Healthcare Obesity Prevention Recommendations: Complete List

Writing a Prescription for Obesity Prevention

It is hard to overstate the influence that doctors and health plans can have on the health choices of individuals. In today’s information-heavy world, where people are bombarded with health messages day in and day out, the first casualty is often clarity. Useful, clear, and evidence-based messages get lost in the static of websites and the 24-hour news cycle. Doctors, healthcare facilities, and health insurance plans can be the antidote to this, offering what most others can’t: personal, reliable, and well-regarded sources not only of health information but also of inspiration to actually make healthy changes.

Hospitals, clinics, and similar facilities can support healthy changes by making sure they promote healthy environments for patients as well as visitors and staff. This includes ensuring not only healthy choices in cafeterias but also bans on fast food, sugary drinks, and similarly unhealthy choices, which have taken a foothold in many hospitals, skewing patients’ views of their healthfulness. (1)Doctors and other healthcare providers see patients across the arc of their lives, providing great opportunity to guide them toward making healthy eating and activity choices. They can be role models for healthy lifestyles. And as members of the broader community, they can bring their knowledge and standing to advocate for healthy changes that reach people well beyond the walls of the clinic.

Health insurance plans, with their broad reach, can in many ways be the most important influence on the weight control behaviors of patients. They can cover the cost of obesity prevention and treatment; create and promote prevention programs that can be instituted plan wide; and use their status in the community to support and sponsor wide-ranging prevention efforts, such as healthy meals in school, jogging and walking events, and the education of policymakers. (2)Hospitals, clinics, and similar facilities can support healthy changes by making sure they promote healthy environments for patients as well as visitors and staff. This includes ensuring not only healthy choices in cafeterias but also bans on fast food, sugary drinks, and similarly unhealthy choices, which have taken a foothold in many hospitals, skewing patients’ views of their healthfulness. (1)Doctors and other healthcare providers see patients across the arc of their lives, providing great opportunity to guide them toward making healthy eating and activity choices. They can be role models for healthy lifestyles. And as members of the broader community, they can bring their knowledge and standing to advocate for healthy changes that reach people well beyond the walls of the clinic.

Recent research in children suggests that health care clinic interventions on their own-in the absence of broader community strategies to prevent obesity-can lead to behavior change but may not be enough to lead to sizable improvements in weight. (3,4) Combining clinic efforts with community-wide changes offers a promising approach, and one that the healthcare sector has begun to pursue in earnest, with efforts such as the U.S.-based Collaborate for Healthy Weight initiative. (5)

This section of The Obesity Prevention Source summarizes obesity prevention recommendations for the healthcare setting, based on a review of expert guidance from the American Academy of Pediatrics, the American Medical Association, the Institute of Medicine, the National Institute for Health and Clinical Excellence, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list on each page, as well as the links to useful toolkits and other resources.


Primary Care and Prenatal Care

Healthy Apple and Stethoscope

Routinely measuring body mass index (BMI) and counseling patients on healthy eating and activity are critically important ways that pediatricians and primary care providers can help prevent obesity. Prenatal providers can promote breastfeeding, stress the importance of staying at a healthy weight before and during pregnancy, and encourage pregnant women to quit smoking. All providers should work to avoid bias and discrimination against people who are overweight or obese.

Here is a summary of primary care and prenatal care obesity prevention recommendations, based on a review of expert guidance from the American Academy of Pediatrics, the American Medical Association, the Institute of Medicine, the Childhood Obesity Action Network, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.


Pediatricians and Pediatric Primary Care Providers

Measure patients’ BMI percentile for age at every well-child visit for children ages 2 and older; for younger children, measure weight-for-length percentile (1,2,3,4,5,6,7,8,9)

Counsel all patients and their families on healthy eating, physical activity, and healthy growth, regardless of current weight status (1,3,4,7,10)

Counsel all patients and their families to limit television time to no more than two hours per day and to remove televisions from children’s bedrooms(1,3,5,7)

Counsel all patients and their families to limit consumption of sugar-sweetened beverages and encourage other healthful eating behaviors: (1,5,7)

  • Eating breakfast daily (1)
  • Limiting restaurant eating, especially fast-food restaurants (1)
  • Eating meals as a family (1)
  • Limiting portion sizes (1)

Counsel all patients and their families to help children achieve 60 minutes of moderate to vigorous physical activity per day (1,7)

Establish procedures for follow-up assessment (including laboratory tests), counseling, and treatment plans for children who are overweight or obese (1,2,3,5,6,7,8,9)

Establish policies to avoid weight bias in pediatric clinics, such as by requiring all employees to be trained on weight-bias prevention (1,5,7,9,10)

Scale and Apple


Adult Medicine Physicians and Primary Care Providers

Talking to Patients about Obesity
Emerging Research

Overweight and obese adults who report that their doctors have told them they are overweight are more likely to have accurate perceptions of their own weight, according to a U.S.-based survey.

