I 
108TH CONGRESS 
1ST SESSION 
H. R. 716
To establish grants to provide health services for improved nutrition, increased 
physical activity, obesity prevention, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 12, 2003
Mrs. BONO (for herself, Ms. GRANGER, Mrs. LOWEY, Mr. WAMP, Mr. 
LAHOOD, 
Mr. 
PAYNE, 
Mr. 
KENNEDY
of 
Rhode 
Island, 
Mr. 
BLUMENAUER, Mr. CASTLE, Mr. JOHNSON of Illinois, and Mrs. MCCAR-
THY of New York) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Commit-
tees on Agriculture, and Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To establish grants to provide health services for improved 
nutrition, increased physical activity, obesity 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) An estimated 61 percent of United States 
adults and 13 percent of children and adolescents 
are overweight or obese. 
(2) The prevalence of obesity and being over-
weight is increasing among all age groups. There are 
twice the number of overweight children and 3 times 
the number of overweight adolescents as there were 
29 years ago. 
(3) An estimated 300,000 deaths a year are as-
sociated with being overweight or obese. 
(4) Obesity and being overweight are associated 
with 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. 
(5) Individuals who are obese have a 50 to 100 
percent increased risk of premature death. 
(6) The Healthy People 2010 goals identify 
obesity and being overweight as one of the Nation’s 
leading health problems and include objectives of 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.
(7) 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. 
(8) The United States Surgeon General’s report 
‘‘A Call To Action’’ lists the treatment and preven-
tion of obesity as a top national priority. 
(9) The estimated direct and indirect annual 
cost 
of 
obesity 
in 
the 
United 
States 
is 
$117,000,000,000, which exceeds the cost of to-
bacco-related illnesses and appears to be rising dra-
matically. 
(10) 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 ‘‘A Call to Action’’ and 
other documents prepared by the Department of 
Health and Human Services and other agencies. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) OBESE.—The term ‘‘obese’’ means an adult 
with a Body Mass Index (BMI) of 30 kg/m2 or 
greater.
(2) 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 
charts or another appropriate childhood definition as 
defined by the Secretary. 
(3) SECRETARY.—Unless otherwise indicated, 
term ‘‘Secretary’’ means the Secretary of Health 
and Human Services. 
TITLE I—TRAINING GRANTS 
SEC. 101. GRANTS TO PROVIDE TRAINING FOR HEALTH 
PROFESSION STUDENTS. 
Section 747(c)(3) of title VII of the Public Health 
Service Act (42 U.S.C. 293k(c)(3)) is amended by striking 
‘‘and victims of domestic violence’’ and inserting ‘‘victims 
of domestic violence, and individuals (including children) 
who are overweight or obese (as such terms are defined 
in section 3 of the Improved Nutrition and Physical Activ-
ity Act) and at risk for related, serious and chronic med-
ical conditions’’. 
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 ‘‘2008’’; 
(2) by redesignating subsection (b) as (c); and 
(3) by inserting after subsection (a) the fol-
lowing: 
‘‘(b) GRANTS.—
‘‘(1) IN GENERAL.—The Secretary may award 
grants to qualified entities to train primary care 
physicians and other licensed or certified health pro-
fessionals on how to identify, treat, and prevent obe-
sity and aid individuals who are overweight (as such 
term is defined in section 3 of the Improved Nutri-
tion and Physical Activity Act). 
‘‘(2) APPLICATION.—An entity that desires a 
grant under this subsection shall submit an applica-
tion at such time, in such form, and containing such 
information as the Secretary may require, including 
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) conduct educational conferences, in-
cluding Internet-based courses and telecon-
ferences, on—
‘‘(i) how to treat and prevent obesity 
and being overweight using nutritional 
counseling, methods to increase physical 
activity, pharmacological therapies, motiva-
tional counseling to promote positive 
changes in health behaviors and to assist 
patients in identifying potential barriers to 
adhering to medical recommendations, and 
other proven interventions; 
‘‘(ii) how to discuss varied strategies 
to promote positive behavior change and 
healthy lifestyles to avoid obesity, being 
overweight, and other eating disorders; 
‘‘(iii) how to identify overweight and 
obese patients and those who are at risk 
for obesity and being overweight and there-
fore at risk for related serious and chronic 
medical conditions; 
‘‘(iv) how to conduct a comprehensive 
assessment of individual and familial 
health risk factors, such as poor nutri-
tional status, physical inactivity, and per-
sonal and family history of obesity and re-
lated serious and chronic medical condi-
tions; and
‘‘(v) how to educate patients and their 
families about effective strategies to im-
prove dietary habits and establish appro-
priate levels of physical activity; 
‘‘(B) conduct training to enhance cultural 
and linguistic competency and communication 
skills needed to effectively interact with patients 
from diverse populations regarding weight, 
health, and nutritional status, including raising 
awareness of issues regarding stigma and preju-
dice about obesity or being overweight; 
‘‘(C) evaluate the effectiveness of the train-
ing provided by such entity in increasing knowl-
edge and changing attitudes and behaviors of 
trainees; 
‘‘(D) develop training materials and course 
content using evidence-based findings or rec-
ommendations that pertain to obesity and over-
weight treatment and prevention ; and 
‘‘(E) collaborate with other training pro-
grams related to overweight and obesity preven-
tion and treatment. 
‘‘(4) EVALUATION.—
‘‘(A) IN
GENERAL.—An entity that re-
ceives a grant under this subsection shall sub-
mit to the Secretary an evaluation that de-
scribes the activities carried out by such entity 
with funds received under this section. 
‘‘(B) CONTENTS.—Such evaluation shall 
include an assessment of the effectiveness of the 
activities in increasing physical activity, improv-
ing nutrition, and preventing individuals from 
becoming overweight or obese, treating individ-
uals who are overweight or obese, and any other 
information that the Secretary may require.’’. 
TITLE II—LOCAL GRANTS 
SEC. 201. GRANTS TO INCREASE PHYSICAL ACTIVITY AND 
IMPROVE NUTRITION. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 399AA. GRANTS TO INCREASE PHYSICAL ACTIVITY 
AND IMPROVE NUTRITION. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention and in consultation with Administrator of the 
Health Resources and Services Administration, the Direc-
tor of the Indian Health Service, and the heads of other 
appropriate agencies, shall award competitive grants to 
cities, counties, tribes, and States to plan, implement, and