holders can be instrumental in making changes to social norms throughout the nation so that obesity will be acknowledged as an important and preventable health outcome and healthful eating and regular physical activity will be accepted and encouraged as the standard (IOM, 2005). What is needed is for the childhood obesity epidemic to reach a “tipping point” (Gladwell, 2000), where small collective changes within and across all sectors will produce a substantial effect so that the obesity epidemic will be acknowledged, environmental changes will take hold, communities will be mobilized, and individuals and families will aspire to pursue healthy behaviors and active lifestyles as the social norm.

This report has sought to provide an extension of the Health in the Balance report. It has emphasized the need for the evaluation of obesity prevention actions across all sectors so that effective evidence-based approaches can be identified, scaled up, adapted to diverse settings and contexts, and widely disseminated. The committee developed five broad conclusions (Box 9-1) based on its assessment of progress in preventing

BOX 9-1


  1. The country is beginning to recognize that childhood obesity is a serious public health problem that increases morbidity and mortality and that has substantial economic and social costs. However, the current level of investment by the public and private sectors still does not match the extent of the problem.

  2. Government, industry, communities, schools, and families are responding to the childhood obesity epidemic by implementing a variety of policies, programs, and other interventions. All of these stakeholders bring strong values and beliefs to obesity-related issues, but evidence-based approaches are needed to guide the nation’s collective actions in the response.

  3. Current data and evidence are inadequate for a comprehensive assessment of the progress that has been made in preventing childhood obesity across the United States. Although the best available evidence should be used to develop an immediate response to the childhood obesity epidemic, a more robust evidence base that identifies promising practices must be developed so that these interventions can be scaled-up and supported in diverse settings.

  4. Evaluation serves to foster collective learning, accountability, responsibility, and cost-effectiveness to guide improvements in childhood obesity prevention policies and programs. Multiple sectors and stakeholders should commit adequate resources to conduct these evaluations. Surveillance, monitoring, and research are fundamental components of childhood obesity prevention evaluation efforts.

  5. Multiple sectors and stakeholders should conduct evaluations of different types and at different levels to assess and stimulate progress over the short term, intermediate term, and long term to reverse the childhood obesity trend and improve the health of the nation’s children and youth.

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