Introduction
Despite the mass educational campaigns -- by the health profession, the public, and the media -- on the benefits of healthy diets and physical activity, obesity continues to be a growing problem not only in the United States but globally. By definition, obesity is an abnormal accumulation of body fat, normally 20% and above over the individual's ideal body weight (The Medical Dictionary). According to CDC, obesity and overweight are ranges of weight that are significantly greater than the healthy weight for a given height. This increases the likelihood of various health problems. Body Mass Index (BMI) is used to determine the obesity and overweight ranges for adults because it correlates with the amount of body fat for most people. A BMI of 25 to 29.9 is regarded as overweight while 30 and above is considered obese (CDC). This paper focuses on the prevalence and trends of obesity in the United States. Various research studies have been analyzed, and a conclusion drawn that, indeed obesity is a growing problem in the United States.
Objective
The main arguments in this paper are limited to the reference materials. No primary data has been used; instead, the researcher analyses the findings of various research studies as draws a conclusion based on the analysis.
Literature Review
The rapid increase in obesity rates started in 1980s. According to Finkelstein et al. (2005), obesity prevalence in the U.S. increased at a rate below 2% to 15% between 1960 and 1980. From 1980 to date, obesity rates have increased more than twice. In the early 1990s, obesity rate was 23%, and by 2000, obesity rate had increased to 31% (Finkelstein et al., 2005). With the increase in obesity prevalence, incidences of obesity-related diseases have also increased. Such diseases include cardiovascular disease, type 2 diabetes, musculoskeletal disorders, gallbladder disease, sleep apnea, and various types of cancer such as kidney, colon, postmenopausal breast, and endometrial cancer (Finkelstein et al., 2005). By 2004, obesity accounted for about 400,000 deaths, the second after tobacco (Finkelstein et al., 2005). Because of this, obesity has now become a public health crisis in the U.S. (Wang et al., 2008). Various data reveal that obesity prevalence has increased steadily over the past three decades, with the current evidence suggesting that the prevalence is likely to rise further (Wang et al., 2008). If the problem of obesity cannot be controlled, it’s likely that the life expectancy of the current U.S generation may be shorter (Wang et al., 2008). Economically, obesity and overweight have greatly increased the health-care costs; with studies revealing that the medical expenses attributed to obesity and overweight is likely to continue to rise with the increased prevalence of obesity (Wang et al., 2008).
Causes of obesity and overweight
An increased in body weight is basically caused by consuming more calories than one can expend. Despite the abundant benefits of maintaining healthy weight and physically active lifestyle (Marks, 2004), people continue to eat large portions of food than needed and remain less active physically. According to Marks (2004), Sedentary U.S. adults eat an average of 500–800 more calories per day than needed. This results into a gain of 1-1.5 pounds a week. The ready availability of food, increased food adverts, and lack of enough opportunities for exercise, all contribute to the rise in obesity rates. Besides, people continue to eat not for hunger, but for social, emotional, and cultural reasons (Marks, 2004). The question, however, is why the imbalance in eating habits and physical exercise changed abruptly from 1980s to date.
Finkelstein et al. (2005) argue that the main causes of obesity are: reduction in energy expenditure, and increase in energy intake. The technological change has greatly reduced the energy expenditure in the workplace (Finkelstein et al., 2005). This largely increases the obesity epidemic. Improvements in workplace technology and the shift from manual employment might have contributed to the increased obesity rates in 1980s. Considering the employment in manufacturing industries against the service industries; the salary and wage workers fell from 27% to 19% between 1980 and 2000 (Finkelstein et al., 2005). The gradual decrease in manual labor is a most likely cause of increased obesity rates. With the invention and increased use of labor-saving devices such as home washing machines and dishwashers, the physical/manual activity gradually decreases. According to Finkelstein et al. (2005), the use of washing machines increased from 55% in 1960 to 79% in 2001, while the use of dishwashers increased from 7% to 54% during the same period.
Various research studies reveal that the number of calories consumed has remarkably increased from 1980s as obesity itself. The growth in energy consumption explains the increase in body weight. Between 1910 and 1985, the intake of calorie remained roughly constant; however, it rose by approximately 12% (300 calories per day) from 1985 to 2000 (Finkelstein et al., 2005). This increase was due to the increased consumption of grains, added sugars, and added fats.
The increase in energy intake is attributed to the increase in carbohydrates consumption. Between 1976 and 1980, adult males and females aged 20–74 years consumed 1039 kcal and 700 kcal of carbohydrates respectively daily. Between 1999 and 2000, the numbers increased to 1283 kcal and 969 kcal (Finkelstein et al., 2005). Beverage consumption also contributes to the increased weight. In 1997, the average consumption of soft drinks and fruit juices by the average American was 53 gallons and 17 gallons respectively, a 51% and 40% increase since 1980 (Finkelstein et al., 2005). Between 1988 and 1994, 20 –24% of calories consumed by children came from beverages.
Changes in the eating patterns have greatly contributed towards the increase in energy intake. For instance, snacking has become more prevalent with time (Finkelstein et al., 2005). Some research findings reveal that higher snack calories are mainly responsible for the increase in energy intake among females and 90% among males. The prevalence of snaking, the number of snacks consumed per day, and the energy density of the snacks, all contribute to increase in weight.
