We are pleased to welcome Thomas Peterson to TDWI as guest blogger.  He is a pediatrician and Executive Director of Safety, Quality, and Community Health at Helen DeVos Children’s Hospital, in beautiful Grand Rapids, MI (love the Leonardo daVinci Big Horse).  De Vos is part of Spectrum Health, an award-winning Michigan health care system.  

By Thomas Peterson, MD, FAAP  

Thomas Peterson, MD, Pediatrician, Grand Rapids, Michigan
Dr. Thomas Peterson, Pediatrician & Patient Safety expert in Grand Rapids, Michigan

I’ve spent much of my life leading efforts that combat smoking, and I’m struck by the similarities between that fight and the one that we must now wage against childhood obesity. The good news is that there are lessons from the struggle against tobacco on which we can build.

Childhood obesity has more than tripled in 30 years, according to the Centers for Disease Control and Prevention: “The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 20% in 2008. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to 18% over the same period. In 2008, more than one third of children and adolescents were overweight or obese.” 

This is a huge issue for both the near-term and long-term health of children, as childhood obesity increases the likelihood of adult obesity and the many chronic and acute illnesses associated with it. It also foreshadows ever-growing challenges in meeting our nation’s health care needs. 

According to “America’s Health Rankings (2010)”, 26.9 percent of the U.S. population is now obese – up from 11.6 percent 10 years earlier. AsUSA Today commented on the report, “If Americans continue to pack on pounds, obesity will cost the USA about $344 billion in medical-related expenses by 2018, eating up about 21% of health-care spending.” 

And those expenses are largely avoidable because obesity is, for the most part, preventable. It’s heavily influenced by what we eat, and that’s where some of the comparisons to tobacco arise. Manufacturers of fast food and snack food are inundating Americans, and especially children, with advertisements that encourage the wrong kinds of food, and are making that food increasingly accessible. 

According to the Yale Rudd Center for Food Policy and Obesity, “The fast food industry spent more than $4.2 billion in 2009 on TV advertising, radio, magazines, outdoor advertising, and other media. The average preschooler (2-5 years) saw 2.8 TV ads for fast food every day in 2009; children (6-11 years) saw 3.5; and teens (12-17 years) saw 4.7. Young people’s exposure to fast food TV ads has increased. Compared to 2003, preschoolers viewed 21% more fast food ads in 2009, children viewed 34% more, and teens viewed 39% more.” 

Not surprisingly, consumption of fast food has grown enormously. According to Fast Food Nation by Eric Schlosser, “In 1970, Americans spent about $6 billion on fast food; in 2000, they spent more than $110 billion.” According to the BBC, Americans spent $3 billion just on potato chips in 2007. 

That’s where the parallels to tobacco become so strong – the sheer weight of the marketing and the focus on influencing young children. 

A recent report from the Campaign for Tobacco-Free Kids states: “The major tobacco companies now spend about $10.5 billion per year (nearly $29 million every day) to promote their products; and many of their marketing efforts directly reach kids. In fact, tobacco company spending to market their deadly products increased by 52 percent from 1998 to 2008 (the most recent year for which complete data is available).” 

Eating badly is different from smoking, of course, in that it’s not addictive, and while we don’t have to smoke, we do have to eat. And the connection between poor diet and poor health is not as direct as the connection between smoking and lung cancer. 

Nevertheless, the parallels are unmistakable: smoking and obesity are the nation’s two most preventable destroyers of health; they are both heavily influenced by corporate marketing, which has typically preyed on children as a focus of marketing strategies, and they have both benefited from growth resulting from relatively inexpensive products. According to Grist, “In 2004, University of Washington obesity researcher Adam Drewnowski found that a single dollar could purchase 1,200 calories of cookies or potato chips, but only 250 calories of carrots.” 

That’s why the lessons from combating tobacco – which helped cut smoking rates in the United States by more than half from 1965 to 2007 – are so valuable. The lessons include the following: 

·         The public achieves benefits when the comparative cost of unhealthy products is increased. In the case of tobacco, that occurred through increased sales taxes; in the case of fast food, it could occur through subsidies for healthy foods – especially fruits and vegetables. 

·         The power of corporate marketing must be counter-balanced. Funding aggressive national campaigns for healthy eating or to fight obesity should become a priority. 

·         Access to unhealthy products should be reduced. Just as smoke-free worksite laws significantly limited access to smoking, the availability of unhealthy food products near or in schools and other public facilities that children frequently access should be increasingly restricted. 

It’s time we put the lessons from tobacco into action for better eating. Our nation’s health depends on it.


Patricia Salber MD, MBA (@docweighsin)
Patricia Salber, MD, MBA is the Founder and Editor-in-Chief of The Doctor Weighs In. She is also the CEO of Health Tech Hatch, the sister site of TDWI that helps innovators tell their stories to the world. She is also a physician executive who has worked in all aspects of healthcare including practicing emergency physician, health plan executive, consultant to employers, CMS, and other organizations. She is a Board Certified Internist and Emergency Physician who loves to write about just about anything that has to do with healthcare.


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