Obesity has become a contentious topic in contemporary Western societies. While it is viewed as a medical and public health concern, it is also accompanied by social connotations and moral judgments. To be obese is to be fat, overweight, plump, large, or big: these are all words that vary in meaning across time and place, as suggested by debates about how to accurately measure and differentiate overweight and obesity. Moreover, while obesity has been associated with wealth and affluence at different historical periods, in contemporary Western society it is symbolically linked with poverty and laziness, while leanness tends to be equated with discipline and moral virtue (Turner, 1984). People who are obese experience discrimination — for instance, in relation to employment hiring and even pay — while popular culture parodies, ridicules, and vilifies overweight individuals on television and in film. Moreover, treatments for weight loss (programs, pills, surgery) play on people's anxieties about obesity and send a message about its undesirability (Sanstad, 2006).
Keywords Body Mass Index; Comorbidity; Epidemic; Incidence; Obesity; Overweight; Prevalence; Prevention
Obesity has become a contentious topic in contemporary Western societies. While it is viewed as a medical and public health concern, it is also accompanied by social connotations and moral judgments. To be obese is to be fat, overweight, plump, large or big: these are all words that vary in meaning across time and place, as suggested by debates about how to accurately measure and differentiate overweight and obesity. Moreover, while obesity has been associated with wealth and affluence at different historical periods, in contemporary Western society it is symbolically linked with poverty and laziness, while leanness tends to be equated with discipline and moral virtue (Turner, 1984). People who are obese experience discrimination — for instance, in relation to employment hiring and even pay — while popular culture parodies, ridicules, and vilifies overweight individuals on television and in film. Moreover, treatments for weight loss (programs, pills, surgery) play on people's anxieties about obesity and send a message about its undesirability (Sanstad, 2006).
However, amid the contention about the cultural meanings attributed to obesity, there is public and professional concern about obesity in the United States and throughout the world.
The Centers for Disease Control and Prevention (CDC) reports that from the early 1980s through 2011, obesity in children more than doubled and more than tripled in adolescents. Indeed, some public health professionals and government agencies argue that this rise in child obesity has reached epidemic proportions with more than one third of US children and adolescents overweight or obese in 2010. Obesity is problematic because it is correlated with hypertension, diabetes, heart disease, osteoarthritis, and other conditions that are costly in both dollars and in quality of life. Consequently, social, political, and economic responses to obesity have emerged that are, according to the Institute for the Future, transforming consumption, business and health practices (Sanstad, 2006).
According to the CDC, overweight and obesity refer to weight ranges that are greater than what is generally considered healthy for a given height. Overweight and obesity are gauged in terms of elevated Body Mass Index (BMI), which in adults is determined by first squaring one’s height in meters then dividing one’s weight in kilograms by the squared height. There are online calculators as well as conversion charts to simplify the procedure. For children and teens, height and weight are plotted against a gender-specific growth chart, which indicates the relative position of the child's BMI number among children of the same sex and age. Overweight for children is defined as having a BMI in the 85th to 95th percentile, while obesity for children is defined as having a BMI in the 95th percentile.
Some researchers (e.g. Ebbeling & Ludwig, 2008) have questioned the usefulness and accuracy of BMI in predicting obesity-related illness, since it does not provide key data such as body composition and fat distribution, nor do its interpreters routinely take confounding variables, such as racial and ethnic considerations, into account. Nonetheless, BMI has become the gold standard for measuring overweight and obesity. Using BMI, the US government has been tracking child height and weight since the 1970s as part of the National Health and Nutrition Examination Survey (NHANES). NHANES uses an in-person interview conducted in the home and in a private mobile examination center, where trained interviewers conduct a physical examination (including weight and height measures) and medical tests.
Rising Obesity Rates and a Leveling Off
According to data collected from a 2008 National Center for Health Statistics (NCHS) survey, the CDC reported a trend in increased obesity in the United States between 1980 and 2008, where the percentage of obese two- through five-year-olds more than doubled from 5 percent in 1980 to 10.4 percent in 2008. The percent of obese six- to eleven-year-olds more than tripled during those years from 6.5 percent in 1980 to 19.6 percent in 2008, as did the twelve- through nineteen-year-olds with 5 percent in 1980 and 18.1 percent in 2008.
This rise in obesity among children has been one of the fastest emerging public health issues of the last few years in the United States and is presented as "a relentless upward slope that threatens to undo progress on heart disease and exacerbate other killer illnesses influenced by weight, including diabetes, high blood pressure and some types of cancer" (Zarembo, 2008).
Racial disparities are sharp. According to the 2008 NCHS survey, among girls aged twelve to nineteen, 29.2 percent of blacks and 17.4 percent of Mexican Americans were obese, compared with 14.5 percent of whites. Among boys in the same age group, 19.8 percent of blacks and 26.8 percent of Mexican Americans were obese, compared with 16.7 percent of whites (Ogden & Carroll, 2010).
