OBESITY IN AMERICA
O
besity has been an ongoing issue that plagues many Americans. Two-thirds of American
adults are overweight and about half are now considered to have full-blown obesity.1
Advertised weight loss regimens, diet pills, and fitness programs are made available
almost everywhere you look. This is an alarming signal that obesity in the United States has
spiraled out of control, but nothing is really being done about it. In America the prevalence of
obesity is undoubtedly high. Data from the National Health and Nutrition Examination Survey
III (NHANES III) showed that around 20 percent of all men and 25 percent of all women in the
United Statse are obese.2 More recent data suggests a dramatic increase.3 In 2010, thirty-two
states in the United States had obesity prevalence equal to or greater than 25 percent. Six of
these states are equal to or greater than 30 percent. With the minimal-activity lifestyle most
Americans are adopting and exercise commixed with fast food culture, it's unsurprising that the
United States is leading in the increasing trend of obesity. With the countless reminders and
health advisories from different health departments and institutes, the number of obese
Americans still continues to rise. People can only ask, "Why is this so?"
Copyright © 2012. Rowman & Littlefield Publishers. All rights reserved.
MASS PROMOTION AND TASTY FOODS
The human body has been made to physiologically adapt to both external and internal changes.
It is full of dynamic processes that simultaneously work together to ensure that the body is in
tip-top shape. What you do to your health can either enhance or destroy your anatomy.
The vast majority of Americans have been exposed or will be exposed to the advancement
in technology that most industrialized countries possess, but even worse, the impact of this
achievement takes a toll on the American society in terms of living a healthy lifestyle.
Technological gains have made it easy to remove physical exercise from conventional
American lifestyle. These gains have also promoted the mass production of cheap, great-tasting
food that is high in calories. Along with technology comes the advancement in advertising
wherein the media has managed to influence what the American population sees with
commercials encouraging everyone to eat these sumptuously unhealthy foods. Imagine this
same scenario as it was decades ago: If you have a sugar craving or a cookie addiction, you
have to mix the dough to be able to prepare the ingredients to home-bake the cookies. These
days, you can simply head over to a convenience store to get a pack of cookies for less than a
dollar. If that's still too much effort on your part, you can just hit the dial button on your phone
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to have it delivered right at your doorstep. It's that easy.4
The wide selection of tasty yet very fattening foods such as baked goods, sweets, and highcalorie drinks that people tend to crave—not to mention that commercial "mocha" coffee
drinks are smothered with so many calories (equivalent to that of a full meal), that the average
American consumes three to four servings of these high-calorie, sugar-rich foods on a daily
basis. People now eat 19 percent more carbohydrate additives in our basic diet than they did in
the early 1970s. This is based on recent figures from the US Department of Agriculture.5
Copyright © 2012. Rowman & Littlefield Publishers. All rights reserved.
A HOLE IN YOUR WALLET
The impact of the growing population of obese and overweight individuals in the United States
raises medical costs on a national level. Economic costs related to obesity and overweight
people are becoming increasingly synonymous with the growing rate of obesity. According to
the British Journal of Clinical Pharmacology, direct medical costs in the United States are
estimated to surpass $93 billion.6
Obese Americans are predisposed to numerous health risks such as diabetes, cardiovascular
diseases, cancer, metabolic disorders, and other chronic health conditions. For this reason,
excess medical expenditures for treatment of these associated health risks prove to be
significant. At least 5 percent of medical spending from the US adult population is attributable
to obesity.7 Diseases included in the cost estimates from the first national study conducted on
the economic outcomes of obesity in the United States were NIDDM (non-insulin diabetes
mellitus), cardiovascular disease, hypertension, gallbladder disease, and colon and postmenopausal breast cancer.8
The World Health Organization reports that total obesity-related expenses were estimated to
be around $39 billion, representing 5.5 percent of the overall cost of illness in 1986. In a
revised estimate in 1990, it was estimated that the total medical cost of obesity was $68.8
billion in which $45.8 billion were direct costs of obesity associated health conditions.9 It is
noted that indirect costs of the disease relates to the loss in productivity due to the worker's
absenteeism, staff turnover, and reduced worker productivity resulting from obesity-related
sickness. Potential cost savings associated with the decrease in obesity prevalence shows that
average savings in prescription costs per subject, over the course of a year, was approximately
$440.10
The global economic costs of obesity will be discussed further in chapter 10, but as one can
see, the situation is critical enough in the United States alone.
