The Obesity Epidemic: Trends and Reactions
Many people — college students surely well-represented among them — are familiar with the feeling of pinching what they perceive to be an extra roll of fat around the waist and wondering where it came from. Shapes, weights and body types have no bearing on a person’s beauty and worth, even though they unfortunately influence that same person’s self-image and self-confidence in unfairly significant ways. The rising concern of the obesity epidemic, however, steps away from the realm of judgments or personal criticisms and moves into the conversation of an objective health crisis. William Dietz, the former Director of the Division of Nutrition and Physical Activity in the National Center for Chronic Diseases Prevention and Health Promotion at the CDC, commented back in a 2002 Web MD article, “The American public still views obesity as a cosmetic problem. The challenge is to get the public to recognize that this is a health problem and it’s one that they can do something about.” This problem holds just as true today as ever before.
Obesity is clinically defined according to body mass index (BMI), a value obtained by dividing one’s weight (in kilograms) by the square of one’s height (in meters). A person with a BMI of 25-29.9 is considered to be overweight, while obesity is characterized by a BMI equal to or greater than 30. According to a 2017 CDC data brief, obesity rates in the U.S. in 2015-16 hovered around 39.8% among adults age 20 and up, exceeding the 18.5% recorded among children between the ages of 2 and 19. While the prevalence of obesity is and has long been undoubtedly greater among adults as compared to children, the prevalence among both age groups has demonstrated a comparable and significant trend toward elevation since the obesity epidemic was first identified in the late 1990s. An alarming 2019 report published by Zachary J. Ward and colleagues in the New England Journal of Medicine predicts that within the next 10 years, obesity rates may spike to nearly 50% of the adult American populace.
Why, though, has obesity risen to the spotlight as a major public health concern? For those who insist that obesity is more than a simple cosmetic problem, what catastrophic consequences do they foresee on the horizon, and why can’t the issue be tackled on an individual, case-by-case basis? With the steady climb in obesity rates, the medical community has observed accompanying climbs in related conditions such as Type 2 diabetes, coronary artery disease, certain associated cancers, and other negative health outcomes. In 2002, James O. Hill, then Director of the Center for Human Nutrition at the University of Colorado Health Sciences Center, addressed this concern. He voiced the fear that dealing with the consequences of the surge in obesity-related diabetes alone “will break the bank of our healthcare system.” In other words, Hill and other like-minded professionals worry that the obesity epidemic will segue into a drastic increase of disease that our current healthcare system will not be able to handle — both in financial terms and in terms of our technical treatment capacities.
Between 2005 and 2010 alone, annual adult obesity healthcare expenses nationwide spiked by 48.7%, reaching a staggering $315.8 billion. If the recent trajectory continues unabated, there will be too many people needing too many treatments and not enough resources to provide the care they need. People may feel personally wounded or criticized when told they are obese, as the issue is closely tied to body image and is therefore sensitive by nature. Nonetheless, while it is important to always maintain respect and consideration, fear of offending people’s sensitivities must be held at lesser importance than the need to save people’s lives and health. According to Dietz, “The focus needs to be on environmental and policy solutions rather than individual behavior change. Because it’s changes in the environment that caused this problem and it’s changes in the environment that will solve it.” Experts in his camp feel that if we deal with cases of obesity on the small-scale, individual level, treating the obesity-related health outcomes as they arise, the battle will already be lost. The only effective stance to take is to work preventatively on the macroscopic level.
Almost everyone, laypeople included, would agree that diet and exercise are the twin pillars that contribute to the maintenance of healthy weight. But the issue is more complex than a matter of whether individuals are theoretically aware of what choices should be made. This complexity is underscored by the socioeconomic and ethnic trends that characterize the distribution patterns of the obesity epidemic. On the most basic level, the CDC has observed that men and women with college degrees are less likely than their lesser-educated counterparts to be obese. It is critical to note that education and income are closely linked; individuals who come from backgrounds of poverty may be struggle to afford or obtain college educations, and those with limited education may struggle to secure higher-paying employment. Certain minority ethnic groups also demonstrate greater obesity rates. For example, African American and Mexican American women seem to be at greater risk. Culture, economic class and community structure may influence these ethnic patterns.
Knowledge of appropriate health behaviors is evidently only a piece of the larger battle. Those with limited economic resources will inevitably opt for cheaper food options, which tend to be higher in fat and sugar. These individuals also may seek low-rent housing and therefore tend to congregate in neighborhoods with lower community safety standards; children in such neighborhoods may not be allowed to play outside as much as they would be in safer areas, leading to reduced physical activity that creates bad habits during their formative years. Life circumstances play a significant role in guiding lifestyle choices and should not be underestimated.
The obesity epidemic may seem overwhelming, but there are practical measures that can be instituted at community-wide and even national levels to combat its reach. CDC recommendations include efforts such as early childhood education to establish healthy behaviors or the creation of what they call “healthy community food environments” by providing economic incentives for businesses to make healthy changes. At the end of the day, it will always come down to the individuals to make the right choices — but it is society’s responsibility and in society’s best interest to facilitate the best arena for these choices.
Photo Caption: Two uneaten burgers at a fast-food restaurant
Photo Credit: Pixabay