Obesity: causes, effects, and health implications

Obesity rates are defined as the percentage of the population with a Body Mass Index (BMI) over 30. Given that information and based on 2006 data, sad to say, the United States is the fattest country in the world with 34% of the population having a 30 BMI or more. That is an increase of 4% in the U.S. from 2002. Sadder news yet is that New Zealand ranked second, but with only a 25% obesity rate -- almost 10% below the U.S. As one might expect, Japan and Korea ranked lowest on the obesity scale with a 4% obesity rate in 2005.

"We live, it is said, in a "nanny state" that constantly tries to regulate our lifestyles. This is almost the exact opposite of the truth. A nanny's first duty is to care for her charges' bodily health, ensuring good diet and frequent exercise. In this respect, successive governments have been scandalously negligent. They have stood by while obesity -- a condition that

leads, for example, to type-2 diabetes, strokes and cancers of the colon and the ovary-has reached epidemic proportions" (How to cut out obesity, 2004, p. 6)

This quote from a British journal is as true in the United States as it is in Great Britain and many other countries. This is not to say, by any means, that obesity is a problem that only the federal government can fix, and should fix. There is also much to say about the negligence of the individual and their own responsibility to take care of the health and well-being of the body.

Obesity in the U.S.

John Cawley, an associate professor in the Department of Policy Analysis and Management, studies health economics, particularly the economics of obesity. As a result of a major study Cawley can confidently state that, "weight lowers wages for white females. An additional 65 pounds is associated with 9% lower wages" (Cawley, Olson, & Wilkins, 2008, p. 19).

That statement alone should give pause for thought. But it is only the beginning of the sociological impact obesity can have.

Saris and Foster (International Journal of Obesity, 2006) make this eye-opening statement, "The prevalence of overweight and obesity has risen dramatically over the past three decades and is threatening to become a global epidemic. A substantial proportion of the population is at increased risk of morbidity and mortality as a result of increased body weight" (Saris & Foster, 2006, p. S1).

These high rates of obesity raise concern because of their implications for the health of Americans. Obesity increases the risk of many diseases and health conditions. These include: coronary heart disease, type 2 diabetes, cancers (endometrial, breast, and colon), hypertension (high blood pressure), dyslipidemia (for example, high total cholesterol or high levels of triglycerides), stroke, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis (a degeneration of cartilage and its underlying bone within a joint), and gynecological problems (abnormal menses, infertility) (Overweight and obesity, 2009).

Total health spending accounted for 15.3% of GDP in the United States in 2006, the highest share in the Organization for Economic Co-operation and Development (OECD), and more than six percentage points higher than the average of 8.9% in OECD countries (OECD, 2008).

Following the United States were Switzerland, France and Germany, which allocated respectively 11.3%, 11.1% and 10.6% of their GDP to health (OECD, 2008).

The United States also ranks far ahead of other OECD countries in terms of total health spending per capita, with spending of 6,714 USD (adjusted for purchasing power parity), more than twice the OECD average of 2,824 USD in 2006. Norway follows, with spending of 4,520 USD per capita, then Switzerland and Luxembourg with spending of over 4,300 USD per capita. Differences in health spending across countries may reflect differences in price, volume and quality of medical goods and services consumed.

The time lag between the onset of obesity and increases in related chronic diseases (such as diabetes, cardiovascular diseases and asthma) suggest that the rise in obesity that has occurred in the United States and other OECD countries will have substantial implications for future incidence of health problems and related spending (OECD, 2008).

Societal Considerations & Social Perspectives

Says Barry Simon, a Toronto, Canada psychologist:

"Obesity is a symptom of a societal disorder. Obesity is a reflection not only of an individual's nature but of their family's values and the society's collective identity. Obese children have it rough in our society. They're criticized for lack of will power. They're controlled by anxious, well-meaning parents. At the same time, their environment smothers them with everything to feed their problem" (Simon, 2002, p. F05).

But disease, disability, and neurosis are not the only ugly outcomes of obesity. There are serious lifestyle complications that contribute to the problem.

"We are a complicated society that is obsessed with either productivity and keeping up or needing to work hard to keep food on the table. Fast food is an inexpensive, time-saving prize for all. Latch-key kids cross socio-economic boundaries with snack foods and computer games or TV to entertain them.

Children are either over programmed to help them live up to our productivity dreams or left to sit on the couch; either way, something has gone very wrong"

(Simon, 2002, p. F05).

There are three sociological perspectives a sociologist might use to view this newly recognized social issue of obesity: functionalism, conflict theory, or symbolic interaction (Runner, 2009).

