The following is an in-depth look at childhood obesity and its effect on ones self-esteem, and the responsibility of society in controlling this issue. The law, ethics and public policy that currently exists on childhood obesity and how it effects self-esteem is great. There are so many things popular right now from healthy vending machines, to teaching children how to eat healthy. There are sociological, economic, and cultural factors that “directly impact the obesity epidemic, complicating the attribution of fault for a child’s obesity. The years of the obesity epidemic have been a period of considerable change in the ethnic and cultural mix of many developed countriesâ€¦” 
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The law has found something popular and interesting about childhood obesity right now. Vending machines are being removed and replaced with “healthier” options, soda is no longer served in some schools, and it’s a bit trendy right now to be “healthy”. This is especially true when one considers the current First Lady and her initiatives to end childhood obesity. First Lady Michelle Obama started a health initiative when she planted her vegetable garden. The First lady has also tried to change public school meals so that they are more nutritious and healthy. In addition, Mrs. Obama can be seen during her numerous appearances on mass media outlets discussing this platform. The ethics of it comes from not just parental responsibility, but those in the community – we are all responsible for the well being of children, and doing what we can to help. “Considering the historic roots of childhood obesity in the United States and exploring the internal and external causes of obesity, we isolate those fundamental causes of childhood obesity that are within parental control. By identifying which of these causes are within parental control, we hope to provide clarity necessary to develop an effective legal standard that can serve as a guideline for legislatures to adopt and courts to enforce.” 
Finally, public policy is very interested in childhood obesity and the impending self esteem because there are so many resources available. The “public policy” that is interested is related to healthcare, education, family, and the environmental factors present in society.  I was born in 1987, and there are more resources available today than when I was growing up. I grew up an overweight child for several years, and myself esteem took a toll from it. Even at Ave Maria School of Law, we have “healthy” vending machines. Gone are the days I can get a sugar crash at 3 pm, I now can pick from a granola bar and coconut water for my afternoon snack.
This paper argues that the obesity epidemic in America is unnecessary. With research and awareness this obesity epidemic can become something of the past. The cost of childhood obesity and issues of overweight children has social and economic costs. In the Indiana Health Law Review, Sally Hubbard states that “youth overweight and obesity-related expenses will affect current and future generations of American citizens. These expenses, however, will not be confined to the treatment of children. Indeed, studies show that obese children are likely to become obese adults. The social costs of this transformation-loss of future wages and a reduction in our natural resource base-combined with the social opprobrium and the increased healthcare expenses associated with obesity, necessitate and reflect the urgency of a deeper exploration of states’ roles in addressing public health crises through public schools. This position is supported by a recent position statement issued by the American Heart Associationâ€¦ Public schools “could become the central element in a community system that ensures that students participate in enough physical activity to develop healthy lifestyles.” 
II. BACKGROUND OF CHILDHOOD OBESITY IN AMERICA
Each state and local school district plays a role in regulating school vending machines, lunches and physical education laws. In 1983, a shift took place from the federal government controlling school nutrition to now the local government controlling it. The case of National Soft Drink Ass’n v. Block  aided in this transition of control. The National Soft Drink Association (American Beverage Association) filed a lawsuit against the Secretary of Agriculture. The Secretary of Agriculture put a ban on the sale of sodas in schools that were federally funded by the Child Nutrition Act  of 1966.
The Court in Block held that the Secretary of Agriculture went beyond the scope of his authority when he declared “time and place regulations” that barred the sale of certain foods in schools until after the last meal had been served during that day. Consequently, The Child Nutrition Act of 1966 was altered to reflect the decision by the court; that sugary soda drinks, and other foods with no nutritional value were allowed in public schools during the day. Because of this, the federal efforts were weakened and states had to create their own laws on what was permitted in their public schools. 
