“The obesity finger-pointing is at things that have always been here. Sugar-coated cereals and fast food were there before the obesity epidemic, so why blame them now?”

Such were the provocative insights that provided some of the highlights to “Obesity: Understanding Issues, Seeking Solutions,” a Saint Joseph's University (Philadelphia) Erivan K. Haub School of Business national conference held June 4, 2004. There, a panel of industry experts addressed recent findings on the causes of childhood obesity, food industry challenges, litigation, consumer and industry perspectives and, most importantly, solutions.

“What's different is that women left the home and went to work--there's been a change in home and family meal patterns,” asserted Ed Slaughter, director, advertising and trends research, Rodale Inc. (Emmaus, Pa.), as he presented findings from new, unpublished telephone interviews of 700 nationally sampled parents and 372 kids aged ten to 17. The survey was conducted by Princeton Survey Research Associates (with offices in Washington and Princeton, N.J.) earlier this year.

The causes of obesity are less clear for children than for adults--there is no strong correlation between diet quality and the overweight. Gender, age and socioeconomic comparisons for weight reveal that:

  • Girls are doing better than boys,

  • Older teens better than younger and

  • The affluent better than the less fortunate.

    Yet attitudinally, kids do not connect being obese to health problems. Overweight kids are least likely to make the association.

    The survey also revealed that diets tend to have too much fat and too little fiber and that eating breakfast correlates with better diets. Overall, boys' diets are worse than girls', and at 15-17 years, diets are poorer but body weights are healthier.

    Yet, while soda consumption and fast food correlates with poorer diets, there is a weak, if any, relationship to the likelihood of being obese. Most notably, few kids have good diets along with regular exercise.

    Parental influences that are likely to lead to healthy weights include:

  • Meals prepared at home,

  • Parent exercises with child and

  • Parent models behavior.

    There is also a much greater likelihood that the child is obese when there is an overweight parent.

    Although the survey results indicate kids are “highly active,” they also have “lousy” diets. Yet, diet and exercise are poor predictors of obesity and few kids have a genuinely healthy lifestyle--something that is a good predictor of healthy weight.

    Most importantly, Slaughter stressed that while the prevalence of obesity is up 250% among kids, we should keep in mind that most kids--71%--are not, in fact, either overweight or at-risk.

    Covering the challenges to industry and policy perspectives, Nancy Childs, professor of food marketing at the university, cited the April 2003 JP Morgan Equities report that ranked food companies by “obesity foods” and risk, noting that Wall Street share prices may be vulnerable when company profits rely on fatty and sugary foods. These are likely to be the subject of future regulation, and because more regulation lowers profit, the risk of litigation increases and global vulnerability also increases. However, these same companies are also best able to capitalize on a health opportunity.

    Regulatory Considerations

    Government policy solutions that are anticipated to be implemented over time include industry incentives in the formulation and promotion of new products; education of consumers involving advertising information and alliances to change behavior; and market rewards for those disciplined to keep slim. There are also a number of considerations potentially impacting food labeling. (See chart “Label Considerations to Come?”)

    The FDA also recommends guidance for developing drugs to treat obesity and working cooperatively with other government agencies, non-profit organizations, industry and academia on obesity research. “Obesity will take center stage over chronic disease,” Childs asserted. “Legal vulnerabilities will drive product portfolio decisions and retailers will be an obstacle if they are not accountable,” she said.

    Relating insights about the legal landscape and obesity litigation, David Eggert, esquire, partner in the law firm of Arnold and Porter (Washington), noted that activists sometimes use litigation to achieve what they could not within the democratic process, leading to higher liability insurance coverage for companies based on the fat content of their foods. Attorneys have rallied in response--their first conference about obesity/fat litigation was so overbooked that they had to change the venue. Eggert pointed out that litigation is only one facet of the approach, that part of an activist agenda taps into broader public concerns that rely on the media, economic pressure, legislation and regulation and attempts to substitute the concept of choice with victimization and neutralize it with addiction.

    To address the food industry response, Robert Doyle, senior vice-president of the Healthcare Solutions Group of Information Resources Inc. (IRI, Chicago), presented data that shows spending is about the same for a normal or overweight household, though different foods are purchased.

