If we really want to decrease childhood obesity, do you know what we need to do?
Fight parental obesity.
I'm serious. We've known for a while that what puts a child at biggest risk of being obese is having an obese parent, and just recently a study was released that said the same thing. Having an obese parent is a bigger risk factor than watching tons of TV or having a bad diet or never exercising. If we could get parents to a better weight, the researchers said, we could cut childhood obesity in half.
That's why ads like these from Blue Cross and Blue Shield of Minnesota make sense:
They are short and worth watching, but in case you don't have time: Basically, overweight parents have embarrassing "aha" moments, realizing that their (overweight) children are imitating their unhealthy habits (buying junk food and eating huge quantities of unhealthy food). "Today is the day we set a better example for our kids," says the tagline.
These aren't perfect ads. I get that. The biggest reason is that they shame people, and that's not a nice thing to do. As Lindy West wrote in a post for Jezebel, "It makes me, a former fat kid and current fat adult, want to die." That's why a lot of us were really uncomfortable with the Georgia ads that featured obese kids with taglines like "It's hard to be a little girl when you're not." Shaming kids crossed a line. But shaming parents... well, that may be necessary.
West makes some good points in her post. It's very true that fat doesn't necessarily equal unhealthy. If you are overweight but exercise regularly and eat a healthy diet, you could very possibly be healthier than a skinny couch potato who lives on Doritos. But in general, being overweight is not good for you. It raises your risk of heart disease (more than we used to think), diabetes, cancer, orthopedic problems, mental health problems and even economic problems. It's certainly not something we strive for -- or want for our children.
And while there are certainly overweight people who eat healthfully, the parents in the ads didn't. That's who the ads are targeting: parents who really do need to take a hard look at what they are putting in the grocery cart or on the dinner table. West is right in saying we should be having campaigns that are aimed at encouraging healthy habits; the fun Blue Cross Blue Shield "Do Groove" video does just that, encouraging people to get moving (I keep hoping to see people dancing in waiting rooms like the guy in the video, but it hasn't happened yet). But as someone who spends a lot of time talking in detail with families about what they eat, I think we need more of those "aha" moments. Since talking until I'm blue in the face isn't helping, maybe shaming people (grown ups, not kids) is what we need to try next.
I also agree with West that we'll never conquer the obesity epidemic if we don't face some hard truths about grain subsidies and other economic (and marketing) factors that are contributing to it. Everyone should be able to afford healthy food -- and have access to safe and affordable exercise options. There are real social justice issues here, and we need a groundswell of indignation and action.
But we can't waste time waiting for the perfect ad, the perfect approach that changes behavior without offending anyone. Lives are in danger, and things aren't getting any better. Just yesterday I was reading about how the military is getting involved in the fight against childhood obesity, because one in four Americans weighs too much for military service (makes me wonder if this is some sort of silver lining -- obesity could end up forcing peace). The implications for the future health of our children, and of our society and our economy, are staggering.
We aren't going to get anywhere in the fight against childhood obesity if we don't deal with the biggest risk factor. To me, it's worth hurting some feelings if we save some lives.
Follow Claire McCarthy, M.D. on Twitter: www.twitter.com/@drClaire