Obesity is a worldwide epidemic that is contributing to increasing burden on the public health system and the economy. The rising rates of overweight and obesity affects both adults and children alike. In the United States, obesity is a leading cause of preventable death, just behind smoking, according to "Worldwide Trends in Childhood Overweight and Obesity."
Definitions
Obesity is a term used to describe excess body fat. Generally obesity is defined using body mass index, which is calculated as weight divided by height squared, in kilograms per meters squared. A BMI between 18.5 and 24.9 is considered normal, below 18.5 is underweight, between 25.0 and 29.9 is overweight and anything greater than 30.0 is considered obese.
Causes
Obesity has both genetic and environmental components, though exact causes have yet to be fully understood. It has been observed that weight status runs in families. However, environmental factors include poor diet, sedentary lifestyle, time spent watching television, and socioeconomic status. Disease states that are linked to obesity include hypothyroidism, Cushing's syndrome, hypothalamic dysfunction and disorders of insulin production and utilization.
Prevalence and Trends
The prevalence of overweight and obesity in the United States has continually been increasing over the past 15 years. According to the medical textbook "Principles of Critical Care," overweight has increased in prevalence from 55.9 percent in 1994 to 64.5 percent in 2000. Over that same time, obesity has increased from 22.9 percent to 30.5 percent The prevalence is highest in Black women. Among children, rates are highest among Mexican American and Blacks.
Comorbidities
Obesity is associated with many serious diseases and conditions including high blood pressure, coronary artery disease, congestive heart failure, obstructive sleep apnea, asthma, type 2 diabetes, high cholesterol, polycystic ovarian syndrome, gastroesophageal reflux disease, liver disease, gallstones, colon cancer, hernias, osteoarthritis, gout, back pain, stress urinary incontinence, breast and uterine cancers, complications of pregnancy, stroke, depression and stretch marks.
Public Health Challenge
As obesity is linked with a number of chronic diseases and increased risk of death, it is not unexpected that increasing rates of overweight and obesity cause a strain to the public health system. In a review on the epidemiology of obesity. Doctors Dang M. Nguyen and Hashem B. El-Serag report that the United States Department of Health and Human Services estimates that the costs of overweight and obesity in the United States was upwards of $117 billion in 2001.
References
- "Behavioral Medicine: A Guide for Clinical Practice, Ch. 19"; Robert B. Baron, MD, MS; 2008.
- "Harrison's Principles of Internal Medicine, Ch. 74-75"; Jeffrey S. Flier, MD, Eleftheria Maratos-Flier, MD, Robert F. Kushner, MD; 2008.
- "Principles of Critical Care, Ch. 109"; Brian Gehlbach, MD, John P. Kress, MD; 2005
- "The Epidemiology of Obesity"; Gastroenterology Clinics. Dang M. Nguyen, MD Hashem B. El-Serag, MD, MPH; 2010.
- "Worldwide Trends in Childhood Overweight and Obesity"; Youfa Wang, MD, PhD, MS, Tim Lobstein, PhD; 2006
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