The endemic of obesity presents a key challenge to the prevention of chronic diseases globally. Fueled by factors such as urbanization, industrialization, sedentary lifestyle choices, economic growth, and nutritional shift to high calorie diets and processed foods over the last 25 years, some nations have seen the prevalence of obesity increase among its citizens (In Litwack, 2013). The purpose of this paper is to explore diabetes as a health problem using a descriptive epidemiological approach. The paper defines the agents and conditions of obesity and studies the data on mortality, morbidity, and diabetes classification. In addition, the paper gives a summary of the existing hypothesis that explain the distribution obesity. Lastly, the paper offers suggestion on areas of further epidemiologic research.
Definition of Health Problem
Obesity is defined as a medical condition whereby excess fat is accumulated in the body to a level that it can affect the normal functioning of the body (In Litwack, 2013). A person is classified as obese when their Body Mass Index (BMI) is more than 30 kg/m2, overweight when the BMI range is between 25–30 kg/m2, and healthy when between the BMI range of 18.5–24.9 kg/ m2. Table 1 showing how BMI is used to determine a person’s health.
Table 1. Classification of Weight Status with respect to BMI (Source: Centers for Disease Control and Prevention (2017))
Obesity is becoming a common problem worldwide because modern lifestyle involves eating disproportionate amounts of cheap foods with high amounts of calories, spending most of the time sitting at homes, in offices, or in cars, and not actively engaging in physical exercise. The leading cause of obesity is an excessive intake of fats, physical inactivity, and genetic susceptibility. In a few cases, the causes of obesity can be linked to medication or endocrine and mental disorders. As posited by Flegal et.al. (2016), people diagnosed with the condition have a high energy expenditure since they require more energy to maintain their body mass.
According to James (2009), obesity is a condition that heightens the possibility of prolonged disease morbidity. The effects of obesity include obstructive sleep apnea, depression, osteoarthritis, cardiovascular diseases, disability, Type 2 diabetes, and some cancers. In the worst case scenarios, obesity may also lead to death. Additionally, obesity in children leads to the same problems leads to premature onset of these problems or an increased probability in adulthood. Therefore, the psychological and economic costs of the condition are striking. Obesity can be prevented by combining improved personal choices and social changes, which include exercising regularly and following a healthy diet. Medication can also be used to decrease the absorption of fats and reduce appetite. Gastric surgery is considered as an option if a combination of these solutions is not effective.
According to data released in 2015, 12 percent of the population in 192 countries, which is approximately 100 million children and 600 million adults, were reported to be obese (CDC, 2017). Professionals in the medical field claim that obesity is among the most severe public health issues of the 21st Century. It was classified as a disease in 2013 by the American Medical Association (AMA). From the above discussion, it is clear that the rates of mortality and morbidity of obesity are significant and should call for more attention towards the appropriate management of the disease.
Summarization of Data
According to data provided by National Health and Nutrition Examination Surveys (NHANES), roughly 69%of adults are obese or overweight with over 79 million adults in the U.S categorized as obese in 2010 (Centers for Disease Control and Prevention, 2017). Additionally, according to National Centre for Health Statistics (NCHS), approximately 37 percent of adults in the U.S are obese. In the U.S, the estimated medical cost of the disease in 2018 was $147.
Data from AMA shows that Non-Hispanic blacks are at a higher risk of becoming obese compared to any other group. They recorded the highest rates of obesity at 48.1% followed by Hispanic whites at 35%, Hispanics at 23%, and non-Hispanic Asians at 11.7%. Studies show that obesity is higher in middle-aged adults aged between 40–59 years and older adults aged 60 and above, and younger adults aged 20-39.
Under the socio-economic factors, those with higher incomes are more likely to suffer from obesity compared to those with low income. Additionally, obesity is higher in women with higher income compared to those with lower incomes. As stated by Flegal et al. (2016), there is a lack of significant connection between education and obesity among men. However, among women, the educated are less likely to be diagnosed with obesity compared with the less educated.
Childhood obesity, on the other, hand is a serious issue in the U.S and puts children at a risk of experiencing serious health issues. Data from 2011 to 2014 revealed that among the children and teenagers from 2 to 19 years, obesity prevalence was stable at 16.5% and affected 12.7 million children. The non-Hispanic blacks recorded an obesity rate of 19.5% and that of non-Hispanic whites was 15%. Additionally, obesity prevalence among 2–5, 6–11, and 12–19 year old children was 8.9%, 17.4%, 20.6%, respectively.