THE LAND OF MODERATION AND NORMAL BODY WEIGHT
VERSUS OVERWEIGHTNESS
In the last twenty years, there has been an increase in obesity in the United States, as shown in
information available from CDC (Centers for Disease Control and Prevention). It reveals that
only one state, Colorado, had a prevalence rate for obesity of less than 20 percent. Thirty-two
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states have an obesity rate equal to or greater than 25 percent. Five of these states, South
Carolina, Mississippi, Oklahoma, Alabama, and West Virginia, have equal to or greater than
30 percent obesity.11
It seems Colorado is the land of moderation and normal body weight, but in spite of
widespread campaigning from health sectors, media, and the public regarding advantages of
healthier diets and exercise, the overall prevalence of obesity and overweightness in America
has doubled significantly over the past four decades.12 It's an alarming find that Americans,
having been the backbone of the most influential country in the world, have succumbed to fat.
People have adopted the practice of consuming more than enough by "super sizing" meals and
making unhealthy, yet affordable and delicious foods available everywhere, including grocery
stores, malls, gas stations, and shopping centers. They don't even have to go anywhere to get
foods rich in transfat, sugar, and calories. It can be made available by delivery at your
doorstep by a single click on the Internet or by pushing a few buttons on your phone.
Things would have been great if it were second nature for most Americans to go through
some exercise and increase physical activity. In retrospect, everyone knows this is not the
case; all of us are guilty of the so-called sedentary lifestyle to a certain extent. Watching a late
night movie while munching on a bag of chips topped with a can of beer is not an uncommon
scenario in the lives of many Americans. Looking back at the time where people had to hunt for
foods such as high-protein meat or gather high-grain crops, one can realize the full potential of
healthy foods. Back then, foods were a lot richer with natural minerals than they are today, and
people ate heartily and stored the fats as adipose tissue to be converted to energy during their
next hunt.
People now have the convenience of acquiring and consuming abundant amounts of food to
store as adipose tissue but a lower amount of activities on which to spend our energy. Food is
available everywhere, and you are overwhelmed by the ads anywhere you turn, whether it's on
television, print ads, billboards, or on the Web. There are fewer opportunities to increase
physical activities. The country does not have enough parks for walking, sidewalks and bike
paths, or accessible stairways.13
An American usually burns around 2,000 calories per day with normal activities.14 In the
meantime, approximately 2 pounds of fat in human body stores 9,000 calories of energy.15
Therefore, a person has to take in 9,000 calories to put on 2 pounds of weight, he or she has to
burn 9,000 calories to lose that same weight. It's very easy to put on weight—all you have to
do eat. However, it is very difficult to take away 9,000 calories. From simple calculations, a
study found that in 2007 that the average person in the United States consumed around 800 to
1,000 calories per fast food meal.16 If you share a meal with someone at a restaurant in the
United States, fast food or not, you will consume half the normal caloric intake. This will also
go easier on your wallet.
FREEING A CHILD FROM OBESITY IN THE UNITED STATES
An estimated 22 million children under five years old are overweight. Obesity in US preschool
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children two to five years old went from 5 to 10 percent between 1976 and 1980 and 2007 to
2008 and from 6.5 to almost 20 percent among six- to eleven-year-old children. Among
adolescents twelve to nineteen years old, obesity increased from 5 to 18 percent during the
same period.17
Obese and overweight children are most likely to become obese adults.18 One study19 has
noted that 25 percent of obese adults had a BMI greater than or equal to 30 when they were
children. It was also noted in the study that if overweightness begins at or before eight years of
age, the likelihood of adult obesity is severe. Indicators for obesity in children between two
and nineteen years old are slightly different from adult BMI. The children's BMI values are
plotted on the CDC growth chart to determine the BMI for age percentile. Overweightness is
characterized by BMI at or above the 85th percentile and lower than the 95th percentile.
