Obesity in the United States
Encyclopedia
Obesity in the United States has been increasingly cited as a major health issue in recent decades. While many industrialized countries
have experienced similar increases, obesity
rates in the United States
are among the highest in the world with 74.6% of Americans being overweight or obese. Estimates have steadily increased, from 19.4% in 1997, 24.5% in 2004 to 26.6% in 2007, to 33.8% (adults) and 17% (children) in 2008.
The direct medical cost of obesity and indirect economic loss to obesity has been estimated to be as high as $51.64 billion and $99.2 billion in 1995, respectively; this rose to $61 billion and $117 billion in 2000. Researchers for the Centers for Disease Control and Prevention and RTI International
estimate that in 2003, obesity-attributable medical expenditures reached $75 billion.
Obesity rates have increased for all population groups in the United States over the last several decades. Between 1986 and 2000, the prevalence of severe obesity (BMI ≥ 40 kg/m2) quadrupled from one in two hundred Americans to one in fifty. Extreme obesity (BMI ≥ 50 kg/m2) in adults increased by a factor of five, from one in two thousand to one in four hundred. There have been similar increases seen in children and adolescents, with the prevalence of overweight in pediatric age groups nearly tripling over the same period. Approximately nine million children over six years of age are considered obese. Several recent studies have shown that the rise in obesity in the US is slowing, possibly explained by saturation of health-oriented media or a biological limit on obesity.
but this is more often a problem associated with a medical disorder. Unlike adults, newborns do not develop obesity. The number one cause of big babies is diabetes
but this is not considered to be an obese baby.
Data from NHANES
surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased: for children aged 2–5 years, prevalence increased from 5.0% to 12.4%; for those aged 6–11 years, prevalence increased from 6.5% to 17.0%; and for those aged 12–19 years, prevalence increased from 5.0% to 17.6%.
In 2000, approximately 19% of children (ages 6–11) and 17% of adolescents (ages 12–19) were overweight and an additional 15% of children and adolescents were at risk to becoming overweight, based on their BMI
.
Analyses of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999–2000, 2001–2002, 2003–2004, and 2005–2006) for either boys or girls. Overall, in 2003-2006, 11.3% of children and adolescents aged 2 through 19 years were at or above the 97th percentile of the 2000 BMI-for-age growth charts, 16.3% were at or above the 95th percentile, and 31.9% were at or above the 85th percentile
Trend analyses indicate no significant trend between 1999–2000 and 2007-2008 except at the highest BMI cut point (BMI for age 97th percentile) among all 6- through 19-year-old boys. In 2007-2008, 9.5% of infants and toddlers were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% were at or above the 95th percentile; and 31.7% were at or above the 85th percentile of BMI for age.
In summary, between 2003 and 2006, 11.3% of children and adolescents were obese and 16.3% were overweight. A slight increase was observed in 2007 and 2008 when the recorded data shows that 11.9% of the children between 6 and 19 years old were obese and 16.9% were overweight. The data recorded in the first survey was obtained by measuring 8,165 children over four years and the second was obtained by measuring 3,281 children.
factors may play a role in this age group when it comes to developing obesity.
for the military reaching $15 million in 2002. Obesity is currently the largest single cause for the discharge of uniformed personnel.
In 2005, 9 million adults of ages 17 to 24, or 27%, were too overweight to be considered for service in the military.
program and 2003–2004 child data from the National Survey of Children's Health.
Care should be taken in interpreting these numbers, because they are based on self-report surveys which asked individuals (or, in case of children & adolescents, their parents) to report their height and weight. Height is commonly overreported and weight underreported, sometimes resulting in significantly lower estimates. One study estimated the difference between actual and self-reported obesity as 7% among males and 13% among females as of 2002, with the tendency to increase.
Looking at the long-term consequences, overweight adolescents have a 70 percent chance of becoming overweight or obese adults, which increases to 80 percent if one or more parent is overweight or obese. In 2000, the total cost of obesity for children and adults in the United States was estimated to be $117 billion ($61 billion in direct medical costs).
Food consumption has increased with time. For example, annual per capita consumption of cheese per capita was 4 pounds (1.8 kg) in 1909; 32 pounds (14.5 kg) in 2000; the average person consumed 389 grams of carbohydrates daily in 1970; 490 in 2000; 41 pounds (18.6 kg) of fats and oils in 1909; 79 pounds (35.8 kg) in 2000. In 1977, 18% of an average person's food was consumed outside the home; in 1996, this had risen to 32%.
