School-based multi-component healthy lifestyle interventions

Experts suggest school-based multi-component healthy lifestyle interventions can improve health outcomes and healthy behaviors among students (Weeldreyer 2025, Nitschke 2022, USPSTF-O'Connor 2020, Abbate 2020, Norbert 2018). Overall, there is strong evidence that multi-component healthy lifestyle interventions improve health outcomes and healthy behaviors (Weeldreyer 2025, Nitschke 2022, USPSTF-O'Connor 2020, Abbate 2020, Norbert 2018). Evidence shows that school-based interventions that focus on weight and weight outcomes do not typically lead to long-term improvements in health outcomes for students (Cochrane-Spiga 2024, Cochrane-Spiga 2024a, Weeldreyer 2025, Norbert 2018, Elagizi 2018, Tylka 2014, Barry 2014a), and instead often cause negative outcomes (Weeldreyer 2025, Norbert 2018, Elagizi 2018, Tylka 2014, Barry 2014a).

Improving health. School-based healthy lifestyle interventions increase physical activity levels, improve diet quality (e.g. increasing fruit and vegetable intake, decreasing unhealthy food consumption) and improve nutrition knowledge (Balderas-Arteaga 2024, Nitschke 2022, Dorame-Lopez 2022, St. George 2022, USPSTF-O'Connor 2020). Increasing these healthy lifestyle habits improves cardiorespiratory fitness (i.e., how well systems in the body work together to supply oxygen during physical activity) and cardiometabolic health (i.e., heart health and metabolic health, or how well the body processes energy), which reduces conditions associated with increased mortality risks, such as insulin sensitivity, cardiovascular disease, inflammation, and more (Weeldreyer 2025, Abbate 2020, Norbert 2018, Elagizi 2018, Barry 2014a). Evidence shows cardiorespiratory fitness and cardiometabolic health have stronger associations with mortality risk than weight and body mass index (BMI) (Weeldreyer 2025, Norbert 2018, Elagizi 2018, Barry 2014a). Positive changes in modifiable behaviors (e.g., regular physical activity and improved diet quality) consistently predict lower mortality and morbidity and reliably improve cardiometabolic markers across all weight categories (Hunger 2020, Weeldreyer 2025, Elagizi 2018, Norbert 2018, Magkos 2016, Unick 2013). Compared to weight-loss focused interventions, weight-neutral programs have better physiological (blood pressure, lipids), psychological (self-esteem, depression), and behavioral (diet quality, reduced disordered eating, physical activity) outcomes, as well as lower dropout rates (Calogero 2019).

Negative effects from focusing on weight alone. Research has identified components of health that are most important to measure to predict an individual’s risk of mortality, chronic disease, cardiovascular disease, and other leading causes of death and disability. However, weight-focused research and healthcare practice have largely relied solely on weight and BMI as a proxy for health, despite studies consistently showing they are poor predictors of mortality and disease risk (Weeldreyer 2025, Barry 2014a). BMI fails to capture body composition, fitness, biomarkers, or lifestyle factors, and legitimizes blaming and stigmatizing patients higher on the weight spectrum (Tylka 2014). Furthermore, intentional weight loss is only inconsistently linked with meaningful health gains; experts suggest it does not meet the evidence standard to inform health policy (Hunger 2020, Calogero 2019). Interventions focused on weight loss appear ineffective for long-term healthy changes and are more likely to lead to weight regain and weight cycling, which are associated with adverse health outcomes, decreases in well-being, increases in unhealthy behaviors, and damage to patients’ relationships with their health and their health care providers (Tylka 2014). Weight-focused interventions reinforce the cycle between weight stigma and weight gain (Talumaa 2022, Calogero 2019), which is correlated with elevated ambulatory blood pressure, unhealthy weight control and binge eating behaviors, bulimic symptoms, negative body image, low self-esteem, and depression among children and adolescents. Further, interventions focused on weight outcomes ignore the fact that weight is more strongly shaped by genetic and macrosocial factors than by personal choice alone (Talumaa 2022, Calogero 2019, Puhl 2009).

