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LEGAL STRATEGIES IN
CHILDHOOD OBESITY
PREVENTION
Workshop Summary
Lynn Parker, Matthew Spear, Nicole Ferring Holovach, and
Stephen Olson, Rapporteurs
Standing Committee on Childhood Obesity Prevention
Food and Nutrition Board
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Govern-
ing Board of the National Research Council, whose members are drawn from the
councils of the National Academy of Sciences, the National Academy of Engineer-
ing, and the Institute of Medicine. The members of the committee responsible for
the report were chosen for their special competences and with regard for appropri-
ate balance.
This study was supported by Grant No. 61747 between the National Academy
of Sciences and The Robert Wood Johnson Foundation. Any opinions, findings,
conclusions, or recommendations expressed in this publication are those of the
author(s) and do not necessarily reflect the view of the organizations or agencies
that provided support for this project.
International Standard Book Number-13: 978-0-309-21019-5
International Standard Book Number-10: 0-309-21019-4
Additional copies of this report are available from the National Academies Press,
500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or
(202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.
edu.
For more information about the Institute of Medicine, visit the IOM home page
at: www.iom.edu.
Copyright 2011 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost
all cultures and religions since the beginning of recorded history. The serpent
adopted as a logotype by the Institute of Medicine is a relief carving from ancient
Greece, now held by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2011. Legal Strategies in Child-
hood Obesity Prevention: Workshop Summary. Washington, DC: The National
Academies Press.
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“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
— Goethe
Advising the Nation. Improving Health.
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The National Academy of Sciences is a private, nonprofit, self-perpetuating society
of distinguished scholars engaged in scientific and engineering research, dedicated to
the furtherance of science and technology and to their use for the general welfare.
Upon the authority of the charter granted to it by the Congress in 1863, the Acad-
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dent of the National Academy of Engineering.
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of the National Research Council.
www.national-academies.org
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PLANNING COMMITTEE FOR A WORKSHOP ON LEGAL
STRATEGIES IN CHILDHOOD OBESITY PREVENTION*
KELLY BROWNELL (Chair), Professor, Department of Psychology,
Professor of Epidemiology and Public Health, and Director, Rudd
Center for Food Policy and Obesity, Yale University
WILLIAM DIETZ, Director, Division of Nutrition, Physical Activity, and
Obesity, Centers for Disease Control and Prevention
ROBERT GARCIA, Executive Director, The City Project, Los Angeles
MARY STORY, Professor, Division of Epidemiology and Community
Health Associate, University of Minnesota School of Public Health
STEPHEN TERET, Associate Dean for Faculty and Education and
Professor, Johns Hopkins Bloomberg School of Public Health
JOSEPH THOMPSON, Director, The Robert Wood Johnson Foundation
Center to Prevent Childhood Obesity, and Surgeon General, State of
Arkansas
Study Staff
LYNN PARKER, Scholar
NICOLE FERRING HOLOVACH, Research Associate
MATTHEW SPEAR, Program Associate
ANTON BANDY, Financial Associate
GERALDINE KENNEDO, Administrative Assistant
LINDA MEYERS, Director, Food and Nutrition Board
*Institute of Medicine planning committees are solely responsible for organizing the work-
shop, identifying topics, and choosing speakers. The responsibility for the published workshop
summary rests with the workshop rapporteurs and the institution.
v
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Reviewers
This report has been reviewed in draft form by individuals chosen
for their diverse perspectives and technical expertise, in accordance with
procedures approved by the National Research Council’s Report Review
Committee. The purpose of this independent review is to provide candid
and critical comments that will assist the institution in making its published
report as sound as possible and to ensure that the report meets institutional
standards for objectivity, evidence, and responsiveness to the study charge.
The review comments and draft manuscript remain confidential to protect
the integrity of the process. We wish to thank the following individuals for
their review of this report:
JESSICA DONZE BLACK, Alliance for a Healthier Generation
TRACY FOX, Food, Nutrition & Policy Consultants, L.L.C.
RUSSELL PATE, University of South Carolina
STEPHEN SUGARMAN, University of California, Berkeley
Although the reviewers listed above have provided many construc-
tive comments and suggestions, they did not see the final draft of the
report before its release. The review of this report was overseen by HUGH
TILSON, University of North Carolina, Chapel Hill. Appointed by the
Institute of Medicine, he was responsible for making certain that an inde-
pendent examination of this report was carried out in accordance with
institutional procedures and that all review comments were carefully con-
sidered. Responsibility for the final content of this report rests entirely with
the workshop rapporteur and the institution.
vii
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Contents
1 INTRODUCTION 1
The Potential of Legal Strategies, 2
Organization of This Summary, 4
2 LEGAL APPROACHES IN OTHER AREAS 7
Air Bags in Automobiles, 8
Firearms Injury Prevention, 9
The Connection to Food, 11
3 ACTIONS BY FEDERAL AGENCIES: A FOCUS ON
FOODS AND BEVERAGES 13
Initiatives by the Federal Trade Commission, 14
Initiatives by the Food and Drug Administration, 15
Discussion, 18
4 PERSPECTIVES FROM THE FOOD INDUSTRY 21
The Perspective of the Grocery Industry, 22
The Perspective of the Restaurant Industry, 26
Discussion, 29
5 USING REGULATIONS AND TAXES TO PREVENT OBESITY 33
The Use of Regulations to Change Food and Beverage
Consumption, 34
The Use of Taxes to Influence Food and Beverage Purchases, 37
Discussion, 39
ix
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x CONTENTS
6 USING THE LAW TO INCREASE PHYSICAL ACTIVITY 41
Legal Approaches to Increase Physical Activity in Communities, 42
Physical Activity as a Civil Rights Issue, 46
Discussion, 49
7 USING LITIGATION TO CHANGE POLICIES AND
PRACTICES 51
Legal Strategies for Obesity Prevention, 52
Using Litigation and the Threat of Litigation to Leverage Change, 54
The Disadvantages of Litigation, 56
Discussion, 58
8 OTHER STATE AND LOCAL OBESITY PREVENTION
STRATEGIES 61
Actions by Local Public Health Agencies, 62
The Roles of Attorneys General, 65
Child Care and Obesity, 66
Discussion, 68
9 CLOSING REMARKS 71
REFERENCES AND RESOURCES 75
APPENDIXES
A Workshop Agenda 79
B Speaker Biosketches 83
