The Epidemic of Obesity in America

The epidemic of obesity presents a major challenge to chronic disease prevention and health across the entire world. Despite growing recognition of this issue, obesity rates are still continuing to increase among all ages and socioeconomic groups. Public efforts have, and are still being made to address this issue, however it has been found that this may possibly be one of the most difficult public issues our society has faced. Fueled by both environmental and behavior factors, including an increasingly sedentary lifestyle, and a nutritional transition to more processed foods and high calorie diets, obesity has more than doubled within the last few decades.

There needs to be more awareness of this issue, more preventative actions must be made, problem areas must be identified, and more efforts must be put in place to reverse this issue.

Obesity is a complex disorder involving an individual carrying an excessive amount of body fat. This is determined by the body’s state of energy balance, or the amount of energy (food) ingested and the amount of energy expended through metabolism and physical activity.

In order to maintain a stable and healthy body weight, energy intake must equal energy expenditure (Mitchell, Catenacci, Wyatt, & Hill, 2012). A negative energy balance will result in weight loss, while a positive energy balance will result in weight gain. The current and most widely used criteria for classifying obesity is body mass index (BMI), obesity being classified as a BMI greater than 30 (Hruby & Hu, 2016). Waist circumference and abdominal adiposity are also two highly used methods.

On onset of excessive weight can be caused by a number of things including genetics, the environment, and behavioral factors.

Although genetics can influence body weight and where an individual stores their fat, environmental and behavioral factors seem to play the largest role in causing an increase in obesity. In today’s society, more technological advancements have been made than ever. These advancements include elevator/escalators instead of stairs, a phone app that allows people to turn on a light without having to get up, an app that will deliver food or groceries to an individual’s home, the ability to work from a computer at home, ect. While these advancements may be great, they may have also come at a cost. Obesity researchers are increasingly recognizing the importance of the physical and social environment in enabling weight gain and obesity. Our current food environment is one in which high fat, high caloric, and processed food is inexpensive, abundant and served in very large portions. Our society has also moved toward a physical activity environment with a rare need for significant energy expenditure for food, shelter, transportation, ect (Mitchell et al., 2012). The development of televisions, the internet, and video games has also filled leisure time with sedentary activities than physical activities (Hill, 2006). These environmental influences and choices in behavior make it easy for people to overeat and get a limited amount of physical activity.

Physical activity refers to any body movement that burns calories (work, daily chores, walking to the mailbox, ect), while exercise refers to planned and structured activities aimed to improve health and physical fitness. Globally, one in three people gets little, if any physical activity (“Physical Activity”, 2016). Studies have found that sport leisure activity has remained stable or increased slightly, while other forms of leisure physical activity have declined. In 1950, 30 percent of Americans worked in high-activity occupations by 2000, that proportion had dropped to only 22 percent. The percentage of people working in low-activity occupations has increased from about 23 percent to 41 percent. Driving cars increased from 67 percent of all trips to work in 1960 to 88 percent in 2000, while walking and taking public transit to work decreased. About 40 percent of U.S. schoolchildren walked or rode their bikes to school in 1969 by 2001, only 13 percent did so (“Physical Activity”, 2016). Physical activity has clearly decreased throughout the years.

The decrease in physical activity and the overconsumption of food, has led to this obesity epidemic. This epidemic is so troublesome due to its effect on the populations health. This excessive weight negatively affects almost all the systems in the body, and it is linked to the most prevalent and costly medical problems in our country (Mitchell et al., 2012). The most prevalent diseases being type 2 diabetes, hypertension, cardiovascular disease, many forms of cancer (endometrial, esophageal, pancreatic, breast, thyroid, and gallbladder), cognitive dysfunction, and even mortality (Mitchell et al., 2012). Obesity is also associated with leukemia, malignant melanoma, feelings of breathlessness, low energy, back and joint pains, and depression. Obesity has a negative effect on the entire body. As more children and adolescents are becoming obese, they are beginning to develop risk factors for chronic diseases much earlier in life than they should be. This including dyslipidemia, hypertension, and hyperinsulinemia. Type 2 diabetes was virtually non existent in this population a few generations ago, but it is now becoming much more prominent in this age group (Mitchell et al., 2012). With the increase in obesity, chronic diseases that could be prevented, are at an all time high. The association of all-cause mortality with obesity is extremely unfortunate, especially because it is an issue that can be completely reversed.

To reverse this epidemic that has become so prominent, certain measures must take place. Food choices must change, along with a greater amount of daily physical activity. Exercise has the capability to promote weight loss alone, however it works best when combined with a nutrient-dense, low caloric eating plan (“Physical Activity”, 2016). If people do not reduce their calories, exercising must be more intense or it must be completed for a longer duration of time. Currently, the American College of Sports Medicine recommends at least 150 minutes of moderate intensity exercise per week, or 75 minutes of vigorous intensity exercise per week, combined with dietary restriction for weight loss (Hruby & Hu, 2016). This is about 30 minutes of exercise per day, an hour being the best for individuals who live a more sedentary lifestyle. This may look like four days of fitness walking for 30 minutes, paired with two-20 minute sessions of resistance training. Along with exercise, individuals should also make more of an effort to move throughout the day. Instead of taking an elevator, take the stairs. Take a five-minute break from doing work, and walk or stretch during these five minutes. Every small interval of physical activity adds up, and is truly beneficial for the body. The American society must learn how to be more physically active during the day.

An alternative strategy for the treatment of obesity is preventative strategies to prevent excessive weight gain. These strategies will include those that will prevent positive energy balance (Hill, 2006). One prevention strategy includes self-management strategies. This may include goal setting, self monitoring, stimulus control, ect. Studies suggest that frequently contact with interventionists or monitoring weight through fitness trackers may be valuable (Hutfless et al, 2013). Another strategy includes maintaining energy balance through a consistent intake of calories and integrating exercises into a daily routine. Lastly, environment-level strategies would be extremely helpful in reducing the availability of processed foods, but more fresh foods, along with a society that promotes physical activity (Hutfless et al, 2013). Instead of having a fast food restaurant at every corner, more fresh markets or healthier food choices should available. Communities should also make a greater effort in improving walkability, whether it be more sidewalks, creating shopping centers that are walking distance from living communities, bike lanes, the integration of more parks, ect.