WP4

Part 1

Rising obesity rates have become a serious public health concern in the United States. A decade ago, no single state had an obesity rate above 35 percent. In 2023, the national obesity rate among adults was recorded at 41.9 percent, while the national obesity rate among children and adolescents ages 2 to 19 has more than tripled since the 1970’s. People are living far more sedentary lifestyles, exercising and moving less in their day to day lives, are addicted to inexpensive, non-physical entertainment and heavily processed, highly-palatable, calorically dense foods, and they are often encouraged to maintain these habits through the advertisements and media they consume. Studies show that obesity is linked to an array of disorders, such as heart disease, diabetes, high blood pressure, stroke, respiratory issues, liver disease, joint problems like osteoporosis and arthritis, gastrointestinal issues, kidney disease, mental health disorders, reproductive issues, metabolic syndrome, cancer, and unsurprisingly, lower life expectancy.

Obesity also comes with significant economic costs. In 2016, a study published in the PubMed National Library of medicine found that obesity related expenditures had grown to $260.6B, with obese individuals costing on average $2,505, or 100 percent, more annually than normal weight individuals. Not only does this place a financial burden on the individuals who must pay a portion of the cost out of pocket, but it places an enormous burden on the healthcare system overall and has trickle-down effects to all members of society. Additionally, obese people miss 56 percent more work days than healthy individuals due to their condition, severely impacting the productivity of the companies they work for, and ultimately raising prices for the average consumer. 

It is our imperative as a collective to reduce national obesity rates to promote health and financial well-being. Because of the severity of this issue, it will require a combination of policies implemented at the federal, state, and local levels. At the federal level, Congress should prioritize the prevention of obesity by ceasing its subsidization of crops that are used to mass produce junk food, as well as the tax deductions associated with advertising them. At the state level, governments should prioritize educating students about nutrition starting at a young age while providing healthier options in cafeterias, and by requiring more physical activity until students graduate high school. Finally, at the local level, government and community organizations should adopt behavioral weight loss programs, which show great promise to help solidify healthy habits.

First of all, the federal government must do its part to reduce its consumption by tackling the issue at the source of production. Since 1995, the federal government has provided farmers with over $300 billion in farm subsidies through its farm bill, which is renewed every five years. The bill uses billions of taxpayer dollars to fund crop insurance, crop subsidies, agricultural research, and food assistance programs like SNAP, which support over 42 million Americans. Following 2023, the bill is forecasted to cost over $700 billion in the five years following, which is by far the largest to date. At face value, this means more people will have food to eat. Practically, the bill and the subsidies it funds incentivize farmers to grow excessive amounts of crops used to produce junk food. Farmers are encouraged to mass-produce crops like corn and soybeans, which are used to produce high-fructose corn syrup, hydrogenated oils, and other unhealthy ingredients that are found in many processed foods. The subsidies also make it cheaper for food manufacturers to produce junk food. On a related note, Congress has continually subsidized the spending of advertising junk food to children and adolescents. Under the federal tax code, food and beverage companies can deduct advertising costs as ordinary business expenses, which essentially subsidizes them targeting junk food ads to children. It is evident that Congress should emphasize healthier food options by reducing the funding they provide for junk food crops and eliminating the subsidies they provide for large corporations to advertise junk food to children. If junk food was not so easily accessible to people, and if children were not shown advertisements of food that will lead them to becoming obese, obesity rates would surely fall. 

Next, state level governments must take accountability for their influence over children’s diets and knowledge of nutrition within public school systems. According to a policy brief by the Association of State Public Health Nutritionists, researchers found that between 2011 and 2013, 93 percent of 704 public school districts in the nation required nutrition education goals in their wellness policies. However, less than one percent of these schools indicated a minimum requirement for the number of NE courses or contact hours. The same survey indicated that only 11 percent of schools require NE training for teachers, and only 8 percent required training for food service staff. A report published by the CDC shows that US students receive less than 8 hours of required nutrition education each year, which is dramatically lower than the 40-50 hours required to form and solidify healthy habits. The data indicates that nutrition and wellness education policies in schools are far too vague, and lack the standards needed to ensure their implementation and success. While there are basic requirements, they are clearly far too insignificant to affect actual change, and are too vague to be properly enforced. 

