The Weight of the Nation challenge: Moving people to fight obesity

Over the years, the foundation has tackled the issue of childhood obesity in any number of ways: We’ve supported organizations focused on helping schools increase students’ activity levels. We’ve supported initiatives to increase kids’ knowledge of and access to healthy foods. We’ve supported organizations that work on making neighborhoods safer. These efforts are critical.

But time and again, we’ve run up against the same twinned challenges: Isolated successes that occur against a backdrop of public complacency. People seem numb to the stats about obesity prevalence. As often as those of us working in public health, in healthcare and in economics have sounded the alarm about obesity, few people move to action. Moreover, a simplistic narrative about personal responsibility dominates much of the public conversation about obesity, distracting our attention from other opportunities for action.

So when John Hoffman of HBO proposed that the Michael & Susan Dell Foundation play a role in The Weight of the Nation, we saw an opportunity to do something unprecedented: To help tell the story of obesity in a way that that addressed the complex roots of the epidemic and moved people to act. And we knew that if anyone could grab our nation’s collective attention and shake us out of accepting the inevitability of continued obesity (and ignoring the related morbidity and mortality issues,) it was the master storytellers at HBO.

Day one: Giddy anticipation

For an outcomes-focused foundation with a history of funding interventions on the ground and looking for evidence of measurable impact on children’s lives, the work of storytelling felt incredibly out-of-the-box. But after I left the first meeting with HBO in New York, I walked away almost giddy at the prospect of what could be created through a partnership between an entertainment company that had a reputation for grabbing and holding our attention; the scientific luminaries they’d partnered with from the Institute of Medicine (IOM), the National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC); and the passion each partner brought to this effort.

I was especially impressed that John and his team did not seek to simplify the issue and provide solutions in 30 minutes or less. Nor did they seek to simply wring their hands over the issue for four hours. What they sought was to tell a complete story (and create a complete action pack) that would, as recently described it, leave viewers “feeling shocked and empowered. Shocked because the magnitude of the obesity crisis is probably larger than you thought, empowered because you’ll have a better understanding of what you can do about it.”

Without understanding the obstacles of the community, how they think, what they care about, even the best designed interventions have little chance of success.

Three years later: Exhaustion, inspiration

Since that first meeting three years ago, this undertaking has been alternately thrilling and exhausting. And throughout, the stories that John’s team has spotlighted have also been inspiring. One story that’s really changed my thinking is that of America Bracho, a spitfire of a public health guru in Santa Ana. I visited America after I heard her speak to the scientific partners on The Weight of the Nation project. America taught me that the key to public health is the community’s participation. You may have heard that if you’re doing public health well, no one really knows you’re doing it. Not true.

When I visited America in Santa Ana, we began the morning at 7:30 at her office, also a community hub.  There, from the doorway of a cafeteria, I saw five rows each of about 10 Latina women, doing Zumba to music so loud, I could feel the bass in my feet.  Toddlers danced between the rows of women and strollers, with infants watching their moms, lined the wall.  As I stepped into the doorway, I realized that the rows of women and line of strollers continued back, five more rows, five more, I counted 15 rows of women.

How had her organization achieved this amazing level of participation?

Without understanding the obstacles of the community, how they think, what they care about, even the best designed interventions have little chance of success. Community health workers, whom I saw in action, ranging in age from elementary schoolers to retirees, went door to door to share information, unearth needs and obstacles and inspire participation.

In America’s model, community residents don’t just provide the intelligence about the community; they are advocates for change. America has urged them not to accept that life expectancy in their neighborhood will be six years shorter than life expectancy in a neighborhood three miles away. She has urged them to demand social justice and equal opportunities for a healthy life. And community members have taken the information may be best transmitted through someone who lives in the same community, experiences the same challenges, and has similar resources.

The work ahead: Reversing the epidemic

Recently, there have been reports of areas in the country where obesity prevalence is reaching a plateau, perhaps even declining.  I hope that people will stop and recognize that although it is encouraging that perhaps some of the efforts we are undertaking are having impact in specific communities, prevalence rates of obesity are still astronomically high.  We should not be taking our foot off of the gas pedal to stop and pat ourselves on the back.  The urgency of this issue is too great – it is not enough to halt the epidemic, it needs to be reversed.

I hope lessons from people like America Bracho will inspire people to launch thousands of conversations about how to be a participant, how to inspire others, and how to enact changes that create a sustainable impact on obesity. I hope the films will drive a broad understanding of the fact that obesity is not simply a matter of individual responsibility and calories in/calories out. I hope people will begin to grasp that sustainable solutions must address the realities of:

  • Families who have to choose foods they can access and financially afford, even though it means paying a much more expensive price that can’t be measured in dollars and cents
  • Communities that are so dangerous that families would rather keep their kids safe in front of the television than allow them to play outside
  • Local, state and federal decisions that seem to sacrifice long term wellness for short term benefits

To us, The Weight of the Nation holds the promise and the potential you might expect of the largest public health campaign in history. We encourage you to learn from the films, to let them move you to tears, to joy, and to utter frustration. And then we hope that you will be moved to action – for yourself, for your family, for your communities and for our nation.

Starting May 14 and 15, you can download the films at