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Introduction

A workshop titled Advancing Effective Obesity Communications, held September 16, 2019, in Washington, DC, was convened by the Roundtable on Obesity Solutions, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. The workshop explored effective communication of obesity-related issues by providing an overview of the current communications environment and addressing the complexity of identifying key audiences and developing targeted messages. Speakers discussed communication strategies to reach specific intermediary audiences (such as the public, decision makers, and policy makers) who influence decisions on such obesity-related topics as nutrition, physical activity, wellness, prevention, and treatment. The workshop also explored challenges in communicating about obesity issues, which include aligning the intended meaning of messages with an individual’s perception of and response to those messages, addressing obesity bias and stigma through communications, and dealing with misinformation. The workshop’s full Statement of Task is in Box 1-1.¹

INTRODUCTORY REMARKS

Nicolaas (Nico) Pronk, president of HealthPartners Institute, chief science officer at HealthPartners and chair of the Roundtable on Obesity

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¹ The workshop agenda, presentations, and other materials are available at https://www.nationalacademies.org/event/09-16-2019/advancing-effective-obesity-communications-a-workshop (accessed April 23, 2020).

Solutions, welcomed participants and provided a brief overview of the roundtable, explaining that it engages leaders from multiple sectors (e.g., health care, health insurance, academia, business, education, child care, government, media, philanthropy, nonprofit) to help solve the nation’s obesity crisis. Through meetings, public workshops, reports, and four innovation collaboratives, Pronk continued, the roundtable provides a venue for informing and inspiring sustainable policy, systems, and environmental change, with a lens on accelerating equity, reducing bias, and catalyzing cross-sector collaboration and engagement to prevent and treat obesity and its adverse consequences across the lifespan. He noted that past roundtable efforts have considered a number of topics with respect to the current state of obesity and explored means of driving progress—such as promising multisector policy, systems, and environmental approaches—and of overcoming challenges of implementation and scalability.

Pronk provided context for the workshop by recounting key points from a previous roundtable workshop, held in April 2019, which focused on mobilizing equity-centered obesity actions. Nearly 40 percent of adults and 18.5 percent of youth have obesity, he began, representing 93 million adults and 14 million children. The prevalence of obesity among adults has increased significantly over the past decade, he continued, and disparities exist by age, sex, race, Hispanic origin, household income, and education. As examples, he pointed to the generally lower prevalence of obesity in

whites and Asian Americans, in adults with annual household incomes of $100,000 or greater, and in college graduates compared with other racial/ethnic, income, and education groups, respectively. Moreover, he reported, men and women have a higher prevalence of obesity in rural than in large urban areas, and disparities in the prevalence of severe obesity between urban and rural men are increasing. Disparities in the prevalence of obesity are also increasing by income and by education (based on the head of household’s educational attainment) among female youth.

Pronk emphasized that obesity is a strong risk factor for noncommunicable diseases, chronic diseases, preventable diseases, and mental health concerns that have a negative impact on quality of life and life expectancy. Obesity is associated with major causes of death and disability, he continued, and predisposes individuals to developing type 2 diabetes, a condition that now occurs as early as childhood. The economic impact of obesity is substantial, he added, and includes both direct medical expenditures and such indirect costs as productivity-related losses among the workforce.

Pronk described the causes of obesity as multifactorial, emanating from multiple changes in U.S. society that have affected various aspects of contemporary life and cultural norms, including physical activity and food consumption patterns. As examples of contributing factors he cited the availability of sidewalks, the affordability of healthy foods, and trends in screen time behaviors, adding that exposure to such influences, both positive and negative, varies by population and results in health inequities.

Pronk commented on the difficulty of maintaining weight loss, pointing out that on average, adults with obesity make five serious weight-loss attempts in their lifetime. Eighty percent lose a significant amount of weight during one or more of those attempts, he said, but only 20 percent maintain a 5 percent weight loss beyond 2 years through exercise and diet alone. Pronk emphasized that though the prevalence of obesity in any population may be stable or slightly increasing, individual weight loss and gain are not static, and a significant knowledge gap exists with regard to drivers of the incidence and remission of obesity. He reported that prevention efforts are more likely to achieve a reduction in obesity status when conducted in such populations as children during their first 1,000 days (i.e., from conception until 2 years of age) and young adults less than 24 years old.

ORGANIZATION OF THIS PROCEEDINGS

This proceedings follows the order of the workshop agenda (see Appendix A), chronicling its sessions in individual chapters. Chapter 2 presents an overview of communications and the communications environment, followed by an outline of the remainder of the workshop. Chapter 3 reviews what is working and what is challenging in the landscape of obesity

solutions communications. Chapter 4 examines potential focus areas for such communications, based on lessons from the field. Finally, Chapter 5 summarizes participants’ reflections on advancing effective communication of obesity solutions. Appendix B is a list of acronyms and abbreviations used in this proceedings, and Appendix C provides biographical sketches of the workshop speakers and planning committee members.