Obesity prevention across the US: A review of state-level policies from 2009 to 2019

Objective: Uniquely, state legislators may enact obesity prevention policies tailored to each state's needs and take diverse policy approaches to address obesity prevalence. The objective of this study was to identify and describe state-level obesityrelated policies between 2009 and 2019. Methods: Using a database of legislation covering 2009-2019, researchers categorized obesity-related legislation by status (proposed/enacted), topic, and environment impacted. Researchers determined the number of policies proposed; enacted, by political party control; obesity prevalence, by states over time. Results: 3256 obesity-related policies were proposed among 50 states and Washington DC between 2009 and 2019. Collectively, 18% (593) of policies were enacted; California (96), Newand Jersey (57) enacted the most. Across environment and topics, the most enacted policies categorized in school environment (226) and school nutrition (150) topic area. Most policies were proposed (496) and enacted (77) in 2011. On average, Democrat-controlled states had higher enactment rates than Republicancontrolled states, as did states with lower (vs. higher) obesity prevalence. Conclusions: States have actively pursued obesity-related legislation across multiple topics and environments from 2009 to 2019, with mixed enactment rates. Evaluating the impact of these policies, alone and in combination, will be important to determine whether these state-level efforts reduce obesity.