Translating Knowledge of Foundational Drivers of Obesity into Practice: Proceedings of a Workshop Series (2023)
Chapter: Front Matter
Translating Knowledge of
Foundational Drivers of
Obesity into Practice
__________
Emily A. Callahan, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
Health and Medicine Division
Proceedings of a Workshop Series
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported in part by the Academy of Nutrition and Dietetics; the Alliance for a Healthier Generation; the American Academy of Pediatrics; the American Council on Exercise; the Bipartisan Policy Center; the Blue Shield of California Foundation; General Mills, Inc.; The JPB Foundation; the Kresge Foundation; Mars, Inc.; the MedTech Coalition for Metabolic Health; the National Recreation and Park Association; Nemours; Novo Nordisk; the Obesity Action Coalition; The Obesity Society; the Partnership for a Healthier America; the Reinvestment Fund; the Robert Wood Johnson Foundation; The Rudd Center; SHAPE America; the Society of Behavioral Medicine; Wake Forest Baptist Medical Center; and Walmart. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-70203-4
International Standard Book Number-10: 0-309-70203-8
Digital Object Identifier: https://doi.org/10.17226/26942
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Translating knowledge of foundational drivers of obesity into practice: Proceedings of a workshop series. Washington, DC: National Academies Press. https://doi.org/10.17226/26942.
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PLANNING COMMITTEE FOR TRANSLATING KNOWLEDGE OF FOUNDATIONAL DRIVERS OF OBESITY INTO PRACTICE1
SARA J. CZAJA, Professor of Gerontology, Director of the Center on Aging and Behavioral Research, Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine
HEATHER D’ANGELO, Program Director, National Cancer Institute, Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Institutes of Health
IHUOMA ENELI, Professor of Pediatrics, The Ohio State University; Director, Nationwide Children’s Hospital Center for Healthy Weight and Nutrition; Associate Director, American Academy of Pediatrics Institute for Healthy Childhood Weight
BRUCE Y. LEE, Professor of Health Policy and Management, Executive Director of the Center for Advanced Technology and Communication in Health, and Executive Director of Public Health Informatics, Computational and Operations Research, City University of New York Graduate School of Public Health and Health Policy
RODNEY LYN, Dean, School of Public Health, and Professor, Department of Health Policy, Georgia State University
STEPHANIE A. NAVARRO SILVERA, Professor of Public Health, Montclair State University
REBECCA L. PEARL, Assistant Professor, Department of Clinical and Health Psychology and Social and Behavioral Sciences, University of Florida College of Public Health and Health Professions
SEAN PHELAN, Associate Professor and Head of Social & Behavioral Sciences, Division of Health Care Delivery Research, and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic
LESLIE SHIERY, Associate Manager, General Mills Bell Institute of Health & Nutrition
LEAH D. WHIGHAM, Founding Director, Center for Community Health Impact, and Associate Professor, Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston
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1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
ROUNDTABLE ON OBESITY SOLUTIONS2
NICOLAAS (NICO) PRONK (Chair), HealthPartners Institute and HealthPartners, Inc., Bloomington, Minnesota
CHRISTINA ECONOMOS (Vice Chair), Tufts University, Boston, Massachusetts
IHUOMA ENELI (Vice Chair), American Academy of Pediatrics, Columbus, Ohio
KATIE ADAMSON, YMCA of the USA, Washington, DC
JAMY D. ARD, Wake Forest University, Winston-Salem, North Carolina
HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
JEANNE BLANKENSHIP, Academy of Nutrition and Dietetics, Washington, DC
JAMIE BUSSEL, Robert Wood Johnson Foundation, Princeton, New Jersey
DEBBIE I. CHANG, Blue Shield of California Foundation, San Francisco, California
JENNIFER FASSBENDER, Reinvestment Fund, Philadelphia, Pennsylvania
AMENDA FISHER, Walmart, Bentonville, Arkansas
ALLISON GERTEL-ROSENBERG, Nemours Children’s Health System, Washington, DC
DEIDRE GRIFFITH, Alliance for a Healthier Generation, Asheville, North Carolina
KAYLA JACKSON, The School Superintendents Association, Alexandria, Virginia
JOHN JAKICIC, University of Kansas Medical Center, Kansas City, Kansas
GABRIELLE N. JOHNSTON, American Council on Exercise, San Diego, California
ELIZABETH A. JOY, Intermountain Healthcare, Salt Lake City, Utah
SCOTT I. KAHAN, The George Washington University, Washington, DC
PETER T. KATZMARZYK, Pennington Biomedical Research Center, Baton Rouge, Louisiana
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
MONICA V. LUPI, Kresge Foundation, Troy, Michigan
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2 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
KELLIE MAY, National Recreation and Park Association, Ashburn, Virginia
