Biking to school is one of many ways children can get more exercise.

The American Academy of Pediatrics recommended recently that more teenagers should have access to bariatric surgery because childhood obesity “is an epidemic within and epidemic” and other approaches are not working.

It’s a tragedy that the AAP has had to make this recommendation, which some may consider extreme but appears to be a last resort to help curb a growing problem. I’m not a doctor and won’t quibble, though teens should understand that bariatric surgery has lifelong consequences and possible complications.

I do, however, think that this recommendation should shock us into evaluating how we raise our kids across the nation and in Southwest Washington, where child obesity rates are well above the state average.

Our society often unjustly stigmatizes obesity, attributing it to laziness, poor decision-making and lack of self-control. Culpability for this epidemic, however, is far reaching and rests with all of us, including farmers, politicians, parents, advertisers, corporate board members and stockholders, and fans and athletes of professional sports.

“Rates of obesity in America’s youth have almost tripled in the last quarter century. Approximately 20% of American youth are overweight, with obesity rates in preschool age children increasing at alarming speed,” the AAP reports.

There are many causes.

Too many kids are sedentary, fixed in front of computer terminals, cell phones or game stations instead of playing and exercising. American teens on average spend about seven hours a day on screen media for entertainment, and tweens spend nearly five hours, according to a report by Common Sense Media, a nonprofit that helps kids, parents and schools navigate media. These tallies don’t include screen time for school and homework.

Pull Quote

Too many kids are sedentary, fixed in front of computer terminals, cell phones or game stations instead of playing and exercising.

Screen time greater than two hours daily is associated with increased rates of obesity, Studies show that teens who spend five hours or more watching TV are five times five times more likely to become overweight.

TV advertising is especially persuasive and contributes to child obesity, according to the American Psychological Association.

“Research has found that children who watch more than three hours of television a day are 50 percent more likely to be obese than children who watch fewer than two hours. … The food and beverage industry has resolved to self-regulate marketing to children, but this has not resulted in significant improvement in the marketing of healthier food.”

TV advertising for sporting events may be especially influential for young athletes and sports fans. So many commercials are for calorie- and cholesterol-laden, fast food dishes that are “heart attacks on a plate.” Many run alongside images of athletes in top physical condition, imparting a subliminal but unhealthy message that it’s OK to eat lots of fat if you exercise.

Salt and sugar

Americans are hooked on salt and sugar, a consequence of farm subsidies that encourage the planting of commodity crops — corn, wheat and soybeans — that are used to make fatty processed foods. Plantings of vegetables and other healthier foods are diminished.

Federal subsidies thus drive down the price of fast food, leaving fresh produce more expensive and less accessible to low-income areas, according to the Bedrosian Center, part of the USC Sol Price School of Public Policy.

Many households of course cannot afford or don’t have time to prepare nutritious meals due to the pressures of work, the need to work long hours and low wages.

Employment, income, family, social support and community safety are significant factors in health outcomes. So obesity is disproportionately common among low-income people. It’s no surprise, then, that economically struggling communities have a problem with overweight youth.

Overweight children grow into overweight adults, and this is one reason why the county ranks near the bottom of the state in adult health outcomes. Thirty-four percent of us are obese, compared to 28% statewide. Twenty-five percent of us are physically inactive, compared to 17% statewide.

Decades ago, parts of Southwest Washington benefited from a humming manufacturing economy. The closure and downsizing of the paper, lumber, fishing and other industries have contributed to declining household income, which on average is around a quarter the state’s.

Put simply, an unhealthy economy produces unhealthy kids.

It would be good for the people who oppose virtually any industrial project to remember that they are literally taking healthy food out of kids’ mouths.

Remember this if you oppose raising the federal minimum wage, which has remained unchanged at $7.25 a hour since 2009.

Remember this if you are a corporate board member or stockholder demanding greater profit at the expense of workers and communities.

Starved for healthy food

The poor are not starving; they are starved for healthy food. Studies show low-income people eat fast food far more often than other socioeconomic groups. They do so out of necessity, not choice.

“The connection between poverty, obesity, and fast food is undeniable,” according to the Bedrosian Center.

In a free society, there are no easy remedy for this problem. But at the very least, we should remember one thing before we judge overweight kids: A lot of America is working against them.