As this country debates health-care reform, attention should be paid to reimbursement mechanisms for nutrition services generally and for obesity treatment programs—certainly the clinical programs and some of the appropriate nonclinical programs as well.

  • Initiatives should be developed that will motivate more people to become physically active. While physical activity enhances health and helps to prevent and treat obesity, people must believe they can fit it into their lives and think of it as an enjoyable way to spend time before they will make the effort. To encourage activity, communities should consider developing innovative social-marketing campaigns, more safe and well-lighted walking and bicycle paths and playgrounds, and low- or no-cost recreation centers supporting a variety of activities. At the national level, the U.S. Public Health Service should continue to expand its efforts to become a more visible advocate of the pleasures and health benefits of an active lifestyle, particularly to children, adolescents, the elderly, and those in lower socioeconomic groups.

  • Investigations should be conducted to determine what methods are most likely to be productive in increasing physician training in the management of obesity.

  • The potential impacts of modifying health insurance reimbursement systems on the treatment and long-term management of obesity should be examined.


The epidemic of obesity in the United States is increasing at a cost to this country of more than $100 billion per year, yet research to understand the causes of this disease and how to more effectively prevent and treat it is seriously underfunded. This chapter has identified some important research needs that offer the hope of substantially reducing the prevalence of this important public health problem, thereby decreasing health-care costs and improving the overall health of the U.S. population. We urge NIH in particular to increase its funding of investigator-initiated research to answer fundamental questions, such as those presented in this chapter, pertaining to the treatment and prevention of obesity.

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