In 1973, and again in 1977, the John E. Fogarty International Center at the National Institutes of Health (NIH), as part of its preventive medicine series, sponsored two conferences that dealt with obesity as a public health problem; controversy was apparent regarding the cause-and-effect relationship between obesity and ill health (40, 41). In 1985, an NIH Consensus Development Conference was held on the health implications of obesity. This conference provided important national recognition that obesity is a serious health condition that leads to increased morbidity and mortality. The Consensus Development Conference concluded that both prevention and treatment of obesity were medical priorities in the United States (42). In that conference, the terms 'overweight' and 'obesity' were defined as part of a continuum of increasing health risk.
In 1990, the Nation's health goals for the year 2000 were set forth with the release of Healthy People 2000 (43), in which a national goal toreduce the prevalence of overweight was articulated. In 1993, the Deputy Assistant Secretary for Health (J. Michael McGinnis) and the former Director of the Centers for Disease Control and Prevention (CDC) (William Foege) co-authored a journal article, "Actual Causes of Death in the U.S." It concluded that a combination of dietary factors and sedentary activity patterns accounts for at least 300,000 deaths each year, and that obesity is a key contributor (25). In 1995, the Institute of Medicine issued a report that expressed concern about the growing prevalence of overweight and obesity in this country, and suggested ways to evaluate various weight loss and weight maintenance programs available to U.S. consumers (44).