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.
