Aug 19 2011

More on the ethics of childhood obesity interventions

This seems to be my week for discussing ethical issues in food politics.

The September issue of Preventing Chronic Disease (PCD), a professional journal published by the CDC, is devoted to papers on this topic.

I taught a graduate course a couple of years ago at NYU titled “Ethical issues in nutrition, food studies, and public health.”   These papers, and the ones I referred to earlier this week, could be the basis for a course on their own.

You are wondering why childhood obesity interventions raise ethical issues?

This diagram, from the paper by Shiriki Kumanyika, is a good starting place.  It asks: Should governments, health professionals, advocates, and others balance the protection of vulnerable populations against corporate imperatives and, if so, how?

Maybe next semester!

In the meantime, here are the papers along with thanks to CDC for taking this on.

ETHICAL ISSUES IN INTERVENTIONS FOR CHILDHOOD OBESITY
A91: Ethical Concerns Regarding Interventions to Prevent and Control Childhood Obesity
John Govea
 


PEER REVIEWED
A92: Protecting Children From Harmful Food Marketing: Options for Local Government to Make a Difference
Jennifer L. Harris, Samantha K. Graff
 


PEER REVIEWED
A93: Childhood Obesity: A Framework for Policy Approaches and Ethical Considerations
Rogan Kersh, Donna F. Stroup, Wendell C. Taylor
 


PEER REVIEWED
A94: Childhood Obesity: Issues of Weight Bias
Reginald L. Washington
 


PEER REVIEWED
A95: Children With Special Health Care Needs: Acknowledging the Dilemma of Difference in Policy Responses to Obesity
Paula M. Minihan, Aviva Must, Betsy Anderson, Barbara Popper, Beth Dworetzky
 


PEER REVIEWED
A96: Public Policy Versus Individual Rights in Childhood Obesity Interventions: Perspectives From the Arkansas Experience With Act 1220 of 2003
Martha M. Phillips, Kevin Ryan, James M. Raczynski
 


PEER REVIEWED
A97: A Question of Competing Rights, Priorities, and Principles: A Postscript to the Robert Wood Johnson Foundation Symposium on the Ethics of Childhood Obesity Policy
Shiriki K. Kumanyika
 


PEER REVIEWED
A98: The Ethical Basis for Promoting Nutritional Health in Public Schools in the United States
Patricia B. Crawford, Wendi Gosliner, Harvey Kayman
 


PEER REVIEWED
A99: Ethical Family Interventions for Childhood Obesity
Mandy L. Perryman
 


PEER REVIEWED
A100: Public Policy Versus Individual Rights and Responsibility: An Economist’s Perspective
Frank J. Chaloupka
 


PEER REVIEWED
A101: State Requirements and Recommendations for School-Based Screenings for Body Mass Index or Body Composition, 2010
Jennifer Linchey, Kristine A. Madsen

 

Comments

It is important to note that, while the CDC Journal Preventing Chronic Disease did publish the collection, all the work was supported by the Robert Wood Johnson Foundation’s Childhood Obesity Activity.

  • Sigmund
  • August 19, 2011
  • 12:10 pm

Paper A99 posits an interesting intervention.

Children with at least one obese parent may, themselves, become obese and may develop low self esteem.

The ethical thing is to intervene early, stigmatize the child, thereby eliminating any risk of failure or delay in developing sufficiently low self esteem. There is nothing worse than a self-assured obese young person but this is preventable.

  • Sigmund
  • August 19, 2011
  • 12:23 pm

Paper A92 is of timely importance to our crusade.

The authors point out marketers offer sweet tasty foods that children innately prefer over bland flavorless treats and this state of affairs must not be permitted to continue, thus “government at all levels has an obligation to act”. The authors do not specify what the governments should act like, exactly, but acting like ‘prying nagging authoritarian dictocrats’ might be a reasonable surmise.

  • Sigmund
  • August 19, 2011
  • 12:32 pm

Paper A95 is, in my opinion, the finest of the lot.

The authors craft a much-needed loophole in strident Nanny State interventions and prescriptions. Declaring a child’s status as ” with special health care needs” excuses everyone involved from direct participation in Nanny State enforcement as it is to be imposed upon the common rabble. Fortunately, my child and yours is and always has been ‘special’ in every important way. I think the kid has earned a little sweet treat, don’t you?

  • Cathy Richards
  • August 19, 2011
  • 2:17 pm

Thanks Marion for collecting these references for us all in one place.

  • Darliene Howell
  • August 20, 2011
  • 3:34 am

@Sigmund – YOU, sir, made me smile and laugh out loud! I love your analysis and pointed summation to these “ethical” essays. Big fat hugs to you!

[...] Marion Nestle provides an interesting look at the ethics of childhood obesity interventions [...]

  • Anthro
  • August 20, 2011
  • 11:49 am

Sigmund is a troll, Darlene, and he amuses only those who miss the entire point of this blog and of Professor Nestle’s tireless work on behalf of public health.

  • Jon
  • August 20, 2011
  • 1:51 pm

Cracked summarized the reason for not intervening on obesity better than anyone. (The article itself is about front groups in general, but the first, second, and sixth ones fit our discussion.)

Sigmund forgets that we’re dealing with children, and children are…children.

And of course, there’s always Michele Bachmann, who hates food stamps, but God help you if you try to restrict what they’re redeemable on. (In that case, soda.)

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