I 
111TH CONGRESS 
1ST SESSION H. R. 2276 
To establish grants to provide health services for improved nutrition, increased 
physical activity, obesity and eating disorder prevention, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 6, 2009 
Mrs. BONO MACK (for herself and Mrs. LOWEY) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To establish grants to provide health services for improved 
nutrition, increased physical activity, obesity and eating 
disorder prevention, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improved Nutrition 
and Physical Activity Act’’ or the ‘‘IMPACT Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) In July 2004, the Secretary of Health and 
Human Services recognized ‘‘obesity is a critical 
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public health problem in our country’’ and under the 
Medicare program language was removed from the 
coverage manual stating that obesity is not an ill-
ness. 
(2) The National Health and Nutrition Exam-
ination Survey for 2002 found that an estimated 65 
percent of adults are overweight and 31 percent of 
adults are obese and 16 percent of children and ado-
lescents in the United States are overweight or 
obese. 
(3) The Institute of Medicine reported in ‘‘Pre-
venting Childhood Obesity’’ (2004) that approxi-
mately 60 percent of obese children between 5 and 
10 years of age have at least one cardiovascular dis-
ease risk factor and 25 percent have two or more 
such risk factors. 
(4) According to Centers for Disease Control 
and Prevention, children who are obese are at great-
er risk for psychological problems such as stig-
matization and poor self-esteem. Obese children and 
adolescents are targets of early and systematic social 
discrimination. The psychological stress of social 
stigmatization can cause low self-esteem which, in 
turn, can hinder academic and social functioning, 
and persist into adulthood. 
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(5) The Ophelia Project reports that approxi-
mately 30 percent of youth in the United States are 
estimated to be actively involved in bullying, either 
as a bully, target, or both. ABC News reports that 
58 percent of children admit that someone has said 
mean or hurtful things to them online. The emo-
tional safety of children who are overweight or obese 
is threatened since they are often the targets of bul-
lying and relational aggression, which can have seri-
ous effects on their physical and emotional health. 
(6) The Institute of Medicine reports that the 
prevalence of overweight and obesity is increasing 
among all age groups. There is twice the number of 
overweight children between 2 and 5 years of age 
and adolescents between 12 and 19 years of age, 
and 3 times the number of children between 6 and 
11 years of age as there were 30 years ago. 
(7) According to the Centers for Disease Con-
trol and Prevention, low income and minority girls 
have the highest rates of childhood obesity. His-
panic, African-American, and Native-American chil-
dren are disproportionately affected by obesity, with 
the highest prevalence found among African-Amer-
ican and Hispanic girls. (‘‘The New Normal?: What 
Girls Say about Healthy Living’’ 2006). 
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(8) According to the 2004 Institute of Medicine 
report, obesity-associated annual hospital costs for 
children and youth more than tripled over 2 decades, 
rising from $35,000,000 in the period 1979 through 
1981 to $127,000,000 in the period 1997 through 
1999. 
(9) The Centers for Disease Control and Pre-
vention reports have estimated that as many as 
365,000 deaths a year are associated with being 
overweight or obese. Overweight and obesity are as-
sociated with an increased risk for heart disease (the 
leading cause of death), cancer (the second leading 
cause of death), diabetes (the 6th leading cause of 
death), and musculoskeletal disorders. 
(10) According to the National Institute of Dia-
betes and Digestive and Kidney Diseases, individuals 
who are obese have a 50 to 100 percent increased 
risk of premature death. 
(11) The Centers for Disease Control and Pre-
vention reports that children spend a considerable 
amount of time with media. One study found that 
time spent watching TV, videos, DVDs, and movies 
averaged slightly over 3 hours per day among chil-
dren aged 8–18 years. Several studies have found a 
positive association between the time spent viewing 
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television and increased prevalence of obesity in chil-
dren. This time with the media can damage girls’ 
physical and emotional health. The Geena Davis In-
stitute on Gender in the Media reports that in many 
forms of media, girls and women are often depicted 
as sexualized objects, which can damage girls’ body 
images. 
(12) The Healthy People 2010 goals identify 
overweight and obesity as one of the Nation’s lead-
ing health problems and include objectives for in-
creasing the proportion of adults who are at a 
healthy weight, reducing the proportion of adults 
who are obese, and reducing the proportion of chil-
dren and adolescents who are overweight or obese. 
