BLOOMINGTON, Ind -- Issues of obesity exist at the nexus of civil liberty and collective responsibility. We claim freedom to eat anything despite health or financial consequences. But the costs are not solely ours.
A sample of obesity’s consequences include heart disease, type 2 diabetes, stroke and osteoarthritis. Heart disease, stroke and diabetes are the first, fourth and seventh leading U.S. causes of death. Annual obesity-related medical costs are estimated at $150 billion to $190 billion.
Balancing liberty and collective responsibility for health, then, is a primary challenge of public health. The Obama administration leads our collective effort with focus on primary drivers of obesity: healthy eating and physical activity. Success depends on these efforts and upon reform of yet another expression of civil liberty: lobbying.
In 2010, the Obama administration initiated a National Task Force on Childhood Obesity, the first such Cabinet-level effort. Examples of outcomes include a campaign to increase physical activity, production incentives to increase availability of healthier foods, revised food labeling, physical activity and nutritional standards; monitoring food marketing to children and increasing access to healthy food retailers in underserved communities.
A specific example is a shift in the national children’s nutrition effort to support purchase of fresh fruits and vegetables, and vouchers at farmers markets across the country.
We might also associate the administration’s efforts with first lady Michelle Obama. She has normalized conversation about healthy eating and exercise through the White House Kitchen Garden, while speaking openly about feeding her family in the face of overwhelming junk food marketing to children. She uses her role well with industry and engages communities to increase physical activity with the Let’s Move! campaign.
Efforts appear to be paying off. CDC’s recent report that obesity rates dropped in most states between 2008 and 2011 is an encouraging sign that we may be headed in the right direction.
While we are seeing glimpses of improvement, there are miles yet to go because our weight is triple what it was 30 years ago, our portion sizes are astronomical, we walk half as much, and many communities are reducing physical activity in schools. Lasting impact on obesity will not be seen right away — or at all — unless we engage in lobbying reform.
The administration’s efforts are bold and could be more so, but they have been met with tremendous industry resistance.
Recent analyses by Reuters described a threefold increase in lobbying efforts and resource directed toward this administration by the food and beverage industry. This began in 2009 as Congress was considering a soda tax, and continued with focus on nutrition, labeling and junk food marketing.
It is no surprise that in 2011 Congress rejected proposed USDA school lunch standards while assuring that tomato paste continued to have four times the “extra vegetable serving credit” than it actually had.
Such insular outcomes are reinforced by the revolving door between Congress and lobbying firms. This year, the Center for Responsive Politics reported that 57.2 percent of food and beverage industry lobbyists are “revolvers” — rotating between federal government and roles as consultants and strategists on K Street.
Leading the change in the obesity epidemic requires vision and courage. We see evidence of both in the administration’s public health policy efforts.
Now we have to assure the conditions that will facilitate change. We as citizens need to “step it up” — in the words of Michelle Obama — not just to eat well and increase physical activity, but to call for lobbying reform in the name of public interest.
Without it, we essentially tie one hand of the administration behind its back in the fight against obesity. This problem is not reserved for the obesity policy arena, but is a structural challenge to democracy that must be addressed for the public good.
Beth Meyerson is an assistant professor at the Indiana University School of Public Health, co-director of the Rural Center for AIDS/STD Prevention and national policy director of then Cervical Cancer-Free America.