Obesity and being overweight

Globally, there are more than 1 billion overweight adults, and at least 300 million of them suffer from obesity. Both have reached epidemic proportions worldwide and both are major contributors to the global burden of chronic diseases and disabilities.

Obesity rates have skyrocketed since the 1980′s, up to three-fold in certain areas of the U.S. along with other industrialized nations, but it is also increasing exponentially in developing nations.

Why is driving the obesity and overweight epidemic?

The obesity epidemic reflects profound changes in society and in the behavioral patterns of society over recent decades. While genes are important in determining the proclivity of weight gain, it is dictated mostly by the energy balance between calorie intake and physical activity. Economic growth, modernization, urbanization, and globalization of the food industry is a major driving force behind the overweight and obesity epidemic. At the same time, there has been a movement towards less physically demanding work complemented by the use of automated transportation, time-consuming telecommunications technology in the home, and the pursuit of more leisurely past times. All of the above are factors in combating obesity and being overweight.

How bad is the problem?

Currently, there are more than 1 billion overweight adults. 300 million of them are clinically obese. Obesity levels range from below 5% in China, Japan, and some African nations, to over 75% in urban Samoa. But even in the lower spectrum of obesity, such as China, some cities boast obesity rates of over 20%.

Childhood obesity is also a driving factor. Worldwide, up to 22 million children under five are overweight. In the USA, according to the Surgeon General, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

Obesity accounts for 2-6% of total health care costs in several developed countries. The true costs are probably much greater as not all obesity-related conditions are calculated.

What can we do about it?

Prevention, weight loss and weight maintenance are the most important long-term strategies for fighting obesity. Other key elements include:

1. Creating a supportive environment through public policies and personal goals that promote the intake of a variety of low-fat, high-fiber foods, and opportunities for physical activity. (No more sitting on the bench for an entire phys-ed class.)

2. Promoting healthy behaviors to encourage, motivate, and enable individuals to lose weight, namely, through a better diet.

3. Mounting a clinical response to the existing burden of obesity and associated conditions by lawmakers and health care providers to ensure effective support and prevention for those most prone to becoming overweight.

Being Overweight

We all know that obesity and being overweight contribute to an ever-increasing list of chronic illnesses. According to some studies, obesity and being overweight is quickly catching up to smoking as the number one cause of preventable chronic illnesses. It causes diabetes in young children and leads to lethargic lifestyles. Obesity and being overweight is overwhelming our health care budget. Some see it as a personal issue while others blame social and environmental factors. Any way you look at it, obesity and being overweight has become a focal point for concern.

But what if it’s not that big of a deal?

Take the case of Mary Anne Ferguson, a 58-year-old grandma. Today, she’s lifting weights at the YMCA, hoping to buy herself another 25 years.

“I want to live well into my 80′s or longer,” said the high-spirited grandma.

But Mary Anne stands only 5 foot 6 inches and weighs 186 pounds.

According to doctors’ charts, Mary Anne is actually just a smidgen away from suffering from clinically obesity and is certainly overweight. In addition, her cholesterol is high and her doctor is worried. Mary Anne is worried. But recent studies have claimed that we may worry too much. Take for instance these headlines in Newsweek and Globe and Mail, respectively, “You can be fat and healthy at the same time” or “Get Fat, Live Longer.”

Excuse me? Doesn’t this goes against all the common assumptions of obesity and being overweight.

According to David Feeney at the Kaiser Center for Health Research in Portland, “One of the things that happens as many people age, is that they start to lose weight and they are at risk of becoming very frail.”

He conducted a 12 year study on 11,000 Canadians and found that people who were overweight lived the longest, especially those over 60. So it’s actually riskier to be underweight in old age. You don’t want to be skin and bones when you get older, focusing on just mortality and disease statistics neglects several obvious downsides of being old and underweight. Frailty is a major issue and resilience seems to falter with weight as well.

