Obesity Epidemic In The United States
The word “epidemic” is typically used to describe diseases such as AIDS, SARS, and the Pandemic Flu; however, there is currently an ongoing epidemic in the Unites States that is caused not by viruses, bacteria, or bioterrorism, but simply through human nature. This advancing disorder is obesity, a condition that has turned into a national public health crisis during the past three decades in the United States. Obesity is the fastest growing epidemic in the United States, and one of the most serious chronic diseases of our time. Currently, as of 2007, two-thirds of all American adults are either obese or overweight (CDC, 2007).
The definition of obesity varies depending on what you read, however, in general, it is a chronic condition defined by an excess amount of body fat. The normal amount of body fat, necessary for storing energy, heat insulation, shock absorption, and other bodily functions, is between 25-30% in women and 18-23% in men (Beresford et al., 2006). Women with over 30% body fat and men with over 25% body fat are considered obese. Obesity is most commonly evaluated using the body mass index, or BMI, calculated by dividing an individual’s weight by the square of his/her height. Other methods of measuring obesity include waist circumference, skin fold thickness (skin calipers), ultrasound, computed tomography, and magnetic resonance imaging. Being obese or overweight is a major risk factor for extremely serious health problems such as Hypertension, Dyslipidemia, Type 2 diabetes, Coronary heart disease, Stroke, Gallbladder disease, Osteoarthritis, Sleep apnea, respiratory problems, and even endometrial, breast, and colon cancer. Overweight and obese individuals, especially children, are very likely to suffer social stigmatization, discrimination, and depression (Beresford et al., 2006).
After cigarette smoking, obesity is the second-leading cause of preventable deaths in the U.S. According to the American Obesity Association, obesity causes approximately 300,000 premature deaths each year and accounts for an estimated $100 billion in annual US health care costs. Health problems associated with obesity have astonishingly significant economic consequences for the U.S. health care system and the economy. In 1998, $78 billion, or 9 percent, of total medical spending was attributable to overweight and obesity. In 2000, the total cost associated with obesity was $117 billion, of which about $61 billion was for medical care expenditures and $56 billion represented wages and earnings lost due to premature death (CDC 2007). Employers also share the economic burden, through direct medical care costs, increased health insurance premiums, and indirect business costs.
Since the 1960s and 70s, the prevalence of obesity has nearly doubled from approximately 15% in 1980 to 33% in 2005 for both adults and children. Among U.S. Adults aged 20-74 obesity has increased from 15% in 1980 to 35% in 2005(Howard et al., 2006). This trend extends equally to children and teenagers, as there is an estimated 25 million obese and overweight children currently in the United States (Howard et al., 2006). For children aged 2–5 years, the prevalence of obesity has increased from 5.0% to 13.9%; for those aged 6–11 years, prevalence increased from 6.5% to 18.8%; and for those aged 12–19 years, prevalence increased from 5.0% to 17.4%. The Centers for Disease and Control reports that today’s children are likely to be the first generation to live shorter and less healthy lives than their parents (CDC 2005). In 2007, obesity rates continued to rise in 31 states, and have not decreased in a single state. As current statistics indicate the situation is worsening rather than improving, concern for the future health of Americans continues to grow.
Overall Bodyweight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status. Bodyweight, unlike wine, unfortunately does not age well. Muscle mass decreases and body fat percentage increases with age, increasing the body’s storage of excess calories in the form of fat. A lowered muscle mass leads to a decrease in metabolism, making it much harder for an individual to lose weight (Howard et al., 2006). Illnesses such as Cushing’s disease, polycystic ovary syndrome, and hypothyroidism, as well as taking medications such as steroids, antidepressants, and contraceptives have all been shown to increase the risk of obesity or weight gain. Although characteristics of bodyweight tend to be hereditary, genetics do not indefinitely predispose obesity. Behavioral modifications with diet and exercise are extremely effective as preventative strategies (Howard et al., 2006).