They are also more likely to be interested in losing weight, and to have tried losing weight. Yet a third of obese patients say their doctors did not tell them they were overweight.

Routinely measure BMI in all adult patients(2,4,5,6,8,11,12,13)

Order appropriate follow-up laboratory tests for patients who are overweight and obese and prescribe a long-term treatment strategy, (4,5,6,8,9,11,12)which may include:

  • Counseling/coaching/behavioral interventions on diet/lifestyle change (4,6,9,11,12,13,14)
  • Weight loss medication for appropriate individuals who have been unable to lose weight through conventional therapy and who have no contraindications(9,11,12,14)
  • Bariatric surgery for patients with severe obesity unable to lose weight through conventional therapy and who have no contraindications (9,11,12,14)

Design physician offices to avoid stigmatizing overweight or obese patients, such as by providing private weighing areas and using scales that can measure weights greater than 300 pounds (9,11,12)


Obstetricians and Pre/Postnatal Care Providers

Early Life Influences on Obesity

Research Summary

Numerous factors during early life can affect a child’s obesity risk later in life: Maternal smoking, weight gain, and blood sugar levels during pregnancy, as well as an infant’s weight gain rate, breastfeeding, and sleep habits. Learn more about early life influences on obesity.

Counsel patients on the importance of being at a healthy weight before pregnancy and gaining weight at a healthy rate during pregnancy (3,6,9,15,16)

Recommend that mothers breastfeed and provide training and support for breastfeeding (3,5,15,17,18,19)

Counsel patients on the importance of avoiding smoking during pregnancy (6,20)

Screen pregnant women for gestational diabetes (21)

Primary Care and Prenatal Care-Source List

1. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164-92.

2. National Committee for Quality Assurance. HEDIS 2009 Summary Table of Measures, Product Lines and Changes.Washington, D.C.: National Committee for Quality Assurance; 2008.

3. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the President. White House Task Force on Childhood Obesity; 2010.

4. Let’s Move. Healthcare Providers Take Action. Accessed February 2, 2012.

5. Koplan JP, Liverman CT, Kraak VI, eds. Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: The National Academies Press; 2005.

6.U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation 2010. Rockville: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

7. Childhood Obesity Action Network. Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity; 2007.

8. America’s Health Insurance Plans. Facing the Challenge of Unhealthy Weight: Recommendations for the Health Care Community; 2008.

9. Centre for Public Health Excellence.Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. London: National Institute for Health and Clinical Excellence; 2006.

10. The Obesity Society. Position Statement: Youth Weight Bias and Discrimination in Healthcare Settings. Silver Spring: The Obesity Society; 2010.

11. Klein S, Burke LE, Bray GA, et al. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 2004;110:2952-67.

12. American Medical Association. Assessment and Management of Adult Obesity: A Primer for Physicians. Atlanta: American Medical Association; 2003.

13. U.S. Preventive Services Task Force. 2003. Screening for Obesity in Adults. Accessed March 8, 2012.

14. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults – The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S.

15. Guidelines for Perinatal Care. Washington, D.C.: American Academy of Pediatrics and the American College of Obstetricians and Gynecologists; 2007.

16. Rasmussen K, Yaktine A. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, D.C.: Food and Nutrition Board, Institute of Medicine, National Research Council; 2009.

17. American Medical Association. 2011. H-245.982. AMA Support for Breastfeeding.

18. Shealy K, Li R, Benton-Davis S, Grummer-Strawn L. The CDC Guide to Breastfeeding Interventions. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.

19. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.

20. Smoking cessation during pregnancy. Committee Opinion No. 471. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2010;116:1241-4.

21. Screening and Diagnosis of Gestational Diabetes Mellitus. Committee Opinion No. 504. American College of Obstetricians and Gynecologists. Obstet Gynecol.2011; 118:751-3.


Healthy Hospitals, Healthy Food

fruits on the forks (fruits_and_forks_small.jpg)

Hospitals should make it easy for staff and patients to make healthy food choices, such as by offering nutritious foods and beverages and limiting junk food and sugary beverages.

Here is a summary of hospital and healthcare clinic food environment recommendations for obesity prevention, based on a review of expert guidance from the American Medical Association, the Institute of Medicine, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Encourage healthcare providers and clinic employees to model healthy eating (1,2,3,4)

Offer healthy food and beverages to employees and patients (1,4,5)

Ban the sale and marketing of unhealthy food and beverages on clinic and hospital premises (5,6)

Promote breastfeeding among new mothers who give birth in the hospital or clinic, as well as for hospital and clinic employees who are nursing (7,8,9,10,11,12)

Healthy Hospitals, Healthy Food-Source List

1. American Academy of Pediatrics. Prevention and Treatment of Child Overweight and Obesity: Policy Opportunities Tool. American Academy of Pediatrics, 2010. Accessed February 7, 2012.

2. Koplan JP, Liverman CT, Kraak VI, eds. Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: The National Academies Press; 2005.

