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Levi etal 09 - F as in Fat-Obesity Policies in US

Levi etal 09 - F as in Fat-Obesity Policies in US

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A report from Trust for America's Health that details national and state level policies aimed at reducing obesity in the U.S. population. However, according to the report, "Adult obesity rates increased in 23 states and did not decrease in a single state in the past year." Also discussed is the increasing occurrence of obesity coexisting with malnutrition. Visit Trust for America's Health at http://healthyamericans.org/
A report from Trust for America's Health that details national and state level policies aimed at reducing obesity in the U.S. population. However, according to the report, "Adult obesity rates increased in 23 states and did not decrease in a single state in the past year." Also discussed is the increasing occurrence of obesity coexisting with malnutrition. Visit Trust for America's Health at http://healthyamericans.org/

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Published by: recycled minds on Jul 05, 2009
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 JULY 2009P
REVENTING
E
PIDEMICS
.P
ROTECTING
P
EOPLE
.
ISSUE REPORT
2009
F as in Fat:
HOW OBESITY POLICIES AREFAILING IN AMERICA 
 
TFAH BOARD OF DIRECTORS
Lowell Weicker, Jr.
President  Former 3-term U.S. Senator and Governor of Connecticut 
Cynthia M. Harris, PhD, DABT
Vice President  Director and Associate Professor 
Institute of Public Health, Florida A&M University 
Patricia Baumann, MS, JD
Treasurer President and CEO 
Bauman Foundation
Gail Christopher, DN
Vice President for Health 
 WK Kellogg Foundation
 John W. EveretsDavid Fleming, MD
 Director of Public Health 
Seattle King County, Washington
 Arthur Garson, Jr., MD, MPH
 Executive Vice President and Provost and the Robert C. Taylor Professor of Health Science and Public Policy 
University of Virginia
Robert T. Harris, MD
 Former Chief Medical Officer and Senior Vice President for Healthcare 
BlueCross BlueShield of North Carolina
 Alonzo Plough, MA, MPH, PhD
 Director, Emergency Preparedness and Response Program 
Los Angeles County Department of Public Health
Theodore Spencer
Project Manager 
Natural Resources Defense Council
REPORT AUTHORS
 Jeffrey Levi, PhD.
 Executive Director 
Trust for America’s Health
and Associate Professor in the Department of Health Policy 
The George Washington University School of Public Health andHealth Services
Serena Vinter, MHS
Senior Research Associate 
Trust for America’s Health
Liz Richardson
Communications Manager 
Trust for America’s Health
Rebecca St. Laurent, JD
Health Policy Research Assistant 
Trust for America’s Health
Laura M. Segal, MA 
 Director of Public Affairs 
Trust for America’s Health
PEER REVIEWERS
TFAH thanks the reviewers for their time, expertise, and insights. The opinions expressed in the report do not necessarily represent the views of the individuals or the organization with which they are associated.
David P. Hoffman, M.Ed.
Director of Chronic Disease Prevention and Control for the Officeof Long Term Care New York State Department of Health
Marcus Plescia, M.D.
Chief, Chronic Disease and Injury Section 
North Carolina Division of Pubic Health
 Joe Thompson, M.D.
 Director of the RWJF Center to Prevent Childhood Obesity and Surgeon General 
State of Arkansas
This report is supported by a grant from the Robert Wood Johnson  Foundation. The opinions expressed in this report are those of the authors and do not necessarily reflect the views of the foundation.
 ACKNOWLEDGEMENTS
T
RUSTFOR
 A 
MERICA 
S
H
EALTH
ISANON
-
PROFIT
,
NON
-
PARTISANORGANIZATIONDEDICATEDTOSAVINGLIVESBY PROTECTINGTHEHEALTHOFEVERYCOMMUNITYANDWORKINGTOMAKEDISEASEPREVENTIONANATIONALPRIORITY 
.
The Robert Wood Johnson Foundation
focuses on the pressing health and health care issues facing our country. As the nation’slargest philanthropy devoted exclusively to improving the quality of the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful, and timely change.For more than 35 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.
 
TABLE OF CONTENTS
INTRODUCTION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
SECTION 1:Obesity Rates, Related Trends, and Health Facts
. . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Obesity Rates and Related Trends
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 A. Adult Obesity and Overweight Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10B. Childhood and Youth Obesity and Overweight Rates . . . . . . . . . . . . . . . . . . . . . . . . .12C. Physical Inactivity in Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14D. Diabetes and Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15E. Obesity and Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Fast Facts about Obesity
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17F. What’s Behind the Obesity Epidemic? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18G. Obesity’s Impact on Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19H. Obesity and Physical Inactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23I. Nutrition: The Other Side of the Energy Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 J. Economic Costs of Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29K. Weight Bias and Quality of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
SECTION 2:State Responsibilities and Policies
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 A. State Obesity-Related Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31B. State Obesity Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53C. State and Community Success Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
SECTION 3:Federal Responsibilities and Policies
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 A. Overview of Some Key Federal Agencies’ Involvement in Obesity Policy . . . . . . . . . .57B. Federal Obesity-Related Legislation up for Reauthorization in 2009 . . . . . . . . . . . . . .59C. CDC Grants to States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63D. Summary of the Obesity- and Disease-Prevention Initiatives in the American Recovery and Reinvestment Act of 2009 . . . . . . . . . . . . . . . . . . . . . . . . . . .64
SECTION 4:Obesity and the Economy
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 A. The High Price of Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66B. Food Assistance Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66C. School Meal Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67D. Fast Food and the Recession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67E. Health Coverage and the Recession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68F. Opportunities in the Midst of the Economic Crisis . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
SECTION 5:Summer Vacation and Childhood Obesity
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71 A. The Summer Slide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71B. Nutrition Hurdles Outside of School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72C. Summer Fitness Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72D. Implications for Prevention Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
SECTION 6:Obesity and the Baby Boom Generation
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 A. Potential Change in the Number of Obese Adults — 65 and Older . . . . . . . . . . . . . .74B. A State-By-State Review of Rising Obesity Rates for Adults Ages 55-64and for Seniors Age 65 and Older . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75C. The Potential Financial Impact of More Obese Seniors . . . . . . . . . . . . . . . . . . . . . . . .77D. State-By-State Medicare and Medicaid Obesity Health Care Costs . . . . . . . . . . . . . . .79E. Disease-Prevention Programs to Control Obesity-Related Conditions and Costs . . . .80
SECTION 7:Recommendations
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83 A. Making Obesity Prevention and Control a High Priority of Health Care Reform . . . . . . . .84B. Launching a National Strategy to Combat Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . .86
 Appendix A:Methodology for Obesity and Other Rates Using BRFSS
. . . . . . . . . . . . . . . . . . . .89
 Appendix B:Methodology for Obesity Rates for Adults Ages 55-64 and forSeniors Age 65 and Older Using BRFSS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
 Appendix C:Methodology for Overweight and Obesity Rates Using NSCH
. . . . . . . . . . . . . . . .91
References
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
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