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The United States...an Obese Nation

~ by Jo Jordan

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More than sixty-five percent of American adults are obese¹

While the statistics themselves are shocking enough, far worse than the soaring numbers are the long-term health consequences for obese Americans.

Medical expenditures attributable to obesity rose from $39 billion in 1986 to $75 billion in 2003.² In addition to the discomfort and social and emotional consequences, obesity is closely linked to numerous other serious diseases such as cancer, diabetes, fertility and pregnancy problems, heart disease, high blood pressure, osteoarthritis, and stroke.

And not only adults are affected by obesity. A National Health and Nutrition Examination Survey (NHANES) recently found that obesity among youth in 2003 through 2006 was over sixteen percent for children and adolescents aged two through nineteen years of age.³

Despite the shocking statistics and long-held knowledge about the health effects of obesity, the condition is not being taken seriously. A study in the Journal of the American Medical Association reported that over a twelve-month period, only forty-two percent of the 12,835 obese patients who visited their physicians were advised to lose weight.⁴

Are You Obese? Calculate Your BMI

In order to deal with the problem of obesity, it is necessary to define what it is and look at causes, risk factors, and complications. Once these have been established, treatment and prevention options can be implemented.

In simple terms, obesity means that someone has a higher proportion of body fat than is considered healthy. A standardized tool for measuring obesity is known as the Body Mass Index (BMI). Use this formula to calculate your BMI:

Weight in pounds multiplied by 705 and divided by height in inches squared.

For example, a 285-pound, 5 foot 10' inch male would have a BMI of 41:

Weight in pounds 285 times 705 = 200925
Height in inches squared: 70 times 70 = 4900
200925 divided by 4900 = 41

The National Heart, Lung, and Blood Institute has defined the following BMI categories:

Normal weight = 18.5 to 24.9
Overweight = 25 to 29.9
Obesity = 30 or greater

Go to http://www.nhlbisupport.com/bmi/bminojs.htm to calculate your BMI.

An Obese Nation

Thirty-three percent of American men and thirty-five percent of the country’s women were overweight in 2006.⁵ While high BMIs are generally associated with a higher risk of certain diseases and an increase in mortality, a large, lean body mass – such as in the case of body builders or professional athletes – will negate BMI values.⁶

Obesity Causes and Risk Factors

Consuming more calories than the body can use causes weight gain and obesity. Often, there is a connection to a diet high in fat and calories, and this problem is worsened by inactivity. Imbalances between calories consumed and calories burned may also be linked to obesity-related factors such as behavior, culture, environment, genetics, and hormones.

Known causes and risk factors of obesity:

• Age tends to correlate with less activity and a reduction in caloric requirements
• Certain viral infections may be linked to obesity
• Cessation of smoking
• Diet, including portion size, consumption of high fructose corn syrup, and intake of fat, soft drinks, and high-calorie foods such as candy, desserts, and fast food
• Endocrine factors such as the mechanisms of metabolism, appetite, and satiety
• Family history: obesity in parents increases the risk in children
• Gender: women are more likely to be obese than men; they burn fewer calories and have less muscle mass
• Genetics affects how efficiently the body converts calories to energy, the amount of fat stored, and where it is distributed
• Inactivity
• Medical problems: in rare cases obesity can be traced to a medical cause such as low thyroid function or excess production of hormones by the adrenal glands
• Medications such as corticosteroids and tricyclic antidepressants, and some high blood pressure and anti-psychotic medications
• Metabolic syndrome
• Intrauterine factors such as maternal diabetes, maternal smoking, and intrauterine nutrition
• Pregnancy: some women find it difficult to shed the weight gained during pregnancy; breast-feeding may also contribute to weight gain

Complications from Obesity

There are many potentially serious health problems associated with obesity:

• Abdominal hernias
• Abnormal blood fats (high cholesterol, for example)
• Cancer (breast, colon, kidney, and endometrial)
• Coronary artery disease
• Diabetes (type 2)
• Fatty liver disease
• Fertility and pregnancy problems
• Gallbladder disease
• Gout
• Gynecological problems (abnormal menses, infertility)
• Heart disease
• Hypertension (high blood pressure)
• Liver malfunctioning
• Osteoarthritis
• Respiratory problems
• Sleep apnea
• Stroke
• Varicose veins

Obesity Prevention and Treatment

Lifestyle Changes

Management and treatment of obesity decreases the risk of various health problems associated with the condition, and can also improve the overall quality of your life. While the loss of a small amount of weight – five to ten percent7 – can effect health improvements and/or prevent obesity-related complications, losing weight and keeping it off can be a challenge. Success with weight management requires both lifestyle and behavioral changes.

A weight management program is often a combination of a healthy diet, physical activity, and an alteration of daily routines. More comprehensive programs may include counseling, prescription medications, and even weight-loss surgery.

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Notes:
1. The National Heart Lung and Blood Institute, ³Working Group Report on Competencies for Overweight and Obesity Identification, Prevention, and Treatment,² http://www.nhlbi.nih.gov/meetings/workshops/overweight/report.htm (accessed December 4, 2008).
2. Ibid.
3. Centers for Disease Control and Prevention, ³Overweight and Obesity,² http://www.cdc.gov/nccdphp/dnpa/obesity/ (accessed December 4, 2008).
4. Medscape, ³Are health care professionals advising obese patients to lose weight?,² http://www.medscapecrm.org/medline/abstract/10546698?prt=true (accessed November 22, 2008).
5. Centers for Disease Control and Prevention, ³Overweight and Obesity,² http://www.cdc.gov/nccdphp/dnpa/obesity/ (accessed December 4, 2008).
6. Dr. Ronald Hoffman, ³Obesity and disease risk,² http://www.drhoffman.com/page.cfm/193 (accessed December 4, 2008).
7. MayoClinic.com, ³Obesity: Treatment and drugs,² http://www.mayoclinic.com/health/obesity/DS00314 (accessed December 4, 2008).