Running Head: OBESITY ‘R’ US 1

Obesity ‘R’ Us

Diego Emestica Montenegro

University of San Diego

Abstract

Obesity is a worldwide epidemic and a public health issue that has reached critical levels

negatively impacting the U.S. Extensive peer-reviewed literature has surfaced and depicts the

link between obesity and the prevalence of disease. Individuals with a Body Mass Index (BMI)

of 30 or more, a sedentary lifestyle, and are socio-economically impacted have a higher

incidence of obesity along with other comorbidities. The U.S. Department of Health & Human

Services (HHS) and the Centers for Disease Control and Prevention (CDC) agree that a

combined 60 percent of children and adults are affected by obesity making these individuals

more susceptible to chronic diseases like diabetes mellitus type 2 and cardiovascular disease.

Local, state, and federal interventions are on the rise in efforts to remedy this epidemic.

Continuous research and efforts are necessary for healthcare to fight against this public health

issue.

Keywords: epidemic, patient care, barriers, mortality, BMI, healthcare

Obesity ‘R’ Us

Our wellness status is no longer defined by healthy and unhealthy but by obese or

extremely obese. According to the U.S. Department of Human Services (2017), an alarming

37.7% of adults and a 23.2% of children ages 2-19, are considered obese or extremely obese. It’s

difficult to pinpoint a rough estimate of deaths caused by obesity for its a root disease leading to

a numerous array of deadly diseases. The Centers for Disease Control and Prevention (CDC)

(2017a) highlights over a dozen serious diseases with hypertension, type 2 diabetes, and

dyslipidemia leading the list. The combination of a popular sedentary lifestyle, a technology-

driven society and the impact of social-economic factors have detrimental effects on the overall

health of our community members.

Low income highly impacted communities lack access to healthy affordable food and

other essential resources. According to Organization for Economic Co-Operation and

Development (OECD) (2017) inequalities in obesity are ever-growing and fueled by lack of

education and other socio-economic factors that influence behavior and the selection of poor

dietary options. OECD (2017) further illustrates that adopting an unhealthy eating habit results in

becoming overweight and obese which also can be determinate to how accomplished an

individual becomes professionally and social settings. Another common trait of urban living is

the easy access to establishments like liquor stores and fast food locations within walking

distance. As emphasized by Burgoine et al. (2016) that the incidence of obesity significantly

increases when individuals are exposed to neighborhood fast food. Burgoine et al. (2016) also

note that individuals with lower education with the same fast food exposure have an increased

risk to have a BMI of 30 or more. Another characteristic found in impacted communities is the
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void unfilled by public health and disease management education. The long-term financial and

health effects of obesity are too significant to ignore.

Obesity is a disturbing reality the nation faces that need to be addressed otherwise it will

continue to debilitate communities throughout the U.S. The following paper will attempt to

highlight the social-economic factors, lifestyle choices and the resources available related to the

development and growth of this epidemic. The paper will also highlight current community and

government efforts taking place to fight the growth of this epidemic. To better understand the

complex disease, we must take a deeper consider its weighty correlation and impact obesity has

on people’s overall health.

Background

An in-depth look at obesity clearly depicts the correlation between unhealthy weight gain

and disease. According to the Obesity Society (2016), obesity is when a person has excess fat

tissue in the body that expel substances that cause inflammation, circulation issues and can lead

people to become resistant to insulin. Due to its lifestyle adoption and the effects it initially takes

on the body, obesity can lead to elevated blood pressure, high cholesterol, and diabetes (CDC,

2014b). According to the CDC (2014a) the obesity-linked chronic disease type II diabetes affects

95% of the 29.1 million patients diagnosed with diabetes in the U.S. According to the Obesity

Society (2016) obesity is related more than 30 chronic health conditions and has been linked to

an estimated 112,000 deaths per year. The Obesity Society (2016) describes the most popular

method, taking the individual's body weight and height, to estimate the amount of body fat tissue

in a person is the Body Mass Index (BMI). The Obesity Society (2016) emphasizes that although

a BMI of 30 or more is the cutoff for obesity there are other factors like age, gender, race and
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family history that need to be considered to obtain a clearer picture of the individual's health

status. The California Department of Public Health (2017) provide a positive light to the fact that

obesity can be counteracted by educating individuals on healthy eating and management habits

and by advocating for the financial cost-effectiveness that the reduction of obesity decrease

would bring.

Economic and Social Impact

Social and economic impacts affect the nation and its community members alike.

