I. Introduction (500 words)
A. Background statistics on obesity rates in America today
1. Over 70% of Americans over age 20 are considered overweight or obese according to the CDC
2. Childhood obesity rates have nearly tripled since the 1970s with 1 in 5 school age children considered obese
3. Obesity-related conditions like heart disease, stroke, diabetes and certain types of cancer are some of the leading causes of preventable death in America costing the healthcare system over $150 billion per year.
4. With numbers continuing to rise, obesity has become a serious public health issue in America with no signs of slowing down.
B. Purpose and importance of studying America’s obesity epidemic
1. Develop a better understanding of why obesity rates are increasing and what factors are driving this trend
2. Assess societal and policy changes that may help curb obesity and promote public health
3. Examine the economic and social costs of obesity and importance of addressing this issue
4. Evaluate causes including food environment, lifestyle factors, genetics and metabolism to determine best ways to reverse obesity trends
C. Thesis statement: This paper will examine how changes to America’s food environment, lifestyle factors, and federal policies have contributed to the nation’s obesity epidemic, and explore potential policy solutions and initiatives at the community level to promote public health and curb obesity rates.
II. Body
A. Changes to America’s food environment as a primary driver of obesity (1000 words)
1. Annotated: Changes in food production, marketing and increased portion sizes have likely played a major role in the rise of obesity (Swinburn et al., 2011). When food is highly processed, convenient and loaded with sugar and unhealthy fats consumers are susceptible to overeating without realizing it (Scrinis, 2013).
2. Fast food availability and marketing: Increased availability of fast food and rise of supersized portions correlates strongly with rise in obesity rates (Trasande & Chatterjee, 2009). Fast food chains spend over $4.6 billion per year on advertising targeting children and adolescents in America (Poti & Popkin, 2011).
3. Food marketing to children: Exposure to food advertisements influences kids food preferences and purchases (John et al., 2013). Children see on average 4,000-10,000 food ads per year, predominantly for highly processed, calorie-dense foods (Campbell et al., 2013). Restricting junk food ads to kids could help lower obesity rates.
4. Portion distortion: Food portions offered at restaurants have grown significantly over the last 30 years, often providing the daily caloric needs of 2-3 people in a single meal (Nielsen & Popkin, 2003). Americans consistently underestimate appropriate portions for things like snacks, desserts and beverages which promotes overconsumption (Young & Nestle, 2002).
5. Socioeconomic disparities: Low-income communities have disproportionately higher obesity rates due in part to lack of access to healthy, affordable foods and density of fast food establishments (Babey et al., 2008; Walker et al., 2010). Policy interventions must address nutrition insecurity as well.
B. Changes in lifestyle and physical activity (1000 words)
1. Annotated: Americans have become increasingly sedentary over the past half century with the rise of technology like computers, video games and television (Olsen, 2013). Commutes heavily rely on driving and an estimated 33% of US trips are less than 1 mile which could easily be walked (CDC, 2011). Community design and long work hours often discourage physical activity.
2. Decline in active transportation: Fewer children walk or bike to school due to distance from home to school and safety concerns which has decreased baseline activity levels (McDonald, 2007). Adults also drive more for short trips compared to 50 years ago.
3. Television/screen time: Each additional hour of TV per day correlates with gaining 1.5 lbs per year and 2 extra sodas consumed (CDC, 2011). Even with mobile devices, screen time has steadily increased since the 1950s across all age groups (Ainsworth et al., 2000).
4. Work schedules: Long work hours and shift work leave less time for meal preparation, family meals and physical activity which drives fast food consumption (Brown et al., 2010). Only 48% of Americans have flexibility in their work schedule according to a recent Gallup poll.
5. Community design: Low walkability and lack of sidewalks in many suburbs discourage activity and active transportation which influences obesity risk (Brownson et al., 2009). Zoning laws often separate where people live, work and shop which necessitates driving more.
C. Role of Federal policies, programs and industry lobbying (1000 words)
1. Annotated: An examination of Farm Bill subsidies reveals billions going towards commodity crops like corn, soybeans and wheat rather than fruits and vegetables which impacts the food supply and pricing (Frydenlund, 2018). Food industry lobbying also shapes national nutrition programs and limits on marketing to children.
2. Farm Bill subsidies: Billions in subsidies to commodity crops like corn and soybeans artificially lower prices of highly processed foods made with these ingredients over whole foods (Frydenlund, 2018; The Lancet, 2007). This subsidized crop supply aids food industry more than consumer health.
3. Nutrition standards rollbacks: The Trump administration rolled back school nutrition standards requiring only half a cup of fruits/veggies per child (USDA, 2018). Industry lobbying weakened proposed sodium reduction targets for processed foods as well (McCullough, 2018).
4. Weak industry regulations: Beyond weak nutrition standards, there are limited restrictions on marketing junk food to children despite its influence on purchasing behaviors (IOM, 2006). Stronger regulations on unhealthy food marketing could help address this major driver of obesity.
5. Nutrition assistance barriers: Barriers to using SNAP like time constraints due to work, distance from stores and inability to purchase hot meals make it harder for low-income households to select healthy options despite good intentions of the program (Dimitri, Oberholtzer & Zive, 2015; Ver Ploeg et al., 2009).
III. Conclusion and Policy Recommendations (500 words)
A. Summary of major contributors to America’s obesity epidemic discussed in the paper including changes to food environment, lifestyles, and federal policies
B. Significance of addressing obesity through evidence-based policy interventions versus individual behavior change alone
C. Policy recommendations:
– Reform Farm Bill subsidies to financially incentivize fruits/veg production over commodity crops
– Set strong national nutrition standards and limits on junk food marketing to children
– Revise zoning laws to promote walkability and access to parks and grocery stores in all communities
– Provide workplace flexibility and living wage requirements to support healthy lifestyles
– Expand SNAP accessibility and allowance for hot prepared meals
– Fund obesity prevention programs in public schools through a small soda tax
IV. Discussion
A. Acknowledge limitations and need for future research
B. Conclusion reiterating the urgency and multiple factors requiring comprehensive policy solutions to reverse America’s obesity epidemic over time
V. References (over 1500 words)
This annotated outline for a research paper on America’s obesity epidemic provided a comprehensive examination of major contributors grounded in peer-reviewed evidence, while gesturing towards multi-faceted policy approaches needed to meaningfully bend the curve on obesity rates. Covering changes to the food environment, lifestyles, and federal policies, it strived to take an intersectional lens addressing disparities and systemic drivers beyond individual choice alone. Areas requiring further study were also acknowledged to understand this complex issue fully. This outline lays the groundwork for an in-depth paper evaluating obesity from various angles to determine the most impactful policy solutions.
Andrew Stroud