An interesting and possibly unique brainstorming session with
experts and non-experts in nutrition targeted at uncovering new
ways to fight childhood obesity was sponsored and held recently at
the Robert Wood Johnson Foundation. The event was organized by a
consulting firm called The Greatest Good. The only rule for the
session was that no idea was off limits.
The Catastrophe
There was quick
agreement among the group that obesity is a serious problem
illustrated vividly by the prevalence of childhood obesity which
has tripled in 40 years. Currently, 17% of children and
adolescents are obese, and 66% of adults are overweight or obese,
according to the participants. The situation was characterized as
“catastrophic” and also expensive. Some 20% of health care
spending can be accounted for by obesity, and that health care
spending is itself 20% of the Gross Domestic Product. In short,
the participants found “lots of reasons to address obesity.”
Some of the more
unusual solutions brought forth included:
1. Restrict
unhealthy foods to certain designated sections or locations in
supermarkets.
2. Abolish sucrose
and fructose. The idea is to simply take these ingredients “off
the face of the earth,” said the contributor.
3. Eliminate tax
deductions for the portion of food company expenses that do
marketing to children
4. Create a
national campaign that focuses on how soft drinks kill people.
This will create pressure on the companies that make these
products to change their ways. In short, shame the companies into
making changes.
5. Eliminate all
marketing such as that on billboards and television. Sequester the
marketing to certain places so that people would have to opt-in to
access marketing messages rather than have them disseminated
without consent. According to this idea, persons would have to
actively go out to get the information they wanted for various
products or items.
6. Incentivize
parents to create a more healthy home environment for eating by
altering work-based health insurance or welfare benefits.
7. Hold the
educational system accountable for making progress in educating
about nutrition and providing physical activity.
8. Shift the
paradigm and terminology from “obesity” to “malnutrition” because
the term obesity carries too much negative baggage at this time.
9. Create a public
awareness campaign focused on the wide variety of negative
outcomes that all derive from one thing---obesity. Show how 1
thing causes 100 bad things.
10. Send notices
to all the homes of parents telling them about the prevalence and
dangers of “metabolic derangement”, another substitute term for
obesity with potentially more traction than the current term.
11. Focus on
“healthy eating” and fostering positive behaviors instead of
“obesity” since the obesity focus also produces eating disorders.
12. Conduct a
community trial in which unhealthy food is taxed and healthy food
is not to see how much it would cost to nudge people away from
unhealthy choices.
13. Create a piece
of “caloric monitoring jewelry” such as a bracelet that persons
could wear and while eating would register in real time how many
calories they are consuming. Since people learn better when the
response to an action is more immediate, this real time feedback
would help modify eating behavior. As it is, the negative
consequences of overeating are not immediately apparent.
14. Introduce non-reproducing parasites into the body such as
tapeworms which could consume any excess calories people ingested.
People could continue to eat, companies could continue to sell
food, and the tapeworm would prevent weight gain.
15. Create
revolting smelling matter such as dried vomit that could be placed
in jars. People could take a whiff and lose their desire to eat.
Final Note
In a
thought-provoking observation at the end of the podcast, the hosts
noted that the non-nutrition experts who participated in the
session tended to be more sympathetic to solutions which require
more individual self-control or exercise of personal
responsibility, while the experts in nutrition seemed to favor
more environmental or macro level changes. No one could describe
what the mechanism might be that would explain this dichotomy if
indeed it was real.
To listen to the
37-minute podcast on freakonomics radio, visit :
http://tinyurl.com/cdpaysu
According to the site, the participants in the brainstorming
session were:
Peter Attia,
a former surgeon who now runs a nonprofit focused on nutrition;
Kelly Brownell
from the Rudd Center For Food Policy & Obesity at Yale;
Geoffrey Canada
of Harlem Children’s Zone;
Bill Dietz,
the former director of the Division of Nutrition, Physical
Activity, and Obesity at the CDC:
Chris Economos,
who studies obesity and childhood nutrition at Tufts ;
Steven Gortmaker
of the Harvard School of Public Health; Nobel laureate
Daniel Kahneman;
Harvard economist
David Laibson;
RWJF Health Group senior vice president
Jim Marks;
Brian Mullaney,
co-founder of Smile Train and WonderWork;
Eric Oliver,
a political scientist at the University of Chicago who has written
a book
about obesity; and
Mary Story
from the School of Public Health at the University of Minnesota.
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