JEFFREY C. MAYES, MedTech Coalition for Metabolic Health, Los Angeles, CA
MYETA M. MOON, United Way Worldwide, Alexandria, Virginia
STEPHANIE A. MORRIS, SHAPE America, Reston, Virginia
JOSEPH NADGLOWSKI JR., Obesity Action Coalition, Tampa, Florida
MELISSA NAPOLITANO, The George Washington University, Washington, DC
PATRICIA NECE, Obesity Action Coalition
MEGAN NECHANICKY, General Mills, Inc., Minneapolis, Minnesota
COURTNEY P. PAOLICELLI, U.S. Department of Agriculture, Food and Nutrition Service, Alexandria, VA
ANAND PAREKH, Bipartisan Policy Center, Washington, DC
SARAH A. WELLER PEGNA, National League of Cities, Washington, DC
BARBARA PICOWER, The JPB Foundation, New York, New York
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
GORDON REID, Stop & Shop, Gordon, Massachusetts
VICTORIA ROGERS, Barbara Bush Children’s Hospital, Portland, Maine
NANCY ROMAN, Partnership for a Healthier America, Washington, DC
CHRISTY N. ROSS, National Association for the Advancement of Colored People, Washington, DC
SYLVIA ROWE, SR Strategy, LLC, Washington, DC
MARLENE SCHWARTZ, The Rudd Center for Food Policy and Health, Hartford, Connecticut
STEPHANIE A. NAVARRO SILVERA, Montclair State University, Montclair, New Jersey
KRISTEN R. SULLIVAN, American Cancer Society, Decatur, Georgia
SUSAN Z. YANOVSKI, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
LESLIE PLATT ZOLOV, Novo Nordisk, Plainsboro, New Jersey
Health and Medicine Division Staff
HEATHER DEL VALLE COOK, Roundtable Director
MARIAH BRUNS, Senior Program Assistant (through February 2023)
CYPRESS LYNX, Associate Program Officer
AMANDA NGUYEN, Program Officer
ANN L. YAKTINE, Director, Food and Nutrition Board
Consultant
WILLIAM (BILL) H. DIETZ, The George Washington University, Washington, DC
Food and Nutrition Board Liaison
SHIRIKI K. KUMANYIKA, Drexel University, Philadelphia, Pennsylvania
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings:
LEAH FRERICHS, University of North Carolina at Chapel Hill
DAVID B. SARWER, Temple University
KRISTEN SULLIVAN, American Cancer Society
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by JOHANNA DWYER, Tufts Medical Center. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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5 CHANGING THE CONVERSATION AROUND REPRESENTATION IN MEDIA AND BODY IMAGE
Weight Attitudes, Representation of Obesity in Media, and Considerations for Changing Norms
The Impact of Marketing and Media on Obesity
6 ENGAGING COMMUNITIES TO ADDRESS STRUCTURAL DRIVERS OF OBESITY
The Role of Causes of and Contributors to Obesity
Effecting Obesity Solutions through Community Systems Change
7 POWER DYNAMICS AND COMMUNITY AS COMPLEX SYSTEMS
The Importance of Understanding and Addressing Structural Racism
Community Empowerment in Harlem
Community Power Building in The California Endowment’s Building Healthy Communities Initiative
8 MOVING TOWARD SOLUTIONS: UNDERSTANDING COMMUNITY DYNAMICS IN RELATION TO POWER AND ENGAGEMENT
The Connecticut Hispanic Health Council SNAP-Ed Program
9 PROMISING INITIATIVES TO BUILD COMMUNITY POWER AND IMPROVE HEALTH
Wai‘anae ‘Ohana Social Services and Produce Prescription Programs
Local Matters: Partnering for Healthy Communities
10 THE SCIENCE, STRENGTHS, AND LIMITATIONS OF BODY MASS INDEX
The Science, Strengths, and Limitations of Body Mass Index as a Measure of Obesity
11 PROGRESS IN OBESITY SOLUTIONS THAT RELATE TO POLITICAL, ECONOMIC, AND ENVIRONMENTAL SYSTEMS
Political and Economic Systems
12 PROGRESS IN OBESITY SOLUTIONS: HEALTH CARE SYSTEMS
Intersectionality, Obesity, and Underrepresented Patients
Complexities and Consequences of Obesity
13 PROGRESS IN OBESITY SOLUTIONS: SOCIOCULTURAL SYSTEMS
Measuring Structural Racism for Health Policy
Engaging Communities to Address Health Inequities
Listening to the Community: Engaging in Community-Based Participatory Research
Workshop Wrap-Up and Closing Remarks
C BIOGRAPHICAL SKETCHES OF WORKSHOP SPEAKERS AND PLANNING COMMITTEE MEMBERS
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Box and Figures
BOX
1-1 Workshop Series Statement of Task
FIGURES
1-1 Causal systems map of obesity drivers and solutions
2-1 The reinforcing loop of obesity contributors
3-1 Percent changes in applicants, matriculants, and enrollment at U.S. medical schools
4-1 Analyzing a soda advertisement using a causal loop diagram of obesity’s drivers and solutions
5-1 Relationships between body image, stigma, and health
6-1 Relationships between causes of and contributors to obesity
7-1 A framework for health equity
7-2 Types of organizations within the power-building ecosystem
8-1 Obesity is a disease with multifactorial causes and contributors
10-3 Edmonton Obesity Staging System (EOSS)
10-4 Distribution of obesity classes at various levels of the Edmonton Obesity Staging System
11-1 Spectrum of community engagement to ownership
12-1 Weight stigma in the treatment of obesity
13-1 Dimensions of structural racism considered in a latent construct approach
13-2 Community engagement continuum
13-3 Continuum of example proximal and distal measures of factors that contribute to obesity