, cardiovascular disease
, and disability. In particular, diabetes has become the seventh leading cause of death in the United States, with the U.S. Department of Health and Human Services
estimating in 2008 that fifty-seven million adults aged twenty and older were pre-diabetic, 23.6 million diabetic, with 90–95% of the latter being type 2-diabetic. Obesity has also been shown to increase the prevalence of complications during pregnancy and childbirth. Babies born to obese women are almost three times as likely to die within one month of birth and almost twice as likely to be stillborn
than babies born to women of normal weight.
Obesity has been cited as a contributing factor to approximately 100,000–400,000 deaths in the United States per year and has increased health care use and expenditures, costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs. This exceeds health-care costs associated with smoking
or problem drinking
and accounts for 6% to 12% of national health care expenditures in the United States.
The Medicare
and Medicaid
programs bear about half of this cost. Annual hospital costs for treating obesity-related diseases in children rose threefold, from $35 million to $127 million, in the period from 1979 to 1999, and the inpatient and ambulatory healthcare costs increased drastically by $395 per person per year. These trends in healthcare costs associated with pediatric obesity and its comorbidities are staggering, urging the surgeon general to predict that preventable morbidity and mortality associated with obesity may surpass those associated with cigarette smoking. Furthermore, the probability of childhood obesity persisting into adulthood is estimated to increase from approximately twenty percent at four years of age to approximately eighty percent by adolescence, and it is likely that these obesity comorbidities will persist into adulthood.
s and cafeterias. State legislators in California
, for example, passed laws banning the sale of machine-dispensed snacks and drinks in elementary schools in 2003, despite objections by the California-Nevada Soft Drink Association. The state followed more recently with legislation to prohibit their soda sales in high schools starting July 1, 2009, with the shortfall in school revenue to be compensated by an increase in funding for school lunch programs. A similar law passed by the Connecticut General Assembly
in June 2005 was vetoed by governor Jodi Rell
, who stated the legislation "undermines the control and responsibility of parents with school-aged children."
In mid-2006, the American Beverage Association
(including Cadbury Schweppes, Coca Cola and PepsiCo
) agreed to a voluntary ban on the sale of all high-calorie drinks and all beverages in containers larger than 8, 10 and 12 ounces in elementary, middle and high schools, respectively.
Non-profit organizations such as HealthCorps
work to educate people on healthy eating and advocate for healthy food choices in an effort to combat obesity.
The American First Lady Michelle Obama
is leading an initiative to combat childhood obesity entitled "Let's Move
". Mrs. Obama says she aims to wipe out obesity "in a generation". Let's Move!
has partnered with other programs.
Developed country
A developed country is a country that has a high level of development according to some criteria. Which criteria, and which countries are classified as being developed, is a contentious issue...
have experienced similar increases, obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
rates in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
are among the highest in the world with 74.6% of Americans being overweight or obese. Estimates have steadily increased, from 19.4% in 1997, 24.5% in 2004 to 26.6% in 2007, to 33.8% (adults) and 17% (children) in 2008.
The direct medical cost of obesity and indirect economic loss to obesity has been estimated to be as high as $51.64 billion and $99.2 billion in 1995, respectively; this rose to $61 billion and $117 billion in 2000. Researchers for the Centers for Disease Control and Prevention and RTI International
RTI International
RTI International is the trade name of the Research Triangle Institute, an independent research institute established in 1958. The founding tenant of North Carolina’s Research Triangle Park, RTI was created as part of a larger effort to harness the intellectual capital of the area’s three major...
estimate that in 2003, obesity-attributable medical expenditures reached $75 billion.
Prevalence
By age group
Historically, obesity primarily afflicted adults, but this has changed in the last 2 decades. 15-25 percent of American children and adolescents are now obese. Children and adolescents who are obese are likely to be obese in adulthood and to develop obesity-related health problems.Newborns
Some newborns may be born bigLarge for gestational age
Large for gestational age is an indication of high prenatal growth rate, often defined as a weight that lies above the 90th percentile for that gestational age...
but this is more often a problem associated with a medical disorder. Unlike adults, newborns do not develop obesity. The number one cause of big babies is diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
but this is not considered to be an obese baby.
