized as the conscience of psychiatry and wrote the great warning book, TOXIC PSYCHIATRY, many years ago to warn everyone that the most dangerous thing you could do is visit a psychiatrist since you are guaranteed a bogus label and prescription after a 10 to 15 minute visit. 

    Do your homework if you expect to survive in this pathocracy.

    Author please do your homework and/or if you are part of the mental death profession scam trying to sidetrack from and hide this issue, you are all too typical since BIG PHARMA has many paid front groups and other paid shills like NAMI, CHADD, BIPOLAR groups, etc.

    For those sadistic liars who claim the benefits of these dangerous drugs outweigh the “side effects” for those who are even willing to admit them since these psychos mostly don’t give informed consent, see books ANATOMY OF AN EPIDEMIC, THE MYTH OF THE CHEMICAL CURE, YOUR DRUG MAY BE YOUR PROBLEM, 2nd ed., THE TRUTH ABOUT THE DRUG COMPANIES, THE EMPEROR’S NEW DRUGS, TOXIC PSYCHIATRY, MEDICATION MADNESS, BRAIN DISABLING DRUGS, 2nd ed.,  MAD IN AMERICA, MANIA: A SHORT HISTORY OF BIPOLAR DISORDER, ADHD FRAUD and countless web sites exposing this evil fraud LIE as described in Dr. M. Scott Peck’s THE PEOPLE OF THE LIE about malignant narcissists who refuse to see or admit their evil crimes so the scapegoat and destroy others.  Recent studies have proven all of these drugs are no better than placebo for the so called illnesses they are supposed to treat like depression (not a chemical brain imbalance per BIG PHARMA ad ploy) while causing much damage and permanent disbility and death.  The military or VA has finally admitted these drugs approved by the FDA also in bed with BIG PHARMA like corrupt politicians to treat trauma and other distress of soldiers are TOTALLY USELESS in addition to being toxic, so they plan to seek alternatives since soldiers are committing suicide in droves thanks to the mental death profession professing nothing but lies and fraud.

    Oh, by the way, BIG PHARMA is now passing off the lethal antipsychotics as antidepressants with its tons of ads to sucker more victims as many of these drugs are coming off patent.  They recommend using them with their dangerous SSRI antidepressants that cause mania and other iatrogenic (physician/drug induced) effects the fiends can label bipolar, etc. to push antipsychotics and so other so called mood stabilizers like useless but deadly Depakote, etc.  Now, they are pushing the lethal cocktail in advance and talking about bipolar depression!!!  CAVEAT EMPTOR!!  That’s the new ploy of the mental death profession in its bogus bible, the DSM 5, to falsely accuse people of being at risk for these bogus unproven, unscientific stigmas so they can push more lethal drugs on a brainwashed public.   THE DSM 5 all mental death experts must use to diagnose so called mental illness is created by the white old boy network power elite by VOTING such labels in and out as they did with homosexuality with no scientific or medical evidence whatever nor any tests such as x-rays or blood tests to prove anyone has them.  Dr. Thomas Szasz, psychiatrist, and long term critic of biological psychiatry as a means of social control has compared it to slavery, the inquisition and witch hunts and claims being an expert in psychiatry is like being an expert in unicorns, witches or astrology.

  • Anonymous

    Forget the blame game.  It is a crisis situation …. 

    There are 3 substances that cause us to overeat – sugar, fat and salt.   Yes, we need some of these substances but only what our DNA was designed to handle – everything else is basicly a RISK and these substances in their highly processed, excessive amounts are addictive.   We now have access 24/7.  The US has the worst problem – other countries are close behind – the indicator for unhealthy eating is primarily obesity rates (but even slender people can consume too much unhealthy food).  The US leads at 34% obesity rate with the highest incidence of chronic preventive diseases and hence (because they are all treated to the max) health care costs are also the highest in the world – at least 2/3 for these (conditions) diseases.  Yes, yes reform should help some aspects but won’t change our eating culture.

    So lets get real – there is only one way to attack this problem (a public health problem).  Follow the tobacco model - it worked – a decrease from 65% to 20%.   Revenue is needed to fix our food system, a strong message must be put on the food with high risk, the unhealthy food ads (especially to kids must be stopped) and so must farm subsidies that make such food so cheap – corn primarily.    

    It can be done – with have Nutrition Facts in grams and mg to calculate the, shall we say RISK tax -Reduction in Sickness .  Just stop the silly labels of fat, junk tax and the idea of food nazis – all of it is propoganda from those who would lose market share if we had a healthy population.  Surverys have been done – taxpayers are ready as long as it is dedicated to helping people with an eating problem.  Grow enormous amounts of vegetables and fruit and subsidize local farmers so they are everywhere (jobs, jobs for local farmers, others in this local business) , change the landscape in the midwest) and decrease the burden on taxpayers for healthcare costs. 

    There are many countries now dealing with this issue.  Hungary and Denmark are doing something, other countries will come around because they have to.  Again – it is a global crisis.   It is time for the US to be a leader and fix its basic systems that are failing – the health of its population, the education of its children,  a crumbling infrastruction.  

  • Anonymous

    Any chance of leaving the tin-foil hats off long enough to stop blaming “Big Food” for our fat children?  Parents decide what children eat, and  many parents are far too lazy to provide healthy food…or discipline, or attention…to their kids.  Shove easy food at them, park ‘em in front of the TV or X-box, and suddenly this whole “parenting” business doesn’t take up that much of your time and energy.

    Now, add this to the number of single-mother households, who are busy either (A) working or (B) trying to snag a new man…..and the child gets half the attention they would get in an intact family.

    And that isn’t even the tip of the iceburg.  Anyone else seen the data about the academic and social performance of kids who sit down to dinner with the family at least five nights a week?

    Let’s stop ignoring the obvious, please.

  • Joe Kosterich

    Lets forget blame and use the word responsibility. Who is responsible for what a child eats? The parent or guardian. It is a function of what they buy and put on the plate. Yes lets support them but not pretend that anyone else is ultimately responsible OR in a position to actually bring about change