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Behavior-Change Facilitation and Addressing the Obesity Epidemic

Our Position

Because research shows that instilling sustainable healthy behavior patterns, including regular physical activity and sound nutrition, is key to addressing the obesity epidemic ( 1 ) ( 2 ), ACE seeks public policies that make highly qualified, science-based, interdisciplinary coaching, counseling, and support for sustainable behavioral change a functional, integral component of the nation’s healthcare continuum.


Our nation’s traditional approach to healthcare—sick patients visit doctors for medical treatments—will not halt nor even slow the obesity epidemic ( 3 ) ( 4 ). Obesity results from a complex mix of physiological, psychological, environmental, cultural and socioeconomic factors. Today, the healthcare system sends individuals at risk for obesity away from the system to manage those risk factors on their own. This approach is simply not working. While treating the consequences of obesity is costing the system billions of dollars annually and compromising quality of life on a grand scale, the system is still investing almost no money in primary prevention of the disease ( 3 ) ( 4 ) ( 5 ).

Interventions that establish healthy patterns of behavior will help reverse obesity trends ( 5 ) ( 6 ) ( 7 ). The healthcare system must invest in sustainable behavioral change at the individual, family and community levels ( 5 ) ( 6 ). Individuals at risk for obesity need ongoing, engaged support by professionals who are well trained in weight management and who specialize in sustainable behavioral change for the large and growing segment of the population at risk for obesity and its co-morbidities ( 6 ) ( 7 ) ( 8 ). Behavioral-change facilitation needs to be integral to the healthcare system, reimbursable by insurers, highly accessible and culturally appropriate for the communities in which it is provided ( 5 ) ( 6 ) ( 7 ) ( 8 ).

Public Policy Priorities

ACE urges federal and state government officials to advance public policies that effectively move obesity prevention and intervention into the healthcare system, including the payment system. Specifically, ACE calls for policies that:

  • Ensure that obesity intervention and prevention is supported and paid for.
  • Recognize and utilize NCCA-accredited health coaches , fitness professionals and other weight-management and behavior change experts in communities as part of the healthcare continuum.
  • Incentivize medical professionals to utilize behavior-change facilitation by well-qualified health and fitness professionals for the large and growing segment of the population at- risk for obesity and its co-morbidities.
  • Increase physical activity among youth at home, at school, and in the early care and education (ECE) setting.

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1.   New York Academy of Medicine & Trust for America’s Health. A Compendium of Proven Community-Based Prevention Programs. 2013 Edition. Retrieved from: healthyamericans.or

2.   Sallis, James F. & Glanz, Karen. Physical Activity and Food Environments: Solutions to the Obesity Epidemic. The Milbank Quarterly. 2009;87(1); 123-154.

3.   Brill, Alex. The Long-Term Returns of Obesity Prevention Policies. April 2013. Retrieved from: www.rwjf.org

4.   Trust for America’s Health. The Truth About the Prevention and Public Health Fund. June 2013. Retrieved from: healthyamericans.org

5.   Kahn, Norman B. The Future of Family Medicine: A Collaborative Project of the Family Medicine Community. Annals of Family Medicine. 2004; 2(1): S3-S32.

6.   American Hospital Association. Workforce Roles in a Redesigned Primary Care Model. January 2013. Retrieved from: www.aha.org

7.   Adelman, Alan M. & Graybill, Marie. Integrating a Health Coach into Primary Care: Reflections from the Penn State Ambulatory Research Network. Annals of Family Medicine. 2005; 3(Suppl 2): S33-S35.

8.   Pagoto, Sherry L. & Appelhans, Bradley M. A Call for an End to the Diet Debates. Journal of the American Medical Association. 2013; 310(7): 687-688.