Weight Problems in America

Obesity in America – What’s all the fuss about?

Obesity – a definitionObesity – a definition

► Overweight & obesity Overweight & obesity are labels for ranges of are labels for ranges of weight greater than weight greater than what is generally what is generally considered healthy for considered healthy for a given height.a given height.

► Expressed by Body Expressed by Body Mass Index (BMI) e.g.Mass Index (BMI) e.g.

HeighHeightt

WeightWeightRange Range (lbs)(lbs)

BMIBMI(kg/m2)(kg/m2)

ConsidereConsideredd

   133133 20.220.2UnderweigUnderweig

htht

5'8"5'8" 163163 24.824.8Healthy Healthy

Wt.Wt.

   170170 25.825.8 OverweightOverweight

   198198 30.130.1 ObeseObese

   125 or less125 or less Below18.5Below18.5UnderweigUnderweig

htht

5'9"5'9" 125-168125-168 18.5-24.918.5-24.9Healthy Healthy

Wt.Wt.

   169-202169-202 25-29.925-29.9 OverweightOverweight

   203+203+ 30+30+ ObeseObese

StatisticsStatistics

Centers for Disease Control & Prevention (1999)Centers for Disease Control & Prevention (1999) 61% adults in U.S. overweight61% adults in U.S. overweight

- 35% slightly overweight- 35% slightly overweight

- 26% grossly overweight or obese- 26% grossly overweight or obese 13% of U.S. children overweight or obese13% of U.S. children overweight or obese

American Medical Association (2002)American Medical Association (2002) 31% of American public obese31% of American public obese

Surgeon GeneralSurgeon General Morbidity & mortality associated with obesity to Morbidity & mortality associated with obesity to

exceed that associated with cigarette smokingexceed that associated with cigarette smoking

The Insurers’ Dilemma

To insure or exclude coverage for weight loss surgery?

Blue Cross & Blue Shield of North Carolina –accept coverage Obese members cost 32% more to cover. Diabetes disappears in 9 of 10 successful surgeries Pharmaceutical costs reduce by 20% in first year after weight

loss surgery.Blue Cross of Florida – no coverage Average cost is $25,000 (pressure on premiums) 1% increase in premium, results in 16,000 uninsured.

Relationship between sleep & obesity?Relationship between sleep & obesity?

Studies by Eastern Virginia Medical School, Mignot, E., (1989) Studies by Eastern Virginia Medical School, Mignot, E., (1989) and Prof. Van Culter, E. (2004)and Prof. Van Culter, E. (2004)

Overweight subjects slept lessOverweight subjects slept less The less sleep a subject gets, the greater their BMIThe less sleep a subject gets, the greater their BMI Changes in hunger proportional to changes in hormone Changes in hunger proportional to changes in hormone

levels.levels. Less sleep>lower leptin level>higher ghrelinLess sleep>lower leptin level>higher ghrelin

-leptin suppresses food intake & stimulates energy -leptin suppresses food intake & stimulates energy expenditureexpenditure-ghrelin stimulates appetite, fat production & body -ghrelin stimulates appetite, fat production & body growthgrowth

Media & Childhood ObesityMedia & Childhood Obesity

Study by Study by Young et alYoung et al. (1996), advertising only . (1996), advertising only affects brand choice. Preference & choice affected affects brand choice. Preference & choice affected by cultural norms.by cultural norms.

The Kaiser Family Foundation (2004)The Kaiser Family Foundation (2004)- media contribution not fully documented or - media contribution not fully documented or conclusively researched.conclusively researched.- Food advertising definitely affects children’s - Food advertising definitely affects children’s purchases and those of their families.purchases and those of their families.

Conclusion

Obesity causes many fatal yet preventable conditions such as diabetes, heart disease, asthma, hypertension, stroke, cancer, sleep apnea and so on.Federal government needs to do more to promote healthy eating & more physical exercise.Media needs to exercise self regulation in content of food ads aimed at childrenA healthy nation is a wealthy nation

References

ANRED. (June 2005). Obesity. Is it an eating disorder? Retrieved July 18, 2005 from http://www.anred.com/toc.htm

Desor, J.A., Maller, O. & Turner, R. (1973). Taste in acceptance of sugars by human infants. Journal of Comparative and Physiological Psychology, 84: 496-501. Retrieved on July 20, 2005 from http://www.store.warc.com/ProductInfo /35Young.pdf

Gifford, R.A. (2005). New thoughts on sleep, weight loss & diabetes. The Saturday Evening Post: 277, 4. Retrieved July 19, 2005 from ProQuest database.

Girion, L. (June 27, 2005). Insurers weigh surgery risks: companies differ on whether to pay for procedures to help patients slim down. Los Angeles Times. Retrieved July 18, 2005, from the ProQuest database.

Henry J. Kaiser Family Foundation (2004).The Role of Media in Childhood Obesity. Retrieved on July 26, 2005 from http://www.kff.org/entmedia/upload/The-Role-Of-Media-in-Childhood-Obesity.pdf

Tufts University Health & Nutrition Letter (April 2005). You snooze, you lose? looking for links between sleep, appetite and obesity. 23, 2. Retrieved July 18, 2005 from ProQuest database.

Spiegel, K., Leproult, R., Tasali, E., Penev, P., and Van Cauter, E. (2004). Sleep curtailment in healthy young men is associated with decreased leptin level, elevated ghrelin levels, and increased hunger and appetite. Annals Internal Medicine 141(11):846-50. Retrieved August 2, 2005 from the ProQuest database.

U.S. Department of Health and Human Services. (2001). The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity: At a Glance. Retrieved on August 4, 2005 from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_glance.htm

Vorona, R.D., Winn, M.P., Babineau, T.W., & Eng, B.P., F.H.R., W.J.C. (2005). Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Archives of Internal Medicine, 165, 25-30. Retrieved on August 4, 2005 from the ProQuest database.

Young, B.M., Webley, P., Hetherington, M. & Zeedyk, S. (1996). The role of television advertising in children’s food choice. London: Report to the Ministry of Agriculture, Fisheries and Food (MAFF). Retrieved on July 20, 2005 from http://www.store.warc.com/ProductInfo/35Young.pdf