The academic knowledge and the impacts
The study by Wang et al. (2008) found that obesity is clearly an alarming epidemic. The study projected that, if the trends do not change, then, 80% of all American adults will either be obese or overweight in the next 15 years. All adults have the potential of becoming obese or overweight, especially the black women whose prevalence rate was 78% in 2008. The study also projected that in every decade, the direct health-care costs attributed to overweight and obesity is likely to be more than twice. This means that, by 2030, the health-care costs could range between $860.7 billion to $956.9 billion. This study and the projections were based on the observed trends in the past three decades. However, the trends may change and the projections may not be accurate. The authors are however, very certain that the increase in obesity prevalence will not slow down unless the future prevalence reaches a high level or effective interventions emerge (Wang et al., 2008). Besides, the continuing societal changes and changes in people’s lifestyles are likely to increase the risk for obesity. As more people get to work in offices, the more they are exposed to snacks and other unhealthy foods. The change in attitude about healthy body weight may also increase the proportions of the obese population. The behavioral and environmental forces that fuel obesity epidemic are not likely to change overnight. Besides, effective prevention measures may give significant impacts after a long period of time.
Wang et al. (2008) believe that obesity is a serious problem that cannot be contained or be stabilized in future, unless very serious interventions are taken. The truth however, is that the study was based on numerous assumptions. These assumptions may not be accurate based on the future behavioral, environmental, and policy changes. Besides, the environment is not likely to worsen at past rates, thus, the obesity prevalence rates may not increase linearly as projected. This study however, provides evidence of severity of obesity and its impacts on the current and future societies if effective interventions are not put in place.
Marks (2004) argue that almost two-thirds of adult Americans are obese or overweight and health care providers do not know how to help the patients. However, with the increased awareness and educational efforts to fight obesity, especially by the NAASO (North American Association for the Study of Obesity) and the ADA (American Diabetes Association), the future of is likely to be brighter. A blend of diets, portion control, self-monitoring, calorie-counting, and increased exercise and physical activity, as recommended by these bodies of experts, are likely to curb the obesity prevalence if people put them into practice. This however depends on the behaviors of the individuals.
The study by Flegal et al. (2012) found that obesity prevalence in men had a significant linear trend between 1999 and 2010. The overall increase for women was not significant. The study further revealed that the obesity prevalence estimates for 2009-2010 for both men and women did not vary significantly from the 2003-2008 estimates. This shows that current obesity prevalence rates are not increasing at the previous rates. Besides, the increase is likely to level off in future. The study however, had no indication of the decline of obesity prevalence. While the increase in food intake may be attributed to the expansion in food system and the success in food processing, resulting into the availability of affordable foods, predicting the future trends in obesity is not easy (Flegal et al., 2012). Most obesity predictions assume that the underlying factors for obesity are likely to increase in future, increasing obesity prevalence; however, the findings by Flegal et al. (2012) reveal that such assumptions may not be accurate and obesity prevalence is likely to level and possibly reduce in future. The study by Li et al. (2007) also revealed an increasing prevalence of abdominal obesity among the U.S. adults, predicting a future increase.
Susan and Jack Yanovski (2011) took a different approach in examining the current and future trends in obesity prevalence. Based on the data and reports from various organizations and research studies, the authors examine the causes of the variations in the reports, which have led to confusions regarding the obesity prevalence. For instance, CDC data disclosed that obesity prevalence increased at 1.1% between 2007 and 2009. Projection of this data indicates that by 2050, 100% of the Americans will be overweight. Other reports suggest that the obesity prevalence has stabilized. Such reports include the CDC’s 2007–2008 report that suggests that obesity prevalence among women and children (35.5% and 16.9% respectively) has been stable over the past 10 years while that of men (32.2%) has not shown any significant change since 2003. These are just but a few of the conflicting reports. It’s amazing that in both reports, data comes from trusted government agencies, yet the estimates of the obesity prevalence are different. While the Yanovskis point out data-collection methods as the main cause of the difference, these two reports lead to some important questions.
If the obesity prevalence has stabilized over the past ten years, what have been the driving factors? This can be due to increased recognition of the effects of obesity by the health professionals, governments, researchers, community organizations, schools, industries, and the public, thus, reducing the environmental and behavioral contributors. Even if this was true, the data incorrectly depicts the actual situation, especially the very heaviest boys whose numbers continue to increase (Yanovski and Yanovski, 2011).
Conclusion
Despite the various conflicting reports, it’s a common knowledge that obesity prevalence is high in United States. However, it may not be as high as indicated in some research studies and reports, especially among some ethnic minority populations. The decreasing trends and stabilization, as indicated in other reports, reveal that efforts are underway to curb the problem of obesity and overweight. However, without effective measures, obesity is likely to be a growing problem. The effects of obesity, especially on the economic, psychological, and physical health of the country (Puhl and Heuer 2009), should not be understated due to the fact that obesity related problems continue to increase both in children and in adults. Currently, the number of children with obesity-related diseases such as hypertension, type 2 diabetes, and fatty liver disease continue to increase. It can therefore be stated, without any fear of contradiction, that obesity is a growing problem.
Further research should be conducted to identify the actual situation regarding obesity prevalence. This would help in avoiding the misreporting and data mismatch, and more importantly help in determining the most effective ways of intervention in order to prevent obesity. Women should be helped to achieve a healthy weight before, during, and after pregnancy. Infants and young children should also be helped, especially in the nutrition, sleep patterns, and activity. With the high prevalence rates, there is increased need for more effective and safer treatments that sustain and encourage weight loss. United States is in trouble despite the current obesity prevalence rates, shall it fail to adopt effective preventive strategies.
Reference
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Definition of Obesity. The medical dictionary. Retrieved December 16, 2012 from
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Wang, Y., Beydoun, M.A., Liang, L., Caballero, B., and Kumanyika, S.K. (2008). Will All Americans Become Overweight or Obese? Estimating the Progression and Cost of the US Obesity Epidemic. Obesity, 16 (10): 2323–2330. doi:10.1038/oby.2008.351 Retrieved December 16, 2012 from
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