Introduction
Obesity is a widespread condition in Western societies today and especially prevalent in the U.S. An obese person is what most would recognize as significantly overweight. They have more body fat than is considered healthy for a person of their particular height. Generally speaking, a person who is 40 to 100 pounds over their recommended weight is considered obese, while those who tip the scale at 100 pounds or more over their desired weight are categorized as morbidly obese. The condition initiates much more than just public humiliation, which itself is very harmful, usually causing serious psychological damage that lasts a lifetime. The physical detriments of obesity are even more severe. The condition dramatically lowers life expectancy and is directly linked to the deaths of at least 300,000 in the U.S. every year. It also reduces the quality of life. The obese suffer a greater number of illnesses, problems in bones and joints and the back region and are more lethargic than those who are not.
Approaching epidemic proportions, obesity is the root of many varied and dangerous health consequences; therefore understanding the cause of this condition and knowing the most viable treatment options available are of utmost importance in the battle against this crippling condition.
We’re Number 1!
Not surprisingly, the U.S. leads the world in the percentage of obese citizens. An alarming 30 percent of Americans are not just overweight but obese. Mexico comes in second place at 25 percent and Britain takes third with 23 percent. Our other neighbor Canada is a more respectable 14 percent. Japan and South Korea hover near the three percent range. The difference is in the diet and exercise habits of these respective country’s citizens. Asians are more likely than Americans to bicycle to work. In addition they consume a much healthier diet which consists largely of fish and rice. Americans, by sharp contrast, is ‘fast food nation.’ (Dietblog, 2009)
‘At Risk’ for Obesity
It’s in the Genes
Heredity significantly influences obesity. Those genetically disposed to being obese have greater difficulty in losing weight and maintaining a desired body mass. Overeating, eating fatty foods, and inactivity in addition to metabolic and socioeconomic circumstances, diseases, endocrine ailments and medications may also contribute significantly to obesity. Some people are simply born to be big. Studies have demonstrated that about half of overweight children have parents who were overweight. Heredity also influences where on the body a person carries their excess weight, whether on the belly or hips. A person’s metabolism refers to how efficiently the body burns up energy.
Metabolic levels and hormonal balances differ widely among individuals and both factor significantly in controlling weight. “Recent studies show that levels of ghrelin, a peptide hormone known to regulate appetite, and other peptides in the stomach, play a role in triggering hunger and producing a feeling of fullness” (“Overview of Obesity”, 2007). Studies have also shown that a correlation exists between substandard economic circumstances and obesity rates, particularly in the case of women.
Lifestyle
Poor women have a six times higher likelihood of being obese than do women who are of middle or upper-class income environment. Minority women also experience a higher rate of obesity. More than three-fourths of Black women over 20 years of age are considered overweight. Lifestyle preferences such as a being a ‘couch potato’ and overeating on a regular basis, not surprisingly, contribute to weight gain. “Eating a diet in which a high percentage of calories come from sugary, high-fat, refined foods promotes weight gain” (“Overview of Obesity”, 2007). Fast-food consumption and lack of exercise are the major controllable factors in obesity of adults. For children, the main factor outside genetics is inactivity. Inordinate amounts of time spent on the computer, watching television, and playing video games leads to higher rates of obesity.
“Over nine million children between the ages of six and 19 are overweight” (“Overview of Obesity”, 2007).
Childhood Obesity
The Cause
The rate of obesity among youths is more than twice what it was just two decades ago. “Every day, nearly one-third of U.S. children aged 4 to 19 eat fast food, which likely packs on about six extra pounds per child per year and increases the risk of obesity” (“Fast Food”). Some schools are attempting to wean their kids off junk foods by removing candy and soda machines in addition to providing meals that nourish the body not just satisfy the appetite. However, this is the exception, not the rule. Junk foods remain in the majority of schools for economic reasons. Parents are allowing their school systems to choose financial considerations ahead of the children’s health. Watching television will make you fat and children are the most at risk. T.V. commercials promote junk foods to an already hypnotized audience. Commercials promoting foods often misrepresent their products to impressionable children, as well as adults, regarding the product’s nutritional values, or lack of. There remains a strong association between obesity, regardless of age, and the amount of time spent watching television. The wide-spread problem, (pun intended) known as the ‘couch-potato’ syndrome, is considered to be the result of consuming large amounts of snack foods that are high in calories and fat content while watching television. Essentially, it’s the result when enticement meets boredom and inactivity. (“Fast Food”).
The Result
Childhood obesity creates many more problems than the simple physical issues one might expect. Being overweight can affect a child’s self-esteem, self-confidence, relationships with peers, and acceptance of self and negatively impacts their academic careers. A typical cycle sees the child increasingly gaining weight as a result of the emotional turmoil that occurs as other children begin to make fun of them or as they perceive themselves not being able to keep up with other children on the sports field. They begin seeing themselves as somehow less than average weight children in every way. Many adults reinforce these beliefs with the idea that an overweight child must be lazy and not as bright as other children. Perceiving these impressions of others, these children retreat to food as comfort while still shunning potentially embarrassing physical activity that further contributes to the weight problem (Rimm, 2004).
Obesity has been linked with at least 30 adverse health conditions. Arthritis of the knees, back, hips and hands are common ailments of the obese. Breast cancer is twice as prevalent among obese women and men as compared to those of comparable gender that maintain a relatively stable weight as an adult.
