Public health agencies face considerable challenges trying to prevent overweight and obesity in society, primarily because a person's own behavior is often the root cause of the disease. Individuals make personal choices about their diet, exercise, and lifestyle, so disease is often thought of as a matter of personal, not governmental, responsibility.
Obesity, one of the 10 leading US health indicators,1 is associated with increased risk of death from type 2 diabetes, hypertension, coronary heart disease, stroke, and certain cancers.2 Yet the proportion of overweight and obese children and adults is alarmingly high and continues to increase. In 2005, 60.5% of adults in the United States were overweight (body mass index, 25-30), 23.9% were obese (body mass index, 31-40), and 3% were extremely obese (body mass index >40). African Americans have the highest obesity prevalence at 33.9%.3 The prevalence of adult obesity increased significantly in every state during the 1990s; therefore, no state will meet the targets for reduced rates of obesity set in Healthy People 2010.4 Similarly, 16% of children and adolescents were overweight, a prevalence that has increased nearly 50% between 1999 and 2002.5 Obesity could shorten the average lifespan of an entire generation by 2 to 5 years, which, if true, would result in the first reversal in life expectancy since data were collected in 1900.6