One in five children is predicted to be obese by the end of the decade. But efforts to turn that tide are scattershot and underfunded, and the government killed one of the few programs proven to work, specialists said Wednesday.
But no one knows which programs really help kids slim down, said the institute said in calling for research to identify best methods.
More troubling, the country lacks the national leadership needed to speed change, lamented an expert panel convened by the scientific group.
"Is this as important as stockpiling antibiotics or buying vaccines? I think it is," said Dr. Jeffrey Koplan of Emory University, who led the IOM's panel. "This is a major health problem. It's of a different nature than acute infectious threats, but it needs to be taken just as seriously."
To reinforce that point, Wednesday's report spotlighted the government's VERB campaign, a program once touted as spurring a 30 percent increase in exercise among the preteens it reached. It ended this year with Bush administration budget cuts.
VERB encouraged 9- to 13-year-olds to take part in physical activities, like bike riding or skateboarding. Slick ads, at a cost of $59 million last year, portrayed exercise as cool at an age when outdoor play typically winds down and adolescent slothfulness sets in.
The demise of the program "calls into question the commitment to obesity prevention within government," the panel concluded.
Koplan was more blunt, calling it a waste of taxpayer money to develop a program that works and then dismantle it.
Officials with the Centers for Disease Control and Prevention, which ran the program, did not immediately comment.
The report cites other examples of promising federal programs that have yet to reach their potential. Kids gobbled fruits and vegetables in an Agriculture Department school snack program, but it only reaches 14 states. And the CDC's main anti-obesity initiative had enough money this year to fund just 28 states starting childhood nutrition and exercise programs.
The report also lauded some creative state and local efforts, including:
--A California program, started in Marin County, to build new sidewalks and bike paths that's getting more children to walk or bike to school.
--A community garden project in Harlem to increase inner-city youngsters' access to healthful food and safe recreation.
--An effort by Arkansas schools notify parents when students are overweight. Combined with new school menus and physical activity programs, the initiative recently reported a leveling off of the state's child obesity rate.
The IOM, which advises the government on health matters, in 2004 called for a joint attack on childhood obesity by parents, schools, communities, the food industry and government. Wednesday's report was the first checkup.
"We still are not doing enough to prevent childhood obesity, and the problem is getting worse," concluded Koplan, a former CDC director. "The current level of public and private sector investments does not match the extent of the problem."
More than individual programs, a full-scale social change is needed so that healthful eating and physical activity becomes the norm, added panelist Toni Yancey of the University of California, Los Angeles.
Some 17 percent of U.S. youngsters already are obese, and millions more are overweight. Obesity can lead to diabetes, high blood pressure and cholesterol, sleep problems and other disorders.
Wednesday's report shows "what the country is doing is like putting a Band-Aid on a brain tuor," said Margo Wootan of the consumer advocacy Center for Science in the Public Interest.