According to the CDC (2017a), it cost over $1400 dollars more to treat an obese individual

compared to someone with normal weight, placing the U.S. medical cost back in 2008 close to

$150 billion. Just one of the linked chronic diseases, type II diabetes cost the healthcare system

$69 billion in lost production and $176 billion in medical costs (American Diabetes Society,

2015). The CDC (2017a) continues by providing a cost range of obese related absenteeism

falling between $3.38 billion and $6.38 billion of annual lost productivity. The American

Diabetes Society (2015) reported obesity-related diabetes varied in prevalence depending on

social economic status and race. The financial burden of obesity is one aspect of the complex

disease and its prevalence.

Two major key players in the prevalence of obesity are income and education. According

to Hruby and Hu (2015) income was a determinant of obesity with higher income resulting in a

higher obesity rate where in recent years the outlook has completely turned. Hruby and Hu

(2015) describe how the access to cheap food along with the “sociocultural norms” create an
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opportunity for low-income individuals to become more susceptible to obesity. In contrast, the

CDC (2017a) found that no relationship for men between education and income but in women,

however, those with low-level education have a higher prevalence of obesity.

Emerging Trends in Treatment

The adoption of unhealthy lifestyles has become a cultural-social norm where obesity is

preserved as community issue (The Obesity Society, 2014). According to the Obesity Society

(2014), fewer American people compared to the U.S healthcare system think obesity is a result

of personal, behavioral choices. Another concerning claim given by the Obesity Society (2014)

is that from 1977 to 2010 the consumption of sugar skyrocketed by a devastating 30% by both

children and adults combined. Concurrently, the CDC (2017b) only a combined 21% of adults

and children met the fruit and vegetable intake recommendation by Choose MyPlate. An increase

in sugary beverages and simple carbs will not only increase the risk of obesity and obesity-

related diseases but it will also make the efforts made by programs to decrease obesity more

difficult.

A health campaign to alleviate the increasing numbers of childhood obesity was

spearheaded and launched by First lady Michelle Obama back in 2010 (Eschmeyer, 2017).

According to Maxwell (2016), Michelle Obama gave full credit to the “Let’s Move” campaign

when findings of decreased in childhood obesity, of 5.5 percent from 2003-2012, appeared in a

2014 report published by the Journal of American Medical Association. Similarly, to the Let’s

Move campaign the OECD (2017) utilized labeling, through its flexible visual forms, to assist
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individuals in making a much healthier decision by engaging the consumer in their product

selection. One of the researched methods described by OECD (2017) is the traffic-light method

which has been proven to decrease unhealthy food choices by 18% and has even influenced

individuals to reduce daily food intake.

A key dietary movement, the vegan diet, is on the rise and the growth in popularity shows

promising for this emerging trend. According to Turner-McGrievy, Mandes, and Crimarco

(2017), the vegan diet pattern is when an individual consumes no product that derives from an

animal and much of the diet revolves around a plant-based menu. Turner-McGrievy et al. (2017)

illustrate that individuals who adopt a plant-based diet are not only lighter in weight but are less

susceptible to diseases like obesity, type 2 diabetes and, cardiovascular conditions.

Unfortunately, Turner-McGrievy et al. (2017) continue to note that although the vegan diet is a

natural and effective form to combat disease most people are not likely to adopt such a lifestyle

due to its perceived limitation and complexity of the vegan food list. Mass advocation for

adopting the healthy lifestyle is necessary at the local, state and federal levels to produce the

most positive outcome.

Federal or state programs

The question arises as to what is being done to alleviate the issues of obesity. The CDC

(2017a) highlights some of the efforts being made by several programs to improve our schools,

workplaces, and communities through outreach focused on nutrition, physical activity, and

obesity education. The mentioned programs focus on the proper reversal strategies for obesity

which include adequate access to food, water, and safe areas to engage in physical activity

(CDC, 2017a). Other programs like those spearheaded by the Obesity Action Coalition
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(n.d.) build partnerships with community-based programs and utilize frameworks like those of

the USDA, MyPlate and Food Exchange System in efforts to tackle obesity by advocating a

positive behavior change towards the improvement of weight, portion control, increased physical

activity and mental health. Statewide efforts are also noteworthy like that of California

Department of Public Health (CDPH) (2017) Nutrition Education and Obesity Prevention

Branch (NEOPB) whose goals focus on research, evaluating data, develop interventions, health

campaigns and providing ongoing support to statewide projects related to obesity and other

chronic diseases in highly impacted low-income communities. The CDPH (2017) illustrates two

ongoing projects that advocate for a healthy lifestyle change in their Champions for Change and

Champions Provider Fellowship campaigns. According to the CDPH (2017), the Champions for

Change movement that using social media, advertising, and other communications channels

attempts to mass disseminate appropriate information selected by CDPH. The CDPH (2017) also

describes the Champions Provider Fellowship is a strategy focused on policy, physician support

and engagement aimed at expanding provider knowledgebase on subjects like food insecurity

and cultural competency.

