The Growing Problem Among Americans
There is a growing epidemic in the United States, literally. Obesity is quickly becoming the number one health concern of the nation, and can lead to a variety of other health conditions, such as diabetes, coronary artery disease, cancer, high blood pressure, high cholesterol, and osteoarthritis. However, the greatest implication that obesity has for the health of our nation is among children. According to the CDC (2009), between the years of 2003 – 2006, 16. 3% of children 2 – 19 years old were obese. The saddest part, though, of the obesity epidemic and its affect on children is that obesity, in a large measure, is highly preventable.
This paper will address what obesity is, what causes it, and what treatments and interventions are available to cure and prevent obesity. About Obesity Body Mass Index (BMI) is a measure of a person’s weight in relation to their height, and offers a convenient and fairly accurate means of determining whether a person is underweight, normal weight, overweight, or obese. Individuals who have a BMI of 25 – 29. 9 are considered overweight, and those with a BMI of 30 or greater are considered obese. In short, obesity is an excessive accumulation of fat in the body.
This excess fat is not, in and of itself, a serious health problem, but what the fat does to the rest of the body IS. Such large amounts of fat can keep people from engaging in physical activity, and creates a significant amount of stress on the body’s systems, including the skeleton, which often cannot carry so much weight without severely damaging joints, and even sometimes fracturing bones. The cardiovascular system, too, must work much harder to pump blood to all the areas of the body, and because so much fat usually diminishes lung capacity by pressing on the lungs, the blood the body is getting does not have as much oxygen in it.
Fat will accumulate around the organs, and create pressure that hinders with proper functioning, and there is even more fat floating around in the blood, causing the liver and kidneys (the body’s filtering systems) to have to work harder as well, and sometimes these organs simply cannot keep up and will shut down. ALL of the body’s normal processes are affected by the excess fat characteristic of obesity, and simply being overweight or obese increases a person’s risk for developing Type II Diabetes, hypertension, and dislipidemia, even as a child (CDC, 2009).
One study has gone so far as to suggest that the prevalence of childhood obesity in America can drastically shorten the average lifespan as our children age (Mann, 2005). In addition to having negative health affects for Americans, obesity has an increasing negative impact on our economic and health care systems. Obesity translates into more time spent away from work (if one is able to work at all), and at the doctor’s office (“Confronting”, 2003). Many obese people have a number of different chronic conditions requiring multiple surgeries, expensive treatments and medicines, etc.
, most of which they cannot pay for, as many insurance companies are now looking at obesity as a pre-existing condition, and many individuals cannot pay the premiums required. Thus, they turn to public forms of health care coverage, and a system that is already deficient. Despite the enormous body of research regarding the effects that obesity has, there is not quite as much research that aims to conclusively determine the cause of obesity, and the prevailing opinion is that there are a variety of behavioral, genetic, and environmental factors that can affect each individual differently.
Some recent studies suggest that as much as 50% of the tendency toward obesity is inherited, particularly in instances of childhood obesity (“Clinical Aspects”, 2001). However, it is important to note that most experts believe behavioral factors, such as diet and exercise, play the largest part in weight gain and obesity, and can significantly influence the impact that genes or environment may have (Ogden & Flanagan, 2008).
As a growing health problem with far-reaching social and economic effects, though, environmental factors have come to be viewed as a serious and problematic influence on weight gain and obesity, especially among the poor and among children. Convenience foods with little or no nutritional value and foods higher in sugar and fat are significantly cheaper than fresh vegetables and fruits, fish, and whole grain products.
Obesity statistics indicate a disproportionate burden of obesity on individuals of lower income, and economic factors in the availability of more nutritious foods is believed to be the primary cause (Popkin & Gordon-Larsen, 2004). Additionally, these “junk” foods are marketed toward children and adolescents, and are highly available to them. Although there has been a shift to providing more healthy snacks, drinks, and lunches to students in public schools, many schools still have soda machines, candy machines, and high-sugar/high-fat lunch alternatives readily accessible, often at the same prices as healthy lunches.
Preventing and Treating Obesity As the old saying goes, an ounce of prevention is worth a pound of cure, and this is especially true when it comes to obesity. As previously mentioned, although genes and environment do play a part in weight gain, most of these negative effects can be counteracted by proper nutrition and physical activity. In efforts to promote better health through diet, the USDA recently re-vamped the Food Pyramid, including recommended amounts of daily physical activity, and their website offers personalized diet plans for men, women, preschoolers, pregnant mothers, and children (“MyPyramid”, 2009).
Good nutritional education begins at birth, and studies suggest that laying the foundations of good nutrition and healthful behaviors in toddlers and young children can effectively help prevent overweight, obesity, and a number of other diet-related health concerns (Moore, 2004). Diet alone is not the answer, however, and sufficient amounts of physical activity are also key to maintaining healthy weight and preventing obesity, among both adults and children.
Although it may seem unlikely that children are not getting their daily recommended amount of physical activity, increases in the amount of time children spend watching television, on the computer or phone, and in schools that have cut physical education programs have contributed to create a largely sedentary population of 2 – 19 year olds. Here, too, the effects of engaged parenting and healthy foundations can be found as helpful to preventing obesity (Moore, 2004). Where prevention is not possible, though, diet and exercise are an essential part of the treatment for obesity, but often are not the only solution.
