Obesity: The Epidemic
Obesity is one of many major problems that millions of Americans face on a day-to-day basis and is now recognized as a public health crisis. It also is said to be the number two cause of preventable death in the U.S. The United States is generally classified as one of the countries with the highest obesity rates in the world. “The prevalence of obesity in the United States is indeed high, exceeding 30% for both sexes and in almost all age groups and ethnic groups. Even so, the proportion of obese individuals still seems to be gradually increasing” (Fernandes 283). Obesity does not only affect adults, but it also affects children as well and has become a widespread and serious epidemic in our country. “Obesity is a worldwide public-health problem, with increasing incidence and prevalence, high costs, and poor outcomes. As a disease, with defined pathologic and pathophysiolgic complications, it is just about a century old. In fact, the term “obesity” does not appear in the English language until the seventeenth century, and then only as a descriptive literary term for excessive fatness or corpulence” (Eknoyan 421).
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According to Paul O’Brien, an MD who specializes in Gastroenterology and Hepatology, “Obesity is likely to be the disease of the 21st century…the World Health Organization estimating more than 1.6 billion people are currently overweight and 400 million obese” (1358). The U.S ranks number one in obesity with 30.6%, with Mexico following behind it with 24.2%. Japan is the least obese country, with 3.2% of its population being obese (OECD Health Data). Throughout history malnutrition and chronic food shortages have been a major issue with millions of people dying from famine. Only after the technology advancements of the eighteenth century did a gradual increase in food supply become available. The advancement has lead to not only food with better quality, variety, and nutrition, but also has lead to increased carbs, cholesterol, and fats as well. There is now an overabundance of easily accessible foods both healthy and not so healthy, coupled with reduced physical activity. From an evolutionary standpoint it is believed that bodily fat seems to serve nature’s purpose. During times of great pestilence and famine, natural selection seemed to reward the genotypes of those who could store the greatest amount of fat from the last amount of available food supply. “This ability to store surplus fat from the least possible amount of food intake may have made the difference between life and death, not only for the individual but also—more importantly—for the species. Those who could store fat easily had an evolutionary advantage in the harsh environment of early hunters and gatherers” (Eknoyan 422).
Statistics & Evolutionary History
The Epidemic
The Culture
In many cultures throughout history, being overweight or obese was seen as desirable especially with the scarcity of food and has been reflected in the arts, literature, and politics of their times. Many Americans diets consists of foods high in calories and fats compared to other countries which is the main contributing factor in obesity and why the rates are so high. Also high poverty rates here in America, which leads to people buying processed, fast, and cheaper foods in order to survive, which is not the healthiest option. “The likelihood of being overweight in the poorest 25% of the population is twice that of people in the highest quarter of economic class” (Campos 1). In the past few decades, childhood obesity has tripled and nearly one in three children in America are overweight or obese. The numbers are even higher in African American and Hispanic communities, where nearly 40% of the children are overweight or obese, and because this problem continues to exist, this provides a stepping-stone for individuals to continue to become obese.
Healthcare
Obesity can cause many health problems as well, including kidney disease, gallstones, type 2 diabetes, high blood pressure, high cholesterol and triglycerides, coronary artery disease (CAD), strokes, and sleep apnea. “The health consequences of obesity began to be noted in the medical literature of the eighteenth century. William Cullen (1710-1790) lists those of fatigue, gout, and breathing difficulties” (Eknoyan 424). The Obesity epidemic has caused major implications for healthcare costs. Both public and private healthcare services in the United States spend billions of dollars a year on obesity-related diseases. In his 1905 textbook, The Principles and Practice of Medicine, William Osler (1849-1929) attributes obesity to “overeating, a vice which is more prevalent than and only a little behind overdrinking in its disastrous effects.” The Quetelet index also known as the body mass index is used for classication of overweight status (BMI >25) and obesity (BMI >30) It is also used in weight control programs around the world. It is named after Alphonse Quetelet who was a Belgian astronomer turned statistician.
Children
Although exercising along with eating healthy are important factors in losing weight, many overweight, obese and morbidly obese individuals have been unsuccessful in doing so. Obesity is also affecting children worldwide especially in the U.S. The number of children and adolescents with excess weight and obesity is growing in numbers. There have been a rise in programs to help combat obesity in children including Let’s Move a program developed by First Lady Michelle Obama to solve the epidemic of childhood obesity within a generation. Many of these programs include changing school lunches to include more fruits and vegetables, whole wheat, and other healthier alternatives. It also promotes and encourages children and their parents to become more active and increase physical activity requirements in schools. These programs are a big step forward in decreasing the occurrence of obesity in children and even some adults but there is still a long way to go.
Eknoyan, Garabed. (2006). A History of Obesity, or How What Was Good Became Ugly and Then Bad. Advances in Chronic Kidney Disease, 13(4), 421-427. Retrieved November 01, 2015, from, http://www.ackdjournal.org/article/S1548-5595(06)00106-6/fulltext
Campos, Paul. (2007, September 21). Culture Matters in The Obesity Debate. Retrieved October 28, 2015, from http://www.latimes.com/la-op-dustup21sep21-story.html
Pêgo-Fernandes, Paulo Manuel, Bibas, Benoit Jacques, & Deboni, Mariana. (2011). Obesity: the greatest epidemic of the 21st century?. Sao Paulo Medical Journal, 129(5), 283-284. Retrieved October 29, 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802011000500001&lng=en&tlng=en.
O'brien, P. (2010). Bariatric surgery: Mechanisms, indications and outcomes. Journal of Gastroenterology and Hepatology, 1358-1365.