Beyond sufficiently educating students from an earlier age, school boards must also practice what they preach by prioritizing healthier cafeteria menus. According to a study conducted by the Food Research and Action Center, during the 2021-2022 school year, on average 15.5 million students received breakfasts and 29.9 millions received lunches from the school cafeteria daily. This overwhelming number shows how vital it is that we provide healthy meals in schools. Schools are allowed to substitute the fruit requirement in school lunches with vegetables, which includes potatoes, or in most cases, french fries. This is just one example of a loophole that school systems can exploit to cut costs and serve unhealthier options, but there are many others. Schools only receive on average $1.30 to feed each student, and this must cover not only the food, but also the labor, equipment, and electricity. Given such a tight budget, it is no surprise that schools are opting to prepare cheaper, less nutritious items. Ultimately, state governments are the largest contributors to school funding. Therefore, it is imperative that they increase their efforts and expenditures to properly educate students about nutrition at an early age, while providing them access to healthier meals, as so many children rely on their school cafeteria and form habits based on what their school and trusted adults tell them. Obviously, parents have an important role to play here too, but schools must take equal accountability for the health of their students if they want to see obesity rates fall.

Finally, local governments and community organizations must take responsibility for the health of their residents. This can begin with the implementation of behavioral weight-loss programs. There is ample support demonstrating the effectiveness of such programs, and some have already been implemented to great success. According to a meta-analysis of over 27 trials conducted by the peer-reviewed medical journal “The BMJ,” after the administration of an individual, 12-month behavioral weight management intervention delivered in primary care, participants lost 2.3 kilograms on average, and showed a reduction in waist circumference of 2.5 cm. While this does show results, the data is certainly more compelling within studies conducted in groups. A report published in the National Library of Medicine covers the data findings of a state-wide internet based program called “Shape up Rhode Island,” which involved a team-based competition to increase physical activity and achieve weight loss. Over 4,700 participants registered with a mean BMI of 29, and 3,311 completed at least 12 weeks of the program. Those who completed 12 weeks reported a mean weight loss of 3.4kg, and 30 percent achieved a clinically significant weight loss of over five percent or more. This data shows more significant results within a much shorter time frame, proving that not only are behavioral weight-loss programs successful, but they make an even greater impact within groups. 

This makes neighborhoods and communities an ideal place to develop behavioral weight-loss programs, and shows that they are worth investing into. Arguably, in-person groups have an even higher potential to foster accountability and a strong sense of community compared to internet groups, and therefore have even greater potential for positive outcomes. Many people do not stick to their weight loss goals because they feel they are alone in their endeavor, and considering the ample evidence linking healthy BMI with less work days missed, higher productivity, and an overall boost economically, it clearly benefits local governments to invest resources into developing programs that show great promise to produce results.

As promising as the proposed policies are, there are certainly downsides which must be addressed to plan effectively. If Congress were to significantly limit subsidies for junk food crops, there could be a shortage of foods that people rely on, and it could harm farmers and businesses that depend on them. These farmers and businesses may rightly say that they built their businesses in good faith, based on current subsidies. To mitigate this, Congress must provide support to these farmers and businesses, and should incentivize them to transition to growing other crops, like fruits and vegetables by shifting subsidy money to these alternatives. Additionally, it can be difficult to define “healthy” and “unhealthy” foods, and identify exactly where they are sourced. These are legitimate and complex challenges, but are worth seeking solutions to if they will lead to an overall increase in health and well-being of the American people.

While the expansion of nutrition education requirements in schools and emphasis on healthier options in cafeterias undoubtedly come with outstanding benefits, they also carry risks. One potential downside is that school meals may become less affordable, and if this burden were placed on families, fewer children who do not receive meals for free may be able to afford them. On another note, many might argue that children in the modern school system are already underprepared for the workforce when they exit the school system, and requiring additional hours for physical activity and nutrition education will exacerbate the issue. I would contend that healthier and happier students are going to be far more compelled to focus and learn, and will be more productive in class, offsetting the reduction in overall instructional time.

Finally, while behavioral weight loss programs, especially in group settings, have great statistical evidence to support their effectiveness, they too come with potential downsides. One is that these programs may be costly and time consuming. Participants may be required to contribute financially and sacrifice time out of their schedules to attend sessions, and this may detour some individuals. Another downside is that these programs may not be effective for everyone, and some participants may feel dissatisfied with their results. In the end, I believe that the data here is compelling, and on average, those who are motivated to lose weight will see these programs as safe spaces that show promise for results, and ultimately worth the potential investment of time and resources.

In conclusion, obesity rates in America are a serious, but multifaceted concern. In order to reverse the upward trend, actions must be taken at the federal, state and local levels. At the federal level, Congress should refocus their subsidies towards healthier crops while eliminating their tax subsidies for junk food advertisements targeted towards children. At the state level, the government should intervene in the school systems to ensure proper nutrition education and healthy cafeteria options. At the local level, city boards should seek to implement behavioral weight loss programs in group settings. Ultimately, there is no fix-all solution to this crisis, and any policy will come with potential downsides. However, health and well-being are extremely valuable metrics indicating the success of society, and in examining the data, the proposed solutions are promising options to nudge our obesity trajectory in the right direction.

