Childhood Obesity: Legislative Policy Approaches and the Evidence Base to Date

Published 2006

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Introduction

American children are growing fatter. Between 1980 and 2002, the number of overweight children and adolescents ages 6 to 19 tripled. With 16 percent of children and adolescents in this age group overweight (9 million children), childhood obesity remains a pressing public health concern. The trend continues. A study published in the April 5, 2006, issue of the Journal of the American Medical Association found that 17.1 percent of children and adolescents ages 2 to 19 were overweight.

Being overweight puts children and teenagers at greater risk for a number of serious health conditions. Type 2 diabetes; risk factors for heart disease, including high blood pressure; other health conditions including asthma and sleep apnea, and psychosocial effects such as decreased self-esteem have been associated with childhood overweight in recent studies. In one large study, 61 percent of overweight 5- to 10-year-olds already had at least one risk factor for heart disease, and 26 percent had two or more risk factors for the disease. Obese children also are more likely to become obese adults.

By adulthood, obesity-associated chronic diseases—heart disease, some cancers, stroke and diabetes—are the first, second, third and sixth leading causes of death in the United States. Obesity also is costly to states; annual obesity-attributable U.S. medical expenses were estimated at $75 billion for 2003. Taxpayers fund about half of this through Medicare and Medicaid. The national cost of childhood obesity is estimated at approximately $3 billion for those with Medicaid. Children covered by Medicaid are nearly six times more likely to be treated for a diagnosis of obesity than are children covered by private insurance.

Fortunately, healthy eating and a physically active lifestyle can help children achieve and maintain a healthy weight and reduce obesity-related chronic diseases. Aiming to start early to prevent the onset of chronic conditions, legislators were active in 2005 in considering childhood obesity policy options.

This report provides a resource for legislators and other policymakers by outlining the variety of legislative policy approaches under consideration to facilitate opportunities for a healthier diet and more exercise, beginning in childhood. Where available, we report evidence about these policy options.

Table 1 provides an overview of the more prevalent state legislative approaches to childhood obesity considered or enacted in 2005. Table 2 provides a summary of policy approaches and available evidence. Detailed information about each policy approach in table 1 and additional policy approaches considered in 2005 follows Table 2, along with more detailed discussion of the available scientific evidence, to date, for each policy approach.