Obesity in America: health impacts, discrimination, and policy solutions

Obesity

The Problem of Obesity

The problem of obesity is important because it affects roughly a third of all adults in the United States (Flegal, 2010, p. 235). Between 30% and 35% of American men and women are believed to be obese in according to the latest study by Flegel, Caroll, et al. (2010). This alarming news indicates that obesity is truly a problem of epidemic proportions. Because obesity does not merely affect one's appearance, it is necessary to understand the problem in all its manifestations. There are a number of health concerns that surround obesity. For example, it is believed to increase one's chances of developing diabetes, heart disease and high blood pressure. Excess weight can also be a factor in the decline of one's mobility. From changing one's diet to changing one's lifestyle, there are many ways to fight obesity -- yet, obesity rates continue to rise in the United States (Flegal, 2010, p. 235). It is imperative that some measures be taken to curb these alarming rates. This paper will analyze the problem of obesity and provide a description of the way obesity impacts one's health. It will examine the challenges, barriers and obstacles one faces in combating obesity; expert opinions; potential interventions; stakeholders' interests; and policy recommendations.

Background

Obesity is best defined as the maintaining of an excessive degree of body fat. This excessive degree is measured according to body mass index (BMI), calculated using one's weight and height. A measurement at or above a BMI of 30.0 is considered obesity.

Individuals who suffer from obesity face a number of serious threats both to their own health and to their social life. Not only are chronic diseases and even mortality common consequences of obesity but also social stigma surrounds individuals who are obese. "Weight discrimination" has nearly doubled in the past decade and according to researchers plays a part in biased decision making just as much racial discrimination (Puhl, Heuer, 2012, p. 941). Obesity affects one's chances of being accepted, for example, into a graduate studies program at a major university just as much as it affects one's chances of developing diabetes (Burmeister, 2013, p. 918).

Yet, aside from discrimination and the well-documented links between obesity and diabetes, heart failure, and high blood pressure, researchers are also beginning to see a link between obesity and sleep apnea (Chen, Beydoun, Wang, 2008, p. 265). More and more studies are being performed that are establishing relationships between excessive body fat and declines in the overall ability of the body to perform normal, routine functions -- like breathing. Even mothers who gain excessive weight during pregnancy are at risk of becoming obese and developing hypertension and diabetes. The health of children and adults in the U.S. is significantly affected by the problem of obesity.

Challenges

Some challenges and barriers in addressing the issue of obesity may be found in the fact that obesity is a highly stigmatized disease. It affects one's appearance, and like race, produces its own stereotypes in culture. Individuals who are obese are often perceived to be lazy, ignorant and unsympathetic. However, none of these perceptions can be accurately applied in any normative way to all obese individuals. The biggest hurdle to addressing the issue of obesity, therefore, is the issue of perception. Obesity needs to be seen more as the disease that it is and less as the "unfortunate" result of "letting oneself go."

Another barrier to treating obesity is the national perception of dietary lifestyles. While more and more attention is being given to organic food items and "natural" or herbal supplements, many Americans still consume large quantities of fast food and keep high calorie, high carbohydrate food items in their diets. National awareness about the causes of obesity, such as inactivity, lack of sleep, and poor diet is something that needs to grow.

However, there are other factors that lead to obesity which do not result from lifestyle decisions, per se. One of these is weight gain due to medication. Some medications, such as anti-depressants, can lead to major weight gain because of the affects they have on the mood, on the body's hormones, and on the individual's overall ability to lead an active lifestyle.

One's approach to obesity needs to balance a number of elements: first, one must not led weight discrimination affect one's perception of obesity as a disease; second, one must understand the relationship between a healthy, active lifestyle and diet and a healthy, normal BMI; third, one must realize that while some medications can help individuals in certain areas, they can harm individuals in other areas. Drugs are not a "cure all" but rather a way to treat symptoms. There is a great danger in American culture, which relies heavily upon pharmaceutical "cures" for its ailments. A big roadblock to treating obesity is the sheer fact that the best way to treat it is one that incorporates a balanced diet with an active lifestyle. In today's corporate world, it is difficult to find that balance and to maintain it. Without that balance, the disease of obesity is one that can slowly develop overtime -- until "suddenly" one's BMI has reached the tipping point.

Expert Opinions

George Bray (2013) asserts that drugs are a powerful way to treat individuals who suffer from obesity: "The goal of medicating for obesity is to help more patients achieve more weight loss" (p. 893). However, not all researchers agree that drug treatment is the best way to approach obesity. Drugs can often have side effects that add to a person's stress, which can in turn lead to greater weight gain if inactivity or depression sets in. Drugs have the benefit of treating the symptom, but understanding the cause of obesity and treating it often depends upon the patient more than it does the doctor.

To that end, researchers like Tamara Dubowitz (2013) devised a study in which they attempted to see the relationship between obesogenic neighborhoods and "land use zoning and parks renovations" (p. 419). What Dubowitz found was that there was not significant amount of data to show that the mere existence of parks and places within a community where one could lead an active lifestyle had any impact on reducing weight gain. Dubowitz argues that such zones may facilitate in the treatment of obesity by inspiring individuals who suffer from the disease to take part in a walks, hikes, runs, etc. But at bottom, outdoor exercise requires an active participation on the part of the individual -- an active participation that might be lacking in obese individuals especially in an overall passive culture, which encourages and promotes passive treatment such as drug treatment.

