Pediatricians, parents, and policymakers
alike are concerned
about high and rising rates of
overweight and obesity among
U.S. children. Over the past
three decades, the share of children who are
considered overweight or obese has doubled,
from 15 percent in the 1970s to nearly 30
percent today, while the share of children
who are considered obese has tripled. The
problem of childhood obesity has captured
public attention and is regularly featured on
the evening news, in school newsletters, and
in articles in parenting magazines. Increasingly
policymakers are recognizing the need
for action. In 2004, the Institute of Medicine
released a report calling the prevention of
childhood obesity a national priority.
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Despite all the public attention, no one is
sure which policies and programs will most
effectively combat childhood obesity. The
uncertainty reflects in part a lack of agreement
about what caused obesity to increase
in the first place. Theories abound. The “epidemic”
in childhood obesity has been attributed
to various factors: increases in television
and computer game use that have led to a
new generation of “couch potatoes”; the explosive
proliferation of fast-food restaurants,
many of which market their products to children
through media campaigns that tout tieins
to children’s movies and TV shows; increases
in sugary and fat-laden foods
displayed at children’s eye level in supermarkets
and advertised on TV; schools that offer
children junk food and soda while scaling
back physical education classes and recess;
working parents who are unable to find the
time or energy to cook nutritious meals or supervise
outdoor playtime; the exodus of grocery
stores from urban centers, sharply reducing
access to affordable fresh fruits and
vegetables; and suburban sprawl and urban
crime, both of which keep children away
from outdoor activities. The problem is not
the lack of explanations for the increase in
childhood obesity, but the abundance of
them. In such circumstances, deciding which
of the possible causes to address first and
which policies and programs will be most effective
is not easy.