Today’s culture promotes eating habits that contribute to dramatic increase of obesity. American culture is accustomed to fast food restaurants and dining out, where high-fat processed foods are served in tremendously large portions. However dining out may not be the only contributing factor of weight gain. A recent study conducted in 2007 indicated that social networks influence weight gain and obesity. The study found that people were more likely to be overweight if their social groups were, suggesting that friends, families and social networks are extremely effective in influencing attitudes and acceptance of overall bodyweight. America’s expanding technology has created many time and labor saving products which contribute to a sedentary lifestyle. Physical activity plays a key role in maintaining a healthy energy balance and preventing weight gain. When it does come down to nutrition, American’s are putting taste and convenience above nutrition. The American diet consists of cheap, accessible foods in large portions, loaded with sugar and trans-fats. The combination of an excessive nutrient intake and a sedentary lifestyle are the main cause for the rapid acceleration of obesity in Western society in the last quarter of the 20th century (Howard et al., 2006).
With the majority of public concern placed on diet, nutrition, and exercise, economical factors contributing to obesity are frequently overlooked. In highly industrialized societies such as the United States, flourishing labor markets produce a general increase in the population’s income. When comparing the U.S. to the rest of the world, not only is the average household income considerably high but the cost of food is considerably low. Americans enjoy the benefits of the present agricultural regime as consumer food currently requires on average less than 10% of their disposable income (Howard et al., 2006). American workers are contributing more of their time to their jobs and have less disposable time for entertainment and other household activities such as food preparation; possibly the reason behind the booming fast-food industry. Increased marketing has also played a role in the rise of obesity with the lack of regulation on the media’s advertisement of foods high in sugars and fats (Howard et al., 2006). Wealthier and more educated individuals are less likely to have obesity problems, with increased access to healthier foods, fitness facilities, and nutritional counseling. Overproduction, and the consequent inexpensive foods, is now recognized as an environmental force favoring the occurrence of pandemic obesity (Howard et al., 2006).
The reduction and control of obesity have only recently made their way into public policy and legislation. In fact, the federal government did not officially acknowledge the connection between diet and the risk of chronic disease until 1969. Throughout history, American agriculture has continued to be highly favored by government policies. The three primary sources of fat in the typical American diet are red meat, plant oils, and dairy products. It is no surprise that producers of all three are subsidized and/or aided by federal, state, and local governments. Public regulation of high-fat foods has been limited to ensuring purity instead of promoting nutrition. No restrictions exist to control the production or consumption of low-nutrition, high-fat foods compared to the countless regulations for alcohol, tobacco, and drugs. Even governmental policies such as the National School Lunch Program (NSLP) for undernourished children have produced studies indicating that the dietary fat in government-approved school lunches far exceeded recommended nutritional guidelines. Fortunately, the future looks hopeful, as more decisive regulatory policies await further politics.
Glimmerings of a movement toward regulatory policies for obesity are becoming apparent in both local, state, and federal governments. State and local community governments are supporting varied approaches to obesity, ranging from public education campaigns to issuing public challenges to get in better shape to increasing parks and recreation development. In July of 2007, New York City became the first municipality in the country to institute a ban on all use of trans fat in its city restaurants. The New York City Board of Health additionally is mandating prominent display of calorie content on restaurant menus and display boards. Another way state governments have tried to impact the obesity epidemic is by promoting the taxation of unhealthy food to reduce its consumption. Seventeen states and D.C. currently have laws that tax foods of low nutritional value.
In addition to the maintaining the goals set in ongoing policies such as Healthy People 2010 and 10,000 Steps a Day, there have been five major federal obesity-related issues that have been under consideration in 2007: Reauthorization of the Farm Bill, reauthorization of No Child Left Behind, reauthorization of the State Children’s Health Insurance Program (SCHIP) Act, funding for CDC Obesity Grants, and acceleration of obesity prevention research (USDHHS, 2007). These efforts all aim to combat the obesity epidemic the obesity epidemic through public education campaigns, treatments of obesity-related diseases, and the development of community active living incentives.
