Combating Childhood Obesity with an Integrated School Curriculum

The prevalence of overweight and obesity among US adults is well-documented [1] and lifestyle intervention remains the foundation for all overweight and obesity treatment interventions, even when bariatric surgery is offered [2]. Unfortunately, lifestyle intervention, though clearly a vital part of any obesity treatment, including bariatric surgery, has not been found to be as effective in achieving health benefits as hoped for. Furthermore, not a single study has documented a benefit of lifestyle intervention in reducing cardiovascular events or mortality [3]. For example, the Look AHEAD study randomized 5145 overweight or obese adults with type 2 diabetes, a population at significant risk for cardiovascular events, to an intensive lifestyle weight loss intervention or standard diabetes support. The intended duration of follow-up of 13.5 years was stopped early at 9.6 years based on a futility analysis that showed no difference in cardiovascular outcomes [4]. A recent commentary emphasizes the difficulty in treating established obesity in adults due to the occurrence of biologic mechanisms that maintain the obese state [5]. It is clear that prevention of obesity is the optimal long-term strategy for addressing the adult obesity epidemic.