In 2012, McAllen, Texas, ranked as the most obese metropolitan area in the country. Almost 40 percent of its population was considered obese. On top of that, the region was a food desert, meaning even if residents wanted to eat healthier, they struggled to find or afford healthy options.
Fast-forward four years later: McAllen's obesity rate has dropped 33 percent, and in July, it became the first "all-star" city in First Lady Michelle Obama’s “Let’s Move” program to reduce childhood obesity.
Few first ladies have had such a tangible influence on local policies as Obama has had with Let's Move. More than 500 cities signed onto the program, all incorporating its goals to improve food access, nutrition, exercise and health education. Since 2012, Let's Move has connected municipalities with private grants and technical assistance from the U.S. Department of Health and Human Services to help them reach those goals.
Now that the Obama administration is coming to a close, what will happen to Let's Move?
“That's the question on everyone’s mind, and there are still more questions than answers,” said Sue Polis, director of health and wellness for the National League of Cities (NLC).
According to Polis, the White House recently convened all of the subcommittees within Let’s Move -- which includes the NLC -- to discuss the program's accomplishments and its future. She and her counterparts are working together to create the next iteration of Let’s Move. But what the program will look like, and what organization could ultimately spearhead it, is still a big unknown.
"Coming out of that meeting at the White House, I was so struck by the variety of organizations involved," she said. "There's a real committment to fight obesity, and it's stronger than it's ever been."
But some worry that without support from the White House, funding sources for local anti-obesity projects will run dry. The incoming Trump administration hasn’t indicated whether it will continue Michelle Obama's efforts.
Polis, however, said she isn’t too worried. Her organization, the National League of Cities, is on the cusp of implementing a $2 million grant from the Robert Wood Johnson Foundation that will help Let's Move cities with a post-Obama transition plan. She's also optimistic that additional dollars will continue to roll in from partner organizations.
“Folks have an appetite for this now," she said. "We’re working on embedding these city programs to continue the emphasis on social determinants of health for the next generation. We just might not call it Let’s Move."
For some of the cities that have been taking part in Let’s Move, anti-obesity policies have already become rooted in the local culture.
In Rancho Cucamonga, Calif., for example, the city changed zoning laws to make it legal to grow a community garden throughout most of the city. It finished a 21-mile trail that accommodates runners, bikers and equestrians. This is in addition to opening more farmers markets, establishing safe routes for kids to walk or bike to school and passing of a lactation ordinance to help new mothers who want to breastfeed.
“The goals of Let’s Move aren’t going anywhere in Rancho Cucamonga,” said Mayor L. Dennis Michael.
As the 500 or so Let's Move municipalities ponder how to keep some of the momentum going, many credit the first lady for her role in empowering cities to tackle this issue.
“This is the first time I can remember that a first lady started a program that’s had such an impact on cities," said Mayor Michael.