Fig 1. Graph showing the prevalence of obesity among children
Table 2. Obesity rates among men and women (NHANES survey of the National Center for Health Statistics (NCHS) in 2013- 2014)
When it comes to marital status, ethnicity and gender take a central role in determining the level of obesity. Married people are likely to be overweight compared with the unmarried, which is more prevalent in men. Data showed that divorced men, Hispanic men, and never marred-black men had lower rates of obesity. In addition, black separated women showed higher chances of becoming obese. White women were found to have lower rates of obesity compared with black married women as their culture accepts various body shapes.
There are many hypotheses proposed to explain obesity that are summarized below-:
One study revealed that there was a remarkable relationship between the increasing population numbers and the growing driving population (Flegal et al., 2016). In this case, the inference is that the use of cars results in reduced physical activity.
Fig. 2 Relation between obesity and driving in America
Another hypothesis is that more than half of the American food dollars are spent on processed, restaurant, and take-away meals, which has more calories compared to homemade food. The average breakfast, lunch, and dinner from restaurants have approximately 261, 183, and 291 calories more than the respective homemade meals, which accounts to 745 more calories daily.
Americans eat few vegetables and fruits on a daily basis. On average, individuals in the country consume 250–300 grams of carbohydrates daily, which is over half their calorie intake. Medical professionals agree that for people to live a healthy life, half of what they eat each day should be food products made from plants, which is one of the factors of obesity in America.
The last hypothesis is that Big Food, defined as the multinational food and beverage industry, is a major contributor of obesity. Sweeteners or added sugars in sugary beverages, cakes, and processed foods constitute a big part of the average US diet. On a daily basis, men and women should not consume more than six and nine teaspoons of sugar, respectively. However, as reported by Center for Science in the Public Interest, the average citizen in the US consumes more than 18 teaspoons of added sugar daily. While added sugar intake plays a role in increasing obesity rates, other causes include social media, high fat intake, stress, less sleep, and environmental chemicals.
While all these hypotheses offer compelling explanations on the increase of obesity, the main driving force is a mixture of behavioral, environmental, and genetic factors.
Further Epidemiology Research
Obesity is a multifaceted socioeconomic and physiological problem that spans a number of research subjects that requires funding. Further epidemiology research should produce a better understanding of obesity mechanisms in a way that the insights gained can be used to develop efficient ways to treat and prevent the disease.
Instead of experts focusing on one causal agent, multiple agents should be addressed as physiological and socioeconomic factors. For instance, the health sector should come up with policies that reduce the intake of added sugars and salts in foods by introducing active screenings and drug therapies. Experts should also research on the effects of population growth on obesity. Research should conducted on developing therapies to detach obesity from its severe effects.
Further research should be done to determine a number of intervention strategies for treating and preventing obesity. People should be educated on environmental, genetic, and biological causes of the condition. Lastly, more information should be provided on the relation between fat distribution and body weight on increased obesity risk and on better ways of assessing energy expenditure and energy intake.
Obesity, as discussed, is a social issue that can cause several health issues such as cardiovascular diseases, Type 2 diabetes, and some types of cancer. Many institutions help in reducing, preventing, and supporting obesity patients. Additionally, these institutions can help by spreading awareness about the benefits of good food habits and daily physical exercise. Obesity presents one of the most severe threats to people’s health. The data presented in this discussion highlighted how obesity has increased among both children and adults worldwide. In conclusion, the paper explored diabetes as a health problem using a descriptive epidemiological approach.
Centers for Disease Control and Prevention (2017). Overweight and 0besity. Retrieved from https://www.cdc.gov/obesity/index.html .
Flegal K., Kruszon-Moran D, Carroll M., Fryar C, & Ogden C (2016). Trends in Obesity among Adults in the United States, 2005 To 2014. The Journal of the American Medical Association. 2016; 315(21):2284–2291.
In Litwack, G. (2013). Obesity. London: Academic Press
James, W. P. T. (2009). WHO Recognition of the Global Obesity Epidemic. International Journal of Obesity, 32(7), 120.
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