LAUSR

Although federal, state, and local health authorities have invested substantively in a diverse range of interventions to combat the obesity epidemic during the past decade (1-3), the original expectation of achieving a modest decline in this condition’s prevalence, as measured by BMI, has not been fully realized. According to the National Health and Nutrition Examination Survey 2015-2016, the prevalence of obesity among US adults and youth was still 39.8% and 18.5%, respectively (4). Although this development does not necessarily suggest a global failure in public health’s response to this epidemic, it does warrant some introspection and review of the approaches being taken to address this public health threat. For example, lingering questions remain: Are policies implemented to improve the quality of food environments effective and adequately supported by evidence? Do the mixed results commonly seen with built environment interventions suggest a poor return on investment for these types of upstream interventions (or is it just simply too early to tell)? How influential is socioeconomic status on health behaviors such as physical activity and sedentary lifestyles?