(13) Another goal of Healthy People 2010 is to 
eliminate health disparities among different seg-
ments of the population. Obesity is a health problem 
that disproportionally impacts medically underserved 
populations. 
(14) The 2005 Surgeon General’s report ‘‘The 
Year of the Healthy Child’’ lists the treatment and 
prevention of obesity as a national priority. 
(15) The Institute of Medicine report ‘‘Pre-
venting Childhood Obesity’’ (2004) finds that 
‘‘Childhood obesity is a serious nationwide health 
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problem requiring urgent attention and a popu-
lation-based prevention approach . . . .’’. 
(16) The Centers for Disease Control and Pre-
vention estimates the annual expenditures related to 
overweight and obesity in adults in the United 
States to be $264,000,000,000 (exceeding the cost 
of tobacco-related illnesses) and appears to be rising 
dramatically. This cost can potentially escalate 
markedly as obesity rates continue to rise and the 
medical complications of obesity are emerging at 
even younger ages. Therefore, the total disease bur-
den will most likely increase, as well as the attend-
ant health-related costs. 
(17) Weight control programs should promote a 
healthy lifestyle including regular physical activity 
and healthy eating, as consistently discussed and 
identified in a variety of public and private con-
sensus documents, including the 2001 U.S. Surgeon 
General’s report ‘‘A Call To Action’’ and other docu-
ments prepared by the Department of Health and 
Human Services and other agencies. 
(18) The Institute of Medicine reports that 
poor eating habits are a risk factor for the develop-
ment of eating disorders and obesity. In 2002, more 
than 35,000,000 Americans experienced limited ac-
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cess to nutritious food on a regular basis. The avail-
ability of high-calorie, low-nutrient foods have in-
creased in low-income neighborhoods due to many 
factors. 
(19) Effective interventions for promoting 
healthy eating behaviors should promote healthy life-
style and not inadvertently promote unhealthy 
weight management techniques. 
(20) The National Institutes of Health reports 
that eating disorders are commonly associated with 
substantial psychological problems, including depres-
sion, substance abuse, and suicide. 
(21) The National Association of Anorexia 
Nervosa and Associated Disorders estimates that 
there are 8,000,000 Americans who experience eat-
ing disorders. Eating disorders of all types are more 
common in women than men. 
(22) The health risks of Binge Eating Disorder 
are those associated with obesity and include heart 
disease, gall bladder disease, and diabetes. 
(23) According to the National Institute of 
Mental Health, Binge Eating Disorder is character-
ized by frequent episodes of uncontrolled overeating, 
with an estimated 2 to 5 percent of Americans expe-
riencing this disorder in a 6-month period. 
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(24) Additionally, the National Institute of 
Mental Health reports that Anorexia Nervosa, an 
eating disorder from which 0.5 to 3.7 percent of 
American women will suffer in their lifetime, is asso-
ciated with serious health consequences including 
heart failure, kidney failure, osteoporosis, and death. 
According to the National Institute of Mental 
Health, Anorexia Nervosa has one of the highest 
mortality rates of all psychiatric disorders, placing a 
young woman with Anorexia Nervosa at 12 times 
the risk of death of other women her age. 
(25) In 2001, the National Institute of Mental 
Health reported that 1.1 to 4.2 percent of American 
women will suffer from Bulimia Nervosa in their 
lifetime. Bulimia Nervosa is an eating disorder that 
is associated with cardiac, gastrointestinal, and den-
tal problems, including irregular heartbeats, gastric 
ruptures, peptic ulcers, and tooth decay. 
(26) On the 2007 Youth Risk Behavior Survey, 
4.3 percent of high school students reported recent 
use of laxatives or vomiting to control their weight. 
(27) The Girl Scout Research Institute found 
that most girls have a holistic view of health and be-
lieve physical and emotional health are of equal im-
portance. This connection is reflected in their behav-
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ior and attitudes toward diet and exercise. Diet and 
exercise patterns are linked to emotional health, self- 
esteem, and body image, which all play a critical role 
in how girls define health. (‘‘The New Normal?: 
What Girls Say about Healthy Living’’ 2006). 
