Can the First Lady Solve the Childhood Obesity Epidemic?

Earlier this year, First Lady Michelle Obama unveiled her signature policy initiative: the Let’s Move campaign. The First Lady’s campaign brings together a diverse group of stakeholders, including government agencies, food and beverage companies, pediatricians and health care providers, athletes, parents, and children with the ambitious goal of solving the childhood obesity problem in America within a generation.

In the weeks since the official launch, Mrs. Obama has addressed both the nation’s mayors and governors to stress the importance of taking action in their communities; traveled to Philadelphia to talk about food deserts and access to healthy foods; visited Mississippi to talk about building healthy school environments; and practiced soccer drills with Major League Soccer stars and Washington, D.C. area school children to emphasize the importance of getting 60 minutes of physical activity each day.

Both the mainstream and non-traditional media have covered her every move, and in doing so, have echoed the four major themes of the campaign: Making healthy food choices; creating healthy school environments, increasing physical activity, and enhancing access to healthy foods for all Americans.

There’s even a blog devoted to tracking the Let’s Move campaign and other White House food initiatives – Obama Foodorama.

There’s no doubt Mrs. Obama’s Let’s Move campaign has re-energized public health officials, community health workers, and advocates who have been fighting the childhood obesity epidemic for years. But the latest numbers from the U.S. Centers for Disease Control and Prevention show just what a challenge solving the problem will be: nearly one-third of American children and adolescents are overweight or obese.

Although the number of overweight and obese kids has stabilized in recent years, the rates are still far too high. Obese and overweight children are not only at increased risk of becoming obese adults, but they also are at elevated risk for many chronic diseases, like type 2 diabetes, heart disease, and some cancers. The health care costs associated with obesity-related illnesses are staggering – an estimated $147 billion a year, or nearly 10 percent of all medical spending. Studies suggest that the current generation of children may live shorter, less healthy lives than their parents.

So what does Let’s Move bring to the table that suggests this initiative might actually succeed?  First, there is strong support from government, specifically that of the President and First Lady as well as top-level cabinet officials. While countless U.S. government reports have called attention to the problem of childhood obesity, this is the first time we’ve seen a call to action from the White House. The First Lady has the unique ability to bring together not only federal officials, but a diverse group of stakeholders who can work together on finding a solution.  She has the best bully-pulpit in the world – the White House – from which to talk about these issues and raise awareness about steps communities, parents, and children can take to eat healthier and engage in more physical activity.

Second, this effort recognizes that the solution to childhood obesity does not lie in one government agency or sector, but rather that this problem requires a cross-cutting, mulit-sectoral systems response. We see this in both the broad support Let’s Move enjoys from various sectors, and in the President’s announcement of a national Task Force on Childhood Obesity. The Task Force is made up of senior officials from not only the Department of Health and Human Services, but also the Departments of Interior, Agriculture, and Education. By reaching beyond only health officials, President Obama and the First Lady have acknowledged there are many factors that influence childhood obesity and that a solution to the problem cannot come from the health sector alone. The Task Force has 90 days from its establishment on February 9 to develop a coordinated federal response to addressing the four priority areas of Let’s Move. In addition to identifying actions federal agencies can take, the Task Force also will identify nongovernmental actions that can be taken to solve the problem of childhood obesity.

The idea that government alone cannot solve this problem is a third reason to think that Let’s Move will succeed. Michelle Obama is the first to acknowledge that parents and children make the ultimate choices about their health, while the role of government is to help make the healthy choices the easy ones. That’s why Let’s Move’s focus on ensuring access to healthy, affordable foods is so exciting. For too long, government officials, doctors, and nutritionists have simply urged Americans to eat healthier by adding more fruit and vegetables, whole grains, lean proteins, and low-fat dairy products to their diets. There wasn’t any sort of recognition that for some communities, these foods were either unavailable in the local stores or simply unaffordable.  (Check out USDA’s Food Environment Atlas to see how your state compares.)

By making access to healthy and affordable foods a priority of Let’s Move – and backing that up with a proposal in the President’s FY 2011 budget to invest $400 million a year to provide financial incentives to grocery stores to open in underserved areas – the campaign is targeting a huge barrier that many American families face when attempting to eat healthy.

So will Let’s Move be able to accomplish what years of work by public health officials, health care providers, and community groups have so far been unable to do?  There is reason for optimism, but of course only time will tell. Sadly, response to the effort has not been completely rosy – already there’s been some backlash from parents who worry about the “Obesity Police” and insist the government has no business telling them how to feed their children.

But as a public health advocate, it is my hope that this effort has at least positioned us nearer to the end of the obesity crisis than the beginning. By working across sectors, outlining clear roles and responsibilities, and challenging children and parents to take responsibility for their own health, Let’s Move has laid some of the best groundwork yet to meet the lofty goal of solving the childhood obesity problem within a generation.