Plentiful and inexpensive food shapes Americans’ lifestyles today with the likes of fast-food dollar deals, all-you-can-eat restaurants, gigantic packaged soft drinks and sweet treats, as well as supermarkets with 40,000-plus great-tasting foods (USDHHS, 2007). American social life, in and out of the home, is often built around eating. Americans must be given the tools to take personal responsibility for their eating habits, including nutritional recommendations, access to supermarkets, nutritional information when they purchase food, and healthy food in schools. Improving diet and nutritional intake is only the first half of the battle in attaining a healthier nation. As outlined in The Healthy People 2010, and almost all other strategies aimed at tackling obesity, healthy diets must be balanced with regular physical activity to maintain a healthy lifestyle (USDHHS, 2007). Through education programs and counseling the public needs to be educated on the health risks of obesity, and the benefits of weight loss. Communities should increase access to physical activity with building sidewalks, parks, and fitness centers. With an increased workforce, worksite physical activity and fitness programs have been shown to be extremely effective in providing a large number of adults with a safe and convenient environment to exercise.
Through my research, I have concluded that the best way to reduce and control obesity is through increasing physical activity. Although there needs to be a balance between a healthy diet and exercise in order to achieve optimum health, physical activity, alone, can lead to improved health outcomes in individuals. It is evident that American’s are in dire need of increasing physical activity levels, as more than a 25% of U.S. health care costs are related to physical inactivity, overweight, and obesity (USDHHS, 2007). Physical activity helps control and prevents a range of health problems, including diabetes, heart disease, and stroke. Studies have found that even small amounts of physical activity help to reduce the risk of death and disease, therefore incorporating even minor changes to sedentary behavior can be extremely beneficial. It is apparent that increasing physical activity is not a top priority to Americans, as more than half of adults are reporting they do not participate in CDC’s recommended level of physical activity (CDC, 2005).
Overweight and obesity are problems in the United States with significant cost and life-threatening consequences. However, the future is looking brighter, as many promising efforts are being initiated across the country. Without a change, it is estimated that 60% of Americans will be obese and costs will double by 2020(Beresford et al., 2006). Nonetheless, action taken by individuals, businesses, community groups, nonprofit organizations and federal and state governments, can, and will, preserve the future health and safety of a thriving America.
Beresford SA, Johnson KC, Ritenbaugh C, et al (2006). “Low-fat dietary pattern and risk of colorectal cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial”. JAMA 295 (6): 643-54.
Centers for Disease Control and Prevention. Nutrition for Everyone. National Control for Health Statistics. Accessed December 15, 2007.
Centers for Disease Control and Prevention. Obesity and Overweight: Economic Consequences. Accessed December 15, 2007.
Centers for Disease Control and Prevention, U.S. Obesity Trends 1984 – 2002.Available at: http://www.cdc.gov/nchs/fastats. htm . Accessed December 8, 2007.
Centers for Disease Control and Prevention, National Center for Health Statistics, Fast Facts A to Z. Available at: http://www.cdc.gov/nchs/fastats/overwt.htm . Accessed December 8, 2007.
The Economic Costs of Physical Inactivity, Obesity, and Overweight in California Adults, report by Chenoweth & Associates Inc. for the Cancer Prevention and Nutrition Section, California Center for Physical Activity, California Department of Health Services, Sacramento, CA, 2005.
Howard BV, Manson JE, Stefanick ML, et al (2006). “Low-fat dietary pattern and weight change over 7 years: the Women’s Health Initiative Dietary Modification Trial”. JAMA 295 (1): 39-49.
Howard BV, Van Horn L, Hsia J, et al (2006). “Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial”. JAMA 295 (6): 655-66.
Lin BH, Guthrie J and Frazao E (1999). “Nutrient contribution of food away from home”. In: Frazao E (Ed). America’s Eating Habits: Changes and Consequences. Agriculture Information Bulletin No. 750, US Department of Agriculture, Economic Research Service, Washington, DC, pp. 213–239
Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 2002;75:978-85.
Nordmann AJ, Nordmann A, Briel M, et al (2006). “Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials”. Arch. Intern. Med. 166 (3): 285-93.
Prentice RL, Caan B, Chlebowski RT, et al (2006). “Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial”. JAMA 295 (6): 629-42.
U.S. Dept. of Health and Human Services, National Institutes of Health. “Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report” (2000). NHLBI document 98-4083.
U.S. Dept. of Health and Human Services, Public Health Service, Office of Surgeon General, The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity 2006 (2007).
World Health Organization. Technical report series 894: “Obesity: preventing and managing the global epidemic.”. Geneva: World Health Organization, 2000.