Government Menu Mandates Are Not Curing Obesity

Obesity rates may be leveling off or even falling.


Mallinaltzin / Wikimedia Commns

Earlier this week, the Robert Wood Johnson Foundation (RWJF), the multi-billion-dollar health philanthropy and grant-maker, took part in an online event hosted by TEDMED, a forum that tracks closely with the TED Talk model (and which was also created by TED's founder).

This week's event, TEDMED Great Challenges: A Candid Conversation About Childhood Obesity, looked at ways to ensure American children have "an equal opportunity to grow up at a healthy weight."

RWJF used the event to highlight Philadelphia, which has become a focal point of RWJF's anti-obesity work. Obesity levels there and elsewhere across the country have been high enough that RWJF has painted a gloomy portrait of our future.

"Just two years ago, the Robert Wood Johnson Foundation and Trust for America's Health predicted that, if trends continued the way they seemed to be going, more than 60% of adults in 13 states would be obese by the year 2030—and have the extremely high medical bills to prove it," the TEDMED primer noted.

But what's happening in Philadelphia has helped changed the narrative.

"But now, we're finally starting to see signs of progress against an epidemic that was once feared to be unstoppable," wrote TEDMED.

So what's the change? And what's behind it?

The good news is that data show obesity levels among K-12 students in Philadelphia fell by 4.7 percent from the 2006-2007 school year to the 2009-2010 school year. The caveat there—and it's a big one—is that the data doesn't track individual students. So there's no way of knowing whether this is due to some influx of younger students who aren't obese, older obese students graduating (or moving away, or dropping out of school), some combination, or something else entirely.

This clear uncertainty, though, hasn't stopped RWJF from suggesting that policy changes it favors are behind the change.

Among the six factors RWJF cites as part of Philadelphia's efforts "working to address obesity" is the fact the city "required chain restaurants to post calorie information on menus and menu boards."

Cheering on mandatory calorie labeling is a constant RWJF refrain. In a 2013 report listing four key strategies for reducing obesity, for example, RWJF also credited four states for "requiring chain restaurants to post nutrition information."

But, as I've written before, laws requiring the posting of calorie counts don't work. In fact, research has shown they can push people to ingest more calories, rather than fewer.

This is precisely the problem. RWJF touts many policies. Some might work. Some might not. That's fine. But some have been shown not to work. And RWJF appears to treat all of these very different animals—the uncertain ones and the certainly-not-working ones—as cogs that are part of a real reduction in obesity levels. And it does so without even knowing who, exactly, the less obese people are.

This sloppiness is a longstanding problem in RWJF's work.

In 2012, for example, I wrote about another RWJF study that looked at areas the group said were experiencing "the most progress" in combating childhood obesity.

As I noted after sifting through the data, what RWJF was touting was, among other things, a reported "decrease of 1.1 percent in the obese/overweight levels of [two] completely different set[s] of students over five years."

Worse than touting a statistically insignificant decrease in childhood obesity as an area of great "progress," RWJF failed to note that the group it paid to carry out the research had also noted that "the majority of counties in the state [of California, where the study was centered, are] still registering increases in obesity rates among school-age children."

If this is evidence from places with "the most progress," then I suppose any old Pyrrhic victory is worth celebrating.

The 2012 study has been updated since my last look, with more data added last year. Some of the decline—as high as 21.4 percent in one case—are impressive on paper. But the data suffers from some of the same flaws, including that the research is often tracking two entirely different sets of individuals in the same location.

In any case, the good news is that obesity levels do appear to be leveling off in some places, and among some populations. As The New York Times reported, in 2012, they are "the first indication that the obesity epidemic, one of the nation's most intractable health problems, may actually be reversing course."

This could be the result of any number of factors. It could be the result of one singe factor. No one knows.

Researchers, the Times reported, "say they are not sure what is behind the declines." But "many scientists doubt that anti-obesity programs actually work."

And until research proves a definitive causal link between specific changes and specific outcomes, groups like RWJF (and others) would best serve the public by halting claims that the group knows how to reduce obesity levels or, worse, that RWJF's disproven policy prescriptions are behind any positive trends.