Politics, Regulations and Obesity

Warisa Panichkriangkrai DDS, MPHInternational Health Policy Program Fellow

Ministry of Public Health, Thailand risapanich@yahoo.com

apps.who.int/infobase/report.aspx?rid=118&print=1

2005

apps.who.int/infobase/report.aspx?rid=118&print=1

2015

The Politics of Obesity: A Current Assessment and Look Ahead

Rogan Kersh, New York University

The Milbank Quarterly, Vol. 87, No. 1, 2009(pp. 295-316)

Outline

1. Obesity Politics: An Issue regime Emerges2. State and Local policy responses

3. Looking Ahead: Promising Approaches

OBESITY

“ Supersizing of America ”

Health Effects

$120 billion lost

NEWS and Reports

“ISSUE REGIME”

BIG & CHAOTIC SMALL & SYSTEMATICideas, arguments,

viewpoints,

opinions from many

parties

Issue regime

1. Familiar voices

2. Solidifying frames

3. Limited national options

1. Familiar Voices

www.ific.org/research/obesitytrends.cfm

2. Solidifying Frames

2.1 Personal responsibility

2.2 Environmental frames

2.1 Personal responsibility = concern of individual consumers

overeating and consuming high-fat, low nutrition foods

Responsibility and Political effect

Obesity = Personal failure

• difficult to mobilize• point away from robust legislative solutions“ SOFT MEASURE ”

Government-sanctioned nutrition education Exercise promotion

2.2 Environmental frames

• expanding portion sizes• foods high in fat, sugar and sodium• availability of food at outlets• advertising of high-fat, low-nutrition foods

“ induced demand ”

3. Limited National Policy Optionsexercise

promotionobesity-

education program

consumer-injury

lawsuits

No policy change effort

3. Limited National Policy Options

Regulations

Successful food-indust

ry lobbyi

ng

Little support from Congress

subsidizing healthy food,

restricting advertising,

limiting unhealthy food sales, offering

economic incentives,

Federal litigation

Issue regime

Minimal federal government action

Positive sideNegative

side• Source of political stability• Shape and guide policy action

• Deterrent to innovative reforms• Difficult to alter the path of action

State and Local policy responses

1. Calorie Menu Labeling

2. School Policies

1. Calorie Menu Labeling

www.worldchanging.com/archives/007241.html

http://www.restaurantdietitian.com/menu_labeling_law.html

Menu Education And Labeling Act

+

-

Calorie Menu Labeling

Questions remain:

• consumers see or understand label?• any difference in consumers behavior?

2. School Policies

• Limits on sugar, fat and sodium consumption in school cafeterias

• Voluntary bans on sodas in vending machines

• School Nutrition Policy Initiative (SNPI)

SNPI

• removing all sodas• encourage the consumption of nutritious foods

50% reduction of obesity incidence

Nationwide D+

Pennsylvania

Looking Ahead: Promising Approaches

1. Foods of Minimal Nutritional Value (FMNV)

2. Reformulation

1. Foods of Minimal Nutritional Value(FMNV)List of reducing

• soft drinks• water ices• chewing gum• certain candies

Remain unchanged since 1980 !!!

2. Reformulation• Removal or reduction of ingredients that linked to rising obesity rates ( fat, salt, sugar )• Government effort• a moral-suasion campaign• creating a low-interest federal loan program for food and beverage industry

• Potential danger = food safety risk

Conclusion

• Policies that gain legislative favor• Clear plan of action• A program of “rapid-response” research• The genetic component research

www.who.int

2005

www.who.int

2015

Ecological Model

Personal responsibi

lityEnvironmental

frames

VS

Policy change

RegulationsPolicy

analysis research,

Media, Food industry

Help groupConcern

about obesity problem

The National School Lunch Program

Schools get cash subsidies from USDA

Schools must serve lunches that meet Federal requirements

http://www.youtube.com/watch?v=tVfAWbitBTs

http://www.opensecrets.org/lobby/indusclient.php?year=2008&lname=N01&id=

Regulatory axes on food advertising

to children on television

Elizabeth Handsley, Kaye Mehta, John Coveney and Chris NehmyAustralia and New Zealand Health

Policy 2009, 6: 1

Outline1. The type of

program2. The type of

product3. The target

audience4. The time of day5. The content of the

advertisement

The type of program: Dedicated children’s program

Australia “ C ” programCommercial free program

Sweden For children under 12 year oldNo advertising during and immediately before or after a program

Britain Programs specially made for children

The type of product

Food generally

Lesser restriction Not contain any misleading or incorrect information

Junk food How to define? - UK: High fat, sugar and salt - High sugar VS beneficial nutrientsAdvertisements for brand VS products

Children’s food

Advertiser Code for Advertising to Children (ACAC) - aim to childrenShould include foods that children have too great preference?

The target audience

AgeNot for children under 13 year old

Criteria Advisory note• nature of product• theme of commercial• story line• visual used in commercial• language• age of actor• target audience

The time of day

Classification

• How children spend their day and when they watch TV?• When children make up a given proportion of audience?• At a given time, what is the proportion of children to be expected watching TV?

Watershed

Exact time

The content of the advertisement

Factors limit the

effectiveness of

regulations

• Personalities

• Premiums

• Pester power

• Misleading

• Promoting unhealthy

lifestyles

Conclusion

The most effective means• Limit time that children expose to food advertising

Consumers can understand the criteria

Program: Thailand view

No commercial free program 42 snack advertisements / 1 hour program

Thailand view

• government: strong regulations, strong action• broadcast system: moral• consumers: breach finding & complaint system