  • The overweight spend more on processed and pre-packaged meats, starchy, convenience and indulgent foods.

  • In households with overweight children, members are less likely to eat the daily recommendation of five or more servings of fruits and vegetables, and more likely to eat fast and indulgent foods most days.

  • Both normal and overweight adults tend to be concerned with trans-fatty acids, genetically modified ingredients, preservatives and additives in food. Yet the overweight are uneducated about eating or shopping.

    The household matriarch is a powerful influence. If mom gets diabetes, for example, the whole household eats differently as compared to if dad is diabetic; in that case, there is a special meal just for him. Concerns about weight will drive certain eating and product trends, Doyle predicts. (See “Predicted Trends” chart.)

    Resulting product development opportunities that were identified include gourmet nutrition; smaller yet satisfying portions of higher quality food; leveraging food science advances; and addressing health and wellness, not just calories and carbs.

    Consumer Perceptions, Industry Opportunities

    Reporting on consumer health, wellness and weight control views, Harvey Hartman, the Hartman Group (Bellevue, Wash.) stated, “It's a myth that consumers are concerned about obesity, influenced by media images or evaluate their weight using BMI (Body Mass Index).” Instead, the realities are that most consumers:

  • Think they are doing O.K., that their weight is perfectly normal and average and feel good about themselves,

  • Are ambivalent about how to manage their weight,

  • Are influenced by social networks--friends and relatives--to decide when it is time to lose or gain weight,

  • Assess their weight by the mirror and photographs or events such as reunions or weddings, and

  • Tend to think it's not an issue as long as they are healthy.

    While consumers demonstrate their awareness of the supposed connection between excess weight and health risks, most do not perceive themselves at risk until they get heavier; a connection is not made until it happens to them or someone else. They, however, do not blame manufacturers and retailers for the “obesity problem” but see it entirely as an issue of personal responsibility and are motivated to lose weight by the desire “to look better” (more than health concerns).

    Rather than changing or reducing their food intake, they are most likely to cite physical activity as the method they initially pursue, seeing exercise as a simpler solution because food is complicated with such considerations as labeling and portion sizes. Instead of being told how to eat, they want options for indulgent as well as healthy foods--fresh, balanced, authentic and “homemade”; convenient and easy to prepare. Their diet of choice is moderation as a guiding principle and making small rather than drastic changes over the long-term, for example, “cutting back here and there” in accordance to how they “feel”.

    Snacking tends to be done alone, indicative of an obesity caused by a socio-cultural eating pattern. Because snacking behavior is largely “invisible” to consumers, marketing snacks that rely solely or primarily on low-fat, low-carb or low-calorie attributes is difficult. Consumers also find eating at home to be an important means of control; weight management strategies dependent upon personal choice and discipline become much more difficult to implement when eating out.

    Confused and overwhelmed amidst an overload of news and advice, consumers want information that is specific to their needs, provided by an independent third party source. They find tangible and portable sources that are easy and convenient to access repeatedly--such as books, magazines and television--most useful. They also desire “shared experiences”--a means to meet others with similar lifestyles and weight control goals, (like a company website as a “community meeting place” for consumers to dialogue with one another).

    Emerging opportunities for industry include offering better solutions for serving sizes such as pre-divided or individually wrapped portions within each package, and positioning products to evoke notions of food as crucial elements of meals consumed at tables, rather than individual food items consumed in isolation.

    “Companies need to create worlds, experiences, communities,” Hartman concluded, citing Trader Joe's, Whole Foods and Starbucks as examples.

    Predicted Trends

    • Healthier eating away from home
    • Food functionality by disease state
    • Integrated health & wellness branding & positioning
    • Age-specific opportunities
    • Organic-/soy-/ingredient-driven choices

    Source: IRI, Healthcare Solutions Group

    Label Considerations to Come?

    • Regulating “Low and Net Carb” claims
    • Re-evaluating serving/portion sizes and calorie labeling within the Nutrition Facts panel
    • Revisiting claims about calories and possibly energy density and activity--i.e. “one cookie equals 200 steps”
    • Coding systems, symbols and nutritional categories to identify products
    • Foodservice menu information
    • Labeling compliance enforcement for more accuracy

    Source: Nancy Child, St. Joseph's University