translates to an estimated total of nearly 73 million adults and 12 million children and adolescents (Ogden et al., 2010b,c), and those overweight are likely to become obese if they gain weight over time. The United States is far from alone in facing the challenges of this epidemic. Many aspects of the epidemic and its causes reach across the globe. An estimated 1.5 billion adults worldwide are overweight or obese (Finucane et al., 2011), and the World Health Organization estimates that 35 million preschool children in developing countries and 43 million preschool children worldwide are overweight or obese (de Onis et al., 2010). However, the nature of the factors causing this epidemic is such that the search for effective solutions must focus on specific drivers as they exist and operate within countries, regions, and localities.

The purpose of this report, developed by the Institute of Medicine’s (IOM’s) Committee on Accelerating Progress in Obesity Prevention, is to chart the pathways to a timely resolution of the obesity epidemic in the U.S. population. The committee was tasked with formulating a coherent set of recommendations that, if implemented, would be likely to significantly accelerate progress toward preventing obesity over the next decade, taking advantage, where possible, of favorable emerging developments. The committee was tasked further with recommending tangible, practical indicators with which to measure progress toward this goal. Specifically, the committee’s charge was to review prior obesity-related recommendations; consider relevant information on progress toward their implementation; develop principles to guide the selection of recommendations fundamental to achieving progress in obesity prevention; and recommend potential indicators that can act as markers of progress and can be readily evaluated through the use of current databases and/or relatively simple measures or surveys. This report responds to the challenges of this charge. The audience for the report includes public policy makers at all levels; private-sector decision makers; leaders in other institutions, including foundations, the education system, and professional and community-based organizations and health agencies; and the public in general.

This chapter sets the stage by articulating the committee’s vision for success (Box 1-1) and introducing concepts of a systems perspective and of engagement and leadership as essential elements for achieving this vision. A clear vision is essential to guard against thinking about obesity prevention in isolation from the complex social and economic systems within which the determinants of obesity— physical activity and eating patterns—are embedded. The committee’s vision imagines what society would look like if obesity prevention were achieved effectively, equitably, and sustainably. It allows for the identification of socially desirable



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