Abstract
The prevalence of childhood obesity is increasing in the United States and globally. Associated with numerous comorbid conditions, childhood obesity is also recognized as a risk factor for multiple chronic conditions and premature mortality in adult life. Children and adolescents, particularly those from ethnic minorities and rural low income populations, bear an excess burden of obesity and its attendant comorbidities. A major contributor to childhood obesity is a physical and social environment that promotes foods high in fat and calories and minimizes the opportunities for physical activity. Despite the strong environmental influences that encourage overeating and sedentary behavior, weight maintenance is viewed as a personal responsibility. Addressing the obesity crisis requires a paradigm shift away from blaming individuals for the lack of willpower to control their eating and physical activity to one of recognizing the "toxic" or "obesigenic" environment as a primary determinant. This article addresses the obesity crisis from individual, family, local community, and public policy perspectives. Emphasis is placed on the role of nurses and nursing, acting to promote change with individuals and families and acting as advocates for multilevel policy initiatives, in reversing the epidemic and improving the health of future generations.