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Monday, March 19, 2012

The Government’s Role in Managing Obesity

By Pamela M. Peeke, MD, MPH, FACP

Debate Teams

Three months ago I posted a discussion forum on our Diet Community entitled: “Should government be involved in obesity prevention and treatment?” I was seeking input from WebMD members to incorporate in an upcoming debate on this subject. I teamed with former U.S. Surgeon General David Satcher, arguing that the government did have some valuable and effective roles in the prevention and management of obesity. The opposing view was represented by Fox TV’s John Stossel and author Paul Campos, both of whom felt the government was ineffective and therefore should not have a role in obesity. To all of the WebMD members who contributed a wide array of priceless comments and heartfelt thoughts, I want to extend a hearty “thanks!” We heard you loud and clear and integrated your words into our dialogue throughout the event. I also encourage you to read the WebMD forum so that you can enjoy the comments from your fellow WebMD members.

The debate took place at NYU as part of the Intelligence Squared forums, eventually airing on PBS as well as NPR. ABC Nightline anchor John Donovan did a great job moderating the teams in front of a sold out audience of 800 New Yorkers, including an army of media. This is a hot topic, to say the least, as was evidenced by this fun interview I did with Slate entitled “Twinkies are science fair projects…and other reasons why the government should play a role in America’s war on obesity”

All of us agreed that the government functions as an imperfect entity, as flawed as the humans who write the rules and strive to execute them. However, where our colleagues saw hopeless ineptitude, we saw predictable problems, but also potential and opportunities. So, what was the bottom line?

Most would agree that the government alone cannot solve the obesity crisis. A problem of this magnitude requires all sectors of society to bring our best thinking to the table. This is a collaborative effort connecting private and public entities to increase our chance for long term success.

WebMD members identified several key areas of opportunity for effective public and private roles. We added a few more to round it out.

Pam Peeke

1)   Leadership: There are countless examples of places where leaders in society can inspire others to change. Let’s Move has helped raise awareness about childhood obesity and opened a national dialogue. When public officials, health care providers, and sports and entertainment celebrities are seen being physically active, they help inspire others. And there are rewards to be had. The President’s Council on Fitness, Sports, and Nutrition offers the President’s Active Lifestyle Award to individuals and families who commit to get more active.

2)   Education: A full spectrum of government departments (e.g. DHHS, CDC, FDA, USDA) provide free information about healthy living. This education process needs to be carried right into the school classroom from kindergarten on up through high school. And it’s got to be fun and engaging to keep it memorable and important to kids and teens. Families together need to have better access to this kind of education so that whole communities can adopt healthier habits.

3)   Protection: Scams abound and it falls upon the government to identify harmful and illegal activities as they relate to purported weight loss supplements, food products, and equipment. Food labels have to be exact and precise, detailing ingredients and macronutrient breakdowns.

4)   Providing Options/Opportunities: There are many government sponsored programs that offer communities opportunities to improve nutrition. The school nutrition program is one example. If a school district accepts the offer and the government finances, they must abide by the stated rules: more veggies, lean protein, and fruits for kids.

5)   Physical Infrastructure: If there’s no sidewalk, it’s a challenge to walk. If there’s no park, there’s no play. The same holds true for biking, walking, and hiking paths. Only the government can provide these invaluable gifts to any community. Public and private groups can work together to establish garden plots throughout a town or city to foster locovore farming and emphasize whole foods.

6)   Public Private Partnerships: New York City is a model for these P-P Partnerships, including the FRESH (Food Retail expansion to Support Health) program, in which 14 new supermarkets were opened to increase access to healthy foods throughout inner city locations. Working to support the White House initiative to inform consumers, the beverage industry launched the Clear on Calories campaign providing beverage calories on the front of each product.

Clearly the public and private groups have ongoing activities in each of these sectors. Our point was that we need to keep pushing these them to do a better job where they can, and to continue to expand their efforts.

At the end of the day, the best strategy is a collaborative one and, happily, everyone agreed on that! We didn’t solve the problem, but we had a heck of a great time debating it!

What do you think government’s role is in controlling and combating obesity? Share your thoughts in the comments below or join the chat in our Diet community.

Photos: Pam Peeke

Posted by: Pamela Peeke, MD at 3:50 pm

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