The U.S. has a long history of supporting prevention to protect children. Child safety seats, childproof medicine bottles, warnings on toys that are choking hazards, immunization requirements and prohibiting tobacco sales have all shown a valuable return on investment and share these attributes with the child obesity epidemic:

	Require behavior modification
	Environmental pressures counteract healthy behavior
	Risk/danger perceived to be self-induced
	Reluctance to inhibit personal freedom

The epidemic of child obesity warrants similar action. Child and health advocates must press for action.

Perhaps it’s not surprising that the loudest, most unified and urgent pleas for action to fight child obesity have come from the medical community.

In August 2003, the American Medical Association devoted the entire issue of its ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE to child obesity. Its recommendations:

	Focus on both prevention and treatment.
	Form a broad public and private partnership with a coalition of stakeholders (including government, third-party payers, professional organizations, industry, advocacy groups, schools and families).
	Target and prioritize public messages.
	Build programs on what we know while acknowledging the unknown factors and supporting research to address them in a prioritized way.
	Ensure access to recommended programs regardless of ability to pay.
	Build flexibility for future changes into policy recommendations as knowledge is gained.

Deep-rooted environmental and cultural issues create barriers to developing public policy on child obesity (but should not dissuade acting to establish and implement such policy).

	Skepticism about the ability policies will have to create change. Counter with: Past recommendations focused on choices by individuals rather than comprehensive public policy change.
	A general misperception that obesity is mostly due to personal weakness. Counter with: The recent U.S. epidemic cannot be the result of changes in the genetic pool nor a “sudden upsurge in moral factors.” A more accurate perception can be built with public education (advertising).
	Our “toxic environment”: It’s hard to overestimate its influence. Supersizing, 24/7 availability and promotion of abundant, cheap, low-nutrient junk food and fast foods. Counter with: Public demand for availability of healthy alternatives to junk and proper portion sizes.
	Political and economic forces that result in a few industries benefiting from food consumption, lobbying government to block any effort to curb overeating. The result is a David-and-Goliath imbalance between resources to fight obesity vs. those promoting food intake. Counter with: News media coverage and advertising to arm parents and kids with knowledge and ways to modify behavior.
	A lack of knowledge about programs that effectively prevent/treat child obesity.

In December 2001, the Oklahoma Task Force on Children’s Health Promotion submitted a recommendation to the legislature to Governor Keating, Sen. Stratton Taylor and Rep. Larry Adair with these recommended requirements:

Grades 1-6:

Physical education: A minimum of 150 minutes/week. Health education: A minimum of 50 minutes per day 2 days per week, using the coordinated school health team teaching approach.

Middle school:

Physical education: A minimum of 50 minutes per day 3 days per week.

Health education: A minimum of 50 minutes per day 2 days per week, using the coordinated school health team teaching approach.

High school:

Physical education: A minimum of 50 minutes per day, 2 days per week.

These recommendations evolved into legislative measures proposed (but not passed) in the 2002 and 2003 legislative sessions.