Engaging municipalities in community capacity building for childhood obesity control in urban settings.

BACKGROUND Reducing rates of child obesity requires an approach that transcends the medicalization of overweight. Family practice doctors and public health professionals need to work with other sectors to establish comprehensive approaches to obesity reduction. OBJECTIVES This study compares the approaches of three cities with different health and political systems (Lisbon, London and New York City) to promoting effective action to decrease child obesity. METHODS Using a comparative case study approach, participant observers in three intersectoral municipal collaborative on child obesity describe their challenges and accomplishments. RESULTS Municipal governments made child obesity a policy priority and coordinate efforts in different sectors. Public health provided relevant information on population characteristics and scientific evidence for decision-making, family practice monitored children's growth and assisted families to adopt healthy behaviors. These sectors, together with university-based researchers, also played an advocacy role, addressing inequalities, alerting the public and policy makers about damaging products or risky situations, and regulating private interests that threaten well-being, e.g., the food and beverage industry that promotes unhealthy products. Local, national and global networks of health providers, municipal agencies and researchers have helped to diagnose problems, coordinate action across sectors and levels, share and evaluate successes and failures, translate evidence into practice and promote social cohesion. CONCLUSIONS These cities have developed common approaches and face similar challenges in reducing high rates of child obesity, suggesting that it may be possible for cities in different parts of the world to learn from each other and thus accelerate progress.