ABSTRACT
Two of the ten leading health indicators of Healthy People 2010 (U.S. Department of Health and Human Services [USDHHS], 2000) focus on weight management and physical activity. Decades of research show the central role of these health behaviors for disease prevention (Koplan & Dietz, 1999) given their association with:
type 2 diabetes and the metabolic sydrome (Ford, Giles, & Dietz., 2002; Harris et al., 1998; Mokdad et al., 2001, 1999);
heart disease, particularly, the association with central obesity (Alexander, 2001; Melanson, McInnis, Rippe, Blackburn, & Wilson, 2001; Pi-Sunyer, 2002);
stroke (Kurth et al., 2002);
colon, breast, endometrial, esophagial, and renal cancers (Bianchini, Kaaks & Vainio, 2002; Calle, Rodriguez, Walker-Thurmond, & Thun, 2003; Friedenreich, 2001; see also Evenson, Stevens, Cai, Thomas, & Thomas, 2003; Kampert, Blair, Barlow, & Kohl, 1996; Lee & Blair, 2002; Vainio, Kaaks, & Bianchini, 2002);
the loss of quality and years of life and premature death (Allison, Fontaine, Manson, Stevens, & VanItallie, 1999; Allison, Zannolli, & Narayan, 1999; Calle, Thun, Pertrelli, Rodriguez, & Heath, 1999; Fontaine, Redden, Wang, Westfall, & Allison, 2003; Mokdad, Marks, Stroup, & Gerberding, 2004); and
the enormous burden placed on the health care system by the dis eases associated with overweight and obesity (Manson & Bassuk, 2003; Must et al., 1999).
