Oral

This session will have a “point-counterpoint” style in arguing for different approaches to address the obesity epidemic. The obesity epidemic has been growing over the past 30 years, and while in some groups it may have plateaued, it is still increasing in others, especially minorities. The consequences to health and well-being are enormous, and no solution to reverse the epidemic has yet to be discovered that makes a difference at the population level. The first two speakers will take two opposite positions on how they conceptualize the causes of obesity and the types of solutions that are necessary. One will argue for substantial change on a level similar to the 19th century Sanitary Revolution which resulted in completely new city infrastructures, including the introduction of indoor plumbing, sewage systems, and strict housing codes. This speaker will argue for increased government regulation of the food environment, including standards for portion control instead of menu-labeling in restaurants and restrictions on impulse marketing, for example prohibitions on selling items like candy, soda and chips in salient locations, like near cash registers or on end aisle displays. The second speaker will argue that individuals have the capacity to take steps to avoid obesity without excessive government intervention. He will present findings that support that the direction of current efforts is acceptable, and that caution must be taken to avoid unintended consequences. The third speaker represents a progressive health insurance company from South Africa that is already taking radical steps to address obesity, and will present examples of one way in which they are both changing the environment and incentivizing health plan enrollees to make better choices, by subsidizing healthy foods. The last speaker will discuss how and why the government should establish performance standards for away from home food and how the standards could be implemented, either voluntary or mandatory, and what the potential implications would be. Finally, the panel will discuss key points and poll the audience as to which direction—increased public health intervention vs. limited government interference and reliance on the private sector will be the best approach.

Session Objectives: 1. Describe the history of public health practice and how it has been effective in reducing morbidity and mortality through regulation; 2. Analyze whether similar approaches are relevant for obesity control; and 3. Describe current approaches to obesity control, and whether they are sufficient.