America’s obesity problem is getting worse. Despite all the new medications, exercises, diet plans, tummy jigglers, and cryotherapies, the prevalence of obesity between 2007 and 2016 increased from 34% to 40% in adults and from 17% to 19% in children.
Yet at the same time, the research community has made massive strides regarding health benefits of specific diets and lifestyle interventions to treat and prevent obesity, along with gaining a much better understanding of the causes of obesity from the moment of conception onward.
So why are we losing the battle?
The Trump administration and the last few sessions of Congress have ignored major scientific advances regarding effective means to combat obesity, particularly in childhood. Sadly, the evidence suggests that this is a conscious federal effort to delay or even eliminate children’s health programming when it conflicts with big business in general and big food in particular.
The greatest beneficiaries of legislative support would be our children, who respond much better to non-surgical weight-loss interventions than adults do. The science of what we can do for kids is no secret. Over the past 15 years, states have made significant improvements in schools and communities by promoting children’s access to healthy food and physical activity. This programming could be even more effective with backing, instead of opposition, from Washington.
Despite the clear benefits of better nutrition and exercise for our children, Congress has left numerous well-crafted bills languishing in committees away from full votes, so that there is no possibility that they might actually pass.
The Stop Subsidizing Childhood Obesity Act, first introduced in 2012, would have ended federal tax subsidies for advertisements that promote unhealthy food, routed the additional tax revenues to provide better nutrition programs to low-income elementary schools, and resulted in more taxes for big food. The bill has been recycled annually from committee to committee and never voted on. The Treat and Reduce Obesity Act, which would improve insurance coverage for obesity, and the Sugar-Sweetened Beverages Tax (SWEET) Act, which would tax sweetened beverages, were first proposed in 2012 and 2014, respectively. Neither bill has come to a vote.
In contrast, the pro-business and anti-Affordable Care Act efforts by the Trump administration via the American Health Care Act of 2017 made it from proposal to congressional vote in just three months.
In addition to blocking pending legislation, the Trump administration is actively working to undermine effective children’s health programs that already exist. For instance, in 2017 the USDA issued a rule exempting schools from meeting some of its own nutrition standards. But healthier school lunches have been shown to improve academic performance.
How we would pay for these programs is a legitimate concern. Fortunately, they more than pay for themselves, with lower projected health care costs ranging from $5 for every dollar invested in better school lunches to over $30 for every dollar invested in implementing the tax on sugar-sweetened beverages.
Certainly, lack of government cooperation with science to promote good health is not unique to this administration. The 1992 Food Guide Pyramid offered flawed nutritional guidance, and the federal government was chastised for inattention to childhood obesity in 2006. However, no previous administration has worked so hard to remove programming that is clearly beneficial to our children’s health.
Obesity costs us over $200 billion per year in direct health care costs alone, according to 2012 research. Obesity can’t remain a toxic issue for politicians. Government should work with biological and sociological scientists to make pragmatic decisions at all levels. Are we going to prioritize big business over children because young citizens don’t vote or make campaign contributions?
Michael Rosenbaum is a professor of pediatrics and medicine at Columbia University Medical Center. He has spent over 25 years studying obesity in children and adults.