What is Obesity?
Obesity comes about when you have too much body fat built up – enough that it starts to affect your health negatively. Most physicians use BMI and body mass index to measure obesity. BMI is the ratio of your weight to your height.
A BMI of 30 or higher means you’ve crossed over into obesity territory. There are different classes of obesity, too, based on how tall you are over 30.
- Class 1: BMI 30 to <35
- Class 2: BMI 35 to <40
- Class 3: BMI ≥ 40, sometimes referred to as “extreme” obesity
An overweight BMI falls between 25 and 29.9. Being overweight isn’t as risky as having obesity, but it still raises your chances of health problems.
Obesity Numbers and Trends in the US
Here’s where we’re at obesity-wise around the U.S. today:
- American adults that are obese are over 40%. That number was 30.5% back in 1999-2000, so it’s rising quite fast.
- Each American state has different obesity rates. That means 25% in States like Colorado and Hawaii have 25% while other states like Alabama and Mississippi have a whopping 35% obesity rate.
- The highest obesity rates can be seen as more prevalent among people aged between 40 and 59 (middle-aged adults). A whole 45% of people in this age group fall in the category of obese people.
- Comparing the races, non-Hispanic black adults have the highest percentage (49.6%) of obesity. Following closely are the Hispanians, where most adults record at least 44.8% of obesity. White adults of non-Hispanic origin are at 42.2%, and non-Hispanic Asian adults at 17.4%.
- Kids and teenagers, mostly aged between 2 to 19 years, record 19.3% of obesity and 16.1% overweight. That’s a whole 14.7 million kids who are obese in the U.S.
Downward Trends
- The number of adults with obesity in the U.S. has nearly tripled. That’s if you are counting from the 1960s when it was only 13%.
- The obesity rates keep rising, with an increase of up to 26% between the years 2008 and 2017.
- The obesity rates for kids and teens have skyrocketed. The numbers have more than tripled since the 1970s.
- Sadly, the CDC predicts about half of American adults will be obese by 2030 if nothing is done about the worrying situation. Even worse is that American kids are getting heavier at even younger ages.
The U.S. records a high number of child obesity rates in comparison to other developed countries. The numbers are among the highest in the world, with the country in 12th place. These numbers are way above the average OECD.
The data shows the urgent need for American citizens to take action against obesity nationwide. But based on these trends, the average American may need help to afford decent healthcare services if these numbers keep rising. Hence, the rise of GLP-1 medication in the recent years. To prevent this, it is the best way to implement the policies and programs put in place by the government to avert unhealthy lifestyles.
Underlying Causes of Obesity
Obesity is a complex condition with no single cause. Multiple factors that shape our environments and behaviors interact to drive the obesity epidemic. These include:
Diet Quality and Calories
Today’s food trend and system advocates for excess consumption of unhealthy foods, from sugar-laden foods, and fatty foods, to salt-laden pre-processed foods. In the U.S., this trend is more prevalent, with the unhealthy diet winning over healthy foods. An example is that most people’s intake of fruits, vegetables, whole grains, and some healthy food falls drastically below the recommended levels. Our daily diets provide too many calories and too few nutrients. This imbalance can readily lead to weight gain over time.
Food Environment and Access
For many Americans, barriers exist to accessing affordable, nutritious foods. Food deserts and food swamps dominate many lower-income neighborhoods, making healthy eating difficult. On the other hand, energy-dense processed and fast foods are cheap and readily available in these communities. Improving access to and affordability of fresh produce and healthy groceries is key to transforming our food environment.
Physical Inactivity
A mere 25% of American adults adhere to the recommended physical activity standards, which call for an average of 150 minutes of moderate exercise per week. Instead, sedentary lifestyles have become a habit. For instance, individuals now spend over 8 hours a day seated. Lack of physical activity reduces daily calorie expenditure while causing slow metabolic processes that promote fat storage.
Genetics and Family History
While not entirely deterministic, genetics and family histories do play a role in obesity risk. Some individuals are predisposed to gain weight more easily due to biological challenges in regulating hunger/satiety or metabolism. Still, behavioral and environmental interventions can help those with greater genetic susceptibility maintain a healthy weight.
Sleep Habits
Both sleep duration and sleep quality have been associated with obesity risk. Getting less than the recommended 7-9 hours of sleep or having untreated sleep apnea can dysregulate hormones controlling hunger and satiety. Prioritizing and improving sleep duration and quality through behavior change and medical treatment may aid weight management.