(28) A strict focus on physical health does not 
resonate emotionally with girls. Any reframing or re-
defining of health needs, including nutrition and 
physical activity, needs to focus on the positive emo-
tional outcomes that are likely to result from healthy 
behavior (other than maintaining normal weight and 
eating nourishing foods). For girls, being healthy 
means not only eating right and looking good, but 
also feeling good about oneself and having a good re-
lationship with one’s peers. (‘‘The New Normal?: 
What Girls Say about Healthy Living’’ 2006). 
(29) The Girl Scout Research Institute reports 
that emotional safety is a top concern for girls. Rela-
tional aggression, or emotional bullying, threatens 
girls’ emotional and physical safety. Efforts to im-
prove girls’ health should include the prevention of 
relational aggression, since most girls define safety 
in terms of relationships and healthy relationships 
are crucial to girls’ physical and emotional health. 
(‘‘Feeling Safe: What Girls Say’’ 2003 and ‘‘The 
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New Normal?: What Girls Say about Healthy Liv-
ing’’ 2006). 
(30) Girls’ body images affects their emotional 
and physical health, such as self-esteem and eating 
and exercise habits. External factors such as family, 
celebrities, and the media also have an effect on 
girls’ perception of their bodies. Therefore, pro-
moting healthy media images of girls and woman 
can help improve their physical and emotional 
health. (‘‘The New Normal?: What Girls Say about 
Healthy Living’’ 2006). 
(31) According to the Girl Scout Research In-
stitute, parents—especially mothers in the case of 
girls—are important influences and role models. Ef-
forts to inspire and motive girls to make healthier 
choices must focus on helping parents support their 
children and teach parents that their choices model 
behaviors for how to live a healthy life. (‘‘The New 
Normal?: What Girls Say about Healthy Living’’ 
2006). 
(32) There is a tension between health aware-
ness and behavior among children and youth. Al-
though girls demonstrate basic knowledge about 
healthy foods and eating behaviors, they are not put-
ting this knowledge into practice and it is normal for 
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many girls to make poor choices with respect to diet 
and exercise. Teaching healthy nutrition and exer-
cise habits should make healthy living seem reason-
able, socially acceptable, applicable and attainable. 
(‘‘The New Normal?: What Girls Say about Healthy 
Living’’ 2006). 
(33) According to the American Academy of 
Pediatrics, the current epidemic of inactivity and the 
associated epidemic of obesity are being driven by 
multiple factors (societal, technologic, industrial, 
commercial, financial) and must be addressed like-
wise on several fronts. Success is more likely to be 
achieved by the implementation of sustainable, eco-
nomically viable, culturally acceptable active-living 
policies that can be integrated into multiple sectors 
of society. (‘‘Pediatrics’’ Vol. 117 No. 5 May 2006, 
pp. 1834–1842 (doi:10.1542/peds.2006–0472) (‘‘Ac-
tive Healthy Living: Prevention of Childhood Obesity 
Through Increased Physical Activity’’)). 
(34) According to the 2006 School Health Poli-
cies and Programs Study, conducted by the Centers 
for Disease Control and Prevention, only 3.8 percent 
of elementary schools, 7.9 percent of middle schools, 
and 2.1 percent of high schools provided daily phys-
ical education or its equivalent for the entire school 
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year for students in all grades. Overall, about 22 
percent of schools did not require students to take 
any physical education. 
(35) Additionally, the 2006 School Health Poli-
cies and Programs Study revealed that 64.4 percent 
of schools with primary responsibility for food prepa-
ration reported they did not reduce the amount of 
fats and oils used in recipes or use low-fat recipes 
when preparing school meals. Nationwide, 21.1 per-
cent of elementary schools, 62.4 percent of middle 
schools, and 85.8 percent of high schools had one or 
more vending machines from which students could 
purchase food or beverages. 
(36) The Institute of Medicine reports that tak-
ing action against childhood obesity must address 
the factors that influence both eating and physical 
activity. According to the Institute of Medicine, 
‘‘[a]lthough a number of organizations, industries, 
institutions, and agencies must be involved in de-
signing and implementing changes, efforts cannot 
succeed unless they also engage the families, schools, 
and communities that create the environments in 
which children live and their behaviors are formed’’. 
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TITLE I—TRAINING GRANTS 
SEC. 101. GRANTS TO PROVIDE TRAINING FOR HEALTH 
PROFESSION STUDENTS. 
