The prevalence of overweight and obesity has reached epidemic proportions in the United States. Nearly two-thirds of adult Americans are overweight or obese, and the prevalence of overweight among American children between the ages of 6 and 19 has tripled during the past 20 years, from 5 percent in 1980 to 15 percent in 2000. United States Surgeon General Richard Carmona calls obesity America's single biggest health problem. The evidence for the relationship between obesity and several chronic illnesses is becoming increasingly clear. Although changing behavior is difficult, growing recognition of the health impact and costs associated with overweight and obesity, combined with increased knowledge regarding effective prevention and treatment interventions, provide momentum for addressing this epidemic. However, reversing current trends will require a multifaceted public health approach.
Myriad genetic, social, and environmental factors contribute to overweight and obesity. The rapid increase in their rates in the United States, however, suggest that social and environmental influences have played the major role in contributing to the nation’s overweight and obesity problem. In particular, recent social and environmental trends that have likely affected weight levels include: decreased physical activity in daily lives, increased use of commercial food products, larger commercial food portions, and increasing prevalence of community design that does not support physical activity. Furthermore, a relationship between obesity and low socioeconomic status has long been documented.
These leading contributors to overweight and obesity suggest that strategies that modify individual attitudes and behaviors and alter environmental conditions can help create a healthier, more fit society. Previous social change successes, such as efforts to reduce smoking rates, increase breastfeeding, and encourage seat belt use, offer several lessons and strategies that can be applied to weight control.
Public health and medical research has provided a breadth of information on prevention and treatment interventions for overweight and obesity both for children and adults that can be utilized to manage weight levels. For all ages, the importance of proper nutrition and food intake, as well as the importance of regular physical activity, cannot be over emphasized. In addition, medical advances have led to the development of pharmaceutical and surgical treatments that have demonstrated moderate to high levels of success in achieving weight loss. Used alone or in combination, these treatments offer avenues for individuals to reach healthy weights and improve their health status. However, research shows that short and long term effectiveness of these therapies varies considerably.
The Chronic Care Model, developed in the late 1990s to improve the quality of care for chronic conditions may provide a framework for coordinating communities, health systems, and public policies to reduce overweight and obesity. This model emphasizes the importance of communities and health care systems working together to address health conditions. In particular, it provides guidance to health care systems for utilizing community resources, internal policies, and organizational structure to create effective patient interactions and positive outcomes. As such, the model can contribute to the effective prevention and treatment of overweight and obesity by connecting individuals with the medical, support, and community resources necessary to sustain healthy choices.
Contents
I. Executive Summary
II. Introduction
III. Social and Environmental Influences on Health Behaviors
IV. A Review of the Evidence: Effective Approaches to Preventing and Treating Overweight and Obesity
V. The Chronic Care Model
VI. Public Policy: Opportunities, Levers, and Challenges
VII. Conclusion
VIII. Appendix A. Other Social Movements as Models for Addressing Overweight and Obesity
IX. Appendix B. Evidence Based Interventions
X. Appendix C. Policy Interventions and Potential Areas for Action
XI. Appendix D. Obesity, Nutrition, and Physical Activity Legislation by State
XII. Appendix E. Selected Obesity and Weight Management Initiatives
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