Wednesday, May 4, 2022

Understanding the Epidemic of Obesity: Causes, Effects, and Solutions

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By Rosabel Zohfelf, MSN-Ed, APRN, FNP-C


Obesity is a global health challenge that has reached epidemic proportions, affecting millions worldwide. Obesity is characterized by excessive body fat accumulation, posing significant health risks and socioeconomic burdens. Understanding the causes, effects, and potential solutions for obesity is crucial in developing effective strategies to combat this widespread issue.


According to the Centers for Disease Control and Prevention (CDC), the latest update (2023) on the prevalence of obesity in the U.S. obesity affects 100.1 million (41.9%) adults and 14.7 million (19.7%) children. This accounts for approximately $147 billion in annual healthcare costs.


Pathophysiology

         The pathophysiology of obesity is complex. It involves the interaction of numerous hormones, cytokines, and neurotransmitters. The mechanisms contributing to the imbalance of energy intake and expenditure have yet to be understood entirely. The adipocyte, a fat cell, is the cellular basis of obesity. Adipocytes secrete hormones and cytokines known as adipokines. Adipokines play a role in the regulation of food intake, lipid storage, metabolism, and insulin sensitivity. Also, they regulate the alternative complement system, blood pressure, angiogenesis, vascular homeostasis, inflammatory and immune responses, female reproduction, and energy metabolism. The accumulation of visceral fat causes dysfunction of adipocytes. It also results in alterations in the regulation and interaction of hormones. These alterations, together with low-grade inflammation, contribute to the causes and complications of obesity. Cardiovascular disease and type 2 diabetes mellitus are among the complications of obesity Symptoms. 

         Obesity has no specific symptoms. The main signs of overweight and obesity are a high body mass index (BMI) and an unhealthy body fat distribution. Obesity can cause complications such as metabolic syndrome, type 2 diabetes, high blood cholesterol, high triglycerides, heart disease, high blood pressure, atherosclerosis, heart attacks, stroke, obstructive sleep apnea, obesity hypoventilation syndrome, back pain, osteoarthritis, non-alcoholic fatty liver disease, urinary incontinence, gallbladder disease, emotional distress, depression and increased risk for certain cancers such as cancer of the esophagus, colon, rectum, pancreas, kidney, ovaries, endometrium, gallbladder, breast and or liver (NIH, 2018).


The American Heart Association (AHA) recommends that all obese patients participate in a medically supervised weight loss program. It is recommended for two or three times a month for at least six months. The treatment plan for weight loss involves:

  • Eating fewer calories than the body needs.
  • Exercising for 30 minutes at least five days a week.
  • Changing unhealthy behaviors.

Obesity can raise blood cholesterol and triglyceride levels, increase blood pressure, and induce diabetes. In some people, diabetes makes other risk factors much worse. Obese people are at higher risk for heart attack, heart disease, and stroke. Obesity is also a major cause of osteoarthritis, gallstones, and respiratory problems. 

There are two types of obesity: visceral obesity and Peripheral obesity. Visceral obesity occurs when body fat distribution is localized around the abdomen and upper body, resulting in an apple shape. Visceral obesity is associated with metabolic syndrome (hypertriglyceridemia, hypertension reduced high-density lipoprotein, increased low-density lipoproteins, hypertension, and insulin resistance), accelerated lipolysis, and has an increased risk for inflammation, type 2 diabetes mellitus, cardiovascular complications, and cancer. Peripheral obesity occurs when body fat distribution is extraperitoneal and is distributed around the thighs, buttocks, and through muscle, resulting in a pear shape. This second one is more common in women. 


Causes of Obesity include:

1. Poor Diet: High consumption of processed foods, sugary beverages, and calorie-dense meals contributes to obesity. These foods often lack essential nutrients and are high in sugars, unhealthy fats, and empty calories.


2. Lack of Physical Activity: A sedentary lifestyle, devoid of regular physical exercise or activity, plays a significant role in the development of obesity. Modern advancements have reduced physical activity levels, exacerbating the problem.


3. Genetic and Environmental Factors: Genetic predisposition can influence an individual's susceptibility to obesity. Additionally, environmental factors such as socioeconomic status, cultural norms, and neighborhood characteristics can impact dietary habits and activity levels.


4. Psychological Factors: Emotional and psychological issues like stress, depression, and anxiety can lead to unhealthy eating habits and overeating, contributing to obesity.


Effects of Obesity:

1. Health Complications: Obesity increases the risk of numerous health issues, including diabetes, heart disease, stroke, high blood pressure, certain cancers, osteoarthritis, and respiratory problems.


2. Mental Health Challenges: Obesity can adversely affect mental health, leading to depression, anxiety, low self-esteem, and body image issues.


3. Reduced Quality of Life: Obese individuals often face reduced mobility, fatigue, and limitations in daily activities, impacting their overall quality of life.


4. Economic Impact: The economic burden of obesity is substantial, encompassing healthcare costs, lost productivity, and reduced work efficiency due to illness and disability.


Solutions to Combat Obesity:


1. Promoting Healthy Eating: Encouraging a balanced/healthy diet rich in fruits, vegetables, whole grains, and lean proteins while reducing the intake of sugary and processed foods can play a pivotal role in obesity prevention.


2. Encouraging Physical Activity: Creating environments that promote physical activity, such as accessible parks, safe cycling paths, and active transportation options, can encourage regular exercise and mitigate obesity risks.


3. Education and Awareness: Raising awareness about the importance of a healthy lifestyle, nutrition, and physical activity through educational programs can empower individuals to make informed choices regarding their health.


4. Policy Interventions: Implementing policies that promote healthier food options, regulate the marketing of unhealthy products, and incentivize physical activity can significantly reduce obesity rates.


Obesity is a multifaceted issue with far-reaching consequences on public health and well-being. Addressing this epidemic requires a comprehensive approach involving individuals, communities, healthcare systems, and policymakers. By fostering a culture of healthy living, improving access to nutritious foods, and encouraging regular physical activity, we can work towards a healthier future for future generations. 


*This article was updated on 10/12/2023.

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