Approximately 21-24% of American children and adolescents are overweight, and another 16-18% is obese; the prevalence of obesity is highest among specific ethnic groups.  Obesity increases the risk for a number of health factors, such as hypertension, adverse lipid concentrations, and insulin resistance and type 2 diabetes, liver and renal disease, and reproductive dysfunction. Childhood obesity also will increase the risk of adult-onset obesity and heart disease. Obesity in the United States has become more prevalent in the final decades of the 20th century than ever before. Notably, there is a slowing of the rate of increase or leveling off. This could be due to the initiatives and health concerns of the lawmakers and general populace. “More than one-third of adults and almost 17% of America’s youth were obese in 2009-2010. There was no change in the prevalence of obesity among adults or children from 2007-2008 to 2009-2010. Obesity prevalence did not differ between men and women. Adults aged 60 and over were more likely to be obese than younger adults.”  Obesity in children is not just a public policy concern, and health issue, it is a rather complex disorder. Throughout the developed world, childhood obesity has increased so significantly that it is considered a “major health concern.” 
The National Health and Nutrition Examination Survey shows that the prevalence of obesity is growing higher and higher in all age groups, in both sexes, and in various ethnic and racial groups among pediatric patients.  “Many factors, including genetics, environment, metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity. However, more than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes.” Id.
III. CHILDHOOD OBESITY IN AMERICA TODAY
The legal system must recognize parental accountability for childhood obesity. The solution to this issue is not tort law; suing fast-food restaurants or soda companies will not solve the problem. In the Duke Law Journal, it was proposed that large companies that sell unhealthy foods and beverages should be assigned the responsibility of helping to reduce the obesity rates in certain groups of children.  “Others believe that government should order specific changes in the behavior of food companies and school officials – and yet, there is little reason for confidence that these “command and control” strategies will make a difference.” 
Parental influence determines the type of food chosen for the children. “Surprisingly, children are more likely to be obese if they live in a household where prepared food items high in fat and sodium are frequently served.”  A study took place between 1977 and 1998. In this study, parents kept increasing the portions they served to their children. In comparison to what children ate in 1970, today’s children are consuming 350 more calories. Perhaps it is this trend which is increasing the risk of childhood obesity.  Some believe that the government should not intervene with the parental responsibility of how to feed their children. However, society needs to spur parents in the right direction when it comes to health and wellness of the children. 
Children who are obese as children are more likely to be obese adults. U.S. school age children consume an excess of 400 billion calories a year. Obesity is more prevalent among African Americans (44%) than among Mexican Americans (39%) and Non-Hispanic Whites (33%).  Over the last two decades, obesity in children two (2) – nineteen (19) has doubled.  These are alarming statistics; what changes have taken place in our country over the last two decades that childhood obesity has doubled? Many parents and governmental officials blame vending machines in school for why children are obese. “â€¦School-age children are eating 400 billion excess calories a year – the equivalent of 2 billion candy bars – from junk food sold in such machines as well as in snack bars and cafeterias that should be off-limits.”  On average, a snack from the vending machine is upwards of 130 calories a day. The calories add up, and turn into pounds. Schools in The South have been the most aggressive at fighting this issue. Some say it is because they have the biggest problem with childhood obesity, and obesity in general. 
In a recent study, researchers analyzed data on 6,300 students, living in 40 states. Their heights and weights were measured in spring 2004, when they were in 5th grade and again in 2007, during the spring of eighth grade.  Research was also conducted on several databases of state laws on school nutrition during the same time.
“The laws were aimed at restricting the food and drinks sold in public school vending machines and school stores, outside of mealtime. Laws were considered strong if they included specific nutrition requirements, such as limits on sugar and fats and were rated weak if the requirements were vague and merely urged sales of “healthy” food without specifics.”  Dr. Daniel Taber says that for laws to be consistent, they are to be enforced consistently at all grade levels. Dr. Taber is a health policy researcher at the University of Illinois at Chicago.
The laws referred to above are laws of each specific state. In some states, there are laws that are stricter on what sorts of foods are available in a vending machine at a school, or in the school lunch programs. Each state has their own laws, despite the new, federal initiatives. “In late 2003, 27 of the states studied had no relevant laws affecting middle-schoolers, seven had weak laws and six had strong laws. Several states and school districts enacted tougher laws affecting middle-schoolers and younger kidsâ€¦as national concern rose over obesity ratesâ€¦ In states with no relevant laws, almost 37 percent of fifth-graders were overweight and 21 percent were obeseâ€¦those numbers barely budged by eighth grade.” 
