Community Health Advocacy: Obesity Prevention in America

Obesity as a Health Issue

The aggregate chosen for this paper is obese Americans. Obesity is a major health issue in the United States caused by unhealthy behaviors. According to Haslam and James (2005), "1.1 billion adults and 10% of children are now classified as overweight or obese. The number of deaths per year attributable to obesity is roughly 30,000 in the UK and ten times that in the USA, where obesity is set to overtake smoking as the main preventable cause of illness and premature death" (p. 1197).

The choice to select obese Americans for this health advocacy paper stems from a strong personal interest in obesity. This paper seeks to present a detailed description of obese Americans as an aggregate experiencing a significant health issue in the United States. Obesity is a preventable disease, and this analysis applies three levels of prevention—primary, secondary, and tertiary—to develop comprehensive intervention strategies for this population.

The dramatic increase in obesity among Americans is well documented. Over one-third of the U.S. population—double the prevalence of 30 years ago—is considered obese. The medical costs linked to obesity in 2005 alone reached $147 billion when accounting for disease treatment, mental health, life satisfaction, and life expectancy (Wilson, Crosnoe, & Daniels, 2012). Many factors contribute to obesity, including family dietary habits, lack of exercise, economic constraints, and limited health literacy. The risk of obesity is particularly high when families lack healthy dietary practices from childhood, patterns that often extend into adulthood (Haslam & James, 2005).

The Three Levels of Prevention of Obesity

The adverse effects of obesity on affected individuals can be devastating. The aggregate collectively spends a substantial portion of the gross national product treating diseases resulting from obesity. According to research cited in the literature, "morbidly obese patients are described as depressed, anxious, having poor impulse control, low self-esteem and impaired quality of life" (Hout, Heck, & Oudheusden, 2004). Haslam and James (2005) further note that "average life expectancy is already diminished; the main adverse consequences are cardiovascular diseases, type 2 diabetes, and several cancers" (p. 1197).

Preventive measures can be applied at any stage along the natural history of disease, with the goal of preventing onset or further progression of the condition. For analytical purposes, preventive actions can be organized into three main stages, though in reality these stages often overlap and blur into one another. According to Nies and McEwen (2011), the three stages of prevention are primary, secondary, and tertiary prevention.

Primary Prevention

This framework provides a useful structure for understanding how different interventions target obesity at different disease stages. Primary prevention aims to stop disease before it occurs, secondary prevention focuses on early detection and treatment, and tertiary prevention addresses management of existing disease to reduce complications and improve outcomes.

Primary prevention of obesity begins early in life. According to Wilson, Crosnoe, and Daniels (2012), "Where are those extra pounds coming from? Some things do not start by themselves. Toddlers do not go shopping for food. Moreover, from the earliest days of life through childhood and adulthood, humans tend to eat together, often in family settings." Primary prevention of obesity must start in early childhood, as parents not only provide the food children consume but also model eating behaviors through family traditions that profoundly affect learned behavioral patterns.

Secondary Prevention

The same principles apply to exercise habits. Exercise is important for the body to maintain energy and well-being. Exercise controls weight, combats health conditions and diseases, improves mood, boosts energy, and promotes better sleep (Mayo Clinic, 2014). Most medical professionals agree that primary prevention addresses conditions before they develop biologically. In other words, primary prevention of obesity begins before obesity starts by paying close attention to diet and exercise habits established in childhood and reinforced throughout life.

The secondary level of obesity prevention involves deterrence through early detection and intervention once the disease process has begun. This level of prevention identifies obesity as a problem and seeks to implement early intervention strategies. According to Kumanyika et al. (2002), "In order to prevent obesity, it is recommended that individuals adhere to a consistent exercise regimen as well as a nutritious and balanced diet. A healthy individual should aim for acquiring 10% of their energy from proteins, 15–20% from fat, and over 50% from complex carbohydrates, while avoiding alcohol as well as foods high in fat, salt, and sugar. Sedentary adults should aim for at least half an hour of moderate-level daily physical activity and eventually increase to include at least 20 minutes of intense exercise, three times a week."

Tertiary Prevention

Secondary prevention focuses on identifying individuals at risk or already experiencing early-stage obesity and implementing lifestyle modifications before serious complications develop. Early intervention during the secondary prevention phase can prevent progression to more severe obesity and associated comorbidities, making this level particularly important for public health interventions in community settings.

Conclusion

Tertiary prevention combats and treats existing disease to reduce or prevent further debilitation. For obesity, tertiary prevention includes pharmaceutical and surgical interventions. Appetite suppressant medications can reduce caloric intake and facilitate weight loss. Surgical procedures such as Roux-en-Y gastric bypass focus on reducing stomach volume to limit food intake. Many treatment options are available today for individuals with severe obesity. However, because the comorbidities resulting from obesity are life-threatening, society must prioritize prevention at all levels rather than relying solely on treatment of advanced disease.

Obesity in Americans is a significant aggregate health concern requiring immediate attention. Combating this disease requires a comprehensive approach across all three prevention levels. Primary prevention that focuses on preventing disease development through healthy family dietary practices and exercise habits is crucial, particularly for children. Early detection and treatment of obesity represent the secondary prevention level and can interrupt disease progression before serious health consequences emerge. Tertiary prevention models, including medications and surgical procedures aimed at controlling existing disease, provide options for individuals with established obesity. The serious comorbidities of obesity demand that society address this problem with sustained commitment and resources across primary, secondary, and tertiary intervention strategies.