It should be noted that obesity can be cured, by losing the excess fat, but it is a chronic condition which requires lifelong management once the weight is lost, and many of the diseases caused by obesity cannot be cured once a person has them, like diabetes. Fortunately, losing weight before developing any of the obesity-related diseases can significantly reduce a person’s risk for developing these diseases in future, and certain studies have indicated that some diseases, like hypertension, can be managed much better with a loss of only 5 – 10 percent of an obese person’s body weight (Gordon, 2004).
Oftentimes, though, obese individuals cannot lose weight simply through diet and exercise, and other measures must be evaluated. Some individuals with obesity have psychological, not physiological, triggers for bad food habits, and require behavioral therapy to ensure that they are able to comply with dietary and activity changes prescribed for weight loss. For others, this means taking an appetite-reducing medicine, only three of which are approved by the FDA – Orlistat, Phentermine, and Sibutramine.
However, in order to safely take these drugs, the obese individual must also make appropriate lifestyle modifications and must be regularly evaluated by a competent physician. Also, none of these drugs have been approved for use in children or adolescents. For individuals who are extremely obese, or who have serious health issues related to their obesity, there are surgeries that can assist them in losing weight. To qualify for most of these procedures, a person must have a BMI score greater than 40, or a BMI of 35 – 39.
9 and serious medical conditions that warrant the treatment (“When Might”, 2003). The most common form of bariatric surgery (weight loss surgery), is reshaping of the stomach with staples or plastic tubes so that it can only hold a few tablespoons of food at one time. In conjunction with this, many surgeons are now also creating a bypass of most of the small intestine, which is where food is absorbed. This way, the stomach is smaller, so the person is eating less, and they are also absorbing fewer calories through the small intestine.
Although this seems like a drastic measure to take, advances in medical technology and the safety of such surgeries has increased the viability of this as a treatment option for the increasing obese population. In 2007 alone, more than 1,000 children and adolescents underwent bariatric surgery, despite the lack of research on the effects that this may have to a growing body (“Obesity Surgery”, 2007). The most unfortunate part, however, may be that the number of children who actually qualify for these surgeries is even higher.
One report on bariatric surgery for children focused on a 14-year-old girl who weighed 363 pounds, which is not considered a normal, healthy weight for ANYONE, not even a grown man over 6’4” tall (Springen, 2004). Overall, research has indicated that a combination of therapies, including diet and exercise, along with drug therapy or surgery, has the greatest effect on weight loss, and when behavioral modifications are added, previously obese individuals are much more likely to keep the weight off.
A study with an experimental form of behavioral therapy for obesity tested an interactive microcomputer system designed to assist obese individuals with self-monitoring their behaviors (Burnett, Taylor, & Agras, 1995). During the first phase of treatment, the participants met with therapist to set goals for weight loss, and received feedback on their progress. Half of the group used the computer to track their food consumption, made reports on their eating habits, and kept track of how they were meeting their goals – the computer beeped every 4 hours to remind them to make reports.
The other group used pen-and-paper to keep track, and the results were significant. Over time, the computer-assisted group lost more weight and had better food habits than the control (pen-and-paper) group. These findings suggest that support is another component of obesity treatment that should not be overlooked. Proponents of organizations like Jenny Craig and Weight Watchers have long espoused the benefits of support during weight loss, but for those who are too embarrassed or simply cannot afford to join such groups, a computer-assisted plan could be a means of support to help them change old behaviors and track progress.
Along the same lines, there has been an increase in internet-forum support groups for individuals struggling with obesity or losing weight, which has proven beneficial for long-term weight loss outcomes. Especially considering the psychosocial effects that obesity has on children and adolescents, these are viable options for behavioral therapy and emotional and social support. Conclusion In summation, obesity is a very real, growing problem in America with far-reaching, wide-spread consequences, and that can no longer be ignored.
Its impact on our children, alone, should inspire us to action and reform of the way our society handles being overweight and obese. The health concerns that accompany obesity, like diabetes, hypertension, osteoarthritis, and even premature death, affect millions of people every year, and place an unnecessary burden on our health care system. Obesity is, for the most part, a preventable condition, and this is where treatment should focus with children, as it is much easier to lay the foundation for good health early, rather than try to fix everything that’s gone wrong later.
For adults, however, there are several viable treatment options that can help obese individuals lose weight and better manage any associated health problems, including diet and exercise, behavioral therapy, drug therapy, and surgery. In short, obesity does not have to mean a life spent in pain, illness, or embarrassment. We must get over the “fat” stigma, teach our children healthy habits from the beginning, and support those children and adults already struggling with obesity in finding a healthier, better life.
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Nutrition Today, 39(5): 200-202. MyPyramid. (2009). Retrieved April 26, 2009, from the USDA official website: http://mypyramid. gov/. National Center for Disease Control and Prevention (CDC). (2009). Overweight and Obesity. Retrieved April 26, 2009, from http://www. cdc. gov/nccdphp/dnpa/Obesity/. Obesity Surgery for Children Rises. (2007, March 6). Wall Street Journal – Eastern Edition, p. D4. Ogden, J. & Flanagan, Z. (2008). Beliefs about the causes and solutions to obesity: A comparison of GPs
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