This doesn’t mean you should sell your treadmill and relegate yourself to the couch during off-hours. Exercise in curbing complications associated with obesity and being overweight is still the best route to go, even if you don’t seem to be making any progress with your weight. In fact, studies show that compared to a normal weight couch potato, someone suffering from obesity or is overweight and walks for 150 minutes a week has a 50% lower risk of death. Exercise is truly a super-drug.

The following are some common complications associated with obesity and being overweight and all of them can be curbed with a steady work out routine.

1. Heart Disease – The most common and devastating side effect of obesity or being overweight.
2. Diabetes – Associated with the poor diet habits that cause obesity or one being overweight.
3. Sleep Apnea – A condition where you stop breathing, causing you to wake up suddenly
4. Respiratory problems – Similar to reasons for heart disease, the lungs are overworked in order to provide more oxygen where it needs to be faster. Plus, conditions such as high cholesterol in the arteries can make it harder for oxygen to move freely through your system.
5. Arthritis – A condition common to obesity and being overweight because of the added stress on joints.

Childhood Obesity

When should you start becoming concerned about your child’s weight? Sure, all children gain weight and many grow into it well. But a few too many extra pounds, more than needed to support growth and development, can lead to childhood obesity.

Childhood obesity is clinically defined as when a child’s BMI exceeds 30. This is also the case for adult obesity. Childhood obesity is particularly troubling because diseases and illnesses associated with older people and adults, such as diabetes or high cholesterol, are becoming increasingly common in children.

The following are some jaw-dropping statistics compiled by the CDC on childhood obesity:

According to the CDC, 16 percent (or 9 million) of children ages 6-19 years old suffer from obesity, a statistic that has tripled since 1980. Another 15 percent were considered at risk of becoming overweight. That makes 18 million children in that age group suffering from obesity or at a high-risk for the condition.

In addition, the CDC also found that over the past three decades childhood obesity rate has more than doubled for preschool children aged 2-5 and adolescents aged 12-19 and has more than tripled for children aged 6-11. Overweight adolescents have a 70 percent chance of becoming obese and overweight adults.

One of the best strategies for combating childhood obesity is to improve the diet and activity levels of your entire family. The following is a series of steps to take in helping you child overcome obesity.

1. Have your child examined by a family doctor or pediatrician to rule out any medical causes for obesity and determine if your child can safely participate in vigorous physical activities.

2. Sit down with your whole family and talk about ways to become healthier that year. Be sure you don’t single out your obese child, but strive to make everyone feel and look better. Remember this, if a parent or both suffers from obesity, your overweight child has a 80% chance of growing up into obesity.

3. Don’t make succumbing to childhood obesity any easier for your child. Go through the pantry and refrigerator and throw out all junk food. Potato chips, pre-sweetened cereals, candy, cookies, ice cream, and sodas (try seltzer water with a little bit of juice). Don’t ban your kid from ever eating them, but not having them in the house will simply make it inconvenient to indulge. Forbidding these items completely will just make them more desirable.

4. If your child or even your family is suffering from obesity, limit fast food and pizza delivery to once a week. Meals prepared at home are generally lower in fat and sugar than fast food meals. To make it easier to always have home-cooked meals, use a crock pot the night before to create some really amazing dishes that will be ready the next day or partially prepare meals and freeze them. Many of the chronic illnesses associated with obesity are linked to a poor diet.

5. Try to avoid having your child come home to an empty house every day after school. Try a Boys & Girls Club if babysitting is out of your budget or try asking a neighbor. Children suffering from childhood obesity are often teased and bullied at school, resulting in there coming home and eating comfort food to make themselves feel better.

6. Get the whole family involved, especially if you all suffer from obesity, in a weekly or daily physical activity. Skate, walk, run, or bike, it doesn’t matter as long as every one picks one and does it. Even if you live in a neighborhood that isn’t conducive to nighttime outings (read: dangerous), pop in an exercise DVD or take advantage of tons of free online resources regarding obesity treatment. However, always ask a doctor if you and your family is healthy enough to participate in strenuous exercises.

