Obesity in America:: An Epidemic Gaining Momentum by Anne Bourland

If you live in America, it is highly likely you are a part of an overweight and obesity epidemic. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 68.8 percent of adults are at least overweight and 35.7 percent are obese (“Overweight and Obesity Statistics”). In general, obesity increases your likelihood of contracting a large variety of conditions and diseases. These conditions include coronary heart disease, high blood pressure, strokes, cancer, sleep apnea, and reproductive problems (“What Are the Health Risks with Overweight and Obesity?”). Although it is not increasing as fast as it has in previous years, the number of obese people and the rate of obesity are higher than they have ever been in past generations. This could possibly lead to an epidemic of gigantic proportions if large numbers of people begin to suffer and die early because of their weight. This epidemic is on such a large scale, you probably know at least several people who are overweight or obese.

History

The origin of the word obesity comes from the Latin word obesitas, which means fat or plump (The History of Obesity Timeline 1). Sometimes it is difficult to imagine that people tens of thousands of years ago could be fat or even obese, but there have always been fat people. Around 33,000 B.C., “the first sculptural representations of the human body” depicted obese females (1). Surprisingly, in 450 B.C., the Greeks were the first to recognize that obesity was a medical disorder and a disease, while it took the World Health Organization (WHO) until 1995 to add morbid obesity as to the International Classification of Diseases (ICD) (James). What happened in 1995 that caused the WHO to add obesity to the ICD? Well, in the United States, fast-food consumption had tripled and “food energy intake from these meals had quadrupled since 1977” (The History of Obesity Timeline). The following years would see a rapid increase in the rate of obesity and the rate of being overweight. In 2012, the United States had the highest obesity rate, with 74.1% being overweight and 30% of those people being obese (The History of Obesity Timeline 1). It is projected that by 2030, 41% of Americans will be obese and that 86% of Americans will be overweight, which will truly be an epidemic (1).

            But what is the cause of the sudden and drastic climb in American and even international obesity rates?

Cause

            The simple explanation is that if a person eats more calories than they burn, then they will begin to gain weight. This creates a destructive cycle where the heavier you become, the less you are capable of moving, and the more food you need to consume to maintain the demands of a bigger body. However, this issue is obviously more complex than just a person’s energy input and output. For example, genetic causes – one or both parents are obese and their children are at a greater risk of being overweight – contribute to this issue (Brandt). In addition to genetics, the rise in obesity rates over the past 30 years has also “been paralleled by increases in the portion size of many foods” and going out to eat as opposed to eating at home, with the concern being over the consumption of foods that have a high energy density (Ledikwe 1). Other contributing factors are the increase in the prevalence of technology and electronic devices used in everyday life, an increase in desk jobs, and simply lifestyle.

Examples

            This first case study focuses on the adult side of the obesity spectrum, specifically a 52-year-old woman with obesity and 9 years of type 2 diabetes (Cypress 1). She claims that “she has gained an enormous amount of weight” every since being put on insulin 6 years ago to treat here diabetes (1). Because of fear of hypoglycemia, she does not follow any specific diet and often eats extra snacks (1). Hypoglycemia is where blood sugar (glucose) is abnormally low and is commonly linked with diabetes (Nordqvist 1). Her health care advisors have often suggested ‘weight loss and exercise” to improve her health, but she complains of pain in her knees and ankles that prevent her from doing “any exercise” (Cypress 1). After being convinced that reducing her insulin doses would help with weight loss, she returned to the clinic 3 months later, feeling less depressed and having lost 7 pounds, despite still overeating at night due to hypoglycemia fears. She was again convinced to further reduce her insulin doses. Two months later, she returned to the clinic having lost a further 12 pounds, making her 246 pounds at 5’ 1 ½” (1). She stated that she felt “much more energetic, no longer felt depressed,” and she was able to start a walking program.

            This individual case is actually quite common. Many patients who are overweight and have diabetes do not communicate their fear of hypoglycemia and their overeating to their health care providers (1). When they present with “poorly controlled diabetes” to their doctors, they are often prescribed an increased insulin dose along with advice to lose weight and exercise (1). The increase in insulin can cause weight gain and if the patient tries to reduce their caloric intake, the “mismatch of insulin to food will result in low blood glucose levels and symptoms of hypoglycemia” (1). Insulin doses must be lowered with caloric restriction to see effective results (1).

            The next individual case is on the other side of the obesity spectrum – a girl named Kayla Matos-Galo is 4 years old but is the weight of an average 12 year old (Yellin 1). As opposed to the previous case, Kayla’s weight “does not stem from any medical problems” according to her doctors (1). The reason they cite for her excessive weight is eating too much and not getting any physical activity for several years. Experts that are carefully monitoring Kayla’s progress are changing how her family rewards her (1). They suggest “ ‘instead of rewarding the child with food, reward them with a fun activity day, like a trip to the park’ ” (1). Kayla is “friendly” and “full of energy,” but as soon as dinner was mentioned, she becomes more demanding (1). Her mother caves in to the tantrums and demands for more food, saying, “ ‘it’s easier to give in to a tantrum than it is to really stay firm’ ” (1). Despite starting a hospital nutrition program two years ago, Kayla is still gaining weight, but her doctors are encouraged by the fact that the weight gain has slowed (1).

            Both of these cases show the variety in the world of obesity. Obesity can be caused by genetics; it also can be caused by environmental factors. Obesity can occur in adults; it also can occur in children. However, in both of these cases and in all cases, obesity can be treated, although that is easier said than done.