Best practices. The education system plays a powerful role in shaping beliefs about nutrition, weight, and bodies. Schools adopting comprehensive, weight-inclusive health curricula can help educators teach about eating-disorder prevention and weight-based bullying and help prevent such behaviors (Hinchey 2024). School-based healthy lifestyle interventions are effective when they are delivered by trained nutrition and exercise professionals (Hinchey 2024, Nitschke 2022). Collaboration with peers, support from principals, state-level policies, professional development and curricular materials are all essential to successful health and nutrition education in schools (Hinchey 2024). Nutrition education materials included in school-based healthy lifestyle interventions should be tailored to the developmental stage of the students (Rozga 2023). School-based healthy lifestyle interventions are more effective with multiple components, especially when they include parent and family engagement efforts (Hassan 2024). Interventions that include relevant and culturally adapted components have been shown to be most effective for people of color (Seo 2010).

Evidence suggests diet and activity behaviors adopted in childhood track throughout life and the potential cumulative effects of small but sustainable changes offer long-term benefits for individuals, communities, and populations (Cochrane-Spiga 2024, St. George 2022). Sustainable health improvement depends on reshaping sociopolitical conditions—access to nutritious food, respectful healthcare, safe environments, social support—rather than pursuing largely futile and potentially harmful weight-loss targets (Calogero 2019). This highlights the need to go beyond individual-level behavior change and implement upstream interventions that support individuals and families by changing the environment to make consuming a healthy diet and being physically active easier (Cochrane-Phillips 2025, Cochrane-Spiga 2024).

The effects of school-based healthy lifestyle interventions on disparities in health outcomes for students higher on the weight spectrum, students of color, and students from families with low incomes are unclear. There are over 100 interconnected factors that influence weight, including macroeconomic drivers, biological factors, food supply and production, weight stigma and discrimination, media, health care, built environment, transport and recreation, technology, early life experiences and education. These factors act differently in different people (Cochrane-Spiga 2024). More evidence is needed to understand intervention effects on the health disparities experienced by weight status, income, race/ethnicity, and gender (Talumaa 2022).

Evidence shows weight-neutral healthy lifestyle interventions are effective at improving physiological health outcomes, as well as mental and physical health behaviors (e.g. self-care practices, therapy, physical activity levels, diet quality) and such interventions have the potential to reduce health disparities (Calogero 2019, Tylka 2014). However, weight-focused interventions have the potential to increase disparities in health outcomes for students higher on the weight spectrum, as this approach ignores the powerful genetic, socioecological, and economic forces—like food access, safe recreation spaces, stress, and socioeconomic status—that limit individuals’ ability to live a healthy lifestyle or control their weight (Talumaa 2022, Calogero 2019). By centering weight loss as both possible and necessary for everyone, it fuels anti-fat bias and stigma, creating health disparities and undermining public health and clinical efforts (Calogero 2019, Talumaa 2022). Anti-fat bias and stigma is prevalent in health care, schools, social media and other spaces, leading to negative relationships, and decreasing students’ motivations to practice healthy lifestyle behaviors (Calogero 2019, Tylka 2014, Puhl 2009). Weight stigma goes beyond the classroom, negatively affecting a student’s health, including increasing risks of depression, low self-esteem, poor body image, and more (Calogero 2019, Tylka 2014, Puhl 2009).

