body fat. BMI is calculated by dividing weight in kilograms by height in meters squared. It can also be calculated by multiplying weight in pounds by 705 and then dividing by height (as measured in inches) twice. Obesity is defined as having a BMI of 30 or above. Overweight is defined as having a BMI between 25 and 29.9 (Obesity Action Coalition, 2018; WebMD, 2017c). Waist circumference is also used when determining obesity. Waist circumference is measured with a tape measure at the uppermost lateral border of the hip crest. Waist circumference of 120 cm (about 47 in) or more for men and 88 cm (about 35 in) or more for women were considered high risk and termed abdominal obesity (Kim et al., 2019). The incidence of obesity is alarming in the United States and other industrialized countries and has markedly increased over the past two decades. Almost 40% of adults between the ages of 40 and 60 are obese (Gersch et al., 2017). The CDC has published statistics regarding the prevalence of obesity in the United States (Centers for Disease Control and Prevention, 2018a): ● The prevalence of obesity was 39.8% and affected 93.3 million U.S. adults in 2015 and 2016. ● Obesity-related conditions—such as cardiovascular disease, type 2 diabetes, and some types of cancer—are some of the leading causes of preventable premature death. ● The estimated annual medical cost of obesity in the United States was $147 billion in 2008 U.S. dollars. ● The medical cost for people who have obesity was $1,429, 42% higher than those of normal weight. Incidence and Prevalence of Obesity Adults Causes and Risk Factors of Obesity What causes obesity? What factors contribute to its development? Historically, most people, including most healthcare professionals, believed that obesity was caused by a lack of self-control and bad eating habits. Many of these same people continue to view obese persons with disdain, assuming that they simply prefer eating to losing weight. Research, however, has indicated that a variety of factors contribute to obesity. Although it is accurate to say that many Americans eat too much; consume too many high-calorie, high-fat foods; and fail to exercise enough, current research indicates that genetics and other issues also play a role in the development of obesity (WebMD, 2017c). Here is a summary of some of the factors that may contribute to the development of obesity (Centers for Disease Control and Prevention, 2018c; Centers for Disease Control and Prevention, 2018d; Comerford & Durkin, 2019; WebMD, 2017c). Genetics and family history can contribute to the development of obesity. As with many, if not most diseases and disorders, genetics may be a contributing factor. Research is underway to identify the impact of genes on obesity. However, clients should not blame their genes on their obesity and assume that they can do nothing to lose weight. Both genetics and behaviors are needed for obesity to exist. Other medical and mental health conditions may contribute to obesity: depression, anxiety disorders, severe stress (people eat when confronted with stressful situations), thyroid disorders, Consequences of Obesity in Adults Obesity has serious health and economic consequences. The health problems linked to being overweight or obese have a marked economic impact on the United States healthcare system. Costs are direct and indirect. Examples of direct costs are preventive measures, diagnostic procedures, and treatment services. Indirect costs are related to morbidity (the value of income lost from decreased or restricted productivity and activity and absenteeism) and mortality (the value of future income that
Some healthcare experts question if obesity should be classified as an eating disorder because they may equate obesity with a pathological relationship with food. Still, more experts point out that weight alone does not meet the criteria for eating disorders. Therefore, although obesity alone is not sufficient evidence of an eating disorder, it is important to evaluate persons who are obese for the presentation of signs and symptoms of eating disorders (National Eating Disorders Collaboration, 2019). Healthcare consideration : It is important to be objective and tactful when assessing obese persons for the possibility of eating disorders (American Psychiatric Association, 2013). ● Obesity is higher in some groups than in others. Hispanic and non-Hispanic Black people had the highest age-adjusted prevalence of obesity, followed by non-Hispanic White and non-Hispanic Asian people. Children Obesity in children in the United States continues to exist in alarming numbers. Statistics provided by the CDC (2018b) showed the following for children aged 2 to 19 years: ● The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents. ● Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. ● Hispanic people (25.8%) and non-Hispanic Black people (22.0%) had higher obesity prevalence than non-Hispanic White people (14.1%). ● Non-Hispanic Asian people (11.0%) had lower obesity prevalence than non-Hispanic Black and Hispanic people. Cushing’s disease, polycystic ovary syndrome. Binge-eating disorder can also lead to significant weight gain and obesity. Various medications cause weight gain as a side effect by increasing appetite or altering the client’s metabolism. Examples of such medications are some antidepressants, steroids, and some anticancer drugs such as tamoxifen (Nolvadex). Weight gain is sometimes the result of too little physical activity. Americans have a variety of choices for leisure and work-related activities that require nothing more than pressing buttons on the television remote to access hundreds of channels or using a computer, iPhone, or iPad. Eating habits affect the rates of obesity to a significant extent. The portions Americans serve in their homes and eat in restaurants far exceed healthy diet recommendations. Even though fast-food restaurants now offer more healthy choices such as salads and grilled sandwiches, many of the choices are high in fat and calories. Supersized hamburgers and french fries are selected by many people who frequent fast-food restaurants. Social habits and culture influence what and how much is eaten. Food and drink are part of holiday celebrations, social gatherings, and even events such as going to the movies where popcorn and soft drinks are purchased in large quantities. Culture also plays a significant part in dietary habits. Foods that are important to cultural customs may be high in fat and calories. Modifying such foods to make them more “healthy” could be offensive to certain cultures. is lost by premature death). According to the CDC, the annual nationwide costs of obesity-related absenteeism range between $3.38 billion ($79 per obese person) and $6.38 billion ($132 per obese person) (Centers for Disease Control and Prevention, 2018c). The health consequences related to overweight and obesity are staggering. Clinical research has shown that being overweight or obese significantly increases the risk for the following health
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