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Robert Wm. Blum MD, MPH, PhD Johns Hopkins University
Multilevel and Life Course Approaches to Obesity
My Background
Came to the Bloomberg School in 2004 as professor and chair of the Department of Population, Family and Reproductive Health
I love teaching this course because it provides the opportunity to merge my clinical background and academic interests
Pediatrician by training
Before coming to Hopkins, my clinical work was in adolescent medicine and in adolescent health
This course looks at adolescent health within a broader context—the context of a life course perspective
In this course, we’re aiming to ... - Give you a framework and an understanding of major
developmental issues across the stages of human life - Highlight measurement issues and effective interventions and
programs
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Multilevel Approaches to Obesity
Section A
Definitions
Overweight: body mass index (BMI) between the 85th and 95th centile on growth charts
Obesity: BMI over 30
BMI:
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Obesity1 Trends among US Adults (BRFSS2, 1985)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1986)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1987)
8
1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1988)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1989)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1990)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1991)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1992)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1993)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1994)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1995)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1996)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1997)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1998)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 1999)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 2000)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 2001)
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1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System Sources: Mokdad, A. H., et al. (1999, October 27). JAMA, 282, 16, 1519–1522; Mokdad, A. H., et al. (2001, September 12). JAMA, 286, 10, 1195–1200.
Obesity1 Trends among US Adults (BRFSS2, 2002)
23 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2003)
24 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2004)
25 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2005)
26 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2006)
27 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2007)
28 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Obesity1 Trends among US Adults (BRFSS2, 2008)
29 1BMI ≥30, or ~30 lbs overweight for 5’4” woman 2CDC’s Behavioral Risk Factor Surveillance System
Why?
What are the factors that contribute to obesity?
Consider multilevel explanations - Individual - Family - Peer - School - Community - Policy
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