Section 747(c)(3) of the Public Health Service Act 
(42 U.S.C. 293k(c)(3)) is amended by striking ‘‘and vic-
tims of domestic violence’’ and inserting ‘‘victims of do-
mestic violence, individuals (including children) who are 
overweight or obese (as such terms are defined in section 
399W(j)) and at-risk for related serious and chronic med-
ical conditions, and individuals who suffer from eating dis-
orders’’. 
SEC. 102. GRANTS TO PROVIDE TRAINING FOR HEALTH 
PROFESSIONALS. 
Section 399Z of the Public Health Service Act (42 
U.S.C. 280h–3) is amended— 
(1) in subsection (b), by striking ‘‘2005’’ and 
inserting ‘‘2010’’; 
(2) by redesignating subsection (b) as sub-
section (c); 
(3) by inserting after subsection (a) the fol-
lowing: 
‘‘(b) GRANTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants to eligible entities to train primary care phy-
sicians and other licensed or certified health profes-
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sionals on how to identify, properly refer or treat, 
and prevent obesity or eating disorders and aid indi-
viduals who are overweight, obese, or who suffer 
from eating disorders. 
‘‘(2) APPLICATION.—An entity that desires a 
grant under this subsection shall submit an applica-
tion at such time, in such manner, and containing 
such information as the Secretary may require, in-
cluding a plan for the use of funds that may be 
awarded and an evaluation of the training that will 
be provided. 
‘‘(3) USE OF FUNDS.—An entity that receives 
a grant under this subsection shall use the funds 
made available through such grant to— 
‘‘(A) use evidence-based findings or rec-
ommendations that pertain to the prevention 
and treatment of obesity, being overweight, and 
eating disorders to conduct educational con-
ferences, including Internet-based courses and 
teleconferences, on— 
‘‘(i) how to treat or prevent obesity, 
being overweight, and eating disorders; 
‘‘(ii) the link between obesity, being 
overweight, eating disorders and related se-
rious and chronic medical conditions; 
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‘‘(iii) holistic health: the connection 
between emotional and physical health; 
‘‘(iv) how to discuss varied strategies 
with patients from at-risk and diverse pop-
ulations to promote positive behavior 
change and healthy lifestyles to avoid obe-
sity, being overweight, and eating dis-
orders; 
‘‘(v) how to identify overweight, obese, 
individuals with eating disorders, and those 
who are at risk for obesity and being over-
weight or suffer from eating disorders and, 
therefore, at risk for related serious and 
chronic medical conditions; and 
‘‘(vi) how to conduct a comprehensive 
assessment of individual and familial 
health risk factors; and 
‘‘(B) evaluate the effectiveness of the 
training provided by such entity in increasing 
knowledge and changing attitudes and behav-
iors of trainees.’’; and 
(4) in subsection (c) (as so redesignated)— 
(A) by striking ‘‘There are authorized to 
be appropriated to carry out this section’’ and 
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all that follows and inserting the following: 
‘‘There are authorized to be appropriated— 
‘‘(1) to carry out subsection (a),’’; and 
(B) by adding at the end the following: 
‘‘(2) to carry out subsection (b), $10,000,000 
for fiscal year 2010, and such sums as may be nec-
essary for each of fiscal years 2011 through 2014.’’. 
TITLE 
II—COMMUNITY-BASED 
SOLUTIONS 
TO 
INCREASE 
PHYSICAL 
ACTIVITY, 
IM-
PROVE NUTRITION, AND PRO-
MOTE EMOTIONAL WELLNESS 
AND HEALTHY EATING BE-
HAVIORS 
SEC. 201. GRANTS TO INCREASE PHYSICAL ACTIVITY AND 
EMOTIONAL 
WELLNESS, 
IMPROVE 
NUTRI-
TION, AND PROMOTE HEALTHY EATING BE-
HAVIORS. 
