Obesity Interventions: Integration with Community- Based Systems

Obesity is a global health problem. Interventions that work beyond controlled, intensive settings are needed to combat the obesity epidemic. The default behavior in obesogenic environments leads toward unhealthy diets and minimal physical activity. Interventions conducted in community settings have the potential to reach a wider population of adults and children; targeting both the individual and the environment. Community health centers, recreation centers, churches, and schools are community settings in which obesity interventions have been successfully implemented. Within community health centers, newer models of obesity care including increased provider and nurse training, remote support for weight loss, utilization of weight loss coaches, and community health educators show promise. Diabetes Prevention Program group interventions have been successfully disseminated through recreation centers such as the Young Men’s Christian Association (YMCA) and churches. In comparison to controlled intensive studies, the magnitude of weight loss and diabetes reduction in community settings yields more modest results. However, the impact of modest weight reductions disseminated at the population level can contribute to significant population level improvements. In targeting childhood obesity, changes in the school environment including changes to the food environment in schools, distribution of body mass index report cards to parents, and increasing physical activity in schools have all shown an impact in reducing obesity. Successful obesity treatment and prevention models that have been disseminated in community settings including healthcare, recreation, church, and schools will be reviewed.

Keywords: Behavior, community health centers, community, diabetes prevention, diet, global health, health care settings, insulin, lifestyle diseases, lifestyle intervention, nurse education, nutrition, obesity, overweight, risk, weight loss, wellness.