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Health Aff (Millwood). 2015 Sep;34(9):1456-63. doi: 10.1377/hlthaff.2015.0371.

An Integrated Framework For The Prevention And Treatment Of Obesity And Its Related Chronic Diseases.

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William H. Dietz ( is the director of the Redstone Global Center for Prevention and Wellness at the George Washington University, in Washington, D.C.
Loel S. Solomon is vice president of community health at Kaiser Permanente, in Oakland, California.
Nico Pronk is vice president of health promotion at HealthPartners, in Bloomington, Minnesota.
Sarah K. Ziegenhorn is a research associate at the National Academy of Medicine, in Washington, D.C.
Marion Standish is vice president of enterprise programs at the California Endowment, in Oakland.
Matt M. Longjohn is the national health officer at the YMCA of the USA, in Chicago, Illinois.
David D. Fukuzawa is health program director at the Kresge Foundation, in Troy, Michigan.
Ihuoma U. Eneli is medical director at the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital, in Columbus, Ohio.
Lisel Loy is director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, in Washington, D.C.
Natalie D. Muth is a senior adviser for health care solutions at the American Council on Exercise, in San Diego, California.
Eduardo J. Sanchez is chief medical officer for prevention at the American Heart Association, in Dallas, Texas.
Jenny Bogard is a senior manager for health care at the Alliance for a Healthier Generation, in Washington, D.C.
Don W. Bradley is an associate consulting professor in the Department of Community and Family Medicine at the Duke University School of Medicine, in Durham, North Carolina.


Improved patient experience, population health, and reduced cost of care for patients with obesity and other chronic diseases will not be achieved by clinical interventions alone. We offer here a new iteration of the Chronic Care Model that integrates clinical and community systems to address chronic diseases. Obesity contributes substantially to cardiovascular disease, type 2 diabetes mellitus, and cancer. Dietary and physical activity interventions will prevent, mitigate, and treat obesity and its related diseases. Challenges with the implementation of this model include provider training, the need to provide incentives for health systems to move beyond clinical care to link with community systems, and addressing the multiple elements necessary for integration within clinical care and with social systems. The Affordable Care Act, with its emphasis on prevention and new systems for care delivery, provides support for innovative strategies such as those proposed here.


Chronic Care; Cost of Health Care; Health Promotion/Disease Prevention; Obesity; Organization and Delivery of Care

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