Obesity is attained when the value is above the 95th percentile. Childhood overweightness is
determined based on age- and gender-specific BMI percentiles rather than by adult BMI
categories, since a child's body composition varies more with age and gender.20
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True Pressure
Environmental factors of childhood in the United States are unlike that of any other country, due
to advancing technologies and growing economic and familial independence of kids these
days. Caution is advised in promoting discipline in your child to avoid weight gain. The child
may perceive this gesture as a restrictive thing and can develop eating disorders in the future if
expressed incorrectly. You have to communicate clearly that the importance of maintaining a
healthy body is not for aesthetic purposes only and that health benefits should be a priority.
This will prevent additional pressure to the youngster to meet the weight standards which are
implicated by the general public. Influences of media, particularly in the world of fashion,
contribute to the pressure of keeping up a thin and lean body. Most American teenagers,
especially girls, experience extreme peer pressure to blend into a society where "model thin"
is "in." They don't realize that it isn't really the big picture for health by medical standards.
Overcoming the stress and pressure of peer acceptance in the adolescent years is difficult
for any teenager. Obese adolescents can experience psychological pressure twice that of their
slim counterparts. The pressure to get accepted and "fit in" is almost always present. An
overweight and obese teenager may experience episodes of depression and isolation. In the
United States, discrimination against obese individuals is prevalent especially in educational
institutions and in the neighborhood. This places the child at a very high risk for decreased
self-esteem and negative body image. Rejection from peers is a challenge for every obese
student in school. A study conducted in the 1960s in a public school and summer camp asked
six hundred subjects to view six different pictures of kids varying in appearance, physique, and
disability.21 They were then asked who they would like to have as a friend. The majority of the
participants ranked an obese child last among those with disabilities and disfigurement. Bias
and negative stereotyping against obese children are reported to happen as early as eight years
of age. One study assessed descriptions of perceived stigmatization among adolescent girls.22
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The study showed that 99 percent of them had negative experiences like teasing, jokes, hurtful
comments, and name-calling. Such discrimination continues at the secondary and tertiary level.
That's why correcting and preventing obesity early in the childhood years can benefit a child's
social development as he or she grows into adulthood. Prevention of overweightness and
obesity must be initiated early in life and should include the continuous healthy eating and
physical exercise patterns to avoid obesity in adults.
"GROWING UP" AS A GROWNUP: ADULT OBESITY IN AMERICA
For the US adult population, the prevalence of obesity is often incorrectly determined through
the BMI, represented by the measured weight in kilograms divided by the square of the height
in meters (kg/ m2). While this method does not provide accurate results to defining obesity as
compared to fat distribution in the body, it's widely used for population screening because it
only requires two easily available quantitative data values: height and weight. Other methods
of measuring body fat and body fat distribution are measurements of skinfold thickness, waist
circumference, waist-to-hip circumference ratio, and medical assessment tools such as
computed tomography, ultrasound, and magnetic resonance imaging.
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WHY US?
Reasons for America's growing problem with obesity lies in the lifestyle changes it has
undergone since the early roots of our modernization. Serving portions are now twice as much
as they were twenty years ago. Servings of fast food items like hamburgers, chips, and fries are
available not only in large sizes, but in colossal servings. It seems difficult for an average
person to eat one of these in one sitting, but he or she manages to "gobble up" these foods in a
short period of time while watching television or working at a computer.
An innate desire to eat flavorful, rich-tasting, deep fried, and salt laden food is so enticing
that willpower alone isn't enough. The influence is literally broadcast everywhere in the
United States. Anyone within reach of a television, cell phone, or print magazine ad would be
encouraged to grab a bite and eat. The love for sugar-filled foods fuels an unwinnable battle,
and it seems only a few can resist eating moist cakes, creamy cheesecakes, delicious ice
creams, pastries, and "divine" chocolates. With more people keeping up with the fast-paced
environment almost everyone lives in, people view the act of eating as a form of stress relief.
This wouldn't have been an unruly problem in the United States if everyone knew that
moderation is the key to maintaining the right waistline.
Is the American Diet Enough?
In the United States there are numerous weight-loss programs and exercise regimens released
every day to combat weight gain along with the highest prevalence of obesity among
industrialized countries. The effort to cure rather than to prevent the growing epidemic is
what's hindering us from obtaining a healthy optimum way of life. The saying "Prevention is
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better than cure" sometimes applies only to the problem at hand. It's one of those things that are
better said than done. If people consistently watch what they eat and thoughtfully stay away
from high-fat, high-caloric foods, everyone will be able to maintain a clean healthy body with
organ systems functioning optimally.