Part Q of title III of the Public Health Service Act 
(42 U.S.C. 280h et seq.) is amended by striking section 
399W and inserting the following: 
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‘‘SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY 
AND EMOTIONAL WELLNESS, IMPROVE NU-
TRITION, AND PROMOTE HEALTHY EATING 
BEHAVIORS AND HEALTHY LIVING. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention and in coordination with the 
Administrator of the Health Resources and Services 
Administration, the Director of the Indian Health 
Service, the Secretary of Education, the Secretary of 
Agriculture, the Secretary of the Interior, the Direc-
tor of the National Institutes of Health, the Director 
of the Office of Women’s Health, and the heads of 
other appropriate agencies, shall award competitive 
grants to eligible entities to plan and implement pro-
grams that promote healthy eating behaviors, phys-
ical activity, emotional wellness, and healthy living, 
and to prevent eating disorders, obesity, being over-
weight, and related serious and chronic medical con-
ditions. Such grants may be awarded to target at- 
risk populations including youth, adolescent girls, 
health disparity populations (as defined in section 
485E(d)), and the underserved. 
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‘‘(2) TERM.—The Secretary shall award grants 
under this subsection for a period not to exceed 4 
years. 
‘‘(b) AWARD OF GRANTS.—An eligible entity desiring 
a grant under this section shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require, in-
cluding— 
‘‘(1) a plan describing a comprehensive pro-
gram of approaches to encourage healthy living, 
emotional wellness, healthy eating behaviors, and 
healthy levels of physical activity; 
‘‘(2) the manner in which the eligible entity will 
coordinate with appropriate State and local authori-
ties and community-based organizations, including— 
‘‘(A) State and local educational agencies; 
‘‘(B) departments of health; 
‘‘(C) chronic disease directors; 
‘‘(D) State directors of programs under 
section 17 of the Child Nutrition Act of 1966 
(42 U.S.C. 1786); 
‘‘(E) governors’ councils for physical activ-
ity and good nutrition; 
‘‘(F) State and local parks and recreation 
departments; 
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‘‘(G) State and local departments of trans-
portation and city planning; and 
‘‘(H) community-based organizations serv-
ing youth; and 
‘‘(3) the manner in which the applicant will 
evaluate the effectiveness of the program carried out 
under this section. 
‘‘(c) COORDINATION.—In awarding grants under this 
section, the Secretary shall ensure that the proposed pro-
grams show a history of addressing these issues, have pro-
gram evaluations that show success, and are coordinated 
in substance and format with programs currently funded 
through other Federal agencies and operating within the 
community including the Physical Education Program 
(PEP) of the Department of Education. 
‘‘(d) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ means— 
‘‘(1) a city, county, tribe, territory, or State; 
‘‘(2) a State educational agency; 
‘‘(3) a tribal educational agency; 
‘‘(4) a local educational agency; 
‘‘(5) a federally qualified health center (as de-
fined in section 1861(aa)(4) of the Social Security 
Act); 
‘‘(6) a rural health clinic; 
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‘‘(7) a health department; 
‘‘(8) an Indian Health Service hospital or clinic; 
‘‘(9) an Indian tribal health facility; 
‘‘(10) an urban Indian facility; 
‘‘(11) any health provider; 
‘‘(12) an accredited university or college; 
‘‘(13) a youth serving organization; 
‘‘(14) a community-based organization; 
‘‘(15) a local city planning agency; 
‘‘(16) a State or local parks and recreation de-
partment; or 
‘‘(17) any other entity determined appropriate 
by the Secretary. 
‘‘(e) USE OF FUNDS.—An eligible entity that receives 
a grant under this section shall use the funds made avail-
able through the grant to— 
‘‘(1) carry out community-based activities in-
cluding— 
‘‘(A) city planning, transportation initia-
tives, and environmental changes that help pro-
mote physical activity, such as increasing the 
use of walking or bicycling as a mode of trans-
portation; 
‘‘(B) forming partnerships and activities 
with businesses, community-based organiza-
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tions, and other entities to increase physical ac-
tivity levels and promote holistic health includ-
ing promote healthy eating behaviors and the 
prevention of relational aggression in schools 
and while traveling to and from schools; 
‘‘(C) forming partnerships with entities, in-
cluding schools, faith-based entities, commu-
nity-based organizations, and other organiza-
tions providing recreational services, to estab-
lish programs that use their facilities or other 
resources for after-school, weekend, and sum-
mer community activities, especially those that 
promote emotional and social wellness or involve 
physical activity; 
‘‘(D) establishing incentives for retail food 
stores, farmers’ markets, food co-ops, grocery 
stores, and other retail food outlets that offer 
fresh fruits and vegetables and other nutritious 
foods to encourage such stores and outlets to 
locate in economically depressed areas; 
‘‘(E) forming partnerships with senior cen-
ters, nursing facilities, retirement communities, 