7. Don’t let childhood obesity get your kid down. Always remind them of how much you love them for reasons besides appearance. Give your child opportunities to develop skills and talents to increase his self-confidence. Don’t let childhood obesity cause depression or social anxiety. Always support them.

Treatment Overview

Treatment for obesity and overweight will be most successful if you create a long-term plan and set reasonable goals with your doctor. Your initial goal should be to improve health, not to achieve an ideal weight. People with clinical obesity or overweight can actually be healthier, when measuring factors such as heart recovery following exercise, than sedentary normal-weighted people.

Although the formula for curing obesity and overweight seems simple, burn more calories than you take in, sounds simple, it is awfully difficult in practice, especially, if a person has lost weight before only to gain it back and then some. As a result, surgery and medication is becoming increasingly popular for people suffering from obesity and overweight. However, health guidelines suggest that people should attempt to make lifestyle changes for at least 6 months before trying surgery or medication to solve their obesity or overweight.

1. Initial Treatment

Be realistic, if you don’t think you are ready to lose weight, focus on improving your health and not gaining any weight. Obesity and overweight is more readily being seen as the end-result, not catalyst, of poor health.  Improve your health and your overweight problem should soon follow suit.

I. Eating Right
Aim for a goal of 1200-1800 calories a day. Research shows that limiting calories, not food types, cause you to
lose more weight. Eat foods that you enjoy, just remember to control portion sizes.

II. Increase Physical Activity
Physical activity helps you burn more calories. One of the best ways to increase your activity is simply walking.
It is an activity you can do safely and routinely alone and is easy to work into the daily schedule. Try using a
step counter as a motivation to improve. Consult your doctor for a moderate and vigorous exercise regiments
and if it is safe for you to do them.

III. Stick With It
There are so many factors that can make us stray from our plans. So start keeping track of everything: start a
food journal, count your steps, track calories burned and factor it into your daily calorie intake. As they say,
seeing is believing and simply looking at the progress you’ve made can be the motivating factor to push you
into the next day. Just remember, battling obesity and overweight may take just as long to heal as it took to
accumulate.

2. Ongoing Treatment

See your doctor after 6 months or so to get an accurate reading on your progress. Some people stop losing weight around this time, because their bodies adjust to the fewer calories, and this effects morale. Your doctor may recommend that you increase your activity and revisit a dietician or nutritionist to further alter your diet. At this point, your goal may switch from losing weight to keeping the weight off. Don’t be discouraged, you have made substantial progress in the battle against obesity and overweight at this point.

In addition, if you cannot lose weight or keep the weight off, it may be time to consider medicines to supplement your new lifestyle change. Remember, medicines without lifestyle changes only result in short-term results at best.

3. Treatment If The Condition Gets Worse

If you’ve made a lifestyle change, but your obesity continues to get worse, it may be time to consider surgery and medicines. The following treatment options are available:

I. Stomach stapling or gastric banding – Both make your stomach smaller and are reversible surgeries.
II. Roux-en-Y bypass or biliopancreatic diversion – Makes your stomach smaller as well, but also limits how much
food is absorbed in the small intestine.

Children's Weight

Results of a American College of Gastroenterology’s 73rd Annual Scientific Meeting in Orlando revealed that many parents do not accurately perceive their children as overweight or at risk for adult obesity. Obesity is often accompanied by an increased risk for a wide array of diseases stemming either from being overweight, or lifestyle habits that brought about being overweight.

In the study, 46 parents of children ages 5 to 9 with a BMI in the 70th percentile or higher (95th and higher is overweight and 85th and above is at-risk) were chosen for the study. Child height and weight were measured during a routine pediatric visit. Parents were then mailed a series of questionnaires which included questions on their perception of their child’s current weight, and whether they perceived that their child was at risk for developing obesity as an adult.

Despite the elevated BMI of their children, less than 13% of the parents of overweight children reported their child as currently overweight. Fewer than one-third perceived that their child’s risk for adult obesity was above average or very high.

