Obesity rates have been rising for decades across states, ages, sexes, and racial/ethnic groups, with continued increases during the COVID-19 pandemic.1,2,3,4,5,6 These long-term, cross-population trends underscore the nature of the crisis as a population-level problem tied to social, economic, and environmental factors in the United States, most of which are outside of an individual’s control. Some of these factors affect available choices and habits directly related to diet, nutrition, and physical activity—for example, the availability, cost, marketing, taste, and accessibility of nutrient-rich foods like fruits and vegetables versus calorie-rich foods like junk food and soda, and the availability, safety, and convenience of active transportation, parks, playgrounds, and facilities for exercise and physical activity. It is also important to consider the role other factors—like stress, discrimination, poverty, economic opportunity, and food insecurity— play in determining the health and well-being of every American.

In response to long-term increases in obesity plus added complications from COVID-19, the United States needs to invest in long-term, evidencebased programs that reduce obesity, increase collaboration across public and private sectors, build bolder and better innovations and solutions, and devote more attention and action to addressing the underlying conditions and structural and systemic inequities that undermine many Americans’ health.

Trust for America’s Health offers the following recommendations for federal, state, and local policymakers and other stakeholders. TFAH’s two guiding principles when making these recommendations are: (1) apply a multisector, multidisciplinary approach (because a single effort in just one sector or discipline is not likely to have a significant impact); and (2) intentionally focus on those populations with a disproportionate risk of obesity. A summary of TFAH’s recommendations are below; the full recommendations are on page 52.

  1. Advance health equity by strategically dedicating federal resources to efforts that reduce obesity-related disparities
  2. Decrease food insecurity while improving nutritional quality of available foods
  3. Change the marketing and pricing strategies that lead to health disparities
  4. Make physical activity and the built environment safer and more accessible for all
  5. Work with the healthcare system to close disparities and gaps from clinic to community settings