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Best In Science

Controlling the Obesity Epidemic

CDC partnerships, innovative interventions, and new research findings in 2008 all contributed to the early signs of success in the prevention and control of obesity on both the state and national levels. From classrooms to living rooms, recent evidence indicates that obesity rates have hit a plateau—a critical first step in reversing the alarming trends that have been increasing since 1980.

For example, CDC surveys found no increase in obesity prevalence among women or men between 2003–2004 and 2005–2006. Evidence from the Youth Risk Behavior Surveillance System indicates that the prevalence of high body mass index (BMI) among children and adolescents has leveled off. CDC’s efforts have also helped to increase recognition of obesity as a national public health problem. From 2000–2006, the number of articles on obesity published in the national press increased from 2,000 to 6,000. Other important indicators include the substantial shifts in available school foods as documented by the 2006 School Policies and Programs Survey, and the large number of US communities mobilizing to address obesity prevention and control.

CDC is making inroads in the fight against obesity on numerous fronts:

Creating Innovative Partnerships. The Healthy Eating Active Living Convergence Partnership seeks to change policies and environments to better achieve the vision of Healthy People Living in Healthy Places. Its innovation lies in its focus on engaging people in fields not traditionally involved in public health. This partnership is currently focusing on two areas—transportation and food systems—as powerful leverage points to develop active living environments and improve access to healthy foods. In 2009, CDC will co-convene a Transportation and Public Health meeting and will co-sponsor a Food Systems and Public Health meeting. Partners include the California Endowment, Kaiser Permanente, Nemours, Robert Wood Johnson Foundation, W.K. Kellogg Foundation, PolicyLink, and Prevention Institute.

Convening National Leadership Activities. CDC is leading the development of the National Roadmap for Obesity Prevention and Control plan, expected in 2010. Two conferences that convened in 2008 were stepping stones for developing the Roadmap: The National Summit on Legal Preparedness for Obesity Prevention and Control, which focused on law-based strategies for obesity prevention and control; and The Community Approaches to Address Obesity Conference, which focused on understanding, reporting and disseminating successful community-level obesity interventions. These conferences laid the groundwork for the upcoming Weight of the Nation Conference, scheduled for summer 2009, which will highlight progress in obesity prevention and control and identify action needed to reverse the epidemic.

Advancing National Collaboration on Childhood Obesity Research (NCCOR). Initiated in 2008, NCCOR is helping to stem the epidemic by advancing coordination across research funding organizations. NCCOR benefits research, evaluation, translation, and dissemination efforts by accelerating the pace of research; reducing redundancy; ensuring focused initiatives in the areas of greatest need; and building capacity for multilevel, integrated research. NCCOR is developing a shared research agenda focused on priority areas for collaboration. To build momentum and achieve early impact, NCCOR is identifying initial projects while the long-term joint research agenda is being developed. Partners include the National Institutes of Health and the Robert Wood Johnson Foundation.

Developing the Measures Project. There is an absence of agreed-upon measures to assess the policy and environmental change strategies that communities are initiating in response to the obesity epidemic. The Measures Project is designated by CDC as state-of-the-art in community practice because it adds to the existing evidence base while simultaneously providing a tool for communities to focus their obesity efforts. Twenty-six promising policy and environmental change strategies, each with a single measure, have been identified. A web-based tool that local governments can use to assess performance on the 26 measures is being pilot tested by 20 communities. These communities will provide feedback on the feasibility and usefulness of the measures for local governments and policy makers at an end-users meeting in January 2009, after which it is expected that the measures will be disseminated and implemented nationwide.

Implementing Early Assessment of Programs and Policies to Prevent Childhood Obesity. This two-year collaboration identifies a set of local-level programs and policies to improve children’s eating habits and physical activity levels and determines which have been implemented with apparent success and which merit rigorous evaluation. This assessment prevents premature investment in evaluating programs and policies that have not been implemented adequately, allowing resources to be targeted to those evaluations most likely to fill important gaps in the evidence base for obesity prevention. Priority is placed on programs and policies implemented in community settings targeting children aged 3–17 years and addressing populations that disproportionately experience childhood obesity (e.g., low income; ethnic groups). Fourteen programs and policies have been deemed ready for immediate, full-scale evaluation, of which one (New York City Daycare Regulations) will undergo rigorous evaluation in late 2009.

Translating Research into Practice

CDC translates research findings for use by practitioners, communities, and the public:

• Lean for Life Web site. A synthesis of the science and practice-based evidence on worksite obesity interventions, this Web site guides companies in planning, building, promoting, and evaluating customized obesity prevention and control programs. Developed in direct response to organizations requesting help in addressing obesity, the Web site includes an obesity cost calculator that projects the cost of obesity for a company and their expected financial return from implementing a program.
• Swift Worksite Assessment and Translation. This evaluation method allows for rapid assessment of worksite health promotion programs that help employees attain or maintain a healthy body weight. The method generates data sufficient to identify promising and innovative worksite strategies for reducing adult obesity. New translation documents for this method include an implementation guide and site visit protocol documents; they are available on CDC’s Healthy Worksite Initiative Web site.
• The Weight Management Research to Practice Series. This series of documents summarizes the science on various weight management topics and highlights the implications of research findings for public health and medical care professionals. Some installments in the series have a companion brochure geared toward the general public. Five documents are completed covering the topics of fruits and vegetables, portion sizes, sugar-sweetened beverages, breastfeeding, and low-energy dense foods.
• Healthy Weight Web site. Launched in 2008, the Healthy Weight Web site was created using CDC’s trusted weight management science as the foundation. The Web site emphasizes that healthy weight loss is not just about a “diet” or “program” and provides consumers with credible information, relevant steps, and tools to help them achieve and maintain a healthy weight for a lifetime.

These activities promote CDC’s Health Protection Goals of Healthy People at Every Stage of Life and Healthy People in a Healthy World. For more information about these translation efforts, go to CDC’s obesity Web site at www.cdc.gov/nccdphp/dnpa/obesity/index.htm and click on “selected resources.”

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