This misconception is despite the fact that 17% of children in the U.S. between the ages of 2 and 19 are diagnosed with obesity. An even more startling fact is that children in within that age range who are currently suffering from childhood obesity have a 70% likelihood of growing into adult obesity. This number is bumped an additional 10% if they have a parent, or both, with obesity or overweight problems.

Since parents are probably the most influential factor in laying the foundation for a child’s weight problems, it’s obvious something need to be done to curb the parental disillusionment with childhood obesity and overweight and, in turn, the obesity-overweight epidemic across the world.

In another study, in the U.K., only 1.9% of parents with children at risk for overweight or obesity accurately identified as being at risk for or being overweight. Only 17.1 percent of parents with overweight children accurately identified their child as being at risk for or being overweight.

In New York, the parents who had concern for their children’s’ overweight, 76% thought it was a concern similar to those about sunburn, while 67% found that concerns about overweight and obesity were similar to prolonged television watching.

Although the numbers only say so much, underlying, yet common, quirks identified by researchers were that a parent’s inability to recognize their child’s risk for obesity was especially pronounced if the parents themselves were suffering from obesity or overweight. This is despite the jaw dropping 80% chance a overweight or obese child has of adult obesity if they have one or more parents who are overweight or obese. Cultural influences also may have played a factor. More black women reported being satisfied with their larger size and overweight than white women.

When Frida Sepulveda was 8, she began developing dark folds of skin around her neck. It is a well known sign of type 2 diabetes. Her mother, Blanca Sepulveda, who has watched other family members struggle with diabetes and obesity, was devastated to see her daughter experiencing similar health problems.

Frida is now age 11, about 5 foot 6 inches tall and weighs a bulky 180 pounds. She is considered to be clinically overweight and is in the high-risk group for childhood obesity and adult obesity, especially because many of her relatives have also suffered from overweight and childhood obesity, and to be considered within a healthy BMI, she would need to grow at least  6 inches to have a borderline normal weight BMI.

According to the 2007 National Survey of Children’s health, 18.1 percent of Latino high school students were overweight and 16.6 percent were suffering from childhood obesity.

Aside from genetics, the problem with childhood obesity and overweight Latin-American children has a lot to do with their social and cultural boundaries and habits. Even Frida’s mother thinks that family and cultural standards are a major contributor to Frida’s, and many other Latin-American children’s', childhood obesity and overweight. “The way I was raised… you don’t [leave] the dinner table until you’re done with all your food. That’s instilled in you,” said Sepulveda.

Such behavior makes sense in countries such as Mexico, where many work for what would be weekly or daily wages for the month, and to be wasteful is looked down on. To create a parallel comparison, following the Great Depression, U.S. children were malnourished at record numbers which resulted in government subsidies for school lunches and a changed attitude in the dining room. Dr. Michael Goran, director of the USC’s Childhood Obesity Research Center, had this to say “You can’t just try to change someone’s behavior necessarily without trying to change their environment.”

Another factor is the immense amount of low-skill immigrants pouring over our borders as the result of an immigration system that stresses kinship ties over skills and education. As a result, according to studies by the Heritage Society, one-third of all immigrants live in families which the head of the household lacks a high schooled education; and first-generation immigrants, as is the case for Frida’s mother, and their families, who are one-sixth of the U.S. population, comprise one-fourth of all poor persons in the United States. In addition, first-generation Hispanic immigrants and their families now comprise 9 percent of the U.S. population, but account for 17 percent of all poor persons in the U.S.; and children in Hispanic immigrant families now comprise 11.7 percent of all children in the U.S., but account for 22 percent of all poor children.

What this translates to is a disproportionate number of Latin American children living in poor neighborhoods. In some of these areas, the nearest full-service supermarket may be a town over or even further. Cheap and easily available fast-food is appealing to parents who may be working late into the night and only aggravates the childhood obesity and overweight problem. In fact, research has shown that affluent neighborhoods have not only a higher availability of healthy food, but the cost of healthy food is also lower.

