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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