Functionalists believe that everything has a function, and when there is a function, there is also inevitably a dysfunction. From a functionalist outlook, maybe obesity in some individuals might be necessary in order to encourage others to strive and work for a healthy body. Maybe the issue of obesity distracts people from things that they cannot change and refocuses them on the issues that they can influence and do something about. A functionalist would be able to locate a reason and purpose for the growing number of obese population (Runner, 2009).

A person who stands behind the conflict theory believes that life and all social interactions are a struggle for power and privilege, even if the gains are the cost of another. They may view obesity as just a result or consequence of the money raked in from the fast food industry, and that it is the individual with low self-control who is at fault for his being overweight, not the people who benefit wealth from his overindulgence. They might see it as a small number of "important" people at the top feeding a large flock of underdogs whose hunger feeds the minority's bank account at the cost of a healthy body weight (Runner, 2009).

Someone using the symbolic interactions theories might view the obesity trend in a number of different ways, depending on what meaning they assigned to it; how they labeled those who are obese. The whole issue would be perceived and handled according to their interpretation of the problem, what they derived from obesity and what attitudes about it they might assign with their symbolism. They might decide to make obese individuals appear to be disgusting, out of control slobs, or, victims of an unhealthy and irresponsible country (Runner, 2009).

It is most probable that a social problem like obesity would be best understood when analyzed using the strengths of all three sociological perspectives.

Impact of Variables

Research leads to three potential sets of social variables that may affect obesity: social class, family, and health-and-diet-related behavior. Studies have looked at the influence of social class on obesity. Research shows that lower social class position is associated with higher calorie intake and a higher weight-for-height score in the children observed (Gerald 1993).

Many studies have found relationships between social class and obesity rates in adults. One theory as to the influence of class on obesity is that class may limit an individual's ability to maintain proper weight. Perhaps class has an impact on an individual's access to low-fat foods and/or regular physical activity. For example, if an individual is working two jobs or cannot afford high fitness club fees, it is difficult for that individual to regularly participate in physical activity (Malnor, 2006).

Another environmental variable in adolescent obesity is the family situation. Research comparing interactions in families with obese children to interactions in families with non-obese children indicated an "obese pattern" of parent-child interaction involving the families' desire to keep up family appearances despite the existence of family problems (Malnor, 2006)

One such question is "would the children in these families [the families with obese children] have become obese if society highly prized and valued obesity?" The family environment can have a strong impact on an individual's health. For example, research has shown that families who eat dinner together regularly consume more fruits and vegetables, fewer fried foods, and less soda than those families who do not eat dinner together (Malnor, 2006).

Another important influence in the development of obesity in adolescents is the balance of dietary intake and physical activity levels. In terms of an individual's food intake, food choice is an important factor. The quality of the food brought into the home can increase caloric intake. For example, calorie-dense foods such as regular milk, sugar sweetened beverages, high-fat foods, and fast foods are potential sources of excess caloric intake. Family food preparation practices such as the use of cream, butter, or high-fat cheeses in recipes can be another source of excess caloric intake. An individual's physical activity is also an important factor in the development of obesity (Malnor, 2006).

Impact of Obesity on Society

Evidence of the considerable costs of obesity to individuals and society is rich. At the individual level, obesity is associated with health care costs that average about 30% above those for normal weight individuals. Overall, obesity-related direct and indirect economic costs exceed $100 billion annually, and the number is expected to grow. "In relative terms, obesity accounts for six percent to 10% of U.S. health care spending, compared with two percent to 3.5% in other Western countries" (Economic impact of obesity, 2008, para. 3). The burden of obesity-related medical costs falls disproportionately on public health care in the U.S., draining resources from public programs like Medicare and Medicaid. Obesity accounted for 27

percent of the growth in real U.S. health care spending between 1987 and 2001. Despite these sobering statistics, the full effects of obesity trends since the 1980s are not yet fully apparent because health problems caused by weight gain take time to appear (Economic impact of obesity, 2008).

Given the significant financial burden imposed by obesity, employers have a stake in reducing obesity in the workforce. Obese workers miss more days of work and cost employers more in medical and disability claims as well as workers compensation claims. "As a result, an average firm with 1,000 employees faces $285,000 per year in extra costs associated with obesity" (Economic impact of obesity, 2008, para. 4)

"Behavior governing weight depends not just on health considerations but also on the desire to appear normal and attractive," say authors Mary Burke and Frank Heiland (Blackwell Publishing, 2007, para. 3). As a result, any change that causes average weight to increase, such as a decline in food prices, will lead to additional weight increases because the weight level considered "normal" will rise (Blackwell Publishing, 2007).