Another aggravating factor is the disadvantaged neighborhoods that many Hispanic children live in. Exercise is a tricky problem if it involves being beat up, robbed, raped, or worse. To that end, research indicates that Latinos living in tightly-knit communities, regardless of poverty, often get more exercise than those in more mixed neighborhoods.

The above factors are incredibly disadvantageous, and could alone be the explanation the overweight and childhood obesity disparity amongst Hispanic children. Exercise and lifestyle habits are the two largest contributors to childhood obesity and overweight and simply put Hispanic children are disproportionately denied the opportunity to practice either healthily.

How can we fix this problem?

Researchers and community advocates alike are attempting to combat the Latino childhood obesity and overweight problem. But the multitude of factors makes facing the issue like trying to hit a moving target and the results of interventions have been mixed.

Associations such as the Healthy Latino Families in Milwaukee has seen success in battling childhood obesity and overweight problems by improving diets and decreasing sedentary time through their programs; however, USC’s Goran, who worked with Latino teenagers over 16 weeks to improve their diet by promoting fiber-rich and low-sugar diets, found that at the end of four months, there were “no significant improvement in the outcomes.”

Childhood Obesity Epidemic

There is an obesity epidemic in the United States. This means that the number of people suffering from obesity has increased steadily in recent years. The root of this problem is often blamed on childhood obesity. According to recent data from the National Center for Health Statistics, approximately one child of every five in the U.S. suffers from obesity.

First, let’s cover what it means to be overweight.

You may think that you can look at someone and tell if they’re overweight, but this is not always true. In fact, obesity is not diagnosed simply by looking at someone, but by taking into account our individual body shape and then measuring our body mass index (BMI), which is calculated using a person’s weight and height. BMI gives an estimate of the amount of body fat relative to lean body mass.

What causes childhood obesity?

There is evidence that ties obesity to genetic factors, but personal behavior and dietary habits are probably the most important factors. Childhood obesity is often the result of children gorging themselves with an increasing amount of calories, especially calories from fat, than they need a day.

What are the complications of childhood obesity?

Besides the social difficulties, and the emotional issues that arise from thus, childhood obesity puts children at risk of health problems such as orthopedic problems, sleep disturbances, menstruation problems and diabetes. Some researchers have also suggested at a link between childhood obesity and asthma. In addition, children who suffer from childhood obesity are also more likely to suffer develop high blood pressure, high cholesterol, heart disease, arthritis, and certain kinds of cancers as adults.

Childhood obesity can also increase chances of being bullied and lead to a life of obesity. The obesity epidemic has extensive personal consequences and, inevitably, significant financial implications as well.

What can be done?

If you suspect your child suffers from childhood obesity, contact their pediatrician. Your child’s BMI will be compared with national growth charts to decide if he will be diagnosed with obesity. Your doctor will then suggest a target weight for your child.

Next, it’s time to sit down together as a family and make a plan. The whole family must be involved, especially if parents or siblings also suffer from obesity. Remember, the child does not make decisions regarding family meals and activities. In addition, refrain from approaching the problem with a “you are fat and need to lose weight” approach, but attempt to convey the idea that “we all need to eat right and be active so that we can be healthy.”

In addition to any changes made at home, be sure that the fight against obesity does not end the minute your child steps into school.

Schools have a responsibility to help students avoid obesity by encouraging them to become more active and eat better. The following are reasons why schools are having such a tough time battling obesity:
1. Soda and snack machines along with snack bars boast impressive financial incentives from their  suppliers.
2. School districts “in the red” are hard pressed for resources to create quality phys-ed programs
3. Increasing demand for higher academic achievement in core subjects

The rate of childhood obesity has skyrocketed since the 1980′s. While the immediate impacts are worrisome, the long-term effects on sustainable health care, general well-being and quality of life are profound. Obesity is a full-blown epidemic and it needs attention now.