Diet alone cannot guarantee protection from weight gain. Researchers believe that to
maintain a given weight, energy from calories consumed should break even with calories
burned.23 Physical inactivity is a relative factor that contributes to weight gain especially if
caloric intake is greater than what you burn. Physical inactivity, sometimes called sedentary
lifestyle, is when body movement is minimal or absent and energy expenditure approximates
the resting metabolic rate. Physical inactivity also involves passive activity like reading,
working in front of a computer, talking with friends or on the phone, driving a car, or
meditating. If your day-to-day activities involve mostly passive activities such as those
mentioned and your caloric intake increases more than your energy expenditure in a prolonged
period of time, the higher the risk you'll have for being overweight. Modest weight reductions,
according to medical research, can decrease your blood pressure.24 It can also lower your total
cholesterol. For a disease like obesity, even these small changes can be important to the
nation's health. The surging social media influence—whether in print or on television,
encourages people to patronize nonnutritious foods depleted of vitamins and essential nutrients
their body needs to supply the energy they expend with daily activities and work. Many
overweight people are inclined to eat high-fat, high-calorie, and sugared foods simply because
they taste delicious and they come in at cheap prices. Junk foods are found in virtually every
grocery and retail store in the United States. If you eat junk foods while doing passive
activities like watching TV, playing computer games, or surfing the Internet, the stored fat will
begin to really show signs as you reach fifty years of age. Currently, one can feel the
consequences from unhealthy eating and lack of exercise as early as forty years of age. This is
a bit frightening since, technically speaking, you are still supposed to be at the prime of your
life at this age.
US Obesity and Genes
Several factors contribute to weight gain, like genetic predisposition, race, gender, and cultural
background in the United States. There are fifty genes involved in fat accumulation. A few of
these genes influence how your body gathers fat and metabolizes energy. Other genes regulate
how much you want to eat and how much it would take for you to feel full. They also regulate
how likely you will utilize the stored calories by performing physical activities.25 The FTO
(fat-mass and obesity-associated) gene is known to be linked to the risk of increased BMI.
This gene is known to be involved in the regulation of energy balance and the body's
metabolism.26
People carrying two copies of an FTO variant have a 30 percent increased risk of getting
obese compared to those without any copies. This explains how sometimes, when two people
who eat the same exact foods and have similar physical activity levels, one has to try a lot
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harder than the other to lose weight.27
People Are What They Stem From
Cultural background plays a contributing role in understanding how the problem of obesity
began in the United States. The food system today has dramatically changed as technology
boosted US agriculture and food production. Most food categories are available during any
season, making the supply of any particular food seem as if it never ends. Though this has
improved food availability, the nutritional value is the real topic in question. Since the United
States is one of the leading industrialized nations in the world, advancement in food processing
technology has made food cheap and easily accessible to most people. Unfortunately, these
cheap foods are usually mass produced, and nutritional value is little or lost.
In many communities in America, socioeconomic levels give rise to an increase in the
prevalence of obesity, possibly because fresh and healthy food is expensive and hard to come
by in low socioeconomic communities, while unemployment allows, but may not necessarily
lead to, physical inactivity. A report suggests that a single dollar can buy 1,200 calories of
cookies or potato chips, but only 250 calories of carrots.28
Copyright © 2012. Rowman & Littlefield Publishers. All rights reserved.
NEIGHBORING ON AMERICAN OBESITY
The above explains why most people belonging to the lower socio-economic bracket are more
prone to obesity. It's much cheaper to buy processed foods than fresh foods like fruits and
vegetables. These processed foods are compact and contain less water but have more fat,
sugar, and salt (preservatives), which makes them delicious, filling, and all the more fattening.
A disease such as obesity doesn't have to stem from eating too much, but rather, from
swelling consumption of the wrong foods coupled with poverty. In underprivileged
neighborhoods in the United States, a person's neighborhood and community can affect an
individual's lifestyle. In poor neighborhoods where houses are cramped and a place to do
physical activities such as walking, biking, and jogging is scarce, individuals will normally
disregard exercise as part of their daily routine.