Socioeconomic inequities are associated with increased risk of having a higher weight status in the U.S. (Cochrane-Spiga 2024, Cochrane-Brown 2019). Families and communities with lower incomes may find it impossible to purchase high-quality nutrient-dense foods such as fresh fruits and vegetables with limited budgets and/or access to such foods. Instead, refined grains and added sugars, fats, and preservatives are generally inexpensive and readily available in lower-income communities (Tylka 2014). Furthermore, lower-income neighborhoods have fewer physical activity resources, such as parks, green spaces, bike paths, and recreational facilities when compared to higher income neighborhoods. Crime, traffic, and unsafe playground equipment are also barriers to physical activity in lower-income communities (Tylka 2014). Experts suggest that primary prevention efforts that start early in childhood, include parental involvement, and improve dietary quality, increase physical activity levels and reduce sedentary behaviors may be most effective for reducing health inequities by socioeconomic status (Cochrane-Brown 2019).

Students of color are more likely to be higher on the weight spectrum than students who are white (Talumaa 2022). Many systemic factors influence weight status and the ability to adopt and maintain healthy lifestyle habits, for example, racism, sexism, ableism, and more (Calogero 2019). Systemic factors also include income status and residential neighborhood location, since having a low income and living in a neighborhood with fewer physical activity resources, unsafe physical environments, and lack of access to affordable healthy food options greatly increases the likelihood of people being higher on the weight spectrum (Tylka 2014). Available evidence that includes international studies suggests school-based multi-component healthy lifestyle interventions are effective at improving diet (both increasing healthy food consumption and decreasing consumption of unhealthy snack foods and sugar-sweetened beverages), increasing physical activity, and decreasing sedentary time (including reducing screen time) among adolescents from ethnic and racial minority backgrounds (Dorame-Lopez 2022, St. George 2022, Hayba 2020).

Women are particularly impacted by weight-focused interventions and weight stigma, with disadvantages for women higher on the weight spectrum appearing in employment, education, leadership, romantic relationships, and the media (Calogero 2019). They are more likely to experience weight stigma as children and adolescents, which increases their risks of unhealthy weight control and binge eating behaviors, bulimic symptoms, negative body image, low self-esteem, and depression (Hunger 2020, Tylka 2014). Weight-neutral healthy lifestyle interventions that include clear causal information that emphasizes how hard it is to control weight and adopt a health-focused model that focuses on sustainable modifiable behavioral changes have the potential to help reduce gender disparities in health outcomes (Talumaa 2022).

Negative views of fatness, weight, and body size have existed for several centuries. In the U.S. weight stigma and fatphobia are rooted in racism against people who are Black (Strings 2023). Beginning in the 1700s, colonists who were white used body size and weight as yet another measure to draw distinctions between themselves and the peoples they enslaved and colonized (Strings 2023). This led to the establishment of a cultural ideal of thinness and the use of body size and shape as social and cultural standards to judge people and their status (i.e. enslaved, socioeconomic status, immigrants) (Strings 2024). The rise of eugenics, a form of scientific racism, in the 19^th and 20^th century co-opted these cultural norms by adapting the Quetelet Index (originally developed in the early 1800s to help study population characteristics based on measurements of a small population of European white men) to establish what an “ideal” and “healthy” height and weight was (Strings 2024). Its proponents claimed that the differences between people who were white and those from other races and ethnicities showed there was a racial propensity to thinness or fatness, and people who were not white were less healthy and physically inferior (Strings 2024).

Health insurance companies, one of the fastest growing industries at the time, chose to incorporate these beliefs in their coverage decision-making by using the index to develop a standardized height and weight table (Strings 2024), effectively placing a white standard on the bodies of people of all races (Strings 2024). This continued even after the medical community directly acknowledged that race is not biological after the devastation of the Holocaust (Strings 2024).

