• Reframing “obesity”—Socioeconomic implications must be addressed proactively. In particular, the discussion of obesity prevention must not be confined to those with more education. At present, for example, the group least likely to be obese in the United Kingdom is affluent women. Therefore, in taking action to combat the problem, it is essential to involve women of all classes, as not to create a divide between classes. Those who work to combat obesity must find language that resonates across all classes of society.

Despite these challenges, Jackson said she wanted to close on a positive note. The level of activity taking place to fight obesity in both countries offers great cause for hope, and both have many promising areas to explore further.

FINAL THOUGHTS: A US PERSPECTIVE

Dietz summarized some of the issues the workshop had highlighted for him:

  • Role of philanthropies—One difference between the two countries is the larger role of philanthropies in obesity prevention in the United States. In addition to national organizations, local foundations, some of which have resulted from nonprofit hospitals transitioning to for-profit institutions, fund many community initiatives.

  • Influence of national-level reports—The Foresight report had a clear, direct impact on UK policy. Although an equivalent report has not emerged in the United States, the IOM has produced a number of influential publications, from its initial report on childhood obesity to its recently released publication on local government actions that can address obesity (IOM, 2005, 2009a).

  • National standards—The United States is several years behind the United Kingdom in terms of setting national food and physical activity standards, although the US government is beginning to focus on voluntary efforts in such areas as food labeling and advertising.

  • Environmental changes—Presenters from both countries agreed on the need for environmental changes. An area of particular commonality is initiatives related to transport.

  • Global evidence—Whereas presenters said global evidence can be used effectively in the United Kingdom, Americans appear to demand US-based evidence. One reason may be the need to frame the issue according to the diversity of the US population. Issues play



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