Overview - Obesity

Obesity
Current Issues, 2010
American culture seems obsessed with thinness. Although fitness centers and health food stores are popping up
in every city and advertisements for weight-loss programs and prescriptions are filling the airways, Americans
are not getting thinner. More than two-thirds of the population is considered overweight or obese, leading many
to label the problem of obesity an epidemic.

Obesity is taxing on the body and debatably one of the nation’s most frequent killers—responsible for a variety of
health problems such as heart disease, diabetes, liver disease, high blood pressure, infertility, gallbladder
disease, depression, several forms of cancer, stroke, sleep apnea, and more. Even children are becoming obese
in numbers not previously seen and are experiencing health care problems typically only seen in adults, such as
type-two diabetes as well as high cholesterol and high blood pressure. Further, despite all the attention given to
it, no program yet has been able to reduce the national rate of obesity.

Obesity Defined
Obesity is defined by a body mass index (BMI) of 30 or above. BMI is thought to be more a more accurate
measurement than weight alone because it takes height into consideration. For example, a 5-foot, 7-inch female
would have a BMI of 30 at 192 pounds, placing her in the obese category. Some have taken issue with this
approach. Columnist Dominic Lawson, for example, writing for The Independent on August 29, 2008, is one such
critic of using BMI, which does not consider muscle mass or other health factors, to diagnose obesity. He writes,
"More pertinently for us all, there is nothing wrong, or even unhealthy, in being obese, at least as defined by the
official measurement known as the Body Mass Index … [O]n current BMI definitions George Clooney and
Russell Crowe are clinically ‘obese’while Brad Pitt and Mel Gibson are ‘overweight’. Meanwhile another doctor
friend of mine points out that many of his anorexic patients would be classified as very healthy according to most
conventional measurements, such as blood pressure; but clearly their attitude to food is anything but healthy."
While BMI is generally considered a helpful tool, a doctor is best able to determine a person’s health by looking
at several factors.

A Complex Issue
Losing weight might seem like a simple matter of math and willpower—people need to consume fewer calories
than they use. However, maintaining a healthy weight is rarely that simple. Assuming that weight loss is only a
matter of willpower further stigmatizes those experiencing problems with weight control who may be struggling
against numerous factors beyond their control. Even science is unable to identify all the factors that contribute to
a person’s weight. In a December 7, 2009 article for Time, Alice Park explains the problem with a simplistic
approach to weight loss is that weight may be more influenced by genetic makeup than most Americans realize.
She explains that "there are cases of identical twins, for instance, who eat and exercise the same amounts, but
while one becomes obese, the other remains thin. Such discrepancies have spurred researchers to look for
alternative causes of weight gain. And their inquiries have led them to a familiar but unexpected place—the gut.
Or more specifically, the intestines and the bacteria that take up residence there." She points to Jeffrey Gordon,
a researcher at Washington University in St. Louis, Missouri, who is studying gut microbiota and learning about
the role these "gut bugs" play in how many calories the body absorbs.

Another study is looking into obesity in infants, who obviously are not eating fast food. A September 21, 2009
story in Newsweek by Sharon Begley reports exposure to some chemicals before or shortly after birth, even in
trace amounts, may affect the genes causing infants to create more fat cells. "They are not the cause of extra
pounds in every person who is overweight—for older adults, who were less likely to be exposed to so many of
the compounds before birth, the standard explanations of genetics and lifestyle probably suffice—but
environmental chemicals may well account for a good part of the current epidemic, especially in those under fifty.
And at the individual level, exposure to the compounds during a critical period of development may explain one
of the most frustrating aspects of weight gain: you eat no more than your slim friends, and exercise no less, yet
are still unable to shed pounds."

Additionally, scientists are looking at the role the brain plays in how much a person eats. As quoted on The New
York Times Web site, Dr. Matthew W. Gilman, the director of the obesity prevention program at Harvard Medical
School Pilgrim Health Care, states, "There are physiological mechanisms that keep us from losing weight." The
site continues, "Scientists now believe that each individual has a genetically determined weight range spanning
perhaps 30 pounds. Those who force their weight below nature's pre-assigned levels become hungrier and eat
more; several studies also show that their metabolisms slow in a variety of ways as the body tries to conserve
energy and regain weight. People trying to exceed their weight range face the opposite situation: eating
becomes unappealing, and their metabolisms shift into high gear." As research into obesity and weight loss
continues, researchers will no doubt discover other surprising factors contributing to weight gain and loss.