Children and teens
From 1980 to 2008, the prevalence of obesity in children aged 6 to 11 years tripled from 6.5% to 19.6%. The prevalence of obesity in teenagers more than tripled from 5% to 18.1% in the same time frame.Data from NHANES
National Health and Nutrition Examination Survey
The National Health and Nutrition Examination Survey is a survey research program conducted by the National Center for Health Statistics to asses the health and nutritional status of adults and children in the United States, and to track changes over time. The survey combines interviews and...
surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased: for children aged 2–5 years, prevalence increased from 5.0% to 12.4%; for those aged 6–11 years, prevalence increased from 6.5% to 17.0%; and for those aged 12–19 years, prevalence increased from 5.0% to 17.6%.
In 2000, approximately 19% of children (ages 6–11) and 17% of adolescents (ages 12–19) were overweight and an additional 15% of children and adolescents were at risk to becoming overweight, based on their BMI
Body mass index
The body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...
.
Analyses of the trends in high BMI for age showed no statistically significant trend over the four time periods (1999–2000, 2001–2002, 2003–2004, and 2005–2006) for either boys or girls. Overall, in 2003-2006, 11.3% of children and adolescents aged 2 through 19 years were at or above the 97th percentile of the 2000 BMI-for-age growth charts, 16.3% were at or above the 95th percentile, and 31.9% were at or above the 85th percentile
Trend analyses indicate no significant trend between 1999–2000 and 2007-2008 except at the highest BMI cut point (BMI for age 97th percentile) among all 6- through 19-year-old boys. In 2007-2008, 9.5% of infants and toddlers were at or above the 95th percentile of the weight-for-recumbent-length growth charts. Among children and adolescents aged 2 through 19 years, 11.9% were at or above the 97th percentile of the BMI-for-age growth charts; 16.9% were at or above the 95th percentile; and 31.7% were at or above the 85th percentile of BMI for age.
In summary, between 2003 and 2006, 11.3% of children and adolescents were obese and 16.3% were overweight. A slight increase was observed in 2007 and 2008 when the recorded data shows that 11.9% of the children between 6 and 19 years old were obese and 16.9% were overweight. The data recorded in the first survey was obtained by measuring 8,165 children over four years and the second was obtained by measuring 3,281 children.
Elderly
Although obesity is reported in the elderly, the numbers are still significantly lower than the levels seen in the young adult population. It is speculated that socioeconomicSocioeconomics
Socioeconomics or socio-economics or social economics is an umbrella term with different usages. 'Social economics' may refer broadly to the "use of economics in the study of society." More narrowly, contemporary practice considers behavioral interactions of individuals and groups through social...
factors may play a role in this age group when it comes to developing obesity.
In the military
An estimated sixteen percent of active duty U.S. military personnel were obese in 2004, with the cost of remedial bariatric surgeryBariatric surgery
Bariatric surgery includes a variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with an implanted medical device or through removal of a portion of the stomach or by resecting and re-routing the small intestines...
for the military reaching $15 million in 2002. Obesity is currently the largest single cause for the discharge of uniformed personnel.
In 2005, 9 million adults of ages 17 to 24, or 27%, were too overweight to be considered for service in the military.
Prevalence by state
The following figures were averaged from 2005–2007 adult data compiled by the CDC BRFSSBehavioral Risk Factor Surveillance System
The Behavioral Risk Factor Surveillance System is a United States health survey that looks at behavioral risk factors. It is run by Centers for Disease Control and Prevention and conducted by the individual state health departments. The survey is administered by telephone and is the world's...
program and 2003–2004 child data from the National Survey of Children's Health.
Care should be taken in interpreting these numbers, because they are based on self-report surveys which asked individuals (or, in case of children & adolescents, their parents) to report their height and weight. Height is commonly overreported and weight underreported, sometimes resulting in significantly lower estimates. One study estimated the difference between actual and self-reported obesity as 7% among males and 13% among females as of 2002, with the tendency to increase.