and assisted living facilities to establish pro-
grams for older people to foster physical activ-
ity and healthy eating behaviors; 
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‘‘(F) forming partnerships with daycare 
and after-school entities to establish programs 
that promote healthy eating behaviors and 
physical activity and that address health holis-
tically, including building strong and healthy re-
lationships; 
‘‘(G) developing and evaluating community 
educational activities targeting healthy relation-
ships, good nutrition, and promoting healthy 
eating behaviors to bridge the gap between chil-
dren’s behavior and their awareness and knowl-
edge of healthy eating and exercise habits; 
‘‘(H) providing, directly or in cooperation 
with State and local parks and recreation de-
partments, programs and other opportunities 
for daily physical activity; 
‘‘(I) identifying and combating issues such 
as bullying and relational aggression, that cause 
overeating, physical inactivity, eating disorders, 
and other unhealthy behaviors; 
‘‘(J) forming partnerships with parents 
and caregivers to form programs that educate 
adults about healthy living and how to teach 
their children self-esteem and healthy eating 
and exercise habits; and 
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‘‘(K) creating educational and media lit-
eracy programs to inform the public, busi-
nesses, community-based organizations, and 
other entities about unhealthy media images 
and their effect on girls’ body image and eating 
habits; 
‘‘(2) carry out age-appropriate school-based ac-
tivities including— 
‘‘(A) developing and testing educational 
curricula and intervention programs designed to 
promote healthy eating behaviors and habits in 
youth, which may include— 
‘‘(i) after hours physical activity pro-
grams; 
‘‘(ii) increasing opportunities for stu-
dents to make informed choices regarding 
healthy eating behaviors and forming 
healthy lifestyles; and 
‘‘(iii) science-based interventions with 
multiple components to prevent eating dis-
orders including nutritional content, under-
standing and responding to hunger and sa-
tiety, positive body image development, 
positive 
self-esteem 
development, 
and 
learning life skills (such as stress manage-
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ment, media literacy, communication skills, 
problem-solving and decisionmaking skills), 
as well as consideration of cultural and de-
velopmental issues, and the role of family, 
school, and community; 
‘‘(B) providing education and training to 
educational professionals and adult volunteers 
for community-based organizations regarding— 
‘‘(i) a healthy lifestyle and a healthy 
school environment; 
‘‘(ii) healthy relationships and emo-
tional wellness through the prevention of 
relational aggression; 
‘‘(iii) integrating eating disorder pre-
vention and awareness in physical edu-
cation, health, and after-school curriculum 
to the maximum extent possible; and 
‘‘(iv) establishing policies on relational 
aggression; 
‘‘(C) planning and implementing a healthy 
lifestyle curriculum or program with an empha-
sis on healthy eating behaviors, physical activ-
ity, and emotional wellness, including the role 
of healthy relationships and prevention of bul-
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lying, 
such 
as 
relational 
aggression 
and 
cyberbullying; and 
‘‘(D) planning and implementing healthy 
lifestyle classes or programs for parents or 
guardians, with an emphasis on healthy eating 
behaviors, physical activity, emotional wellness, 
and the connection between emotional and 
physical health; 
‘‘(3) carry out activities through the local 
health care delivery systems including— 
‘‘(A) promoting healthy eating behaviors 
and physical activity services and emotional 
wellness to treat or prevent eating disorders, 
being overweight, and obesity; 
‘‘(B) providing patient education and coun-
seling to increase physical activity, promote 
healthy eating behaviors, and improve emotional 
wellness; and 
‘‘(C) providing community education on 
good nutrition, physical activity, and emotional 
wellness to develop a better understanding of 
the relationship between diet, physical activity, 
and emotional wellness and eating disorders, 
obesity, or being overweight; or 
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‘‘(4) other activities determined appropriate by 
the Secretary (including evaluation or identification 
and dissemination of outcomes and best practices). 
‘‘(f) MATCHING FUNDS.—In awarding grants under 
subsection (a), the Secretary may give priority to eligible 
entities who provide matching contributions. Such non- 
Federal contributions may be cash or in-kind, fairly evalu-
ated, including plant, equipment, training, curriculum, or 
a preexisting evaluation framework. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary may 
set aside an amount not to exceed 10 percent of the total 
amount appropriated for a fiscal year under subsection (k) 
to permit the Director of the Centers for Disease Control 
and Prevention to provide grantees with technical support 
in the development, implementation, and evaluation of 
programs under this section and to disseminate informa-
tion about effective strategies and interventions in pre-
venting and treating obesity and eating disorders through 
the promotion of healthy eating behaviors, physical activ-
ity, and emotional wellness. 
