Obesity: Myths, Challenges, and Successes

William H. Dietz MD, PhDFormer Director

Division of Nutrition Physical Activity, and ObesityCenters for Disease Control and Prevention

Obesity Trends Among U.S. AdultsBRFSS, 1991

Obesity Trends Among U.S. AdultsBRFSS, 1993

Obesity Trends Among U.S. AdultsBRFSS, 1995

Obesity Trends Among U.S. AdultsBRFSS, 1997

Obesity Trends Among U.S. AdultsBRFSS, 1999

Obesity Trends Among U.S. AdultsBRFSS, 2001

No Data <10% 10%–14% 15%–19% 20%-24% > 25%

Obesity Trends Among U.S. AdultsBRFSS, 2003

Obesity Trends Among U.S. AdultsBRFSS, 2005

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends Among U.S. AdultsBRFSS, 2007

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends Among U.S. AdultsBRFSS, 2009

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends Among U.S. AdultsBRFSS, 2010

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends Among U.S. AdultsBRFSS, 2010

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Ogden et al. 2012, NCHS data brief. Adults 20+ years

Obesity Trends in Adults over the Past 12 Years

Prevalence of Obesity in Boys NHANES 2009-2010

Ogden et al; JAMA 2012; 307:483-90

Prevalence of Obesity in Girls NHANES 2009-2010

Ogden et al; JAMA 2012; 307:483-90

Prevalence of Obesity in Girls NHANES 2009-2010

Ogden et al; JAMA 2012; 307:483-90

Obesity Trends in Youth over the Past 12 Years

Ogden et al. 2012, NCHS data brief

Year

Thousands per year

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990

Great Depression

End of WW II

1st Surgeon General’s report

Broadcast advertising ban

Federal cigarettetax doubles

Fairness Doctrinemessages on TV and radio

Nonsmoker’s rightsmovement begins

1st smoking cancer concern Surgeon

General’s report onenvironmentalTobacco smoke

Master settlement agreement

Nicotine medications Available over the counter

1st World Conferenceon smoking and health

1998

1st Great American smokeout

Annual Adult per Capita Cigarette Consumption and Major Smoking and Health Events- US 1900-1998

Myths and Misconceptions

Shifts in Food Practices in the United States

Increased cost of healthful foods

Decreased cost and increased caloric density of processed foods

Increased portion sizeWidespread availabilityIncreased varietyDesigned for palatability and

shelf-life

Changes in Dietary Habits and Weight Change

Weight Change over 12-20 Years

Mozaffarian D et al. NEJM 2011364:2392

Evidence-based Community Design

Street- and community-scale urban design and land use

Strategies for a Health Care System

Social Ecological Model

tlll

Individual

Federal and State

Community

Interpersonal

Greatest Impact

SmallestImpact

Institutions

Federal, state and localpolicies to regulate and support healthy actions

Knowledge, attitudes,beliefs and behaviors

Family, peers, socialnetworks

Policy, regulations and informal structures

Policies, standards,social networks

Let’s Move Initiatives• Let’s Move Outside (Parks and Recreation)• Let’s Move Cities and Towns • Chefs Move to Schools• Let’s Move Salad Bars to Schools• Let’s Move Child Care Challenge• Let’s Move in Indian Country

Nutrition and Physical Activity Targets for a Health Care

System

Reduce energy intakeDecrease high and increase low energy dense

foods Increase fruit and vegetable intakeReduce sugar drinksDecrease television time (advertising time)

BreastfeedingIncrease energy expenditure

Increase daily physical activity

Healthy Kids Out of School: Drink Right, Snack Smart, Move

More

So How Do We Get from Here to There?

Panel Discussion