Solutions

 

Since there is no single cause to obesity, unlike some illnesses or diseases, there can’t be just one fix all solution. One organization that poses the power to have a large impact on the outcomes of the many solutions to fight obesity is the government,

As mentioned earlier, proportion sizes and increased consumption of foods that have a higher energy density are big contributors to the increase in obesity. A solution to promote the consumption of healthier food at reasonable proportions is government subsidization of healthier foods. The US Public Interest Research Group found that “the government subsidization of treat-food additives pay for 21 Twinkies per taxpayer per year,” but they only paid for half an apple for the same taxpayers (Fell 1). By making healthier food more affordable and treat food more expensive, this could have a drastic effect on improving eating habits (1). In addition, childhood obesity can be specifically targeted by implementing regulations on advertisement for unhealthy food that is campaigned to young kids (1).

Another solution to progress the fight against obesity is to better educate the public on the many issues, solutions, and myths that surround the subject of weight loss and weight gain. An example of this is to “stop promoting physical activity as the solution for weight loss” (1). Exercise can play an important role in losing weight but the “amount of exercise it takes to compensate” for a bad diet is impossible for the majority of people to accomplish (1). In addition, there should be greater access to bariatric surgery, which has “the highest success rate of any kind of weight loss intervention” (1). Bariatric surgery is any surgical procedure that restricts the amount of food the stomach can hold, causes malabsorption of nutrients, or a combination of both (Bariatric Surgery Procedures). Most of these surgeries are performed laparoscopically, which means they use “minimally invasive techniques” to perform the surgery (1). The most common procedures are “gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch (1).

 

Absurdity

The existence of obesity isn’t absurd, it’s the scale and the fact that it is gaining momentum that is absurd. The fact that a society exists where the population is able to overindulge in food while other countries can’t even imagine that as a reality is absurd.

What Camus means by the word absurdity is a person’s innate desire to find a meaning to life. In this quest, humans try to rationalize their existence by trying to find meaning but soon discover that there is no purpose to their existence. In obesity, there is no rationale that is logical to explain why people gain weight to a lethal amount and put their health at risk when they live in a developed country that is plagued by few difficulties in comparison to developing countries around the world and even some developed countries, like North Korea. Trying to find meaning in this epidemic will result in nothing.

Conclusion

            There is a certain irony to the fact that the countries that have avoided being plagued by starvation and famine have found another way for food to reap preventable deaths on a massive scale; this is through the increasing rates of obesity for all ages, sexes, and races. It is estimated that by 2030, 41% of the American population will be obese and 86% will be overweight. This is why my topic is important. In thirteen years, close to half of the people in my graduating class could be obese and the majority of them will be overweight. Clearly, our nation is moving toward a society where soon, skinny, healthy people will be a minority due to a preventable, treatable disease.

            But there are solutions to this epidemic. The government can increase the affordability of healthy foods to low socioeconomic demographics that rely on subsidized foods to feed themselves and/or their family. To help reduce childhood obesity, advertisement of unhealthy foods to children can be regulated also. The weight loss industry also has a need to be regulated since it is saturated with fraud cures to their weight. And finally, access to bariatric surgery must increase to the demographics that need it. This solution is important because bariatric surgery is the leading method in sustainable weight loss.

           

Works Cited

“Bariatric Surgery Procedures.” American Society for Metabolic and Bariatric Surgery, asmbs.org/patients/bariatric-surgery-procedures. Accessed 3 May 2017.

Brandt, Michelle L. “Obese Parents Increase Kids' Risk of Being Overweight.” Stanford University, 21 July 2004, news.stanford.edu/news/2004/july21/med-obesity-721.html. Accessed 24 Apr. 2017.

Cypress, Marjorie. “Case Study: A 52-Year-Old Woman With Obesity, Poorly Controlled Type 2 Diabetes, and Symptoms of Depression.” Clinical Diabetes, journal.diabetes.org/clinicaldiabetes/V17n31999/Pg142.htm. Accessed 24 Apr. 2017.

FACEP, Jerry R. Balentine DO. “Obesity Symptoms, Treatment, Causes - What Causes Obesity?” MedicineNet, www.medicinenet.com/obesity_weight_loss/page3.htm. Accessed 9 Mar. 2017.

Fell, James. “What Is the Solution to Obesity?” Body for Wife, 16 Oct. 2015, www.bodyforwife.com/what-is-the-solution-to-obesity/. Accessed 2 May 2017.

James, W P T. “WHO Recognition of the Global Obesity Epidemic.” Nature News, Nature Publishing Group, 1 Dec. 2008, www.nature.com/ijo/journal/v32/n7s/full/ijo2008247a.html. Accessed 9 Mar. 2017.

Ledikwe, J H, et al. “Portion Sizes and the Obesity Epidemic.” The Journal of Nutrition., U.S. National Library of Medicine, Apr. 2005, www.ncbi.nlm.nih.gov/pubmed/15795457. Accessed 24 Apr. 2017.

Nordqvist, Christian. “Hypoglycemia: Causes, Diagnosis, and Treatment.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/166815.php. Accessed 24 Apr. 2017.

 “Overweight and Obesity Statistics.” National Institutes of Health, U.S. Department of Health and Human Services, www.niddk.nih.gov/health-information/health-statistics/Pages/overweight-obesity-statistics.aspx.

“The History Of Obesity Timeline.” HistoWiki, 15 June 2015, histowiki.com/history/health/2375/the-history-of-obesity-timeline/. Accessed 9 Mar. 2017.

“What Are the Health Risks with Overweight and Obesity?” National Institutes of Health, U.S. Department of Health and Human Services, www.nhlbi.nih.gov/health/health-topics/topics/obe/risks.

Yellin, Jessica, and Leigh Simons. “Obesity Reaches Preschool.” ABC News, ABC News Network, 9 Feb. 2007, abcnews.go.com/Nightline/Diet/story?id=2863420&page=1. Accessed 24 Apr. 2017.