il mondo è fatto a scale

Building Scalable Obesity Treatment

Finding scalable obesity treatment approaches has long been a worry for health policymakers. With obesity, we have a complex chronic disease that affects up to a third of the population. The scale of the effort required to reverse it is daunting. Maybe that’s why it’s been easier to deny that it’s a disease and just blame the people affected — until now.

Since the blame and shame thing hasn’t worked out too well, people are getting serious about finding an evidence-based approach that can be implemented on a large scale across communities. And the YMCA is playing a central role in many of these efforts.

Gary Foster and his colleagues at Temple University’s Center for Obesity Research and Education have been working to develop childhood obesity treatment and prevention programs that will work on a large scale. They published encouraging results late last year in Pediatrics. Through a community-based program delivered through YMCAs, they were able to deliver a 4.3% reduction in the percentage of of children under 13 with excess weight. Along with these reductions in excess weight, they found significant improvements in the quality of life reported by both children and their parents.

The YMCA is also at the center of large and diverse efforts across America to translate the results of the Diabetes Prevention Program (DPP) into programs that can reach millions of adults with obesity and excess weight that puts them at risk of diabetes. Employers and health plans are contracting with the Y to implement these programs on a scale that could be an impressive leap forward for evidence-based obesity treatment.

Others are getting into the act, too. Investigators from Georgia Regents University, Medical College of Georgia, University of Pittsburgh, CDC, and Emory are translating the DPP into an intervention for African American churches. The Fit Body and Soul study is ongoing to evaluate the efficacy and cost utility of this program in the largest known cohort of African Americans in a faith-based DPP translation.

Likewise the VA health system has recently implemented their own DPP translation — called MOVE — and reported excellent results from three years’ follow-up at the American Diabetes Association scientific sessions this year.

Scalable, evidence-based treatment for obesity is a critical link in obesity strategy. Now that the last holdouts are recognizing  obesity as a chronic disease we can no longer ignore, the time is right to be forging ahead.

Click here to read more about Foster’s study in childhood obesity, click here to read more about scaling up the DPP in the Wall Street Journal, click here to read more about the Body and Soul study, and click here to read more about the VA MOVE program.

Il Mondo è Fatto a Scale, photograph © Paolo Margari / flickr

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