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Journal Issue: Childhood Obesity Volume 16 Number 1 Spring 2006

Introducing the Issue
Christina Paxson Elisabeth Donahue C. Tracy Orleans Jeanne Ann Grisso

Introduction

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.1

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 tie-ins 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.

This issue of The Future of Children lays out the evidence on the multiple causes, consequences, and methods of dealing with childhood obesity. Now is an opportune time to assess what is and is not known. Many policymakers, having become convinced that childhood obesity is indeed a problem, are searching for effective ways to combat it. The Child Nutrition and WIC (Women, Infants, and Children) Reauthorization Act of 2004, for example, responding in large measure to the rise in childhood obesity, requires school districts that participate in the National School Lunch Program or School Breakfast Program to develop a local wellness policy by the beginning of the 2006–07 school year. Many states are developing broader programs aimed at curbing obesity and improving health among their citizens. The “Healthy Arkansas” initiative, launched in 2004, aims—ambitiously—to reduce the state's rate of childhood obesity from 11 percent to 5 percent. Other states are taking similar steps, many with the support of the Centers for Disease Control and Prevention (CDC), which in 2005–06 gave funds to twenty-one states to build capacity in the area of obesity and to seven more to implement programs. But while the policymakers' desire to reduce obesity is clear, state and federal budgets are stretched thin. It is crucial to develop programs and policies that are effective and can be implemented at reasonable cost.