Effects of Medications and Health Conditions
Some medications like steroids, antidepressants, and seizure meds can make you want to eat more and cause weight gain. Also, some health problems like polycystic ovarian syndrome, PCOS, Cushing’s disease, and hypothyroidism can make you put on some extra pounds. In such cases, treating the underlying condition when possible and making appropriate medication adjustments can help with unexplained weight gain.
Socioeconomic Factors and Healthcare Inequities
Poverty, discrimination, and unequal access to medical care and other resources create barriers to achieving a healthy weight, especially in marginalized racial/ethnic communities. Improving economic opportunities and healthcare access while also addressing systemic biases is needed.
Health Risks and Costs of Obesity
The risks that accompany obesity are very serious and even scary. Here are some examples to look out for:
Type 2 Diabetes
Obesity increases your chances of getting diabetes. We’re talking over 90% of folks with diabetes are dealing with excess weight. That extra body fat leads to insulin resistance and whacky high blood sugar levels, which is diabetes in a nutshell. Even losing a moderate amount of weight can make a huge difference in controlling diabetes and avoiding complications. Many people with diabetes are taking GLP-1 medications such as Victoza and Trulicity to manage their blood glucose.
Cardiovascular Disease
All that extra weight stresses your cardiovascular system, leading to heart complications. Obesity is tied to:
- Coronary artery disease
- Heart attacks
- Strokes
- Heart failure – you name it.
Dropping some pounds improves cholesterol, lowers blood pressure, and reduces your risk of cardiovascular disease.
Cancer
Thirteen different kinds of cancer are more likely with obesity, which is not a good thing. Some of the big ones include
- Breast
- Colon
- pancreatic
- Kidney
- Esophageal cancer.
Some possible reasons involve metabolic dysfunction and chronic inflammation from too much fat tissue.
Nonalcoholic Fatty Liver Disease (NAFLD)
About 75% of obese folks have this condition where fat builds up in liver cells, and it can progress to cirrhosis and liver failure. Losing at least 10% of weight may help resolve the fat accumulation and inflammation.
Chronic Kidney Disease
Obesity-related diabetes and high blood pressure are major causes of CKD. But, excess weight itself also leads to kidney disease through inflammation and other mechanisms, even without diabetes or hypertension.
Impact your Quality of Life
In addition to the elevated risks of medical complications, obesity often negatively impacts mental health and quality of life, including:
- Discrimination
- Reduced self-esteem
- Depression
- Anxiety
- Social isolation
Obesity seriously impacts people’s quality of life as most obese folks often have trouble with physical functioning, and some report worse overall health-related quality of life.
Worse? The medical costs of treating all those obesity-related diseases are crazy! We’re talking around $173 billion annually, making up nearly 10% of all healthcare spending. That’s an insane chunk of change.
For one person, being obese can make their annual healthcare costs jump by $1,861 on average compared to someone at a healthy weight. The financial burden on top of the health impacts shows why obesity is such a significant public health crisis.
Solutions and Interventions
With obesity exacting high individual and societal costs, impactful solutions are needed at all levels. Some of these solutions are:
Individual Changes
Physicians should initiate respectful conversations with patients about weight status and work collaboratively to set diet, physical activity, sleep, and stress management goals tailored to the patient’s needs and preferences. Even a 5-10% weight loss confers meaningful health benefits. Referral to nutritionists or comprehensive weight loss programs may provide further support.
Healthcare System Programs
Insurers should cover, and healthcare systems should provide evidence-based obesity treatment options, including:
- Nutritional counseling
- Physical activity coaching
- Cognitive behavioral therapy
- Anti-obesity medications
- Bariatric surgery for severe obesity.
Just as treatment is covered for other chronic diseases, comprehensive obesity care should be accessible and affordable for all patients.
Community and Environment
Local governments can implement policies to promote healthier behaviors. Ensuring underserved neighborhoods have access to:
- Affordable, nutritious foods
- Constructing sidewalks and bicycle lanes
- Creating exercise facilities and programs in parks
- Establishing community gardens and farmers markets to enable healthier eating and activity habits.
Policy Interventions
These include evidence-based policies like sugary beverage taxes to reduce consumption of empty calories, implementing nutrition education curricula in schools, financing grocery stores offering fresh produce in food deserts, and running obesity prevention public health media campaigns.
Health Equity Efforts
We must address disparities in healthcare access, income, and other social determinants that disproportionately predispose lower-income and minority groups to obesity.