Employment loss and the shift of women taking on jobs to sustain families in the lower
economic bracket of the US population have changed family dining habits. The mother will
normally prepare a meal for the family but due to the lack of "home time" caused by work, the
family resorts to eating instant, fast food items, or processed prepared meals that are high in
sodium and fat, rather than a well-cooked, balanced meal.
Cultural background and practices, ethnicity, and other lineages are factors that influence the
American's dietary patterns and contribute to the increase in the number of individuals
suffering from obesity. Religious beliefs can also determine which dietary intake one will need
to adapt. As in the case of Islam, religious followers are banned from consuming pork. Thus,
their diet has been modified.
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UNDIVIDED, YET DIVERSE
Obesity is affected by globalization, the process which integrates regional economies and
culture with an international network of communication and trade. However, the trade industry
is affected by the distribution of nonnutritious foods by food processing companies and
retailers across relatively underdeveloped countries. Acculturation happens when traditional
beliefs are changed due to the merging of different groups in a society. This is typical in the
United States as many migrants from all over the world are arriving. Differences in dietary
practices are still widespread, as evidenced by the personal preference ratings of many
international minority groups in the United States. Branding has a great impact on the country's
obesity, especially in the vast distribution of affordable American processed foods. This
includes anything ranging from chips, chocolates, sweeteners, sodas, and other energy-dense
items. Since it is cheaper and convenient, mass-produced foods that are highly caloric and
sugar rich sell rapidly. From a nontraditional standpoint, mass-produced foods affect obesity
by encouraging the abandonment of cultural characteristics which minimize the risk of obesity.
It also promotes the adoption of new beliefs and behaviors that make you more prone to
obesity as well as many other health problems.
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Other Epidemics in the United States
The increasing risks associated with varying lifestyles among cultures are what everyone
really should be concerned about in America. The life threatening, chronic health risks
associated with obesity constitutes four areas: (1) cardiovascular problems, including
hypertension, stroke, and chronic heart disease; (2) conditions associated with insulin
resistance, for example, non-insulin dependent diabetes mellitus (NIDDM); (3) certain types of
cancer; and (4) gallbladder disease.29
Obesity is predisposing Americans to a number of cardiovascular risk factors, including
hypertension, raised cholesterol, and impaired glucose tolerance. This is particularly true for
most Americans diagnosed with cardiovascular diseases and BMI greater than 30. Based on
the Framingham Heart Study, one can conclude that the degree of overweightness is related to
the rate of development of cardiovascular disease (CVD).30 This is very alarming, since a
recent report writes that heart disease is the predominate cause of death in the United States
and globally.31
The risk is higher in younger Americans and those with abdominal obesity. Spiking blood
pressure is a common incidence in obese people and is regularly associated with decreased
activity and increased intake of fatty foods that are chiefly responsible for weight gain. The
direct link between obesity and elevated blood pressure can be attributed to high circulating
levels of insulin. This is due to renal retention of sodium, which results in hypertension.32
Increasing intra-abdominal fat correlates with triglycerides and cholesterol levels in the blood
and subsequently lowers the high-density lipoprotein in the body. This could thicken your
blood and predispose you to blood clots. Your arteries can clog, causing impeded blood
supply to vital organs, such as the heart and brain, which regulate all bodily functions. Once
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blood supply is incidentally redirected from these vital organs, irreversible damage may take
place and symptoms of neurological imbalance will result. Droopy eyelids, paralysis, slurred
speech, decrease tactile sensitivity, and a loss of consciousness can occur.
Getting fat is not only aesthetically unpleasant for many onlookers, but it's also a danger to
an American's physical capabilities and normal functioning. Restrictions in our ability to
perform well in work and outside of work may be brought by the increased weight. Problems
such as gout and osteoarthritis may bring discomfort and prevent us to do the things people
need to accomplish. Stress is said to affect obese Americans more than those who are
physically fit, and the stress coming from the stigma and prejudice of being fat doesn't make
things any better. Emotionally, stress affects our self-esteem since social stigmatization on
obesity still occurs in the workplace, subways, shopping centers, and parking lots.