Evidence from the CDC suggests, however, that obesity rates among children in the United States are leveling off as there was not a significant rise in obesity levels between 2008 and 2010 (Ogden, Carroll, Kit, & Flegal, 2012). Although this is taken as a positive sign by many, the goal to reduce childhood obesity rates is still unmet.
Obesity as a Global Issue
Childhood overweight and obesity are also problems seen on a global scale. For instance, childhood obesity levels in boys and girls between eleven and fifteen almost doubled in Britain between 1995, when 13.9 percent of boys and 15.5 percent of girls were obese, and 2004, when 24.3 percent of boys and 26.7 percent of girls were obese. From 2004 to 2011, however, those rates fell slightly in boys to 23.8 percent and more dramatically among girls to 16.5 percent (Eastwood, 2013).
A January 2013 study from the Australian Bureau of Statistics reported that between 2011 and 2012, 24 percent of Australian boys and 27 percent of Australian girls aged five to seventeen were overweight. The World Health Organization has also identified obesity as an epidemic, even in developing countries — where in 2011 it was estimated that over 30 million children were overweight as opposed to 10 million overweight children in developed countries (World Health Organization, 2013). Obesity is especially a problem for children because their eating and physical activity habits become entrenched in ways that can contribute to life-long health problems.
Implications of Overweight
Overweight and obesity contribute to a raft of health, social, and economic problems that are costly and sometimes debilitating (Sanstad, 2006). Elevated BMI is correlated with hypertension, diabetes, heart disease, osteoarthritis, and other conditions that are costly in both dollars and quality of life. According to the Surgeon General, "risk factors for heart disease, such as high cholesterol and high blood pressure, occur with increased frequency in overweight children and adolescents compared to children with a healthy weight," and overweight adolescents have a 70 percent chance of becoming overweight or obese adults. This increases to 80 percent if one or more parent is overweight or obese (Office of the Surgeon General, 2007).
One study found overweight was associated with the early appearance of cardiovascular disease risk factors among children between the ages of five and ten and also with an increasing incidence of type 2 diabetes (Kaplan, Liverman & Kraak, 2005). Type 2 diabetes, previously considered an adult disease, has increased dramatically among children and adolescents. Diabetes is the sixth reported cause of death in the United States and increases the risk of heart disease and stroke, contributes to hypertension and nervous system diseases, and can cause blindness, kidney disease, peripheral vascular disease (potentially leading to amputation), and dental complications (Sanstad, 2006). One implication of the link between obesity and the early appearance of risk factors for these conditions is that children will live with the burden of disease for considerably longer periods of time than adults who develop these conditions. Researchers have shown that managing diabetes as a sixteen-year-old is quite distinct from managing it as an older person and has implications for self-identity and social status (e.g. Greene, McKiernan and Greene, 2008). Also, heart disease and other conditions take a physical toll that may contribute to comorbidity (Lobstein, 2008) and even reduced life expectancy.
However, children view social discrimination as the most immediate consequence of overweight and obesity, which in turn is associated with poor self-esteem...
One of the greatest challenges that have been identified for the United States is the problem of childhood obesity. Childhood obesity is when children experience the reality of being seriously overweight to the point of being extremely unhealthy. For a while, the percentage of children that were becoming clinically obese at a young age was steadily increasing through out the nation. However, there have been programs implemented in primary schools across the US in order to fight the presence of childhood obesity. Some of the measures that are being taken include the implementation of health programs at a younger age, the increase of physical fitness in schools, the decrease of the presence of vending machines, and the integration of a healthier school lunch menu. These are just a handful of some of the procedures taken to help children to become healthier on a regular basis.
While schools cannot control the nutrition and foods that are available to children at home, they can regulate a healthier program for children during the school day. The times of students having access to unhealthy foods from vending machines and in the school cafeteria are long gone. Now most schools are getting rid of their vending machines so that students do not even have the option to purchase unhealthy foods. One of the greatest actions that a school can take to help with the health of students is educating them on the healthy choices that they can make in school and at home. Schools can offer all of the healthy foods that they want; however, if the student is eating improperly at home and on the weekends then the efforts are negated. Therefore, the healthy food options as well as the education are necessary to help fight childhood obesity. Furthermore, the increase of the amount of physical activity that students are allowed to engage in during the day will also help with the battle against obesity in children.
In regards to the education system’s role in helping to battle childhood obesity, there are a number of really important steps being taken. Some of the most impactful actions that schools are taking include the implementation of health programs at a younger age, the increase of physical fitness in schools, the decrease of the presence of vending machines, and the integration of a healthier school lunch menu. With these actions in place, children have a better chance of knowing how to make better choices for their food options in the future.