Cost of Obesity
Obesity is a painful problem for those who are suffering from the emotional and physical effects of the condition,
but they are certainly not alone. According to a study published by the Centers for Disease Control and
Prevention (CDC) in 2010, 34 percent of U.S. adults are overweight and an additional 31 percent are obese. In
fact, in 2004 the CDC announced that obesity was quickly becoming the leading cause of preventable
death—second only to tobacco use. In 2000 the CDC estimated that obesity caused 400,000 deaths, whereas
tobacco was responsible for 435,000. Although the CDC later revised this figure to 112,000 per year in 2005,
obesity remains a costly problem.

Medical expenses related to obesity in 2002 exceeded $75 billion, or 9.1 percent of the total U.S. medical costs.
Diabetes alone, according to estimates from a study conducted at the University of Chicago, will amount to $336
billion a year in health care costs by 2034 for the estimated 44 million Americans who will have developed
diabetes.

Obesity Rates Plateau

On January 6, 2010, the CDC reported that obesity rates had remained steady for five years for men and nearly
ten years for women and children. However, everyone is not convinced that this reflects true progress in the fight
against obesity. Dr. David Ludwig, the director of the Optimal Weight for Life Program (OWL) at Children’s
Hospital Boston, is one such skeptic. On January 14, 2010, The New York Times reported that "Dr. Ludwig said
the plateau might just suggest that ‘we’ve reached a biological limit’ to how obese people could get. When
people eat more, he said, at first they gain weight; then a growing share of the calories go ‘into maintaining and
moving around that excess tissue,’ he continued, so that ‘ a population doesn’t keep getting heavier and heavier
indefinitely.’" Others are more optimistic and hope the study will bring renewed attention, and hopefully, new
solutions to the problem.

Weight-Loss Medication and Bariatric Surgery

Although many have hoped for a quick fix to obesity, no real substitute exists for following a careful diet and
engaging in routine exercise. A number of weight-loss drugs are available on the market, but most of them have
significant negative consequences. The once-popular Fen-phen, for example, was found to cause heart-valve
disease and was pulled off the market in 1997, which resulted in more than $21 billion in legal costs to the drug
company that distributed it. Xenical, one of the newer drugs on the market, can cause gastrointestinal side
effects such as loose, oily stools, particularly following the consumption of high-fat meals, so a careful diet must
still be followed.

Weight-loss, or bariatric, surgery is becoming increasingly popular both in the United States and abroad, with
more than 344,000 surgeries performed around the globe in 2008. The most popular form of the surgery is called
gastric bypass, where a portion of the stomach is sectioned off into a small pouch and reconnected to the lower
part of the small intestine to reduce the amount of food absorbed by the body. Although, on average, people who
have had a gastric bypass lose 124 pounds in their first year following surgery, the surgery is certainly not an
easy way out of obesity either. Patients must make significant lifestyle changes and follow strict guidelines to
ensure they receive proper nutrients and hydration. Also, serious related complications can develop. For
example, after the surgery their stomachs are so tiny that they can only eat a few ounces of food at a time, and
they cannot consume liquids and solid food within half an hour of each other. Overeating, even a little bit, can
cause severe pain and nausea, but enough nutrients must be consumed to ensure proper health.

Weight Loss in the United States

Although the majority of Americans feel that health is a matter of personal responsibility, losing weight and
maintaining a healthy weight are not goals that are easily achievable without a lot of support from family, friends,
and the community. From creating community education programs to building bike and walking paths that make
it possible to exercise safely or even bike or walk to work, local communities can do a lot to encourage healthy
lifestyles. Work environments can do more to contribute to employees' physical well-being. Some employers are
already taking positive steps to improve the health of their employees by offering benefits that include gym
memberships or workout facilities within their buildings along with time set aside during the workday to use them,
and cafeterias that encourage healthier food choices. Research also shows that children and adolescents are the
group most likely to be successful in their weight-loss goals, so focusing on this group could go a long way
toward turning the obesity rate around. In the battle to reduce the obesity rate, it is clear that everyone can play a
role.

Full Text: COPYRIGHT 2011 Gale, Cengage Learning.

Source Citation:
"Obesity." Current Issues: Macmillian Social Science Library. Detroit: Gale, 2010. Gale
Opposing Viewpoints In Context. Web. 24 Mar. 2011.

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