Seceral US studies have found a correlation between obesity and cancer, particularly
endocrine and gastrointestinal cancers. This increased incidence in the obese population is
greater in those with truncal obesity and is said to be caused by certain hormonal changes.33
The risk of acquiring diabetes concurrently with obesity is high in the United States.
Diabetes can be life-threatening as it affects various organ systems in the body. There was a
study where women between thirty and fifty-five years of age were observed for fourteen years
for the risk of developing NIDDM.34 Obese participants in this study were over four times
more likely to get NIDDM than those who were slim. Type 2 diabetes, which is another name
for NIDDM, is a progressive disease if not controlled by insulin, diet, and exercise. It will
lead to multiple organ failure if it isn't managed effectively. Insulin resistance is often
associated with obesity especially in intra-abdominal fat accumulation. Obese individuals are
likely to develop insulin resistance as accumulated body fat disrupts the body's normal
response to insulin. A lot of people suffering from diabetes have not shown symptoms of the
disease and are unaware of the existing condition. As diabetes progresses, it will affect the
blood vessels, heart, kidneys, and nervous system. Treatment with proper diet and drug
regimen, either by oral glucose treatment or insulin, is needed.
Obese individuals in America are also predisposed to metabolic disturbances such as
dyslipidemia, when triglycerides are increased, HDL or "good cholesterol" is reduced, and
LDL or the "bad cholesterol" levels are elevated. This is mostly seen in obese individuals with
intra-abdominal fat accumulation.35
Gallbladder disease is correlated with obesity in the development of gallstones in all age
groups and gender. Gallstones occur three to four times more often in the obese as compared to
lean individuals. There is greater risk for obese individuals with intra-abdominal fat
accumulation. The supersaturation of bile can be induced by cholesterol, so reducing the
motility of the gallbladder is considered to be the underlying factors in gallstone formation.
Complications in obese individuals, including acute and chronic cholecystitis (gallbladder
inflammation), acute pancreatitis, and biliary colic, are likely to develop.36
Other medical conditions that impede optimum quality of life in the United States are the
debilitating health problems associated with obesity: osteoarthritis, gout, difficulty breathing,
and sleep apnea. Osteoarthritis can be uncomfortable and usually affects the joints in the lower
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extremities due to the excessive strain and the mechanical stress the joints take from the excess
fat accumulation concentrated on your abdomen. Increased risk of gout in obese individuals is
brought on by hyperuricemia (too much uric acid) particularly in women and may also involve
central fat distribution.37 Pulmonary stress is also evident in obese people who have symptoms
of breathing difficulties and episodes of sleep apnea characterized by narrowing of air
pathways related to accumulation of fat in the pulmonary area. A study involving 200 woman
and 50 men noted sleep apnea in 3 percent and 40 percent in the participants, respectively. In
the same study, 77 percent of those with a BMI higher than 40 experienced episodes of sleep
apnea. Research suggests that sleep apnea is possibly attributed to central obesity as well as
neck size.38 Although this research was done in China, similar results may exist for obese
people in the United States.
Facing the Other Epidemics
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Getting yourself to start eating healthy and planning nutritious foods to serve on the table is
never an easy task. Since many people really don't have the time to seek out meals with high
nutritional value, they are tempted to order and eat out at any one of America's growing fast
food chains or to buy processed frozen foods. Facing away from the potential risks that people
impose on their bodies, the population has formed this habit of eating "instant" food that's very
appealing to taste buds. All of this of course applies to foods containing high sugar, high fats,
and high sodium, enough to fill our senses with a natural euphoric sensation. Health risks don't
show until one day you realize how large you have become and are feeling a bit tired and
fatigued at the end of a normal workday. Activities become limited and before you know it,
you're visiting your medical doctor more often for symptoms of stress, cardiovascular
diseases, and fatigue. This holds true for most Americans, as reflected by year-long medical
expenditures.
OBESITY PREVENTION IN THE UNITED STATES
The American health care industry focuses more on curative strategy than prevention when
dealing with health problems. Addressing obesity which is evoked by overeating and other
sociocultural differences among Americans is a goal that is far from completion. There are
numerous factors responsible for the prevalence of obesity in the United States. Some of these
factors include, but are not limited to, physiological and regulatory mechanisms of the body
and genetic and biological factors, such as race, gender, and hormonal activity. Modifiable
factors that an obese individual can control are diet and physical activity.
