I n 2004,then-Surgeon General Richard Carmona appeared before a U.S. Senate subcommittee to testify about a growing public health crisis in America. The problem had multiplied in the past few decades, becoming particularly acute among children. The threats posed by this crisis, Carmona warned, were so grave that America was at risk of seeing the first generation in its history have a shorter life expectancy than their parents. Carmona wasn’t talking about tobacco, or drugs, or violent crime. He was talking about obesity.
In the decade since Carmona’s testimony, the statistics have grown even more grim. More than one in three American adults suffers from obesity, as do nearly one in five American children. Obesity leads to osteoarthritis, diabetes, heart disease, stroke, and several types of cancer. In the past 35 years, the rate of obesity among children ages 6 to 11 has more than tripled, leading Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at UConn, to call the trend “a national disaster.”
A Personal Mission
Schwartz should know. As the director of one the nation’s few public policy centers focused exclusively on obesity-related issues, she leads a team of researchers and policy experts dedicated to reversing the troubling trend. The Center, which in January left its longtime home at Yale and moved to Hartford to become part of the Center for Health, Intervention, and Prevention (CHIP) at UConn, differs from many scientific research centers in that its mission extends far beyond the walls of academia. The Rudd Center doesn’t just do research; it puts that research into action.
In the past 35 years, the rate of obesity among children ages 6 to 11 has more than tripled
“If all I’m doing is publishing in a journal,” Schwartz says, “that’s not helping anybody else. As a researcher I only want to do research that answers an important question for public policy.”
That passion for advocacy is as much personal for Schwartz as it is professional. Around the time of Carmona’s 2004 Senate testimony, Schwartz was both a clinical psychologist working with an increasing number of obese children, and a mother with children entering elementary school. She realized that there was a connection between the obesity epidemic she was seeing in her clinical work and the environment her own kids faced at school.
“I realized I could continue to do clinical work and help people one at a time,” Schwartz says, “or I could try to change the environment that was making it so difficult for these families.” With the launch of the Rudd Center in 2005, and its first major effort focused on changing the environment in schools, Schwartz saw the opportunity to merge her roles as scientific researcher and concerned parent.
Sodas in Schools
The problems in schools weren’t about the way the kids were being taught, according to Roberta Friedman, another faculty member at Rudd. The problem stemmed from the environment outside of class. “In the classroom we teach kids to eat fruits and vegetables,” Friedman says, “but if they walk out into the hallway and the vending machines are full of candy bars and soda, what’s the message there?” Changing that message meant working with legislators to change the law, which is Friedman’s specialty.
Scientific articles have long been notorious for their muddled narratives and impenetrable prose. Conclusions often lie buried beneath mountains of tables and figures, with key findings sometimes sandwiched between less relevant results. Friedman’s job is to scour those articles for the salient points and translate them into language that can be easily understood and acted upon. “[Articles] are written for scientific journals,” Friedman says. “Often the conclusions need to be pulled out and put into English.”
In 2006, that work of translating scientific findings into useful legislative information scored its first major victory. Working with Don Williams, then-president of the Connecticut State Senate, Rudd researchers were instrumental in helping craft legislation that banned the sale of sodas and other sugary drinks in all Connecticut public schools. The law was one of the first in the nation and remains one of the strongest such laws anywhere in the country, helping trigger a policy shift nationwide. Today, 24 states have similar laws on the books.
From New Haven to Hartford
Schwartz stresses that the research that helped power the legislation was greatly facilitated by Connecticut’s unique structure of government. “Even in a state as small as we are,” she says, “we have 159 school districts.” That means there may be hundreds of different policies to compare and contrast against one another – an advantage from a research perspective, according to Schwartz. In contrast, many states clump several communities together under the umbrella of huge school districts, the largest of which oversee more students than the entire state of Connecticut does.
Friedman, too, sees the Center’s recent move from New Haven to Hartford and from Yale to UConn as an opportunity to cooperate more closely with state government, particularly through CHIP – what she calls “a wonderful confluence of policy people and researchers.”
At the same time, adding Rudd’s impressive roster of researchers to CHIP’s already robust program of research in obesity prevention stands as yet another milestone in the University’s continued growth into a powerhouse research institution. “It adds some remarkable synergies which are just terribly exciting,” says Jeff Fisher, Board of Trustees Distinguished Professor of Psychology and director of CHIP. “We began with an HIV prevention focus, and were internationally known in that area. I’d say we are now as strong in obesity prevention as we are in HIV prevention.”
Battling the Stigma of Obesity
In recent years, the work at Rudd has expanded into new and previously unexplored areas of obesity research. One of these, led by Rudd researcher Rebecca Puhl, is the study of how weight-based stigma affects people struggling with obesity, and what role public policy can play in helping combat those stigmas.
The first step, according to Puhl, is challenging the persistent assumption that obesity is a matter of personal choice, or the result of a defect of character. “That’s a false assumption,” says Puhl, pointing out that obesity is now officially classified as a disease by the American Medical Association. Yet many assume that people who suffer from that disease are simply lazy, a ludicrous proposition, Puhl contends, in a country where two-thirds of the population are overweight or obese. “Two-thirds of our population aren’t just lazy,” she says.
“In the classroom we teach kids to eat fruits and vegetables,” Friedman says, “but if they walk out into the hallway and the vending machines are full of candy bars and soda, what’s the message there?”
Yet that stereotype is persistent and its negative effects are felt in the workplace, in schools, and beyond. According to Puhl, “Weight-based bullying is the most prevalent reason kids are bullied in school – more than sexual orientation, more than race.” And employees struggling with obesity are denied the kinds of legal protections given to people with other mental or physical disabilities. With the exception of a handful of state and local laws, it is legal to not hire someone, fire them, or assign them a lower salary, all based on weight.
‘An Enemy to Health’
These outside pressures make the struggle infinitely harder. ”We’ve known for decades that disease-related stigma is an enemy to health,” says Puhl, and obesity is no exception. “When people experience bullying or stigma as a result of their weight, they are more likely to binge eat, more likely to avoid physical activity, and more likely to have depression, anxiety, and suicidal thoughts and behaviors.”
Combating that stigma is a key component of the Rudd Center’s work moving forward, as are a host of other initiatives, including improving the way obesity is handled by health care professionals, changing the way obesity is portrayed in the media, and addressing the way unhealthy foods are marketed, especially to kids.
That work may seem daunting, and the challenge is formidable, but the efforts of those at the Rudd Center may be beginning to show results. National statistics on childhood obesity indicate that while overall rates remain high, the youngest demographic – children ages 2 to 5 years – recently saw a sharp decrease, with the obesity rate falling from 13.9 percent to 8.4 percent over an eight-year period.
Whether this change represents a turning of the tide in the battle against obesity remains to be seen, but from their new space in downtown Hartford, the Center’s growing team is perhaps better equipped than ever to continue the fight – from battling weight-based stigmas to partnering with legislators to shape progressive policies going forward.