Beginning in the 1950s, these standards also began to be adopted in medicine. They adapted the Quetelet Index as the standard for doctors to use in assessing “healthy weight,” and changed the name to Body Mass Index (BMI) (Strings 2024). By the 1970s, BMI became the norm in medical practice and the research that informed these “universal” standards continued to exclude women, people of color, and people with low incomes, further entrenching racism and discrimination in health care (Strings 2023). In essence, doctors who worked for insurance companies created medical guidelines that were not evidence-based and only served to intensify the tacit whiteness of medical standards in the U.S. (Strings 2024). The values for BMI used to determine what is a “healthy weight” still meant most people, especially women of color, were defined as overweight and thus “unhealthy,” triggering initiatives to “fix” their bodies (Strings 2024). The standards for what qualifies as a healthy BMI have been revised several times, with each iteration leading to more and more people being defined as unhealthy (Strings 2024). These systematic efforts fuel weight stigma and weight-centric messaging that permeate schools, workplaces, healthcare, and media, harming mental health, educational and economic outcomes, and doctor–patient relationships (Talumaa 2022). For example, experts highlight the correlation between “BMI report cards” some school districts send to families and increases in weight status as promoting weight stigma (Talumaa 2022).

Inspired by civil rights and social justice movements, community leaders and experts started to push back against these sociopolitical constructs of health and weight that are rooted in racism, sexism, and other discriminatory frameworks (Strings 2023). Over time these movements have led to new frameworks that rely on measures and healthy lifestyle habits that not only are more indicative of health but also help dismantle the various -isms related to weight (i.e. racism, sexism, sizeism, ableism) (Calogero 2019).

There are several other contextual factors that influence health in the U.S. Throughout U.S. history, discriminatory housing, lending, and exclusionary zoning policies entrenched racial residential segregation and concentrated poverty (Zdenek 2017, Kaplan 2007). This systemic disinvestment and exclusion by both government and private entities created and maintains community environments with limited resources, deteriorating infrastructure, hazardous industries and waste disposal sites, and many other factors that lead to poorer health outcomes for people of color and people with low incomes (Braveman 2022, Prochnow 2022, McAndrews 2022, Brookings-Semmelroth 2020). Communities shaped by discriminatory policies are often areas that have limited access to healthy and affordable food, formerly known as food deserts (Beaulac 2009, Walker 2010b). Individuals who live in these communities face higher food costs, fewer store options, and must travel further to purchase healthy food than those who live in well-resourced communities (Beaulac 2009). Residents also have increased exposure to high calorie foods that have little nutritional value, which often leads to worse health outcomes (Walker 2010b). Many rural areas also lack access to fresh and affordable food, even in areas where farming is an important part of the local economy (RHIhub-Rural food and hunger). Experts recommend continuing to recognize that a patient’s context likely matters the most for health, such as their food environment, socioeconomic status, medical comorbidities, and social support, as well as practical factors (Hall 2018a).

• Are schools in your community aware of weight-inclusive practices that can foster trust and engagement in a mutually beneficial relationship centered on health? Are healthcare and public health institutions aware of weight-inclusive practices? Do they have the necessary resources and information to shift their focus from weight-centric care to health-focused care that uses neutral language and emphasizes behaviors over body size? What trainings or resources could help institutions improve their understanding and support teaching and practice?
• What weight-inclusive programs are available in your schools? In neighborhoods with low incomes? Or for racially/ethnically diverse communities? Are they accessible and affordable?
• How can school leaders, community leaders, and public health professionals tailor their communication and efforts to shift their focus from weight-centric to weight-inclusive practices? What efforts can they support to increase access to healthy nutrient-rich foods, opportunities for physical activity, and mental health support and counseling?

There are an increasing number of resources available to support shifting from weight-centric approaches to weight-inclusive approaches in programs and policies. Health at Every Size works to support providers so their practice is based on weight inclusivity, health enhancement, respectful care, eating for wellbeing, and life-enhancing movement all to support building healthy habits versus fixating on weight (ASDAH-HAES). Educators have a demonstrated interest in implementing weight-inclusive approaches, however there are few available resources for curricular content, and the lack of state-level policy support challenges their ability to do so (Hinchey 2024).

