Public Policy Strategies to Reduce Prevelance of Obesity / Overweight

Member Login

Lifestyles that support and sustain the maintenance of a healthy weight, for both individuals and the population as a whole, are a major focus of the American Dietetic Association and its nearly 70,000 members. In the last 20 years, obesity rates have increased among adults in the United States by more than 60 percent. Perhaps more troubling is that rates have doubled among children and tripled among adolescents since 1980. This rapid rise in the prevalence of overweight and obesity among all segments of the U.S. population, identified by the Surgeon General as a national epidemic, is of grave concern as people’s health and quality of life suffer and society’s health care costs and related burdens soar.

Dietetics professionals are ideally qualified and positioned to make vital contributions toward the prevention and treatment of obesity. In their everyday roles, they translate complex nutrition principles into a vast array of healthful and appealing food options for millions of Americans. At nearly every level where professionals and institutions attempt to deal with the health and social consequences of obesity, dietetic professionals help lead the way in finding individual and national solutions. For these reasons, obesity is a primary focus of ADA’s work.

GUIDING KNOWLEDGE
ADA’s work on the issue of overweight and obesity is guided by the following statements:

Obesity is a complex multifactoral chronic disease state involving interactions between genetic, physiological, psychological, metabolic, and environmental influences.
- The medical definition of obesity must be evidence-based, appropriate to each segment of the population, and reflect the obesity syndrome that is more than extreme levels of fatness.
- The environment promotes increased consumption of calories and decreased physical activity, leading to weight gain for many individuals.
- The increasing incidence of obesity and associated chronic disease is estimated to cost more than $100 billion in the United States this year, and the costs are rising.
Prevention and treatment strategies are both needed.
- Success requires life-long commitments to healthful lifestyles and behaviors - including those that guide food habits and physical activity.
- A variety of intervention options must be available to meet individual needs, including diet and lifestyle modifications, pharmacotherapy and surgery, as appropriate.
Prevention and treatment of obesity/overweight must be addressed in a multidisciplinary team approach.
- Registered dietitians (RD) and dietetic technicians registered (DTR), physicians, nurses, psychologists, exercise physiologists, pharmacists and others must work collaboratively to identify people at risk and to implement successful interventions that create awareness, teach appropriate nutrition and exercise strategies and skills and address environmental contributors to obesity and overweight at all stages of the life span.
- All foods can fit into a healthful eating style as a part of a balanced diet when consumed in moderation with appropriate portion sizes, and combined with regular, adequate physical activity.
The nature and depth of work required to intervene effectively on an individual or community basis will require resources beyond those routinely provided today for promoting healthy lifestyles.
- Addressing obesity will reduce the risk for many chronic diseases and substantially reduce the millions of dollars now spent on treating diabetes, hypertension, coronary heart disease and knee osteoarthritis.
Public and private initiatives are needed to combat factors that contribute to increase in obesity.
- Government, academia, the health care community and the food industry all have roles to play in addressing the factors contributing to obesity and overweight. Coordination of activities and partnerships are vital if rapid progress is to be made and sustained.

STRATEGIES FOR ADDRESSING OVERWEIGHT/OBESITY

ADA supports the following strategies for addressing the epidemic:

Promote healthy weight for children.
ADA urges a comprehensive strategy for reducing the number of overweight children, with particular emphasis on family and community-based interventions that promote healthful eating practices and daily physical activity. As effective programs and programmatic elements are identified, family, school and community-based physical activity and nutrition education efforts should be implemented and expanded.

Designate obesity a disease by federal agencies and insurers.
This designation would lead to system changes for reimbursement and include sanctioned insurance coverage for obesity treatment. This means that all categories of obesity defined under the ICD-9 codes would be covered, not just surgical intervention for the morbidly obese.

Support multidisciplinary health initiatives over a substantial period of time, with registered dietetic professionals placed to bring their particular knowledge and skills to bear.
Interventions must be carefully targeted and chosen based on generally accepted, peer-reviewed scientific research. Obesity is such a complex chronic disease that it requires the expertise of a multidisciplinary team over an extended period to effectively address.

Increase funding for basic, translational and outcomes research.
Currently, there is a limited understanding of the etiology of obesity and the outcomes associated with weight management. Advancements in the fields of biology, genomics, psychology, pharmacology, and nutrition as well as an understanding of environmental factors, including economics, can lay the groundwork for improved responses. Clinically useful outcome measures should be developed to evaluate interventions. To achieve appropriate goals, research is needed to support evidence-based practice and quality improvement initiatives for successful prevention and treatment of obesity and research focusing on economic incentives needs to be explored. Greater funding should be directed to these and other facets of obesity in both public and private research.

Ensure continued, current and adequate monitoring and data collection of food intake, eating behavior and health status.
To assess the incidence of obesity, identify at-risk populations and define contributing factors to increased prevalence of overweight and obesity, accurate data are vital to document changes and in designing and implementing successful interventions.

Involve stakeholders to achieve a coordinated effort to address the issue at a national as well as local level.
The nature and scope of the obesity problem requires a shared commitment by individuals, in addition to governmental, social, business and health care institutions. For example, the model of shared commitment that has yielded progress in addressing drunk driving and seat belt use may be well suited in addressing obesity.

Create and support programs integrating both nutrition and physical activity, and support the individual to be able to make wise lifestyle choices.
Culturally appropriate and non-stigmatizing, sensitive approaches are needed, offering people the opportunity to gain access to programs and facilities through numerous venues. Creative programming should be included in elementary and secondary schools’ educational curricula, corporate wellness, community and other programs appealing to a broad range of individual interests.

The American Dietetic Association is the nation’s largest association of food and nutrition professionals. Guided by a reliance on sound science and evidence-based practice, the organization is a sought-out participant in the deliberation and resolution of food, nutrition and health issues. ADA members’ unique education, supervised practice experience, national registration examination, and mandated continuing professional education equip them to collaboratively identify, prevent and treat overweight, obesity and its health consequences at all stages of the life span and in a myriad of educational, community, medical, commercial, and research environments.

AMERICAN DIETETIC ASSOCIATION
1120 CONNECTICUT AVE.; SUITE 480
WASHINGTON, D.C. 20036
Phone: 202/775-8277