Special Contributor Serena Vinter is a Senior Research Associate at Trust for America’s Health. Her bi-monthly column for the Health Policy Forum focuses on the need to include prevention and wellness in our discussions about the health system in the United States. “Special Contributors” are regular contributors to the Health Policy Forum who pose their own opinions and policy positions in the realm of health care and health policy. As a leading nonprofit health care research and consulting institute dedicated to improving human health, Altarum encourages open discussion and debate about the many challenges in health care today. All postings to the Health Policy Forum (whether from employees or those outside the Institute) represent the views of the individual authors and/or organizations and do not necessarily represent the position, interests, strategy, or opinions of Altarum Institute. Altarum is a nonprofit, nonpartisan organization. No posting should be considered an endorsement by Altarum of individual candidates, political parties, opinions, or policy positions. Read more.

2 Responses to Can the First Lady Solve the Childhood Obesity Epidemic?

  1. Dee Leggett

    Another silly backlash is the recent ruling by NYC schools that bake sales can only sell pre-packged calorie labeled foods.

    I hope that USDA’s role is more than school lunch and nutrition programs, but also considers food supply issues, organic food availability, the farm bill (very political I understand but still in desperate need of reform), and the web of so many things that affect what we eat and what we pay for what we eat.

  2. Kudos to First Lady Michelle Obama and Let’s Move for the increased visibility, dialog, and action we are now seeing!

    Still, even as the First Lady hits the airways to promote Let’s Move, the national campaign “to solve the epidemic of childhood obesity within a generation,” we are seeing a range of inspired, apparently well intended, though too often superficial, fixes. Most of these fixes choose to work around the current system, rather than change it — it all seems a bit nip-here, tuck-there when we really need a complete transformation — and so the question is, when it comes to childhood obesity, will “workarounds” work?

    A workaround, according to Wikipedia, “is a bypass of a recognized problem in a system…a temporary fix that implies that a genuine solution to the problem is needed. Typically they are considered brittle in that they will not respond well to further pressure from a system beyond the original design. In implementing a workaround it is important to flag the change so as to later implement a proper solution.”

    Of course, “later” is always “later.” And ”implementing a proper solution” means that we will need to acknowledge the underlying causes of the problem we had previously decided to “bypass.” And when we do decide that “later” is now (perhaps when “further pressure” from the “system” becomes too much for our “brittle” workarounds to bear) – and we are finally willing to address the “recognized problem” with a “genuine solution” — will we undo all these ”temporary” changes we so diligently remembered to “flag”?

    Phew! Makes me wonder why we bother with workarounds in the first place…

    But let’s give credit where credit is due. Many of the actions we’re now seeing are, as the Wikipedia definition goes, “as creative as true solutions.”

    For example, just last week we read about an innovative effort in Baltimore that uses libraries as “virtual supermarkets” to work around severe nutrition gaps in the city’s food deserts. We heard snack and soda companies vow to alter their ingredients and distribution practices to work around the more drastic step of abolishing or taxing their products. And we learned of a new bill that dramatically reduces the money requested for school food reform to work around the lack of support for an earlier proposal.

    Admittedly, each of these actions will produce a result. And perhaps quick fixes are a way to get us moving, which seems to be the spirit of the Let’s Move campaign.

    A step further is to “flag” these and similar fixes as provisional, so that we can begin to understand their impact as well as their shortcomings, as we continue with equal passion the ongoing work of uncovering the roots of the epidemic. In this work, we begin with questions rather than fixes. We ask, for instance, why is it that food deserts exist in the first place?

    We might even begin to unravel that most gnarly of hairballs at the center of the obesity epidemic: How is it that America became, as Newsweek’s Claudia Kalb puts it, “the world’s preeminent fat-making machine”? She writes:

    “We got here through multiple innovations, many of them meant to improve, not corrupt, our lifestyles. Fast food is a quick fix for hungry working families. Cars and buses get kids to school faster than sidewalks. We have grown used to a world order of speed and convenience…

    “The National School Lunch Program, signed into law in 1946 by President Harry Truman, was designed to feed hungry children who needed extra calories… With a focus on standards of learning propelled by the reading- and math-focused No Child Left Behind Act, many schools cannot afford, financially or academically, to offer physical education… Our suburban designs, influenced by age-old zoning laws, also work against us… And then there’s rampant marketing. Food and drink advertising to children… (And) government subsidies on abundant commodities like corn and soy. High-fructose corn syrup, synthesized from corn, is a main ingredient in a multitude of sweetened drinks and snacks.”

    In short, she concludes, “An entire cultural shift is required.”

    So, when it comes to childhood obesity, will a new round of workarounds work? Will they see us through until we get to a genuine solution? Will we question after the root causes? Or will we keep adding workarounds to our workarounds, with the illusion of progress, until our passion turns to complacency, or resignation, or distraction — or whatever it was that consumed us when we first saw the trends (5, 10, 20 years ago?) and decided that a “proper solution” just wasn’t palatable?

    As the First Lady writes in her recent Newsweek article, “For years, we’ve known about the epidemic of childhood obesity in America.” The good news, she notes, is “that we can decide to solve this problem.”

    (from blog posting at:

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Senior Research Associate, Trust for America's Health