| State & District of Columbia | Obese Adults | Overweight Adults | Obese Children & Adolescents | Obesity Rank |
|---|---|---|---|---|
| Alabama | 30.1% | 65.4% | 16.7% | 3 |
| Alaska | 27.3% | 64.5% | 11.1% | 14 |
| Arizona | 23.3% | 59.5% | 12.2% | 40 |
| Arkansas | 28.1% | 64.7% | 16.4% | 9 |
| California | 23.1% | 59.4% | 13.2% | 41 |
| Colorado | 21.0% | 55.0% | 9.9% | 51 |
| Connecticut | 20.8% | 58.7% | 12.3% | 49 |
| D.C. | 22.1% | 55.0% | 14.8% | 43 |
| Delaware | 25.9% | 63.9% | 22.8% | 22 |
| Florida | 23.3% | 60.8% | 14.4% | 39 |
| Georgia | 27.5% | 63.3% | 16.4% | 12 |
| Hawaii | 20.7% | 55.3% | 13.3% | 50 |
| Idaho | 24.6% | 61.4% | 10.1% | 31 |
| Illinois | 25.3% | 61.8% | 15.8% | 26 |
| Indiana | 27.5% | 62.8% | 15.6% | 11 |
| Iowa | 26.3% | 63.4% | 12.5% | 19 |
| Kansas | 25.8% | 62.3% | 14.0% | 23 |
| Kentucky | 28.4% | 66.8% | 20.6% | 7 |
| Louisiana | 29.5% | 64.2% | 17.2% | 4 |
| Maine | 23.7% | 60.8% | 12.7% | 34 |
| Maryland | 25.2% | 61.5% | 13.3% | 28 |
| Massachusetts | 20.9% | 56.8% | 13.6% | 48 |
| Michigan | 27.7% | 63.9% | 14.5% | 10 |
| Minnesota | 24.8% | 61.9% | 10.1% | 30 |
| Mississippi | 34.4% | 67.4% | 17.8% | 1 |
| Missouri | 27.4% | 63.3% | 15.6% | 13 |
| Montana | 21.7% | 59.6% | 11.1% | 45 |
| Nebraska | 26.5% | 63.9% | 11.9% | 18 |
| Nevada | 23.6% | 61.8% | 12.4% | 36 |
| New Hampshire | 23.6% | 60.8% | 12.9% | 35 |
| New Jersey | 22.9% | 60.5% | 13.7% | 42 |
| New Mexico | 23.3% | 60.3% | 16.8% | 38 |
| New York | 23.5% | 60.0% | 15.3% | 37 |
| North Carolina | 27.1% | 63.4% | 19.3% | 16 |
| North Dakota | 25.9% | 64.5% | 12.1% | 21 |
| Ohio | 26.9% | 63.3% | 14.2% | 17 |
| Oklahoma | 28.1% | 64.2% | 15.4% | 8 |
| Oregon | 25.0% | 60.8% | 14.1% | 29 |
| Pennsylvania | 25.7% | 61.9% | 13.3% | 24 |
| Rhode Island | 21.4% | 60.4% | 11.9% | 46 |
| South Carolina | 29.2% | 65.1% | 18.9% | 5 |
| South Dakota | 26.1% | 64.2% | 12.1% | 20 |
| Tennessee | 29.0% | 65.0% | 20.0% | 6 |
| Texas | 27.2% | 64.1% | 19.1% | 15 |
| Utah | 21.8% | 56.4% | 8.5% | 44 |
| Vermont | 21.1% | 56.9% | 11.3% | 47 |
| Virginia | 25.2% | 61.6% | 13.8% | 27 |
| Washington | 24.5% | 60.7% | 10.8% | 32 |
| West Virginia | 30.6% | 66.8% | 20.9% | 2 |
| Wisconsin | 25.5% | 62.4% | 13.5% | 25 |
| Wyoming | 24.0% | 61.7% | 8.7% | 33 |
Epidemiology
According to the NHANES data, African American and Mexican American adolescents between 12 and 19 years old are more likely to be overweight than non-Hispanic White adolescents. The prevalence is 21%, 23% and 14% respectively. Also, in a national survey of American Indian children 5–18 years old, 39 percent were found to be overweight or at risk for being overweight.Looking at the long-term consequences, overweight adolescents have a 70 percent chance of becoming overweight or obese adults, which increases to 80 percent if one or more parent is overweight or obese. In 2000, the total cost of obesity for children and adults in the United States was estimated to be $117 billion ($61 billion in direct medical costs).
Food consumption has increased with time. For example, annual per capita consumption of cheese per capita was 4 pounds (1.8 kg) in 1909; 32 pounds (14.5 kg) in 2000; the average person consumed 389 grams of carbohydrates daily in 1970; 490 in 2000; 41 pounds (18.6 kg) of fats and oils in 1909; 79 pounds (35.8 kg) in 2000. In 1977, 18% of an average person's food was consumed outside the home; in 1996, this had risen to 32%.
Medical costs
There has been an increase in obesity-related medical problems, including type II diabetes, hypertensionHypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, cardiovascular disease
Cardiovascular disease
Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...
