Obesity in the US
More than 4 in 10 Americans are Obese
“More people in the US die of too much food than too little”
John Kenneth Galbraith
Today, rising levels of obesity are causing a public health crisis across the United States. Obesity results from an individual’s inherited factors combined with their lifestyle choices including diet and exercise. According to the CDC, the prevalence of obesity increased from 30.5% to 42.4% between 2000 and 2018 while severe obesity increased from 4.7% to 9.2% in this same time period. Many factors have led to this increase – the intake of higher levels of sugar, processed and fast foods and greater consumption of fat, larger meal portions, poor sleep, higher levels of stress and anxiety, and reduced levels of daily activity due to sedentary, desk-bound jobs.
People who are overweight or obese are at risk of many serious diseases. Obesity-related health conditions include heart disease, stroke, type 2 diabetes and certain types of cancers –all which can lead to premature death. In fact, obesity has been tied to:
Type 2 diabetes
High blood cholesterol and high triglycerides
Heart disease and high blood pressure, atherosclerosis, heart attacks and stroke
Respiratory issues including obstructive sleep apnea , asthma, and obesity hypoventilation syndrome
Cancers of the esophagus, pancreas, colon, rectum, kidney, endometrium, ovaries, gallbladder, breast, and liver
Osteoarthritis, a chronic inflammation that damages the cartilage and bone around the joint. This inflammation is a major cause of knee replacement surgery in patients who are obese
Urinary incontinence
Metabolic syndrome -- a cluster of conditions occurring together which increase your risk of heart disease, stroke and type 2 diabetes. These conditions can include increased blood pressure, high blood sugar, excess body fat, and abnormal cholesterol or triglyceride levels.
Emotional challenges such as low self-esteem or depression
Social isolation
And reduced quality of life
As we have discovered in the past year, people with certain underlying medical conditions such as COPD, cancer, kidney disease, heart disease and obesity are at increased risk for serious illness from COVID-19.
Obesity is primarily caused by the increase in the size and the amount of fat cells in the body. Commonly this occurs from an energy imbalance. Your energy ”in”, (as measured in calories), does not equal your energy “out”, the amount of calories your body uses for basic functions -- breathing, digesting, being physically active, and regulating body temperature. Obesity develops over time when you take in more calories than you use in turn causing your body to store fat.
Some risk factors for obesity you can control such as a lack of physical exercise, unhealthy eating patterns, not enough sleep, and high amounts of stress; other risk factors such as your age, genetics, or race are beyond our control.
To diagnose obesity, doctors measure body mass index (BMI) and waist circumference. A healthy weight for adults is usually when your BMI is 18.5 to less than 25. “Overweight” is defined as a BMI of or greater than 25. “Obesity” is a BMI greater than or equal to 30.
To find your BMI, visit https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
Like a high BMI, an increasing waist circumference also boosts your risk for obesity-related medical complications.
The key to maintaining a healthy weight is not short-term diets; it requires a lifestyle which consistently includes healthy eating, the right caloric intake, and regular physical activity.
For adults with normal weight, 2 ½ hours of physical activity a week is recommended and should include aerobic activity as well as exercises that strengthen muscles. To control or reduce body weight, increasing the intensity of weekly activity or the amount of time is likely required. In terms of diet, it is best to eat three meals and avoid snacking, focus on lower calorie, highly nutritional fruits, vegetables, nuts and whole grains while avoiding saturated fats, sweets, alcohol and heavily sweetened beverages. To learn more about your energy intake and optimal levels of exercise visit https://www.niddk.nih.gov/bwp and https://health.gov/MoveYourWay/Activity-Planner/
If healthy lifestyle changes are not enough to reduce weight to a healthy level, a doctor may recommend FDA-approved medications such as diethylpropion, phendimetrazine, lorcaserin, naltrexone/bupropion, and liraglutide. These medicines can change the way our brain controls our urges to eat. For people who do not respond to healthy lifestyle changes or medication, surgery may be recommended. Gastric bypass, gastrectomy or gastric banding – all decrease the amount of food you can consume.
With the COVID-19 pandemic, controlling our weight to better manage underlying health conditions is more important than ever before. The good news is that most often a healthy weight can be accomplished through a consistent diet and physical activity.