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Introduction

Obesity affects the health and well-being of individuals in the United States and the United Kingdom and has a growing impact on the health care expenditures and overall economies of both countries. Over the past few years, researchers, health professionals, policy makers, and many others have tried to understand the underlying causes of the problem and to develop effective strategies for preventing and reducing obesity in children and adults. A recent leveling off in the prevalence of obesity in children may indicate that this focus on the problem is bearing results, although it is generally acknowledged that any significant change will take time.

SETTING THE STAGE

On October 22, 2009, policy makers, researchers, and program staff from the United States and the United Kingdom came together at the US Institute of Medicine (IOM) of the National Academies in Washington, DC, to share perspectives and experiences in addressing the obesity problem. The workshop provided insight into the similarities and differences in how the two countries are addressing obesity prevention and was a forum for a comparative understanding of obesity-related policies. The IOM Standing Committee on Childhood Obesity Prevention felt it would be informative to learn about challenges and promising approaches from both a British perspective and American perspective given the two countries similarity in obesity rates. (See Appendix A for the workshop agenda.) The workshop



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1 Introduction O besity affects the health and well-being of individuals in the United States and the United Kingdom and has a growing impact on the health care expenditures and overall economies of both countries. Over the past few years, researchers, health professionals, policy makers, and many others have tried to understand the underlying causes of the problem and to develop effective strategies for preventing and reducing obesity in children and adults. A recent leveling off in the prevalence of obesity in children may indicate that this focus on the problem is bearing results, although it is generally acknowledged that any significant change will take time. SETTINg THE STAgE On October 22, 2009, policy makers, researchers, and program staff from the United States and the United Kingdom came together at the US Institute of Medicine (IOM) of the National Academies in Washington, DC, to share perspectives and experiences in addressing the obesity problem. The workshop provided insight into the similarities and differences in how the two countries are addressing obesity prevention and was a forum for a comparative understanding of obesity-related policies. The IOM Standing Committee on Childhood Obesity Prevention felt it would be informative to learn about challenges and promising approaches from both a British perspective and American perspective given the two countries similarity in obesity rates. (See Appendix A for the workshop agenda.) The workshop 

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 PERSPECTIVES FROM UK AND US POLICY MAKERS was hosted by the Standing Committee and the UK Department of Health and planned by a committee appointed by the IOM. Standing Committee Chair Jeffrey Koplan, Vice President for Global Health and Director of the Global Health Institute at Emory University, set as goals of the workshop to share current concerns and the status of interventions, address emerging issues, and discuss potential opportunities for collaboration. To launch the workshop, Richard Gephardt, former Majority Leader of the US House of Representatives, highlighted some of the issues involved in what he described as a “crisis epidemic,” yet one that research and inno- vative programs can successfully address. He cited several companies that support programs designed to reduce tobacco use and encourage healthier eating and physical activity. One tangible benefit for these companies is slower growth in their health insurance costs. Gephart suggested that, from a policy point of view, progress will occur, but it will take time. National recognition of the scale of the obesity problem, including its role in health care costs, will be necessary. Attacking the problem will also require policy and programmatic strategies to change behaviors and research to under- stand the physiological, psychosocial, societal, and environmental reasons for unhealthy eating and low levels of physical activity. REPORT ORgANIZATION This summary generally follows the organization of the workshop. After an overview of the scope of the problem in the two countries (Chapter 2), Chapter 3 highlights government efforts that touch, in various ways, peo- ple’s diet and physical activity. The next two chapters describe policies and programs that relate to school meals (Chapter 4) and the built environment (Chapter 5). Chapter 6 provides case examples of national-level policies and programs related to nutrition and physical activity, while Chapter 7 offers several case examples of local-level policies and programs in the United States. Finally, Chapter 8 summarizes closing remarks that point to similarities and differences between the two countries in approaches to preventing obesity. The aim of the workshop was not to present an exhaustive listing of all policies and programs related to obesity prevention. Rather, by focus- ing on promising approaches and identifying current gaps and challenges, the workshop was intended to give participants, as well as readers of this summary, useful ideas to consider in each country’s context.