3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation 2010Rockville: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

4. Centre for Public Health Excellence. Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. London: National Institute for Health and Clinical Excellence: 2006.

5. American Medical Association.Proceedings of the 2005 Annual Meeting of the House of Delegates: Resolutions. Chicago, IL: American Medical Association; 2005.

6. Strasburger VC. Children, adolescents, and advertising. Pediatrics. 2006;118:2563-9.

7. Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496-506.

8. American Medical Association. H-245.982 AMA Support for Breastfeeding. In: American Medical Association PolicyFinder; 2011.

9. Shealy K, Li R, Benton-Davis S, Grummer-Strawn L.The CDC Guide to Breastfeeding Interventions. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.

10. Let’s Move. Healthcare Providers Take Action. Accessed February 2, 2012.

11. Parker L, Burns AC, Sanchez E.Local government actions to prevent childhood obesity. Washington, D.C.: Institute of Medicine; 2009.

12. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.


Health Insurance Providers

Insurance Form

Health insurance providers have an important role to play in obesity prevention, from covering preventive services to supporting community-wide obesity prevention efforts.

Here is a summary of obesity prevention recommendations for health insurance providers, based on a review of expert guidance from the American Academy of Pediatrics, the Institute of Medicine, America’s Health Insurance Plans, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Cover obesity-related services such as assessment, prevention, evaluation, treatment, and follow-up, and streamline reimbursement procedures (1,2,3,4,5)

Provide subscribers incentives for maintaining healthy body weight or adopting healthy behaviors, such as charting regular physical activity (3,6)

Measure and track progress in body mass index screening, through Healthcare Effectiveness Data and Information Set (HEDIS) data collection (6,7)

Fund obesity prevention efforts in the community, and/or participate in community obesity prevention coalitions (3,6)

Health Insurance Providers-Source List

1. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164-92.

2.White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the President: White House Task Force on Childhood Obesity; 2010.

3. Koplan JP, Liverman CT, Kraak VI, eds. Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: The National Academies Press; 2005.

4. The Obesity Society. Position Statement: Solutions – Eradicating America’s Obesity Epidemic. Silver Spring: The Obesity Society; 2009.

5. Childhood Obesity Action Network. Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity; 2007.

6. America’s Health Insurance Plans. Facing the Challenge of Unhealthy Weight: Recommendations for the Health Care Community; 2008.

7. National Committee for Quality Assurance. HEDIS 2009 Summary Table of Measures, Product Lines and Changes. Washington, D.C.:National Comittee for Quality Assurance; 2008.


Healthcare Professional Training and Advocacy

Gold Cadeceus

Every healthcare professional’s training toolbox must include the skills to counsel patients about obesity prevention and lifestyle change. Actions speak louder than words, so it’s important for clinicians to model healthy eating and active lifestyles. They can also be strong advocates for obesity prevention efforts in their communities.

Here is a summary of obesity prevention recommendations for healthcare professional associations and healthcare professional advocacy, based on a review of expert guidance from the Institute of Medicine, the American Academy of Pediatrics, the American Medical Association, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.


Healthcare Professional Training and Associations

Require training in obesity prevention and lifestyle counseling, such as (1,2,3,4)

  • Interpreting BMI percentile for age
  • Counseling on nutrition and physical activity
  • Motivational interviewing skills

Distribute position statements and other evidence-based information on obesity prevention (2)

Encourage members to be role models for healthy eating and activity (2)


Healthcare Professionals as Advocates

Serve as leaders and role models, within one’s practice and community, to encourage healthy changes in physical activity, nutrition, and the built environment (2,4,5,6)

Advocate at the practice, professional organization, local, state, and federal levels for policy and built environment changes that promote healthy eating and physical activity in child care settings, schools, after-school programs, and communities (4,7,8,9,10)

Encourage parents to advocate for environmental changes that promote physical activity in their children’s schools and communities (11)

Healthcare Professional Training and Advocacy-Source List

1. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the President: White House Task Force on Childhood Obesity; 2010.

2. Koplan JP, Liverman CT, Kraak VI, eds.Preventing Childhood Obesity: Health in the Balance.Washington, D.C.: The National Academies Press; 2005.

3. The Obesity Society. Position Statement: Youth Weight Bias and Discrimination in Healthcare Settings. Silver Spring: The Obesity Society; 2010.

4. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation 2010Rockville: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

5. American Academy of Pediatrics Council on Sports Medicine and Fitness and Council on School Health. Active healthy living: prevention of childhood obesity through increased physical activity. Pediatrics. 2006;117:1834-42.

6. Let’s Move. Healthcare Providers Take Action. Accessed February 3, 2012.

7. Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics. 2007;120 Suppl 4:S229-53.

8. Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496-506.

9. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164-92.

10. Childhood Obesity Action Network. Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity; 2007.

11. Tester JM. The built environment: designing communities to promote physical activity in children. Pediatrics. 2009;123:1591-8.