Experts highlight the need for increased education for all on obesity’s complex etiology and clear causal information emphasizing low personal controllability, adoption of a health-focused and weight-inclusive care model, as well as mixed-method interventions combining multiple approaches to improve healthy habits (Talumaa 2022). Additionally, experts highlight the need for public health programs and policies, as well as campaigns, to shift from their focus on weight-centric metrics and language to ones that are weight-inclusive to reduce weight stigma and promote health-enhancing behaviors (Hunger 2020).

Social media is another source that can both alleviate and exacerbate weight bias and stigma, in part because of the ability of users to remain anonymous and free of consequences for harmful behavior (Clark 2021). It can be a positive agent of change, allowing movements like Body Positivity, the Fatosphere, and Health at Every Size to create more inclusive space online that counter negative stereotypes (Clark 2021). Experts highlight the need for public policy development supported by public health professionals, parents, educators, and policymakers to minimize the detrimental effects of social media (Clark 2021). For example, enacting legislation that makes weight-based discrimination illegal, like Michigan and Washington have done (Clark 2021, Hunger 2020). A key intermediate alternative to legislation is industry self-regulation and accountability, including updating community guidelines outlined by social media platforms and training machine learning algorithms to detect potentially discriminatory content (Clark 2021).

‡ Resources with a focus on equity.

AFHG-Schools - Alliance for a Healthier Generation (AFHG). Schools.

ASDAH-HAES^‡ - The Association for Size Diversity and Health (ASDAH). (2024). Health at Every Size (HAES). Retrieved October 23, 2025.

ChangeLab-Healthy communities toolkit - ChangeLab Solutions. How to create and implement healthy general plans: A toolkit for building healthy, vibrant communities.

ChangeLab-Planning guide - ChangeLab Solutions. A roadmap for healthier general plans: A guide & infographic about the planning process.

CI-WOTN - Community Initiatives (CI). The Weight of the Nation (WOTN).

NYS DOH-EWPH - New York State Department of Health (NYS DOH). Eat well play hard (EWPH).

Talumaa 2022 - Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022). Effective strategies in ending weight stigma in healthcare. Obesity Reviews, 23(10), e13494.

* Journal subscription may be required for access.

Abbate 2020* - Abbate, M., Gallardo-Alfaro, L., Bibiloni, M. D. M., & Tur, J. A. (2020). Efficacy of dietary intervention or in combination with exercise on primary prevention of cardiovascular disease: A systematic review. Nutrition, Metabolism and Cardiovascular Diseases, 30(7), 1080–1093.

ASDAH-HAES - The Association for Size Diversity and Health (ASDAH). (2024). Health at Every Size (HAES). Retrieved October 23, 2025.

Balderas-Arteaga 2024* - Balderas-Arteaga, N., Mendez, K., Gonzalez-Rocha, A., Pacheco-Miranda, S., Bonvecchio, A., & Denova-Gutiérrez, E. (2024). Healthy lifestyle interventions within the curriculum in school-age children: Systematic review and meta-analysis. Health Promotion International, 39(2), daae020.

Barry 2014a* - Barry, V. W., Baruth, M., Beets, M. W., Durstine, J. L., Liu, J., & Blair, S. N. (2014). Fitness vs. fatness on all-cause mortality: A meta-analysis. Progress in Cardiovascular Diseases, 56(4), 382–390.

Beaulac 2009 - Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966-2007. Preventing Chronic Disease. 2009;6(3):A105.

Braveman 2022 - Braveman PA, Arkin E, Proctor D, Kauh T, Holm N. Systemic and structural racism: Definitions, examples, health damages, and approaches to dismantling. Health Affairs. 2022;41(2):171-178.

Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.

Calogero 2019* - Calogero, R. M., Tylka, T. L., Mensinger, J. L., Meadows, A., & Daníelsdóttir, S. (2019). Recognizing the fundamental right to be fat: A weight-inclusive approach to size acceptance and healing from sizeism. Women & Therapy, 42(1–2), 22–44.