‘‘(h) LIMITATION ON ADMINISTRATIVE COSTS.—An 
eligible entity awarded a grant under this section may not 
use more than 10 percent of funds awarded under such 
grant for administrative expenses. 
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‘‘(i) REPORT.—Not later than 6 years after the date 
of enactment of the Improved Nutrition and Physical Ac-
tivity Act, the Director of the Centers for Disease Control 
and Prevention shall review the results of the grants 
awarded under this section and other related research and 
identify programs that have demonstrated effectiveness in 
promoting healthy eating behaviors, physical activity, and 
emotional wellness in youth. Such review shall include an 
identification of model curricula, best practices, and les-
sons learned, as well as recommendations for next steps 
to reduce overweight, obesity, and eating disorders. Infor-
mation derived from such review, including model program 
curricula, shall be disseminated to the public. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) ANOREXIA NERVOSA.—The term ‘Anorexia 
Nervosa’ means an eating disorder characterized by 
self-starvation and excessive weight loss. 
‘‘(2) BINGE
EATING
DISORDER.—The term 
‘binge eating disorder’ means a disorder character-
ized by frequent episodes of uncontrolled eating. 
‘‘(3) BULIMIA
NERVOSA.—The term ‘Bulimia 
Nervosa’ means an eating disorder characterized by 
excessive food consumption, followed by inappro-
priate compensatory behaviors, such as self-induced 
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vomiting, misuse of laxatives, fasting, or excessive 
exercise. 
‘‘(4) EATING
DISORDERS.—The term ‘eating 
disorders’ means disorders of eating, including Ano-
rexia Nervosa, Bulimia Nervosa, binge eating dis-
order, and eating disorders not otherwise specified. 
‘‘(5) HEALTHY EATING BEHAVIORS.—The term 
‘healthy eating behaviors’ means— 
‘‘(A) eating in quantities adequate to meet, 
but not in excess of, daily energy needs; 
‘‘(B) choosing foods to promote health and 
prevent disease; 
‘‘(C) eating comfortably in social environ-
ments that promote healthy relationships with 
family, peers, and community; and 
‘‘(D) eating in a manner to acknowledge 
internal signals of hunger and satiety. 
‘‘(6) OBESE.—The term ‘obese’ means an adult 
with a Body Mass Index (BMI) of 30 kg/m2 or 
greater. 
‘‘(7) OVERWEIGHT.—The term ‘overweight’ 
means an adult with a Body Mass Index (BMI) of 
25 to 29.9 kg/m2 and a child or adolescent with a 
BMI at or above the 95th percentile on the revised 
Centers for Disease Control and Prevention growth 
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charts or another appropriate childhood definition, 
as defined by the Secretary. 
‘‘(8) YOUTH.—The term ‘youth’ means individ-
uals not more than 18 years old. 
‘‘(9) EMOTIONAL WELLNESS.—The term ‘emo-
tional wellness’ means the quality or state of being 
in good mental health and maintaining high self-es-
teem, a strong self-image, and healthy relationships. 
‘‘(10) HOLISTIC HEALTH.—The term ‘holistic 
health’ means the many components of health, in-
cluding physical, mental, emotional, and social 
health. 
‘‘(11) RELATIONAL
AGGRESSION.—The term 
‘relational aggression’ means behaviors that harm 
youth by damaging, threatening, or manipulating re-
lationships with their peers or by injuring a child’s 
feeling of social acceptance. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$60,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2014. 
Of the funds appropriated pursuant to this subsection, the 
following amounts shall be set aside for activities related 
to eating disorders: 
‘‘(1) $5,000,000 for fiscal year 2010. 
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‘‘(2) $5,500,000 for fiscal year 2011. 
‘‘(3) $6,000,000 for fiscal year 2012. 
‘‘(4) $6,500,000 for fiscal year 2013. 
‘‘(5) $1,000,000 for fiscal year 2014.’’. 
SEC. 202. NATIONAL CENTER FOR HEALTH STATISTICS. 