Interventions should be carefully planned out and should aim at prevention rather than cure
to avoid the incidence of obesity. Principles of prevention and effective management of weight
should be simplified for easier understanding and compliance will be ensured. Primary
prevention is essentially up to you, the patient, because you are the major driving force in
preventing the modifiable risk factors for obesity. Primary prevention strategies should focus
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on (a) normal-weight individuals on the verge of becoming overweight, (b) people who are
already overweight, and (c) previously obese individuals who have successfully shed pounds
through an effective weight loss program. In the latter, the goal is to maintain normal weight
levels for as long as possible.
Primary Prevention in the United States
Concentrate more on prevention than curing obesity, because obesity doesn't happen overnight
and the longer the time for fat buildup, the less likely it is for a "miracle" treatment to
succeed.39 Obesity over a long period gives you complications that may not be easily reversed
by weight loss. For instance, the problems with diabetes and coronary heart diseases cannot be
reversed automatically if you begin to lose weight or if weight loss is greatly achieved.40
Though prevention may not effectively work for countries that already have too much
prevalence of obesity and overweight population, it will still be useful for the population that
has just started to adapt a change in lifestyle, like rural areas, for example, and prevention
strategies will be helpful for obese and overweight children in preventing continuing obesity
as they approach maturity.
Secondary Prevention
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Secondary prevention strategies are more about screening for obesity so your doctor can
identify your situation before things get really bad. In the United States, obesity prevention
objectives can be specified in a health care setting because primary prevention is normally
aimed at decreasing the number of new cases. Primary prevention essentially keeps normalweight individuals in check against obesity. This approach seeks to lower the known cases of
obesity by targeting any possible sources.
Tertiary Prevention
This form of obesity prevention attempts to stabilize or reduce the amount of disability and
complications resulting from the disease.41 Preventing obesity and managing the known cases
of the disease begins by having a broad knowledge of the disease itself. Like any national
disaster, Americans cannot address a problem without fully acknowledging that such a problem
exists. Information dissemination is essential to promote awareness of the problem that faces
the United States today. It commences with widespread information awareness campaigns that
will propose targeted goals and outcomes of prevention and management.
Training health care individuals to help obese individuals get treated is significant for more
reasons other than to simply increase the level of knowledge and skills in obesity management.
It is crucial for getting rid of negative attitudes against the obese and the disease itself. With
this in perspective, social stigmatization must be stopped so people can take one step further
toward fully understanding the disease.42
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NOT JUST A PIECE OF CAKE
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Any obesity prevention program should promote a healthy diet that has very low fat, has an
adequate amount of calories, and is rich in vitamins and minerals. The importance of a
complete and balanced diet should be stressed to avoid unnecessary fat accumulation that can
lead to irreversible damage to the body. Shared responsibilities between the US government,
educational sectors, media, and local groups concerning the crisis on obesity should be
utilized:
The US government can facilitate provisions in food production and mandate nutrition and
fortification of foods with essential vitamins and minerals. The government can also
propose programs that will enable workplaces to be conducive to exercise.
Places for physical activity should be provided in the community not only for the high
socioeconomic bracket, but to economically disadvantaged communities as well.
Regular walks in the park are highly enjoyable and offer sunlight and fresh air, which gym
workouts cannot offer; they are also free.
This is where the government's efforts to provide a place where people can do these
nonstrenuous everyday activities pose a challenge. Making streets safe for walking so
people don't use cars so much helps to promote physical activity while conserving
environmental resources such as fuel.
Encouraging exercise as a fun and enjoyable activity rather than as a vigorous and
strenuous one will increase compliance to the goal of promoting and maintaining regular
energy expenditure and will avoid sedentary lifestyle.
Countrywide programs such as marathons, walkathons, and other mass activities not only
engage the community in social awareness, but will also instill values of responsibility in
taking charge of one's health.
The media can do more through regulation of food advertisements and releasing educated
advocacies focusing on keeping a healthy lifestyle.
Educational institutions in the United States can help out with information dissemination
and implement balance between proper diet and physical activity in schools to prevent
childhood obesity.
