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August 2003

Pediatric Obesity Policy: The Danger of Skepticism

Arch Pediatr Adolesc Med. 2003;157(8):722-724. doi:10.1001/archpedi.157.8.722

OBESITY-RELATED ILLNESSES are threatening the health of US children. It is now time to build a cohesive national policy that combats obesity in children and adolescents. In this article, we suggest principles for policy development based on barriers, precedents, knowledge available, and knowledge gaps.

Evidence repeatedly demonstrates the rising prevalence of obesity and obesity-related illnesses, with 30% of US children having a body mass index higher than the 85th percentile for their age.1-5 Although comprehensive data are needed on the long-term effects of pediatric obesity on health, it is known that more than two thirds of obese children 10 years and older will become obese adults6 and that obesity in young adults causes on average 5 to 20 years of life lost.7 Obesity is also associated with a 36% increase in inpatient and outpatient spending and a 77% increase in medication use compared with expenditures for healthy-weight individuals.8 Some people have expressed reluctance to involve government or professional bodies in personal affairs pertaining to weight control.9 However, several facts combine to make pediatric obesity a public health priority that requires a concerted societal response. These include the magnitude of the problem, the fact that children cannot be fully responsible for their own health choices, and the recognition that obesity reflects a combination of genetic, behavioral, and environmental influences—together with society's special obligation to protect and care for children.