Background and process
Obesity is blind to age, race, ethnicity, and socioeconomic status, costs ∼$190 billion annually, and lurks as the driving force behind myriad chronic diseases and devastating disability. With two-thirds of U.S. adults and almost one-third of U.S. children overweight or obese, there is no debating that America has a serious problem in this regard. Although some progress has been made over the past few decades in preventing and treating obesity, rates continue to increase. In response, the Robert Wood Johnson Foundation recently teamed up with the Institute of Medicine (IOM) to identify catalysts that might speed progress in obesity prevention.
The Committee on Accelerating Progress in Obesity Prevention, chaired by Daniel Glickman (executive director of congressional programs at the Aspen Institute and senior fellow at The Bipartisan Policy Center) was charged by the IOM with developing a set of recommendations for accelerating progress toward obesity prevention over the next decade and proposing potential measures of progress toward this goal. After identifying nearly 800 previously published recommendations and associated strategies and actions related to obesity prevention, the committee filtered out those that could work together most effectively, reinforce one another’s impact, and be used to achieve the goal of nation-wide obesity reduction. The committee then used a systems approach to develop 5 goals encompassing 5 “environments” needing immediate public action. Details concerning these goals, the environments, and the committee's associated recommendations and strategies are available in the committee's final report, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation (The National Academies Press, 2012).
Overview of goals and recommendations
The committee’s goals are summarized below. It is noteworthy that, although they are presented individually and in a linear fashion, the committee suggested that the goals be thought of as unfolding simultaneously, so that they can interactively influence each others’ success. In this way, it is hoped that these initiatives will work synergistically, accelerating obesity reduction at an even more rapid pace than would be expected if each goal were tackled in sequential order.
Goal 1: Make physical activity an integral and routine part of life. The committee recommended that communities, transportation officials, community planners, health professionals, and governments make promotion of physical activity a priority by substantially increasing access to venues and opportunities for such. Strategies related to this goal include enhancing our physical and built environments, providing and supporting programs that increase access to activity, requiring childcare providers to adopt more rigorous physical activity standards, and providing support for the science and practice of physical activity (including science translation).
Goal 2: Create food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice. Governments and decision makers in the business and private sectors were urged to decrease unhealthy food and beverage options and increase the availability of healthier, affordable choices. This might entail the adoption of policies to reduce consumption of sugar-sweetened beverages, increasing the availability of lower calorie food and beverages sold in restaurants, applying more rigorous nutritional standards to all foods and beverages, reforming U.S. agriculture policy and research to improve the American diet, and ensuring availability of affordable, healthy food for all people.
Goal 3: Transform messages about physical activity and nutrition. The committee recommended that important stakeholders act “quickly, aggressively, and in a sustained manner” to renovate their communications regarding physical activity, food, and nutrition. Suggested strategies include: launching nationwide social media campaigns, developing and implementing more stringent standards for marketing foods and beverages to children, expanding and improving across-the-board nutrition labeling, and ensuring that federal food programs are consistent with the Dietary Guidelines for Americans.
Goal 4: Expand the role of health care providers, insurers, and employers in obesity prevention. Attainment of this goal would involve increasing support structures among health care and health service providers, employers, and insurers to achieve better population health and obesity prevention. This might entail improved standards of practice regarding obesity prevention, screening, and treatment; ensuring coverage of, access to, and incentives for obesity-related medical care in regard to health insurance; worksite initiatives that support wellness; and supporting programs that encourage healthy weight gain during pregnancy and provide breastfeeding-friendly environments.
Goal 5: Make schools a national focal point for obesity prevention. Government entities were urged to work coordinately with parents, teachers, and the business community to make educational facilities more accessible and effective centers for health enhancement. This might involve requiring additional opportunities for physical education and rigorous activity in schools, the provision of only healthy foods and beverages in educational facilities, and offering more extensive nutrition science education to students.
Related resources
Although this report provides an exhaustive discussion concerning strategies, possible actions for implementation, and indicators of success for accelerating obesity prevention, it is merely one component of a much broader, more extensive network of related resources. These include an unprecedented, 4-part documentary entitled The Weight of the Nation, a joint project of Home Box Office (HBO), the IOM, the CDC, the NIH, the Michael and Susan Dell Foundation, and Kaiser Permanente. This made-for-television miniseries (a great resource for the classroom and other educational venues) features case studies and myriad interviews with leading obesity experts as well as individuals and their families struggling with obesity. The CDC’s Division of Nutrition, Physical Activity, and Obesity also sponsored the Weight of the Nation 2012 Conference on May 7–9, 2012 in the nation’s capital.
Conclusion
As stated by IOM President Harvey V. Fineberg, “Obesity is both an individual and societal concern, and it will take action from all of us—individuals, communities, and the nation as a whole—to achieve a healthier society.” This report and its allied resources represent a multifaceted blueprint by which we might move collectively toward this goal.
For More Information
Free copies of this report (and information about ordering a paperback version) are available at http://www.iom.edu/Reports/2012/Accelerating-Progress-in-Obesity-Prevention.aspx.
The 4 films associated with this publication (broadcast May 14–15, 2012 on HBO) can be viewed free of charge at http://theweightofthenation.hbo.com/.
To learn more about the Weight of the Nation 2012 Conference, which took place on May 7–9, 2012 in Washington, DC, go to http://www.weightofthenation.org/.