Children in the study gained less weight from the fifth grade until eighth grade if they lived in states with strong, consistent laws that governed which snacks are available in schools, compared to the children in the same age category who lived in areas with no laws on the issue. 
The government has an interest in children being fit, not just because its important to be healthy, but these students may join the military some day.  Retired Air Force Lieutenant General Norman Seip said “The folks that are going to enter the military in 2025 are in school right now. So it’s up to us to ensure that when those children reach the age of between 17 and 24 that they are ready or eligible to join the military.” The fact that the military is concerned with childhood obesity shows how far the epidemic has gone, and how far its reach is. Eileen Lainez, a Defense Department spokeswoman said “Only 25 percent of young U.S. adults qualify to enlist in the military.  Among the remaining 75 percent, more than a third have weight-related problems.  ” On average, recruits that are too heavy to join are about thirty (30) pounds overweight. 
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IV. THE FIRST LADY’S INITIATIVE
Michelle Obama has made it her mission to reduce childhood obesity and encourage healthy lifestyles. In 2010, Mrs. Obama developed a bipartisan group of lawmakers and Cabinet members to firm up plans for a national campaign to reduce childhood obesity.  This was at the beginning of her husband’s first term as President. This shows her strong intent to be involved, rather than point fingers and expose an already exposed problem.  Mrs. Obama sought to involve not just lawmakers and Cabinet members, but “families, schools, businesses, nonprofits and governmentâ€¦”  Part of Mrs. Obama’s initiative was to revise federal childhood nutrition programs  and opportunities on a local level so that 30 million kids can enjoy the benefits of the impact she wishes to leave.
On February 28, 2013, Jonathan LaPook of CBS News sat down with the First Lady and discussed her continued plans to maintain her initiative.  Her new prescription for the issue is to “Get Moving!” She is trying to promote the idea of exercise and learning so that not only will children move, but they will learn while doing it. One major struggle that Mrs. Obama mentioned was that she is having a hard time with big companies who want to keep pushing junk food on “our kids.”  Mrs. Obama reiterates that this a “generational goal” and that no matter what, we must press on. LaPook notes that Mrs. Obama has done the “pushing” every step of the way, and that the industry has given lots of push back when it comes to marketing to children. Mrs. Obama remarks “One of the things that we have to remind parents is that we are the ones that set the demand. So if we are asking our food producers and our restaurant chains and the companies that sell us food and market to us, if we are changing that demand curve, they are going to follow us. It is really the logic of the market. If we demand it, they will make it is because they are trying to, they want us to buy their stuff.” 
V. AFTER SCHOOL PROGRAMS TO COMBAT OBESITY
Communities and neighborhoods are not what they used to be. They are very different from the traditional European model.  At one point in time, communities sought to keep residential and industrial areas separate so that the health of residents was paramount to everything else.  Today, zoning requirements are different from a Supreme Court case from 1926. Ambler Realty v. Village of Euclid recognized the health issues taken into account for zoning. Currently, it is believed that the mixed zoning and mixed use of land might help reduce obesity.  This “urban sprawl” increases probability of childhood obesity because it proves fewer opportunities for physical activity, and there are less active people around to be active.  Those in the neighborhood can, and will influence the physical activity of children. Even a small change, like walking or biking to schools “has the potential to affect the increase in weight gain we have seen in our community.” 
Girls On The Run is an organization that works with communities across the United States and Canada. They have a network of over 200 “councils” which are committed to the mission of Girls On The Run. The mission seeks to inspire girls to be joyful, healthy and confident using a fun, experience-based curriculum, which creatively integrates running into the process. The basis of the program is that young girls are taught team building and self reliance skills, along with life skills and dynamic, conversation based lessons via games. Throughout the process, the girls train physically and emotionally to run a 5K marathon. Girls on the Run is a program for girls that are ages 8-13. This is a crucial age for girls, especially in terms of establishing confidence with lifetime appreciation of health, fitness and emotional stability.