CG-Obesity - The Guide to Community Preventive Services (The Community Guide). Obesity.

Clark 2021 - Clark, O., Lee, M. M., Jingree, M. L., O'Dwyer, E., Yue, Y., Marrero, A., Tamez, M., Bhupathiraju, S. N., & Mattei, J. (2021). Weight stigma and social media: Evidence and public health solutions. Frontiers in Nutrition, 8, 739056.

Cochrane-Brown 2019 - Brown, T., Moore, T. H., Hooper, L., Gao, Y., Zayegh, A., Ijaz, S., Elwenspoek, M., Foxen, S. C., Magee, L., O’Malley, C., Waters, E., & Summerbell, C. D. (2019). Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews, 2025(8).

Cochrane-Phillips 2025 - Phillips, S. M., Spiga, F., Moore, T. H., Dawson, S., Stockton, H., Rizk, R., Cheng, H.-Y., Hodder, R. K., Gao, Y., Hillier-Brown, F., Rai, K., Yu, C. B., O’Brien, K. M., & Summerbell, C. D. (2025). Interventions to prevent obesity in children aged 2 to 4 years old. Cochrane Database of Systematic Reviews, 2025(6).

Cochrane-Spiga 2024 - Spiga, F., Davies, A. L., Tomlinson, E., Moore, T. H., Dawson, S., Breheny, K., Savović, J., Gao, Y., Phillips, S. M., Hillier-Brown, F., Hodder, R. K., Wolfenden, L., Higgins, J. P., & Summerbell, C. D. (2024). Interventions to prevent obesity in children aged 5 to 11 years old. Cochrane Database of Systematic Reviews, 2024(7).

Cochrane-Spiga 2024a - Spiga, F., Tomlinson, E., Davies, A. L., Moore, T. H., Dawson, S., Breheny, K., Savović, J., Hodder, R. K., Wolfenden, L., Higgins, J. P., & Summerbell, C. D. (2024). Interventions to prevent obesity in children aged 12 to 18 years old. Cochrane Database of Systematic Reviews, 2024(7).

Dorame-Lopez 2022 - Dórame-López, N. A., & Esparza Romero, J. (2022). Effectiveness of multicomponent lifestyle intervention programs on adiposity indicators in schoolchildren from vulnerable groups: A review article. Nutrición Hospitalaria, 39(5), 1122—1134.

Elagizi 2018* - Elagizi, A., Kachur, S., Lavie, C. J., Carbone, S., Pandey, A., Ortega, F. B., & Milani, R. V. (2018). An overview and update on obesity and the obesity paradox in cardiovascular diseases. Progress in Cardiovascular Diseases, 61(2), 142–150.

Hall 2018a - Hall, K. D., & Kahan, S. (2018). Maintenance of lost weight and long-term management of obesity. Medical Clinics of North America, 102(1), 183–197.

Hassan 2024 - Hassan, M. A., McDonough, D. J., Ryu, S., Zhou, W., Oginni, J., & Gao, Z. (2024). Comparative effectiveness of school-based obesity prevention programs for children and adolescents: A systematic review and network meta-analysis. Frontiers in Public Health, 12, 1504279.

Hayba 2020 - Hayba, N., Elkheir, S., Hu, J., & Allman-Farinelli, M. (2020). Effectiveness of lifestyle interventions for prevention of harmful weight gain among adolescents from ethnic minorities: A systematic review. International Journal of Environmental Research and Public Health, 17(17), 6059.

Hinchey 2024 - Hinchey, D., Garnett, B. R., Gamble, J., & Pope, L. (2025). Support for a weight‐inclusive curriculum? Exploring partner perspectives and influences on nutrition education in Vermont high schools. Journal of School Health, 95(1), 17–25.

Hunger 2020* - Hunger, J. M., Smith, J. P., & Tomiyama, A. J. (2020). An evidence‐based rationale for adopting weight‐inclusive health policy. Social Issues and Policy Review, 14(1), 73–107.