The provision of convenient exercise facilities like parks and bike lanes are very helpful
when it comes to health promotion. Increasing physical activity to advocate the positive
use of physical energy. The emphasis should be placed on long-term, low-impact physical
activity rather than vigorous exercise.
The ultimate goal in obesity treatment and management is weight loss. This is a concept that
much of the American population must accept in order to defeat obesity within US borders.
Various weight loss programs are being advertised in print and media. Most of them use
different approaches to dieting such as low-protein and low-fat diets. Exercises like yoga,
cardio workouts, and pilates also help. Chapter 11 describes in much more detail how exercise
techniques are centralized into a single objective: ditching the extra pounds. Once an obese
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individual loses a significant amount of weight, these weight loss programs often stop there.
There are only a few programs that teach you how to keep your weight suppressed after losing
a huge chunk of it.
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Follow-Ups, Exams, and Shared Responsibility
Obesity prevention and management in the United States focuses on how to keep a previously
obese individual from regaining the weight that he or she lost. Prevention generally requires
dieting techniques and physical activity. The majority of the work will come from the
individual's self-discipline and willpower. A body weight kept constant over ten years
represents a successful outcome. It's an important achievement for anyone belonging to an
obese family that is particularly susceptible to worst-case scenarios. People should realize that
moderate and sustained weight loss of 5 to 15 percent of initial weight is medically more ideal
than abrupt and rapid weight loss stemming from "crash diets." Such a percentage of weight
loss is very beneficial, especially if it lasts.
A comprehensive health assessment is a great starting point in obesity treatment that can
prove useful in many ways. In the United States, a comprehensive health assessment can take
place once (annual exam) or twice a year (biannual exam). These exams serve as benchmarks
for identifying potential health risks associated with your current state of obesity. The exams
determine if you are predisposed to acquiring illnesses such as diabetes, coronary heart
disease (CHD), and other medical conditions as indicated by family history, diet, lifestyle,
laboratory tests, and other personal history information. Factors such as dietary patterns,
physical activity, anthropometric measurements, and genetic predisposition play important
roles in determining your overall health as an American.
Make it a shared responsibility between yourself and your medical provider. Health
professionals in the United States usually advise on dietary changes somewhere along the
course of treatment. They also talk about exercise, appropriate medical interventions, and
social support. Social stigmatization should be eradicated in the health care profession here
since doctors are on the frontline in helping obese people feel good physically and
emotionally. Though you would like to manage obesity alone if possible, you can't embark on
the journey alone. It takes support from the community, guidance of health care providers, and
help from government, media, and the right food to address your obesity issues effectively.
Proper identification of the risks that predispose an individual in the United States to obesity
is very important for lowering the probability of acquiring such a disease. If awareness is
there, intervention and other preventive measures to address the problem will facilitate better
health. It's all about gathering available data and planning future strategies that will tackle the
underlying causes of this national epidemic.
HOLD YOUR HEAD UP HIGH
In the land of seemingly unlimited opportunity, it's never too late for a change. It begins with
awareness, and from there, a lot of hard work and perseverance is needed to succeed in
Ali, Naheed,, and M D Ali. The Obesity Reality : A Comprehensive Approach to a Growing Problem, Rowman & Littlefield Publishers, 2012. ProQuest Ebook Central,
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Copyright © 2012. Rowman & Littlefield Publishers. All rights reserved.
changing how Americans eat. Food choices need to improve and people need to exercise
almost daily. Support from the government, media, and community is essential to prove that our
projects and advocacies for treatment of obesity are successful. The support from the family in
increasing awareness about the disease is mandatory, especially because there is a genetic
predisposition to the existing condition.
Lastly, approaching our obesity problem domestically may seem very complex in a
mechanized country like the United States. With assistance from international clutches such as
the World Health Organization and other obesity support groups, it will be much easier to take
down the beast. To address the problem at the national level and to be able to present it in a
structured manner, one should also take into account the risk factors that are unearthed by both
individual and social assessments of obesity in the United States.
Ali, Naheed,, and M D Ali. The Obesity Reality : A Comprehensive Approach to a Growing Problem, Rowman & Littlefield Publishers, 2012. ProQuest Ebook Central,
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Created from unnc-ebooks on 2017-08-31 01:13:49.