With one in three children in the United States struggling with weight problems, the fight against childhood obesity is becoming ever more desperate. Some of the new health care provisions that are going into effect this year include insurance coverage for screening, counseling and other preventive care measures for obese children.

While the need for more programs for preventing and treating childhood obesity is obvious, experts say that creating them poses considerable challenges. “Few proven models exist for helping children and adolescents to achieve and maintain a healthier weight, and researchers do not even fully understand the factors that contributed to the rapid rise in childhood obesity in recent years,” writes Reed Abelson in an article for the New York Times, titled “Learning to be Lean” (1/17/2012).

Insurance companies are developing new policies to determine treatment coverage of childhood obesity. One insurer, Wellpoint, is working with pediatricians by offering training in obesity treatment and connecting them with dietitians. And Weight Watchers has announced an upcoming program specifically designed to meet the needs of overweight children and teenagers.
Experts agree that for the fight against childhood obesity to be successful, the focus must be on the greater environment today’s children live in, including families, the media, schools and communities.

Parents
The home is the place where children first learn and develop their eating and lifestyle habits. Parents decide what kind of food is being brought into the house, how it is prepared and how much is served at the dinner table. Parents influence through their own behavior what lifestyles their kids adopt, how physically active they are, how much time they spend watching TV, and how much sleep they get.

For these reasons and others, diet- and lifestyle counseling and education should first be directed towards the parents, according to Dr. Adam P. Knowlden and Dr. Manoj Sharma, both pediatricians at the University of Cincinnati and co-authors of a systematic review of clinical studies of pediatric obesity. Unfortunately, the need for educating parents of overweight children is often difficult to meet. Even those who seek counseling (and by far too few do) don’t always have access to the right resources.

Media
Parents are oftentimes defenseless against outside influences, especially the daily onslaught of advertising by food companies that spend billions on TV ads and product placements geared towards children, according to Dr. Victor Strasburger, a professor of pediatrics at the University of New Mexico School of Medicine and lead author of a study report by the American Academy of Pediatrics (AAP), titled “Children, Adolescents and Advertising.”

“It’s not that easy when you are up against Ronald McDonald,” says Dr. Strasburger, referring to McDonald’s iconic clown character that is popular with many kids. “In fact, it is inherently unfair and deceptive to advertise to children who are too young and too impressionable to distinguish between advertising and factual reporting,” he says.

On average, children watch up to 10,000 food and snack commercials every year, according to the AAP. The best thing parents can hope for is limiting the time their kids are exposed to television and other advertising outlets, which, of course, is easier said than done.

In response to the AAP report, the Federal Trade Commission (FTC) has asked food manufacturers to regulate their marketing efforts to children but has stopped short of asking for any binding policies. Critics say that calling for voluntary self-regulation by the industry is not sufficient to change the existing advertising practices.

Schools
Despite of the government’s more recent efforts to improve the National School Lunch Program with “The Healthy, Hunger-Free Kids Act of 2010,” many schools across the country still don’t have the necessary resources for facilities and personnel to meet the nutritional needs of their students. Due to the downturn of the economy in years past, millions of children depend on the free or subsidized meals they receive at their schools, which in many cases is the only food source available to them. School officials say the increase of federal reimbursement for school lunches by 6 cents per meal does not nearly cover the costs for the growing demand.

So, vending machines filled with sodas and snack foods will not disappear from campuses as long as schools depend on corporate funding for many of their programs and services. And physical Education (PE) is still not available in all schools because of budget limits. The bottom line is that too many schools continue to fail doing their part in the fight against childhood obesity.

Communities
When Michelle Obama started the “Let’s Move” initiative, she put much emphasis on the role of communities. In general, the response was strong and countless grassroots movements have been brought to life all over the country ever since. What is sorely lacking, however, are important changes in our infrastructure. Due to budget crunches, more public parks and playgrounds are being closed than opened. Many cities don’t have bike paths or safe areas to run. Low-income neighborhoods are often too dangerous to let kids play outside or even walk to and from school. In a nutshell: Too many communal environments are not designed to allow kids to be physically active and stay healthy and fit.

Of course, there are many more factors to be considered if we are to deal with the childhood obesity crisis effectively. But these are some of the central issues in this complex task. Education of the public, regulation of industry, funding of school lunch programs and other health services for the young as well as building community support systems and infrastructure are all crucial elements in this fight. Addressing all of them in a comprehensive manner might get us somewhere, hopefully sooner rather than later.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.