National comprehensive obesity prevention strategy: necessity and scope

Obesity

To what extent do we need to develop a national and comprehensive obesity prevention strategy?

Do we as a nation need to fight fat? Obesity is becoming a national epidemic affecting the lives and livelihood of men, women and children alike. Without a comprehensive educational campaign targeting children and adults about the dangers of obesity, Americans are doomed to succumb to the consequences of living an unhealthy lifestyle. A national plan that focuses on raising public awareness about obesity and encouraging as well as teaching healthy eating habits beginning at the school level is necessary for the epidemic that is obesity to be halted in its tracks.

Crister suggests that obesity can be stopped in its tracks if it is addressed in childhood (Crister, 2001). True, childhood obesity is increasingly a problem, and as Crister argues if it is not addressed early on then obesity becomes an adult problem. Further Crister asserts that controlling obesity early in life is critical to ensure healthy habits that last a lifetime (Crister, 2001). Crister is supported by Koplan and Dietz who point out that Americans are becoming dangerously fatter each and every year (Koplan & Dietz, 1999).

One method of approaching obesity from a national perspective is to address it in early childhood as Crister, Koplan and Dietz suggest. Children develop habits early on that lead to adult behaviors and outcomes. If children are taught early on the benefits of eating well and leading a healthy lifestyle, they are more likely to grow into adults that are healthy and fit rather than adults who struggle with obesity. There is much evidence supporting the notion that children need to grow up in an environment that is supportive of healthy eating habits. The National Board of Health, American Obesity Association and Surgeon General are among top officials that emphasize the importance of early childhood education with regard to obesity prevention.

The key to conquering obesity is to approach it from the standpoint that knowledge is power. Too often children grow up in a society that encourages consumption of fast food as the staple. Crister is correct in his assumption that children need to be taught the value of a healthy diet. The National Board of Health aggress that obesity is a national epidemic, and in September of 2001 began developing a proposal for a national action plan for preventing and treating obesity (NBH, 2003). The plan does not offer an ideal image of slimness, but rather suggests that the key to good health is a balanced view of body weight and health "which implies that slim does not equal healthy" but rather aims to balance the message that healthy eating promotes a positive mental outlook (NBH, 2003).

There are some that suggest that a national plan encouraging obesity prevention will encourage dissatisfaction with one's body and further the problems associated with eating disorders. As Mary Ray Worley points out, such a focus on body image causes immense self-hatred to self acceptance emphasizing just how difficult a time fat people have in coping with body image (Behrens & Rosen, 2001). True there are many images in the media that portray body images that are outrageously thin.

Many people that are already obese have a distorted body image and are often depressed. However a large body of evidence supports the idea that a comprehensive national plan that educates and also addresses the behavioral patterns of obese individuals will help combat negative self-imagery and in fact, reverse negative self-image (AOA, 2002). It is in fact, possible to replace negative images of oneself with positive ones when a comprehensive obesity strategy is utilized, one that emphasizes positive aspects of healthy weight maintenance, not the negative aspects of overeating.

The key however to a successful national plan as the National Board of Health points out, is not emphasizing an ideal shape or aspiration to be slim. Rather the focus needs to be on maintaining overall health and well being, and encouraging children and families to engage in healthy habits that will last a lifetime. The surgeon general has recently advised consumers that the best approach is to aim for a 'healthy weight' one that is based on BMI measurements (USDHHS, 2004). The surgeon general supports the notion that encouraging healthy activity, exercise and proper eating are essential components of a national obesity campaign, not an emphasis on being thin or achieving a certain level of thinness (USDHHS, 2004).

Why emphasize BMI? Obesity is linked with numerous conditions including heart disease and cancer, type 2 diabetes, stroke, arthritis and depression (USDHHS, 2004). In a nation facing a health care crisis, it is increasingly important that individuals learn to take charge of their health and fight back against obesity and chronic illnesses that are for all intents and purposes, preventable if a person maintains a healthy body weight and regularly exercises.

For a national plan to fight obesity to work, adults must become actively involved in healthy eating habits and the lives of their children, and set an example that can be followed from generation to generation. It isn't enough to simply teach children to eat well. This will not cure the epidemic of obesity in the United States. Parents and other adults have to set an example by getting the entire family involved in healthy eating, working with the family physician to learn about proper buying habits and actively engaging in activities together other than time spent in front of the television (AAFP, 2001).

Children often learn from adults. If a child learns healthy eating habits at school but then goes home and is served French fries battered in mayonnaise for dinner, they will not learn to adopt healthy eating habits no matter how hard educators and health officials try to teach them about the benefits of healthy eating. A comprehensive strategy must include all members of the family, not simply children.

A national plan to combat obesity needs to emphasize a reduction in TV viewing time and an increase in physical activity for adults and children alike. Children and adults need to engage in activities that involve cardiovascular exercise (AAFP, 2001). According to the American Obesity Association, a decrease "in the amount of daily activity related to work, transportation and personal chores" contributes to the high percentage of overweight and obese people in America today (AOA, 2002). Thus one may only logically conclude that more emphasis must be placed on physical activity for entire families. Moderate physical activity has been reported to be a key component of achieving and maintaining long-term weight loss and a healthy fitness level in general (AOA, 2002).

Behavioral therapy may also prove useful in the national campaign against obesity. Behavioral therapy strategies would involve changing the diet and physical activity patterns and habits of obese patients to "new behaviors that promote weight loss" (AOA, 2002). Strategies that have been proven successful with regard to behavior therapy include rewarding positive actions including engaging in physical activity, changing "unrealistic goals and false beliefs" about weight loss and body image "to realistic and positive ones" and development of a social support network that can encourage and motivate participants to continue on their journey toward healthy living (AOA, 2002).

Seid points out that the body size that is considered appropriate in the United States continues to get thinner and thinner, however the majority of national proponents of an anti-obesity campaign have all targeted their efforts toward knowledge and education, as well as promotion of a healthy level of fitness and wellness. None of the national efforts are targeted toward promoting or encouraging an ideal of thinness at any standard. The primary concern with all of the campaigns is encouraging individuals to be healthy and adopt lifestyle choices that facilitate overall health and wellness, not simply thinness.