The obese also have a higher risk of contracting other cancers such as colorectal, esophageal, gastric and endometrial. The risk of cardiovascular disease is greater because obesity has a direct correlation with high cholesterol levels, which blocks the arteries of the heart. In addition, the veins of the obese are more constricted, which slows oxygen to the tissues of the body and prompts complaints of breathing problems, sleepiness, and general fatigue. Obesity heightens the risk of stroke and hypertension by a significant amount.
More than 75 percent of people who suffer from hypertension are obese. Up to 90 percent of people with diabetes (type two) are either overweight or obese, a startling statistic. Next to alcohol abuse, obesity is the leading cause of liver disease (acute hepatitis and cirrhosis), gallbladder disease, and pancreatitis. The obese are three times more likely to develop gall stones and are more susceptible to infection and pneumonia. These and many other maladies, including problems with pregnancy and childbirth are also associated with obesity (“Health Effects”, 2002).
The Financial Costs
Obesity is the precursor of many significant health risks which costs individuals their lives at an early age and costs everyone else billions of dollars. In 1995, for example, obesity cost taxpayers almost $100 billion.
About half of this figure is costs related to health care services, the other half in indirect expenses such as the total economic production lost due to time off work. “The direct costs associated with obesity represent 5.7 percent of the national health expenditure within the United States. The indirect costs attributable to obesity are $47.6 billion and are comparable to the economic costs of cigarette smoking” (Wolf, 1998: 97). The monetary costs are high, but the human cost is a tragedy of epidemic proportions. According to a study by the Veterans Administration, a morbidly obese person aged 25 to 34 is twelve times more likely to die during that time of their life than an individual of average weight (Drenick, 1980: 444). If a person’s parents are overweight and they live in economically deprived conditions, then they are likely to at least be overweight and cost everyone dearly, including and especially themselves. There is, however, no obesity panacea. Diet, exercise, behavior modification, medication, and surgery have all had successes and failures in the treatment of obesity to varying degrees.
Remedies
Conventional Route
The way to lose weight and not be obese is to eat less, eat low fat foods and exercise regularly, very simple sounding. Yet, it’s hardly simple, far from it. Why are poor women more likely to be overweight? Poverty leads to stress, and emotional response which then leads to them seeking an outlet for this emotion. Food is the perfect remedy for pent up emotions. It’s legal, relatively inexpensive and readily available, and inherently intertwined with human emotions in many ways. When people are stressed, bored, or sad, they tend to eat.
Food is also part of celebratory activities. To inhibit this emotional attachment to food involves extensive and expensive behavioral therapy. If this technique is not successful, surgery may be the best choice because the obese do not have the stamina or inclination to exercise and safety of medications remains suspect by the medical community.
Surgical Solution
The general consensus is tilting steadily toward surgery as the best option for obesity. “Surgical treatment is more effective than non-surgical treatment for weight loss” (Shekelle et al, 2004). Medications, exercise or dieting alone has proven successful in producing long-term weight reduction for less than 10 percent of the morbidly obese. “Surgery is the only proven method to allow the severely and morbidly obese person to reach normal weight and maintain it” (“Health Effects”, 2002). A 2000 study indicated that gastric bypass surgery reduced not only weight for patients but instances of diabetes and hypertension within the study group as well (Sjostrom, 1999). Gastric bypass surgery is more common, but the newer and less invasive Lap-Band method is growing in popularity. The latest and least invasive type being developed is performed via the mouth (“Health Effects”, 2002).
Conclusion
On the surface, obesity seems to be caused by poor lifestyle choices alone, but for most, the choices they make are rooted at least somewhat within their biological make-up. The cause of obesity was discovered through scientific means, and seemingly, the cure will be as well. Obesity is responsible for the poor health of millions and the deaths of hundreds of thousands every year while costing taxpayers billions. The most viable way to stem this tragic and widespread condition is modern surgical techniques followed up by behavioral modification therapy as a means of maintaining a more healthy weight.
References
Drenick, E.J., et al. (1980). “Excessive Mortality and Causes of Death in Morbidly Obese Men.” Journal of the American Medical Association. Vol. 243 pp. 443-445.
“Fast Food Linked To Child Obesity” (2003) CBS News. Web.
Grey, Wellington. (2009). “A Picture of Obesity Around the World” Diet blog. Web.
“Health Effects of Obesity.” (2002). AOA Fact Sheets. American Obesity Association. Web.
“Overview of Obesity.” (2007). Cardiovascular Diseases. University of Virginia Health System. Web.
Rimm, Sylvia. (2004). “Rescuing the Emotional Lives of Overweight Children.” New York: St Martin’s Press.
Shekelle, P.G.; Morton, S.C.; Maglione, M., et al. “Pharmacological and Surgical Treatment of Obesity. Summary, Evidence Report/Technology Assessment: Number 103.” (2004). AHRQ Publication Number 04-E028-1. Agency for Healthcare Research and Quality, Rockville, MD.
Sjostrom, C.D., et al. (1999). “Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study.” Obesity Research. Vol. 7, N. 5. pp. 477-484.
Wolf, A.M. & Colditz, G.A. (1998). “Current Estimates of the Economic Costs of Obesity in the United States.” Obesity Research. Vol. 6. pp. 97-106.