ABSTRACT

Obesity is now accepted as a serious public health prob-

lem throughout most of the world and is firmly on the

agenda of policy makers, health professionals, and the

general public across the world. The rates of obesity

throughout both the developed and developing world are

increasing at a dramatic rate. Indeed, the pandemic of

overweight and obesity is now so advanced and so wide-

spread that few regions of the world (with the possible

exception of parts of sub-Saharan Africa) appear to have

escaped its effects. The effective prevention of obesity has

been widely acknowledged as the only feasible solution to

addressing the problem in the long term. However, assess-

ments of past obesity prevention initiatives (1-3) have

come to a common conclusion that their impact has been

very limited. However, they all conceded that given the

considerable health risks associated with obesity, the high

rates of overweight and obesity in most countries, the cost

implications, and the limited long-term success of current

weight reduction methods, priority should be given to the

prevention of obesity and weight maintenance in prefer-

ence to weight loss interventions. Jeffery and French (4)

have also argued that the behavior change required to

prevent small increments in weight with age is likely to be

easier to sustain than the behavior change required to

achieve and maintain large weight losses. This makes

sense not just in terms of the magnitude of effort needed

but also because of the adaptive response in humero-

hypothalamic mechanisms, which operate to maintain

weight gain.