, and disability. In particular, diabetes has become the seventh leading cause of death in the United States, with the U.S. Department of Health and Human Services
United States Department of Health and Human Services
The United States Department of Health and Human Services is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America"...
estimating in 2008 that fifty-seven million adults aged twenty and older were pre-diabetic, 23.6 million diabetic, with 90–95% of the latter being type 2-diabetic. Obesity has also been shown to increase the prevalence of complications during pregnancy and childbirth. Babies born to obese women are almost three times as likely to die within one month of birth and almost twice as likely to be stillborn
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...
than babies born to women of normal weight.
Obesity has been cited as a contributing factor to approximately 100,000–400,000 deaths in the United States per year and has increased health care use and expenditures, costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs. This exceeds health-care costs associated with smoking
Smoking
Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...
or problem drinking
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
and accounts for 6% to 12% of national health care expenditures in the United States.
The Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
and Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
programs bear about half of this cost. Annual hospital costs for treating obesity-related diseases in children rose threefold, from $35 million to $127 million, in the period from 1979 to 1999, and the inpatient and ambulatory healthcare costs increased drastically by $395 per person per year. These trends in healthcare costs associated with pediatric obesity and its comorbidities are staggering, urging the surgeon general to predict that preventable morbidity and mortality associated with obesity may surpass those associated with cigarette smoking. Furthermore, the probability of childhood obesity persisting into adulthood is estimated to increase from approximately twenty percent at four years of age to approximately eighty percent by adolescence, and it is likely that these obesity comorbidities will persist into adulthood.
Anti-obesity efforts
Under pressure from parents and anti-obesity advocates, many school districts moved to ban sodas, junk foods, and candy from vending machineVending machine
A vending machine is a machine which dispenses items such as snacks, beverages, alcohol, cigarettes, lottery tickets, consumer products and even gold and gems to customers automatically, after the customer inserts currency or credit into the machine....
s and cafeterias. State legislators in California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
, for example, passed laws banning the sale of machine-dispensed snacks and drinks in elementary schools in 2003, despite objections by the California-Nevada Soft Drink Association. The state followed more recently with legislation to prohibit their soda sales in high schools starting July 1, 2009, with the shortfall in school revenue to be compensated by an increase in funding for school lunch programs. A similar law passed by the Connecticut General Assembly
Connecticut General Assembly
The Connecticut General Assembly is the state legislature of the U.S. state of Connecticut. It is a bicameral body composed of the 151-member House of Representatives and the 36-member Senate. It meets in the state capital, Hartford. There are no term limits for either chamber.During...
in June 2005 was vetoed by governor Jodi Rell
Jodi Rell
Mary Jodi Rell is a Republican politician and was the 87th Governor of the U.S. state of Connecticut from 2004 until 2011. She was the Lieutenant Governor of Connecticut under Governor John G. Rowland, who resigned during a corruption investigation. Rell is Connecticut's second female Governor,...
, who stated the legislation "undermines the control and responsibility of parents with school-aged children."
In mid-2006, the American Beverage Association
American Beverage Association
American Beverage Association is a trade organization that represents the beverage industry in the United States. Its members include producers and bottlers of soft drinks, bottled water, and other non-alcoholic beverages....
(including Cadbury Schweppes, Coca Cola and PepsiCo
PepsiCo
PepsiCo Inc. is an American multinational corporation headquartered in Purchase, New York, United States, with interests in the manufacturing, marketing and distribution of grain-based snack foods, beverages, and other products. PepsiCo was formed in 1965 with the merger of the Pepsi-Cola Company...
) agreed to a voluntary ban on the sale of all high-calorie drinks and all beverages in containers larger than 8, 10 and 12 ounces in elementary, middle and high schools, respectively.
Non-profit organizations such as HealthCorps
HealthCorps
HealthCorps is an American non-profit organization that responds to the obesity crisis through school-based health education and peer-mentoring in addition to community outreach to underserved populations – mostly Hispanic and African-American....
work to educate people on healthy eating and advocate for healthy food choices in an effort to combat obesity.
The American First Lady Michelle Obama
Michelle Obama
Michelle LaVaughn Robinson Obama is the wife of the 44th and incumbent President of the United States, Barack Obama, and is the first African-American First Lady of the United States...
is leading an initiative to combat childhood obesity entitled "Let's Move
Let's Move!
Let's Move! is a campaign to end childhood obesity in the United States. The campaign was started by First Lady Michelle Obama. The initiative has the goal of "solving the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight."The...
". Mrs. Obama says she aims to wipe out obesity "in a generation". Let's Move!
Let's Move!
Let's Move! is a campaign to end childhood obesity in the United States. The campaign was started by First Lady Michelle Obama. The initiative has the goal of "solving the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight."The...
has partnered with other programs.