people who are obese, and effects on high-risk racial/ethnic minority and low-income populations.

  Measures with which to track progress are critical. Progress in achieving obesity prevention can be assessed in the short term by indicators of change in the environments that influence physical activity and eating.

It is clear from the preceding chapters that tremendous strides have been made in addressing the obesity epidemic, given the sheer amount of attention to the problem and the number and coherence of efforts to address the epidemic and bolster the scientific underpinnings and policy basis for taking action. Evidence of the stabilization of obesity prevalence in at least some demographic groups suggests that these deliberate initiatives to address the epidemic are on track, perhaps in concert with other, spontaneous countering forces. Given the scope and scale of what is needed and the inevitability of a time lag before true progress can be estimated, however, the developments to date create a unique opportunity to restate goals and refine targets and approaches in order to accelerate progress. As reviewed in this chapter, the goals themselves are clear with respect to the desired outcomes, as well as the types of behavioral changes that are relevant. There is not yet agreement on what specific set of strategies and actions will best curb and ultimately reverse the trends of increasing obesity prevalence. However, existing frameworks and successful models of social change can offer guidance on how to tackle the obesity epidemic and strongly indicate the need to take a systems approach, as described in Chapter 4.

GOALS OF OBESITY PREVENTION

The overall goal of obesity prevention is to create, through directed societal change, an environmental-behavioral synergy to foster the achievement and maintenance of healthy weight among individuals and in the population at large (IOM, 2005). This goal reflects a focus on prevention of obesity development, that is, primary prevention. Primary prevention emphasizes strategies that increase the



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