Kaplan 2007* - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.

LHF-Wisc CSHP - Live Healthy Fairfax. (n.d.). Wisconsin’s Coordinated School Health Program. Live Healthy Fairfax. Retrieved December 10, 2025.

Magkos 2016 - Magkos, F., Fraterrigo, G., Yoshino, J., Luecking, C., Kirbach, K., Kelly, S. C., de las Fuentes, L., He, S., Okunade, A. L., Patterson, B. W., & Klein, S. (2016). Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity. Cell Metabolism, 23(4), 591–601.

McAndrews 2022* - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.

Nitschke 2022 - Nitschke, E., Gottesman, K., Hamlett, P., Mattar, L., Robinson, J., Tovar, A., & Rozga, M. (2022). Impact of nutrition and physical activity interventions provided by nutrition and exercise practitioners for the adult general population: A systematic review and meta-analysis. Nutrients, 14(9), 1729.

Norbert 2018* - Stefan, N., Häring, H.-U., & Schulze, M. B. (2018). Metabolically healthy obesity: The low-hanging fruit in obesity treatment? The Lancet Diabetes & Endocrinology, 6(3), 249–258.

Prochnow 2022* - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.

Puhl 2009 - Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941–964.

RHIhub-Rural food and hunger - Rural Health Information Hub (RHIhub). Rural hunger and access to healthy food.

Rozga 2023 - Rozga, M., & Handu, D. (2023). Nutrition interventions for pediatric obesity prevention: An umbrella review of systematic reviews. Nutrients, 15(24), 5097.

Seo 2010* - Seo D-C, Sa J. A meta-analysis of obesity interventions among U.S. minority children. Journal of Adolescent Health. 2010;46(4):309-23.

St. George 2022* - St. George, S. M., Kobayashi, M. A., Noriega Esquives, B. S., Ocasio, M. A., Wagstaff, R. G., & Dorcius, D. P. (2022). Pediatric obesity prevention and treatment among Hispanics: A systematic review and meta-analysis. American Journal of Preventive Medicine, 62(3), 438–449.

Strings 2023 - Strings, S. (2023). How the use of BMI fetishizes white embodiment and racializes fat phobia. AMA Journal of Ethics, 25(7), E535-539.

Strings 2024 - Strings, S., & Bell, C. (2024). BMI is bunk, but fat women are diseased: The hypocrisy of “The normal (white) man.” Social Sciences, 13(6), 276.

Talumaa 2022 - Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022). Effective strategies in ending weight stigma in healthcare. Obesity Reviews, 23(10), e13494.

Tylka 2014 - Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, 1–18.

Unick 2013 - Unick, J. L., Beavers, D., Bond, D. S., Clark, J. M., Jakicic, J. M., Kitabchi, A. E., Knowler, W. C., Wadden, T. A., Wagenknecht, L. E., & Wing, R. R. (2013). The long-term effectiveness of a lifestyle intervention in severely obese individuals. The American Journal of Medicine, 126(3), 236-242.e2.

USPSTF-O'Connor 2020 - O’Connor, E. A., Evans, C. V., Rushkin, M. C., Redmond, N., & Lin, J. S. (2020). Behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 324(20), 2076.

Walker 2010b - Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: A review of food deserts literature. Health and Place. 2010;16(5):876-884.

Weeldreyer 2025 - Weeldreyer, N. R., De Guzman, J. C., Paterson, C., Allen, J. D., Gaesser, G. A., & Angadi, S. S. (2025). Cardiorespiratory fitness, body mass index and mortality: A systematic review and meta-analysis. British Journal of Sports Medicine, 59(5), 339–346.

Zdenek 2017 - Zdenek RO, Walsh D. Navigating community development: Harnessing comparative advantages to create strategic partnerships. Chapter: The background and history of community development organizations. New York: Palgrave Macmillan; 2017.