The benefits of early comprehensive youth obesity prevention strategies outweigh the costs to consumers and reimbursers
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The prevalence of obesity in the United States is at the highest it has ever been. Adolescent and adult obesity rates have increased greatly over the past three decades, and those individuals who are already obese continue to gain weight. More recently, levels of obesity have stabilized but the number of obese individuals in the country is still very high. Efforts must be made at reducing these levels of obesity, as obesity is associated with the development of chronic diseases, significant reductions in quality of life, and insurmountable costs. The economic impact of obesity expands beyond direct healthcare costs into the workplace, reducing individual productivity levels and increasing the number of workdays missed as the severity of obesity increases. These realities provide incentives for both governmental and private sectors to take an interest in the prevention of obesity. The causes of obesity are many, and an appropriate treatment that will reduce obesity on a population level has not been identified. Current literature suggests the most effective population to target for obesity prevention is youth, especially around the ages of five to seven while lifestyle habits are being formed. This is mostly due to the relatively small changes needed to prevent childhood obesity as compared to the more difficult approach of reducing adult obesity. As opposed to the treatment of adult obesity, the prevention of childhood obesity requires a much smaller correction to daily calorie intake. Furthermore, obese youth tend to maintain their obesity into adulthood. The earlier in age that childhood obesity develops, the more difficult it is to prevent the development of adult obesity. Evidence currently shows that childhood obesity levels are related to the quality of meals and eating habits influenced by parents or caregivers and increased consumption of sugars and high-calorie foods strongly associated with aggressive food and beverage marketing. In addition, decreased levels of physical activity are associated with childhood obesity risk. In these ways, the current social and economic environment in the US strongly promotes childhood obesity. The most effective obesity prevention strategies involve a holistic modification of the surrounding environment. Studies show that addressing the school environment and thoroughly educating parents about the importance of nutritious eating and physical activity are important components of childhood obesity prevention efforts. While school and community interventions are moderately effective, a rise in BMI does tend to occur during summer months when children are typically on a less structured schedule and may not have encouragement from school programs to eat healthy foods and exercise. Schools also provide the opportunity for extracurricular activities, such as sports programs and other such supportive measures, which may prevent the development of childhood obesity. Suggested policy actions may modify the community and environment in such a way that obesity reduction is economically favorable. A tax on sugar-sweetened beverages is estimated to be highly effective in reducing childhood consumption of sugar, and subsequently lowering obesity rates. Other policy interventions that would be effective for reducing childhood obesity include imposing limits on the types of foods sold in school to children, and restricting marketing efforts aimed at children. Implementing a sugared-beverage tax and reducing tax subsidies from advertisements of food and beverage companies would produce positive return-on-investments and raise additional funds for additional adolescent obesity prevention efforts. Policymakers, local governments, parents, schools, and the community will need to invest time and finances into these modifications for obesity prevention to be effective. Policy changes, specifically sugared-beverage taxes, have recently been enacted in Mexico and in Berkeley, California. Evaluation research will provide additional evidence for the efficacy of these policy actions in obesity prevention. Current projects that will contribute to the gaps in preventive community modification research are in progress in California, Massachusetts and Texas. Additionally, research into the prevention of summer-month BMI increases in children may be beneficial for maintaining appropriate lifestyle modifications when school is not in session.