Few other public health issues have drawn as much attention, and garnered as much support for policy and programming as obesity. Obesity programs have been initiated and implemented at the federal and state levels, and all fifty states currently have early childhood education physical activity and healthy eating regulations and policies (The State of Obesity, 2018). All the major national public health research organizations, including the Centers for Disease Control and Prevention and the National Institutes of Health likewise inform and promote obesity-related policies and programs. Government agencies like the Food and Drug Administration and the USDA also have distinct policies and programs. In spite of the abundance of both private and public funding for anti-obesity research, policy development, and programming, the majority—two-thirds—of American adults are overweight or obese, and more than a fourth of all healthcare costs in the nation are consumed by obesity-related issues (Levi, Vinter, Richardson, et al. (2009). With a few exceptions, obesity policies in general have been relatively ineffective at reducing overall rates of obesity or changing public health trends.
The most effective anti-obesity programs implemented in the United States have been the school-implemented ones, particularly those that combined in-school programming when they are combined with home and community involvement (Wang, Cai, Wu, et al., 2015). School-based physical activity programs have been evaluated for their effectiveness at increasing fitness levels, reducing sedentary activities like television viewing, and reducing cholesterol, but not necessarily BMI (Levi, Vinter, Richardson, et al., 2009).
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Even when they are effective, program evaluation results have been “moderate” at best, and the majority of interventions have yielded few promising results (Wang, Cai, Wu, et al., 2015). The CDC has likewise proclaimed inconclusive evidence supporting its own school-based initiatives (Levi, Vinter, Richardson, et al., 2009). Similarly disappointing results have been found when measuring the effectiveness of obesity prevention programs administered through early childhood education in other countries. For example, one UK study showed that school-based programs led to no statistically significant reduction in overall BMI scores; the results show that “schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments,” (Adab, Lancashire, Hemming, et al. (2018, p. 1).
Among all populations, the most important reason why anti-obesity policies and programs have been ineffective is that they have failed to address some of the systemic issues at stake. Some of the overarching, systemic concerns include socioeconomic class, disenfranchisement, and persistent disadvantage: social factors that are linked with higher prevalence of the disease. In almost all countries, obesity rates are higher among lower socioeconomic groups (Kornet-van der Aa, Altenburg, van Randeraad-van der zee, et al., 2017). The connection….....
Adab, P., Lancashire, E.R., Hemming, K., et al. (2018). Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study). BMJ 360(2018): 360:k211
CDC (2018). Overweight and obesity policy resources. https://www.cdc.gov/nccdphp/dnpao/division-information/policy/obesity.htm
Kornet-van der Aa, D.A., Altenburg, T.M., van Randeraad-van der zee, C.H., et al (2017). The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: a systematic review. Obesity Reviews 18(5): 581-593.
Levi, J., Vinter, S., Richardson, L., et al. (2009). F as in fat. http://healthyamericans.org/reports/obesity2009/Obesity2009Report.pdf
The State of Obesity (2018). State policies to prevent obesity. https://stateofobesity.org/state-policy/
Wang, Y., Cai, L., Wu, Y., et al. (2015). What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obesity Review 16(7): 547-565.
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