Who Should Obesity Prevention Strategies Target

Deciding where to invest limited time and resources in obesity prevention is a difficult task but finite health resources make this a necessity. WHO has identified three distinct but equally valid and complementary levels of obesity prevention (Figure 1). The specific 'targeted' approach directed at very high-risk individuals with existing weight problems is represented by the core of the figure, the 'selective' approach directed at individuals and groups with above average risk is represented by the middle layer, and the broader universal or populationwide prevention approach is represented by the outer layer. This replaces the more traditional classification of disease prevention (primary, secondary, and tertiary), which can be confusing when applied to a complex multifactorial condition such as obesity.

Universal prevention is the domain of public health, whereas selective and targeted prevention

Figure 1 Levels of obesity prevention intervention. (Adapted from Gill TP (1997) Key issues in the prevention of obesity. British Medical Bulletin 53(2): 359-388.)

Figure 1 Levels of obesity prevention intervention. (Adapted from Gill TP (1997) Key issues in the prevention of obesity. British Medical Bulletin 53(2): 359-388.)

are predominantly dealt with in community and health care service settings. Community settings include schools, colleges, worksites, community centers, and shopping outlets.

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