For starters, that might mean passing laws limiting food
marketing to kids. Another important step, he says, will be
to adjust the relative price of healthy versus unhealthy foods.
Highly processed junk foods are often cheaper than fruit or
other healthy, “whole” foods.
One way to address that imbalance is through a tax on sugar-sweetened drinks, an initiative that Brownell has pushed in his
work at the Rudd Center. Though controversial, such taxes have
been considered in a number of states and communities, and
several other countries have enacted junk-food taxes to limit
soda consumption. Brownell and his colleagues estimated that
a penny-per-ounce tax on sugar-sweetened beverages could
reduce consumption by 24 percent, cutting 45 to 50 calories per
day from a soda drinker’s diet (Preventive Medicine, 2011).
Even with pinching consumers’ pocketbooks, though,
changing our environment won’t be easy. Over the years, the
food industry has trained us to snack between meals, gulp down
fast food morning and night and expect bottomless soda refills
with our vat-sized portions of pasta.
Despite that, Brownell is hopeful. In communities across
the country, people are paying more attention to where their
food comes from and looking twice at the practices of powerful
food companies. “Social norms are beginning to change. People
are more concerned than ever about protecting the health of
children through nutrition,” he says.
Not everyone agrees with such measures, however.
Restricting ads aimed at kids raises hackles among many critics
on the grounds that doing so impinges on freedom of speech.
And plenty of people oppose the government’s interference in
the free marketplace through taxes or regulations.
Nevertheless, our food environment is beginning to shift,
says APA President Johnson. A few years ago, initiatives such
as soda taxes seemed impossible, she says. But this fall, the
New York City Board of Health approved a ban on the sale of
large sodas in restaurants, street carts and movie theaters, a
move championed by Mayor Michael Bloomberg. Elsewhere,
communities including San Francisco have banned toys in
fast-food kids’ meals. “I think people are going to start paying
attention” to these social experiments, Johnson says. “I’m
optimistic, but we have to be very vocal — the folks that are
selling the junk are extremely well funded, and very intent on
keeping things just the way they are.”
Certainly, huge challenges remain. One of the most pressing issues,
Wilfley says, is securing reimbursement for professionals who
provide obesity treatment. Because most insurance policies don’t
cover obesity prevention and treatment programs, an overweight
child or teenager can’t take advantage of such programs unless his
or her family is able to pay for it out of pocket.
“The sad part is we can have a much better impact if we treat
children at lower levels of overweight,” she says. Instead, those
kids are overlooked by the health-care system until they develop
Another important next step is to move from testing
interventions to implementing the ones that work. “There are
lots of things going on in communities across the country, and
nobody’s evaluating them,” Foster says. “We have to be thinking
about how we can inform policy with data.”
In addition to developing and implementing treatments,
psychology can do more to promote a healthy, active lifestyle. In
2009, APA endorsed a resolution encouraging psychologists to
challenge the disproportionate emphasis on weight reduction
and instead apply more energy to helping patients adopt
healthier diets and engage in more physical activity.
At the same time, there’s still plenty of basic research to be
done. Scientists are just beginning to understand food addiction
and the ways tempting treats can act like addictive drugs in the
brain. Researchers can also contribute to our understanding
of what makes certain children vulnerable to obesity, how
food becomes rewarding and how parents can help enhance
executive functioning and self-control in kids, Epstein says.
“Our prevention efforts will be better if we understand more
about these basic processes.”
Ultimately, experts agree that we need to attack this problem
from every possible direction to win our nation’s battle of the
bulge. And psychologists have something to offer every step of
“Obesity isn’t a mental health condition — you won’t find it
in the DSM- 5,” says Foster. “But if you believe that psychology
is a science of behavior change, then obesity is an optimal
condition for leveraging the expertise of psychologists.” n
Kirsten Weir is a freelance writer in Minneapolis.
In August, 2012 APA President Suzanne
Bennett Johnson, PhD, presented the APA
Award for Outstanding Lifetime Contributions
to Psychology to two psychologists who
have made obesity the cornerstone of their
careers. Kelly Brownell, PhD, director of Yale
University’s Rudd Center for Food Policy and
Obesity, has focused on changing public policy
to make our eating environments healthier.
Rena R. Wing, PhD, professor of psychiatry and
behavior at Brown University and director of the
Weight Control and Diabetes Research Center at
the Miriam Hospital in Providence, R.I., is best
known for her work on the Diabetes Prevention
Program, a lifestyle intervention proven to help
adults shed pounds and prevent the onset of
type- 2 diabetes.