Section 306 of the Public Health Service Act (42 
U.S.C. 242k) is amended— 
(1) in subsection (m)(4)(B), by striking ‘‘sub-
section (n)’’ each place it appears and inserting 
‘‘subsection (o)’’; 
(2) by redesignating subsection (n) as sub-
section (o); and 
(3) by inserting after subsection (m) the fol-
lowing: 
‘‘(n)(1) The Secretary, acting through the Center, 
may provide for the— 
‘‘(A) data collection of student fitness levels and 
physical activity and nutritional behaviors among a 
nationally representative sample of students from 
grades 1–12 that can be linked to school-level data 
on physical education, physical activity, and school 
nutrition policies and programs, and with individual 
data on academic performance; 
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‘‘(B) collection and analysis of data for deter-
mining the connection between children and youth’s 
physical and emotional health; and 
‘‘(C) analysis of data collected as part of the 
National Health and Nutrition Examination Survey 
and other data sources. 
‘‘(2) In carrying out paragraph (1), the Secretary, 
acting through the Center, may make grants to States, 
public entities, and nonprofit entities. 
‘‘(3) The Secretary, acting through the Center, may 
provide technical assistance, standards, and methodologies 
to grantees supported by this subsection in order to maxi-
mize the data quality and comparability with other stud-
ies.’’. 
SEC. 203. HEALTH DISPARITIES REPORT. 
Not later than 18 months after the date of enactment 
of this Act, and annually thereafter, the Director of the 
Agency for Healthcare Research and Quality shall review 
all research that results from the activities carried out 
under this Act (and the amendments made by this Act) 
and determine if particular information may be important 
to the report on health disparities required by section 
903(c)(3) of the Public Health Service Act (42 U.S.C. 
299a–1(c)(3)). 
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SEC. 204. PREVENTIVE HEALTH SERVICES BLOCK GRANT. 
Section 1904(a)(1) of the Public Health Service Act 
(42 U.S.C. 300w–3(a)(1)) is amended by adding at the 
end the following: 
‘‘(H) Activities and community education pro-
grams designed to address and prevent overweight, 
obesity, and eating disorders through effective pro-
grams to promote healthy eating, and exercise habits 
and behaviors, and emotional and social wellness.’’. 
SEC. 205. REPORT ON OBESITY AND EATING DISORDERS 
RESEARCH. 
(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of this Act, the Secretary of Health and 
Human Services shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the House of 
Representatives a report on research conducted on causes 
and health implications (including mental health implica-
tions) of being overweight, obesity, and eating disorders. 
(b) CONTENT.—The report described in subsection 
(a) shall contain— 
(1) descriptions on the status of relevant, cur-
rent, ongoing research being conducted in the De-
partment of Health and Human Services including 
research at the National Institutes of Health, the 
Centers for Disease Control and Prevention, the 
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Agency for Healthcare Research and Quality, the 
Health Resources and Services Administration, and 
other offices and agencies; 
(2) information about what these studies have 
shown regarding the causes, prevention, and treat-
ment of, being overweight, obesity, and eating dis-
order, as well as the connection between physical 
health and emotional health, especially in youths; 
(3) recommendations on further research that 
is needed, including research among diverse popu-
lations (including diverse women and girls), the plan 
of the Department of Health and Human Services 
for conducting such research, and how current 
knowledge can be disseminated; and 
(4) information on the effect media images have 
on youth’s body image, emotional health, and eating 
and exercise habits. 
SEC. 206. REPORT ON A NATIONAL CAMPAIGN TO CHANGE 
CHILDREN’S HEALTH BEHAVIORS AND RE-
DUCE OBESITY. 
Section 399Y of the Public Health Service Act (42 
U.S.C. 280h–2) is amended— 
(1) by redesignating subsection (b) as sub-
section (c); and 
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(2) by inserting after subsection (a) the fol-
lowing: 
‘‘(b) REPORT.—The Secretary shall evaluate the ef-
fectiveness of the campaign described in subsection (a) in 
changing children’s behaviors, identifying the connection 
between emotional and physical health, promoting both 
emotional and physical health as a way to increase general 
health in youth, including preventing and reducing child-
hood obesity and eating disorders, and reducing obesity 
and shall report such results to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the House of 
Representatives.’’. 
Æ 
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