Conclusion

The epidemic of obesity is detrimental to our physical, mental, social and overall

wellbeing. Over 60% of adults and children combined are affected by obesity in the U.S. alone

(U.S. Department of Human Services, 2017). Creating opportunities towards modifying behavior

and improving the health choices made by individuals has given rise to efforts in family

engagement, improved nutrition, food access, health education, social services, federal and state

programs and most of all by the individuals suffering from this gateway disease to change and
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prolong their lives (CDC, 2017a). Identifying the lack of support, engagement and proper

interventions given to alleviating a specific environment have brought light to the prevalence and

susceptibility of an individual to obesity allowing advocation to key strategies in areas like

physical activity and financial literacy to occur (Hruby & Hu, 2015). Alongside, environmental

factors of obesity are the sociocultural norms that enhance the acceptance of the disease and

devalues its risk significance (Obesity Society, 2014). While improving the health status of

millions of Americans, the financial and economic toll produced by obesity can be decreased and

a positive surge can be obtained in productivity in the U.S. workforce (CDC, 2014a). A growing

network of health professionals and entities is essential to tackling such a complex health burden

such as obesity. The time is long overdue for healthcare professionals to meet obesity with the

same ferocity the epidemic attacks our communities, advocate increasing patient empowerment

through community outreach and research and recognizing obesity not as a disease but as a

public health issue with numerous risk factors.

References

American Diabetes Society (2015, June 22). The cost of diabetes. Retrieved from

http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html

Burgoine, T., Forouhi, N. G., Griffin, S. J., Brage, S., Wareham, N. J., & Monsivais, P. (2016).

Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity? A

cross-sectional study. The American Journal of Clinical Nutrition, 103(6), 1540–1547.

http://doi.org/10.3945/ajcn.115.128132

California Department of Public Health. (2017) Research and Evaluation Section.

Retrieved from

https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/NEOPB/Pages/ResearchandEvalu

ation.aspx

Centers for Disease Control and Prevention. (2017a, August). Adult Obesity Causes &

Consequences. Retrieved from

https://www.cdc.gov/obesity/adult/causes.html

Centers for Disease Control and Prevention. (2017b, November). Only 1 in 10 adults get enough

fruits and vegetables. Retrieved from

https://www.cdc.gov/nccdphp/dnpao/division-information/media-tools/adults-fruits-

vegetables.html
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Centers for Disease Control and Prevention. (2014a). National Diabetes Statistics Report,

2014: Estimates of Diabetes and Its Burden in the United States. Retrieved from

https://ole.sandiego.edu/bbcswebdav/courses/HCIN-541-MASTER/national-diabetes-

report-web.pdf

Centers for Disease Control and Prevention. (2014b). Strategies to prevent & manage obesity.

Retrieved from https://www.cdc.gov/obesity/strategies/community.html

Eschmeyer, D. (2017). Let’s Move! Retrieved from

https://letsmove.obamawhitehouse.archives.gov/

Hruby, A., & Hu, F. B. (2015). The Epidemiology of Obesity: A Big Picture.

PharmacoEconomics, 33(7), 673–689. http://doi.org/10.1007/s40273-014-0243-x

Maxwell. F. (2016, April). New study reveals the results of Michelle Obama’s ‘Let’s Move’

Program. The Western Journal. Retrieved from

https://www.westernjournal.com/new-study-reveals-the-results-of-michelle-obamas-lets-

move-program/

Obesity Action Coalition. (n.d.). Community-Based Programs. Retrieved from

http://www.obesityaction.org/obesity-treatments/community-based-programs

Organization for Economic Co-operation and Development [OECD]. (2017). Obesity Update

2017.

Retrieved from https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf

The Obesity Society. (2016). What is Obesity? Retrieved from

http://www.obesity.org/obesity/resources/facts-about-obesity/what-is-obesity
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The Obesity Society. (2014). Obesity Infographics. Retrieved from

http://www.obesity.org/resources/facts-about-obesity/infographics

Turner-McGrievy, G., Mandes, T., & Crimarco, A. (2017). A plant-based diet for overweight

and obesity prevention and treatment. Journal of Geriatric Cardiology: JGC, 14(5), 369–

374. http://doi.org/10.11909/j.issn.1671-5411.2017.05.002

U.S. Department of Health and Human Services, National Institute of Health. (2017, August).

Overweight & Obesity Statistics. Retrieved from

https://www.niddk.nih.gov/health-information/health-statistics/overweight-

obesity#causes