The Pricey Search for Answers About Childhood Obesity

Most anti-childhood obesity programs, whether they are prevention-oriented or cure-oriented, have one thing in common: they need money. Whether the source of funds is the government, a foundation, or an eccentric millionaire with a mattress full of large-denomination currency, somebody is going to make a decision about who gets the money. Who is more deserving? The donors may have different criteria, but they will all arrive at the point of making a judgment about who is most deserving.

Who are the most deserving clients? Do we want a program that helps teenagers who weigh over 400 pounds and have already undergone a stomach stapling that didn’t take? Or do we want to buy a year of Garden Based Learning for a whole classroom full of five-years-olds? It’s so easy to think, “The government should do this or that.” But pausing to reflect on the many sides of these issues could give a person a head cramp.

It’s not enough to know what works; we also have to figure out who can most benefit from the limited pool of help. Some say, treat the worst first. When resources are abundant, it’s doable. But in a battlefield situation or a disaster situation with little hope of relief, you go by a different triage plan, and you don’t treat the worst first. You let them go, and treat the saveable ones.

Some might say, with the economy in the shape it’s in, getting a program funded is a battlefield scenario. You have to look at what will produce the greatest good for the greatest number, and write your grant proposal accordingly. So there are a lot of layers to the problem, and a lot of voices steering the concern in different directions.

For instance, we talked about an important meeting between various food policy folks, who were gathered together by NPLAN (National Policy & Legal Analysis Network to Prevent Childhood Obesity) and CED (the Ludwig Community and Economic Development Clinic). The assembly was also supported by a grant from the Robert Wood Johnson Foundation. The authors of the report “Farm Bill 2012: Building Coalitions for Change” are Allison Tait and Lang Liu of NPLAN. The warlike aspect of it all is emphasized by this section of the report:

The prospect that scarce funding could discourage coalition-building efforts was a concern shared by all panelists. One stakeholder’s project could be sacrificed to fund another stakeholder’s new idea, pitting potential allies against each other.

In other words, all these organizations are competing for the spoils. How can they be friends? From the workshop’s very frank discussion about money, we learn that…

Every panelist mentioned the difficulty in obtaining funding for new or expanded programs in the current economic environment. Congress is currently operating under “pay-as-you-go” rules, which means that any new spending authorization must be paid for by increased tax revenue or a cut in funding to another program. All participants predicted a difficult political fight simply to maintain funding for current farm bill programs.

The farm bill is divided into ten sections or “titles,” of which one is Research. The workshop participants characterized research as vital, because that is exactly what long-term farm policy and food policy ought to be based upon. Yet, strangely…

…the amount of research funding available in the farm bill is tiny compared with the level of funding the National Institutes of Health (NIH) receives.

This reflects the dichotomy we mentioned earlier. The NIH is actively defeating serious medical conditions right now, whereas research is trying to plan for the future. Broadly speaking, one is in the prevention business and the other is in the curing business. The participants didn’t use the word triage, but triage is what they were talking about. Which proposals are most likely to receive funding? Some people thought it would be a good idea to go for

…the start-up capital costs of developing a particular element of local food systems–for example, a mobile slaughterhouse that would allow more local meat to be processed, or local canning operations that would process fruits and vegetables from the area in bulk… Another recommended strategy was to look for policy change opportunities that do not require new expenditures, such as improving existing program structures and rules.

Yes, resources are limited. It’s a sad day when an organization has to resort to such an un-dynamic plan as “look for policy change opportunities that do not require new expenditures.” It’s kind of like throwing a bake sale to buy the playground equipment. Both are signs of a society that is running on empty and whose wheels are falling off. On the other hand, who can complain when bureaucrats take a fiscally conservative and responsible stance with the taxpayers’ money? But there is hope. The report also suggests that…

…advocates could take a broad approach to find a way to increase funding for research on how food is grown by utilizing the connection between food and its effects on chronic disease. This framing would bring the issue into the realm of NIH, which has a much larger research budget.

Your responses and feedback are welcome!

Source: “Farm Bill 2012: Building Coalitions for Change (PDF),”
Image by treesftf (Trees For the Future), used under its Creative Commons license.

One Response

  1. Research and more research is not the answer to the childhood obesity epidemic!!!!!!!

    At this point in time research has grown contradictory and states that anything and everything contemplated can be corresponded to the cause of Childhood Obesity including Tonsillectomies, Arthritis, Vitamin D deficiency, travel, genes, lack of organics food, school food and somewhere along the way someone is going to say that research has found that it is the Dog’s fault that a child has become obese!

    Sorry DR. but Childhood Obesity will not be cured, solved or dealt with in a lab, as it can only be cured within the confines of the home and with dedication, effort and a whole lot of love!

    And here’s the kicker— nutrition and the ed of such, is a minor factor when overcoming childhood obesity. In fact it is more of a habitual/behavioral issue related to habits developed early in life. This could be relative to parental overfeeding out of love and a want to keep the baby quiet and happy, food rewards, role modeling or the child unconsciously learning that food provides a sense of inner comfort whether it is healthy or not.
    Additionally, keep in mind that the majority of obese kids live in rural, urban and inner city neighborhoods that lack access to fresh foods and dry ingredients—otherwise known as grocery stores—so why spend more money on research rather than on building grocery stores where there are none within easy reach by public transportation?
    Research and the USDA claims that overweight and obese people need more fresh fruits and veggies in their diets; YET how are they going to get access to such when they are not available in a 10 mile radius or even 5 mile radius.
    Yet Money/funds are not going into helping these neighborhoods gain access to healthful choices, instead funds are used to build multi million nutritional research facilities, and Fit and Trim programs which cater to Healthy Kids!

    Therefore do we really need more research when the cause is so blantantly obvious?

    The cause:
    A> The enormously cheap availability of more and more inexpensive and nutritionally weak prepackaged food advertised to make a parent’s life easier, especially when they reside in a “Produce Desert”!

    B> Sorry,TV is not a cause–for it has been around for 60+ years and the epidemic of childhood obesity only began about 6-10 years ago. Sure there have always been fat kids, but not the amount of today. However, VIDEO GAMES can become an addictive sedentary behavior, for they kill empty time, provide a sense of accomplishment/confidence and can be played alone—hence secured opp not to be abused for weight, non athleticism, nerdiness or geekiness.

    C> The ever rising Stigma, developed by the The Mightier than thou attitude of those who falsely believe that they are better than you, me or someone who is overweight reinforces the want for comfort, which can often be immediately found in food.

    Nutrition===is secondary to overcoming the real cause of Childhood Obesity

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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