In This Article Expand or collapse the "in this article" section Obesity Prevention

  • Introduction
  • General Overviews
  • Reference Works
  • Textbooks and Anthologies
  • Bibliographies
  • Electronic Databases and Search Engines
  • Journals
  • Special Journal Issues or Supplements
  • Prevalence in Adults
  • Prevalence in Children and Adolescents
  • Health Burden and Economic Costs
  • Causal Models and Analytic Frameworks
  • Environmental Influences
  • Controversies
  • Public Policy
  • Interventions in Children
  • Interventions in Adults and Communities
  • Considerations for Interventions in High-Risk Ethnic and Socioeconomic Status Groups
  • Evidence and Evaluation

Public Health Obesity Prevention
by
Shiriki K. Kumanyika
  • LAST REVIEWED: 22 April 2013
  • LAST MODIFIED: 22 April 2013
  • DOI: 10.1093/obo/9780199756797-0086

Introduction

Obesity reflects a physiologically harmful excess of body fat, overall or accumulated in specific parts of the body. The obesity “epidemic” is characterized by trends that show increases in average body weight levels in populations at large and the consequent increases in the proportions of these populations whose weight levels fall into the upper part of the weight status distribution and who, therefore, meet the criteria for “overweight” or “obesity.” The significance of overweight and obesity relates to the associated increased risk for chronic diseases or risk factors such as diabetes, high blood pressure, heart diseases, certain types of cancer, respiratory diseases, and musculoskeletal diseases, together with their disabling or fatal consequences. Obesity issues are, therefore, an important subset of a much larger set of issues related to the increasing dominance of chronic diseases not only in high-income countries such as the United States or the United Kingdom, but also in low- and middle-income countries. Like obesity treatment, the target of obesity prevention involves a balance of energy intake (from foods and beverages) and energy output (through various types of physical activity). In light of higher obesity prevalence rates, specific strategies to prevent the development of clinically significant overweight and obesity have been articulated separately from strategies to treat established obesity. This article takes a multidisciplinary perspective to identify books, scientific journals, evidence reviews, practice guidelines, and other resources relevant to understanding obesity prevention. Citations include resources that explain obesity prevention concepts and the social, economic, and public policy contexts for undertaking obesity prevention, highlighting controversies, and providing guidance on the evidentiary and methodological underpinnings for planning and evaluating interventions.

General Overviews

The impetus for large-scale efforts to prevent obesity begins with recognition that the problem affects whole populations and that clinically oriented treatment approaches do not address the constant influx of more people becoming obese. Also, the fact that obesity, once established, is very difficult to reverse adds to the rationale for preventing excess weight gain. The US Surgeon General’s 2001 Call to Action (Office of the Surgeon General 2001), the detailed technical report of the World Health Organization (WHO) (World Health Organization 2000) on the global obesity epidemic, and the overview of population approaches to obesity prevention for the American Heart Association (Kumanyika, et al. 2008) provide representative examples of the recognition of obesity as a public health problem and arguments for addressing it at a population level. With respect to children, the comprehensive review for the International Obesity Task Force (Lobstein, et al. 2004) and the Institute of Medicine’s Health in the Balance report (Koplan, et al. 2005) provide comprehensive overviews of obesity prevention issues in children. Publication of the Global Strategy on Diet, Physical Activity and Health report (World Health Organization 2004) signaled a global commitment to taking population-level actions on chronic diseases and risk factors, including obesity.

  • Koplan, J. C. Liverman, V. A. Kraak, et al. 2005. Preventing childhood obesity: Health in the balance. Washington, DC: Institute of Medicine, National Academies Press.

    This consensus study report, developed at the request of the US Congress, sets forth a national action plan for addressing the epidemic of childhood obesity in the United States. Recommendations are directed to government, industry, media, schools, communities, and families. The plan is bold in calling for comprehensive approaches that will lead to a “social transformation.”

  • Kumanyika, S. K., E. Obarzanek, N. Stettler, et al. 2008. Population-based prevention of obesity: The need for comprehensive promotion of healthful eating, physical activity, and energy balance: A scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention. Circulation 118.4: 428–464.

    DOI: 10.1161/CIRCULATIONAHA.108.189702

    This comprehensive review highlights the need for population-oriented obesity prevention to prevent excess weight gain in children and adults and explains how such approaches differ from, but complement, clinical treatment approaches. Frameworks for identifying potential targets for environmental and policy changes and the types of intervention strategies that can be used to address these targets are presented.

  • Lobstein, T., L. Baur, and R. Uauy. 2004. Obesity in children and young people: A crisis in public health. Obesity Reviews 5.S1: 4–85.

    DOI: 10.1111/j.1467-789X.2004.00133.x

    Contributions by numerous experts provide an overview of the scope of the global problem of childhood obesity, raise awareness of the crisis it represents, and urge policymakers to take timely actions to address the problem. Sections address measurement issues, prevalence and trends, health outcomes, and treatment and management and emphasize the importance of prevention for both developed and developing countries.

  • Office of the Surgeon General. 2001. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Washington, DC: US Government Printing Office.

    This US Public Health Service report, issued when Dr. David Satcher was the US Surgeon General, gave official federal government recognition to the epidemic of obesity in the United States and set forth some key principles for action. This was a forerunner of the Institute of Medicine report (Koplan, et al. 2005) that provided a more detailed national action plan.

  • World Health Organization. 2000. Obesity: Preventing and managing the global epidemic. Technical Report Series No. 894. Geneva, Switzerland: World Health Organization.

    This World Health Organization expert consultation was the first official recognition of obesity as a global public health issue affecting not just high-income countries, but also low- and middle-income countries, where undernutrition also remains a major health and nutrition problem. This detailed report provides a comprehensive overview of obesity etiology, health consequences, treatment, and prevention considerations.

  • World Health Organization. 2004. Global strategy on diet, physical activity and health. Geneva, Switzerland: World Health Organization.

    This strategy document provides the overarching policy guidance for member countries of the World Health Organization (WHO) with respect to dietary and physical activity patterns to prevent cardiovascular diseases, cancer, diabetes, and other noncommunicable diseases. This strategy marked the culmination of several WHO expert consultations and resolutions on these issues and is now in the implementation phase.

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