Abstract
Obesity is responsible for at least 90 billion dollars in direct U.S. health care costs annually. A high proportion of people who were overweight or obese at younger ages survives past age sixty-five to experience adverse consequences. The determinants of obesity are complex and multifactorial, with genetic, biological, behavioral, social, and environmental contributors. The effects of adverse weight in older age have negative implications for healthy aging and lead to greater societal expenditures. Given the high costs and ineffectiveness of existing programs to treat obesity, perhaps the only solution to the obesity epidemic is primary prevention of weight gain beginning in youth.