Girls On The Run is in direct alignment with an article that Laure DeMattiaa & Shannon Lee Denney wrote in 2008 for the American Academy of Political and Social Science.  This article focuses on the community’ interaction with children and their weight. Within the article, community programs are evaluated and questioned based on their success rates.  Included in the success of a program is eating, school based activities, and overall intervention programs. The authors suggest that these efforts must first focus on those communities with populations at high risk (i.e. low income families) and women who are old enough to have children who happen to be obese.  Interventions that occur at this time in those communities are known to have successful prevention of childhood obesity.  The Institute of Medicine stated in Preventing Childhood Obesity: Health in the Balance (2004), that “it is a national duty to take steps to reverse the obesity trend.”  “A committee that included representatives from various disciplines (nutrition, physical activity, obesity prevention, pediatrics, family medicine, public health, public policy, health education, community development, and behavioral epidemiology) convened in response to the report to develop ways to address the increasing numbers of children who are overweightâ€¦” 
Shawna Wanemacher and Lyn Martin both volunteer for Girls On The Run. Miss. Wanemacher is 34 years old, and is the owner of her own company, Body and Spirit Fitness, Inc. In looking for which organization to volunteer for, she stumbled upon Girls on the Run flier. She donates her time, two nights a week, as a coach to train the girls to run the 5K. In doing so, she faces the challenge of realizing what motivates each girl so that they can complete the race with confidence, and build healthy learning and living skills.
I spoke with Miss. Wanemacher and conducted an interview. I find her opinion valuable as she is a personal trainer, coaches’ girls running, and is overall well versed in the ways of health and wellness. In August 2012, she started training girls with GOTR. She did this because she could help young girls to become strong, independent, healthy, fit, and positive. Miss. Wanemacher has a passion in helping kids realize their self worth and to believe in themselves along the way. As a personal trainer, the statistics about childhood obesity make Miss Wanemacher sad and she finds them bothersome. In her training, the statistics mentioned above do not play much of a part as with other trainers. This is because the majority of the girls in her group enjoy physical activity. Miss. Wanemacher attributes those high statistics previously referenced to lack of parental involvement. “I think parents are working more in this day and age and therefore are less available. I see many parents with 2+ kids in their families that are still finding a way to be involved in their children’s physical fitness and healthy eating regime and it shows in them in the GOTR club alone. I feel like it CAN be done or at least be better in a few simple changes.” As our conversation came to an end, I asked Miss Wanemacher if there were any changes that she thought should be made. She said, “I feel it starts in the home. I feel the parents need to be more involved and motivate their children to find activities that interest their children rather than allowing them to sit in front of a tv and/or video games so much. I also think they need to assist in the education of healthy eating habits. If your child tries soccer and decides he/she does not like it, find another sport/activity/club that involves physical fitness. Keep plugging along until you find one that suits your child. I also find that when parents work out with their children; running, swimming etc; it is not only giving the child a great sense of support but it is a great bonding moment/time for the parent and child.”
VI. PERSONAL REFLECTIONS
As a child, I was overweight and obese. I never fit in with the popular girls, and felt bad about myself from a very young age. I so badly wanted to be able to wear the outfits that they did, and look as pretty. Childhood is a cruel time, and this affected me greatly. It was not until I was in high school, and I started to take health and fitness into consideration. I lost forty pounds before I entered the ninth grade. I looked like everyone else in my school uniform, and people actually walked up to talk to me at school. I thought this was strange; only 4 months before some of these girls would not even say “hello” to me in the halls. At 14 years old, I realized to look inside the person, not judge at what they look like. I wish that I was part of a program that not only taught about health and wellness, but taught self esteem tools in doing so.
Now, as a future attorney and someone who takes law, ethics, and public policy into consideration – this issues is a change that I can be a part of.
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