Jessica LaRose (2013) has shown that young adults who combat obesity do so from the motivational standpoint of "appearance and social influences" (p. 449). Older adults are more motivated to lose weight because of overall health concerns (LaRose, 2013, p. 449). For both young adults and older adults, however, "physical activity appears to play an important role in their weight-loss efforts" (LaRose, 2013, p. 449). This indicates that individuals who suffer from obesity may be motivated to fight the disease for different reasons -- but one major way to fight it is through an active lifestyle in which exercise is a big factor.

Finally, Satoshi Kanazawa (2013) asserts that an important factor in combating obesity is the role of intelligence. More informed individuals are more likely to control their BMI through dietary means. Individuals who have been made aware of the nature of obesity actively develop diets that help them to fight the disease.

Stakeholders' Interest

Politicians like New York City mayor Michael Bloomberg have done a great deal in overseeing the passing of legislation designed to curb citizens' tendency to cull unhealthy dietary habits. Bloomberg recently sought to limit the sale of soda sizes in New York City. Bloomberg is interested in obesity because as a public official he sees the epidemic proportions of the problem in the nation's largest city and wants to do his part in the campaign to fight the problem. Whether Bloomberg's proposal to ban large sized sodas will actually play a successful part in the fight remains to be seen. As researchers like Dubowitz have found, there is a lot of uncertainty surrounding the relationship of official efforts to fight obesity and the actual loss of weight in obese individuals.

Nonetheless, more and more administrators are seeing the need to do something. Healthcare providers are being made aware of the problem thanks to work by doctors like J. Michael Gaziano (2010), who notes that "by 2020 almost half of U.S. adults" will meet the World Health Organization's "criteria for obesity" (p. 275). As a result of such result, organizations like Mayo Clinic offer several avenues to learning, fighting and dealing with obesity.

Obesity in children is also becoming a big concern for administrators who see themselves as having a social responsibility in the fight against obesity. Public school lunches are under constant review and revision and even the First Lady, Michelle Obama has sponsored a nationwide campaign to fight obesity through a more active lifestyle and better eating. Such administrators and officials are in key positions to raise national awareness concerning the obesity epidemic and as leaders of a democratic Republic, their actions are meant to be the consequence of the nation's voice.

Policy Recommendations

The best policy in fighting obesity should consider the following points: first, obesity is a disease that can be caused by a number of varying factors ranging from physical ailments to mental illness to simple lifestyle habits. It is important to deal with each individual case of obesity accordingly. While there are several ways to fight obesity in general, every person will need to approach the problem in a unique way that addresses the underlying issues exclusive to that individual. This is where developing a weight-loss program especially designed for the patient can be most helpful. After meeting with a physician, counselor, and other experts, an individual can address problem areas related to diet, exercise, mental health, and environment that might be affecting his inability to lose weight.

Second, the stigma of obesity needs to be understood better. Such a stigma may have both negative and positive effects: for instance, young adults are motivated to lose weight by the fear of stigma. Other individuals may be afraid to address their obesity because of an unwillingness to be labeled obese. Finding the right approach to each individual is essential.

A general policy that could facilitate in the fight against obesity may focus on better eating habits. A nationwide recommended eating program might help to facilitate weight-loss. A nationwide recommended exercise program could do the same. An active lifestyle and a healthy diet are two excellent ways to counter obesity.

Summary and Conclusion

In summation, the problem of obesity is important because it has reached epidemic proportions in the United States. Obesity can lead to heart disease, hypertension, diabetes and even death if not combated. It is also the leading factor in weight discrimination.

A number of factors can lead to obesity, but the primary factors in most cases of obesity are inactive lifestyles and unhealthy eating habits. Attending to each of these issues is imperative in the fight against obesity.

One way to treat obesity is by developing a weight-loss program with the help of a healthcare provider. Because every case of obesity is unique, a weight-loss program should be customized to fit the individual's needs. For instance, one patient may require more exercise than another. Or one patient may need more help in devising a suitable diet as a consequence of other health issues. There is no one "cure all" method of fighting obesity.

Prescription drugs are available as treatment but they are a passive form of treatment and do not promote the active habits that help an individual to maintain a healthy BMI. Drugs like Xenical may address the symptoms of obesity, but in many cases an individual's mindset needs to be addressed as well.

The mindset is best addressed by raising national awareness of the dangers of obesity. As the 21st century continues, obesity threatens to be the epidemic of the century, far outstripping all other epidemics in terms of the number of the U.S. population to suffer from the disease. Already the numbers are shockingly high. Unless some action is taken, obesity rates will continue to climb. Administrators are doing so, like NYC Mayor Bloomberg -- but ultimately it will be up to every individual to meet with physicians and/or counselors to determine the proper approach for him.

Reference List

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