Works Cited

Mead, Andy, and Sutton Stokes. How Should We Reduce Obesity in America?, National Issues Forums Institute, 2016. ProQuest Ebook Central, https://ebookcentral.proquest.com/lib/socal/detail.action?docID=4697978.

Cawley J, Biener A, Meyerhoefer C, Ding Y, Zvenyach T, Smolarz BG, Ramasamy A. “Direct medical costs of obesity in the United States and the most populous states.” J Manag Care Spec Pharm. 2021 Mar;27(3):354-366. doi: 10.18553/jmcp.2021.20410. https://pubmed.ncbi.nlm.nih.gov/33470881/

“Food Labeling.” USDA, 2023, https://www.ers.usda.gov/topics/food-choices-health/consumer-information-and-labeling/food-labeling/.

Gostin, Lawrence O., et al. “Ending Tax Subsidies for Junk Food Advertising to Children.” O’Neill Institute for National and Global Health Law, 2012, https://oneill.law.georgetown.edu/ending-tax-subsidies-for-junk-food-advertising-to-children/.

“Nutrition Education in America’s Schools: Results from the School Health Policies and Practices Study 2016.” Association of State and Territorial Public Health Nutrition Directors, 2017, https://asphn.org/wp-content/uploads/2017/10/2016-Nutrition-Education-in-Americas-Schools.pdf.

“School Nutrition Education.” Centers for Disease Control and Prevention, 2023, https://www.cdc.gov/healthyschools/nutrition/school_nutrition_education.htm.

“The Reach of Breakfast After the Bell Programs in the 2017-2018 School Year.” Food Research & Action Center, 2023, https://frac.org/news/schoolmeals2023#:~:text=FRAC’s%20The%20Reach%20of%20Breakfast,for%20breakfast%2C%20and%2010.1%20million%20(.

Gabbatt, Adam. “The Sad State of America’s School Lunches.” Green Matters, 2019, https://www.greenmatters.com/food/school-lunches-america.

“School-Based Obesity Prevention Programs: An Evidence-Based Review.” National Center for Biotechnology Information, 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708457/.

Part 2

My WP4 part 1 is a policy brief which addresses the rising obesity rates in the United States and proposes policy measures at the federal, state, and local levels to combat this issue. It does this through argumentation, with the development of a thesis which I support with data, reasoning, and counterarguments. The ideas for this piece stemmed from my WP3, where I delved into the issue of obesity in America from a more holistic approach, arguing against the fat acceptance movement by detailing the negative health and economic costs, as well as addressing multiple layers of nuance regarding the distinction between body positivity and fat acceptance, the shortcomings of BMI in determining health, general misinformation related to obesity, etc.

I touched more briefly on potential policies that could be implemented to mitigate the rise in obesity in WP3, and encountered many points of view on the matter throughout my research. My interest in the policy side of the issue grew, and my idea for WP4 was born. I wanted to address policy makers specifically, as opposed to the broader, more inclusive audience I targeted in WP3. WP4 is not intended for those who may dismiss or trivialize the issue of obesity or are not interested in policy discussions related to public health. Unlike in my WP3, I made no effort to be sensitive or inclusive to capture a wider audience, but simply presented the facts. This allowed me to cut through much of the expository fluff, make assumptions about my audience’s prior knowledge and spend more time discussing policies in particular. I give a general synopsis of the issue, but assume that policymakers reading my brief are already aware of the severity of the obesity epidemic, and need not be convinced that it is an issue worth considering. Rather, my objective was to propose solutions and persuade policy-makers that the specific policies I set forth are worth implementing. 

Both my WP3 and WP4 align themselves with the point of view advocating for healthier dietary practices, increased physical activity, and the need for policy changes to address the root causes of obesity. I would say that, in a sense, the schools of thought in my WP3 and WP4 are significantly overlapping, as they both advocate a need for change. However, my WP3 focuses more on why we need to change, whereas my WP4 goes into greater detail about how exactly we might do so. Additionally, my WP3 discusses elements of personal accountability and intends to convince anyone reading that they individually should make changes to their lifestyle to become healthier. My WP4, on the other hand, does not point the finger at individuals, but rather at the multiple tiers of government. In doing this, I did not intend to minimize the aspect of individual accountability that I believe people must take if they want to make lasting changes, but I simply wanted to emphasize a specific aspect of the ultimately complex and multifaceted solution.

Ultimately, WP4 serves as a call to action, urging Congress to eliminate subsidies for unhealthy food production and targeted advertising of these foods to children, advocating for states to sponsor improved nutrition education and access to healthy meals in schools, and encouraging the implementation of behavioral weight-loss programs at the local level. I assume my audience is interested in reducing obesity rates, but are stakeholders in something larger, and therefore need to be persuaded. In response, I structure an argument that combines statistical evidence and logical reasoning to support my policy proposals and engage policymakers in a concerted effort to combat this public health crisis.