After decades of increases in the obesity rate among U.S. adults and children, the rate recently has dropped among some populations, particularly young children. What are the factors responsible for these changes? How can promising trends be accelerated? What else needs to be known to end the epidemic of obesity in the United States? To examine these and other pressing questions, the Roundtable on Obesity Solutions, of the National Academies of Sciences, Engineering, and Medicine, held a workshop in September 2016. The workshop brought together leaders from business, early care and education, government, health care, and philanthropy to discuss the most promising approaches for the future of obesity prevention and treatment. This publication summarizes the presentations and discussions from the workshop.
The remarkable increase in the prevalence of obesity among children and youth in the United States over a relatively short timespan represents one of the defining public health challenges of the 21st century. The country is beginning to recognize childhood obesity as a major public health epidemic that will incur substantial costs to the nation. However, the current level of investment by the public and private sectors still does not match the extent of the problem. There is a substantial underinvestment of resources to adequately address the scope of this obesity crisis. At this early phase in addressing the epidemic, actions have begun on a number of levels to improve the dietary patterns and to increase the physical activity levels of young people. Schools, corporations, youth-related organizations, families, communities, foundations, and government agencies are working to implement a variety of policy changes, new programs, and other interventions. These efforts, however, generally remain fragmented and small in scale. Moreover, the lack of systematic monitoring and evaluation of interventions have hindered the development of an evidence base to identify, apply, and disseminate lessons learned and to support promising efforts to prevent childhood obesity. Progress in Preventing Childhood Obesity: How Do We Measure Up? examines the progress made by obesity prevention initiatives in the United States from 2004 to 2006. This book emphasizes a call to action for key stakeholders and sectors to commit to and demonstrate leadership in childhood obesity prevention, evaluates all policies and programs, monitors their progress, and encourages stakeholders to widely disseminate promising practices. This book will be of interest to federal, state, and local government agencies; educators and schools; public health and health care professionals; private-sector companies and industry trade groups; media; parents; and those involved in implementing community-based programs and consumer advocacy.
Childhood obesity is a serious health problem that has adverse and long-lasting consequences for individuals, families, and communities. The magnitude of the problem has increased dramatically during the last three decades and, despite some indications of a plateau in this growth, the numbers remain stubbornly high. Efforts to prevent childhood obesity to date have focused largely on school-aged children, with relatively little attention to children under age 5. However, there is a growing awareness that efforts to prevent childhood obesity must begin before children ever enter the school system. Early Childhood Obesity Prevention Policies reviews factors related to overweight and obese children from birth to age 5, with a focus on nutrition, physical activity, and sedentary behavior, and recommends policies that can alter children's environments to promote the maintenance of healthy weight. Because the first years of life are important to health and well-being throughout the life span, preventing obesity in infants and young children can contribute to reversing the epidemic of obesity in children and adults. The book recommends that health care providers make parents aware of their child's excess weight early. It also suggests that parents and child care providers keep children active throughout the day, provide them with healthy diets, limit screen time, and ensure children get adequate sleep. In addition to providing comprehensive solutions to tackle the problem of obesity in infants and young children, Early Childhood Obesity Prevention Policies identifies potential actions that could be taken to implement those recommendations. The recommendations can inform the decisions of state and local child care regulators, child care providers, health care providers, directors of federal and local child care and nutrition programs, and government officials at all levels.
As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives. Community efforts to combat obesity vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact. In this context, the Institute of Medicine held two workshops to inform current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume.
In a brief, clear and easily accessible way, this summary illustrates the dynamics of the obesity epidemic and its impact on public health throughout the WHO European Region, particularly in eastern countries. It describes how factors that increase the risk of obesity are shaped in different settings, such as the family, school, community and workplace. It makes both ethical and economic arguments for accelerating action against obesity, and analyses effective programs and policies in different government sectors, such as education, health, agriculture and trade, urban planning and transport. The summary also describes how to design policies and programs to prevent obesity and how to monitor progress, and calls for specific action by stakeholders: not only government sectors but also the private sector - including food manufacturers, advertisers and traders - and professional consumers' and international and intergovernmental organizations such as the European Union.
Since 1980, childhood obesity rates have more than tripled in the United States. Recent data show that almost one-third of children over 2 years of age are already overweight or obese. While the prevalence of childhood obesity appears to have plateaued in recent years, the magnitude of the problem remains unsustainably high and represents an enormous public health concern. All options for addressing the childhood obesity epidemic must therefore be explored. In the United States, legal approaches have successfully reduced other threats to public health, such as the lack of passive restraints in automobiles and the use of tobacco. The question then arises of whether laws, regulations, and litigation can likewise be used to change practices and policies that contribute to obesity. On October 21, 2010, the Institute of Medicine (IOM) held a workshop to bring together stakeholders to discuss the current and future legal strategies aimed at combating childhood obesity. Legal Strategies in Childhood Obesity Prevention summarizes the proceedings of that workshop. The report examines the challenges involved in implementing public health initiatives by using legal strategies to elicit change. It also discusses circumstances in which legal strategies are needed and effective. This workshop was created only to explore the boundaries of potential legal approaches to address childhood obesity, and therefore, does not contain recommendations for the use of such approaches.
The fully updated 2nd edition of this textbook continues to serve as a comprehensive guide for information dealing with the ever-evolving field of bariatric surgery. The chapters are written by experts in the field and include the most up-to-date information, including new sections on quality in bariatric surgery, endoscopic surgery, and management of bariatric complications. This new edition continues to cover the basic considerations for bariatric surgery, the currently accepted procedures, outcomes of bariatric surgery including long-term weight loss, improvement and resolution of comorbidities, and improvement in quality of life. Other special emphasis is given to the topics of metabolic surgery and surgery for patients with lower BMI. In addition, new endoscopic bariatric procedures including the gastric balloons, endoscopic revisional procedures, and newer pharmacotherapy for obesity are reviewed. The ASMBS Textbook of Bariatric Surgery Second Edition will continue to be a leading source of scientific information for surgeons, physicians, residents, students, and integrated health members today and for years to come.
Malnutrition is a huge burden on the Arab Republic of Egypt’s economy. Undernutrition—manifested by poor linear growth (stunting), wasting, and micronutrient deficiencies in children and by anemia among women of reproductive age—collectively saps an estimated two percent of Egypt’s annual gross domestic product through forgone productivity and health care costs, representing an economic hemorrhaging of billions of U.S. dollars per year. Adding to this challenge is the co-occurrence of overweight and obesity among children, leading to a malnutrition double burden. Scaling Up Nutrition in the Arab Republic of Egypt aims to inform the development of nutrition policy and guide nutrition investments over the coming years. It reviews Egypt’s nutrition situation, the interventions currently in place, and the opportunities, costs, benefits, and fiscal space implications of scaling up a set of high-impact interventions to address undernutrition. The book, a collaborative effort between the World Bank and UNICEF, is targeted at all those involved in developing and implementing nutrition interventions in Egypt and beyond.
At the 2013 Nutrition for Growth Summit in London, 96 signatories (governments, civil society organizations, donors, United Nations agencies, and businesses) agreed to support the creation of an annual report on global nutrition that would be authored by an independent expert group, in partnership with a large number of contributors. The first edition of this report, the Global Nutrition Report 2014, puts a spotlight on worldwide progress by the 193 member countries of the United Nations in improving their nutrition status, identifies bottlenecks to change, highlights opportunities for action, and contributes to strengthened nutrition accountability on country and global levels.
