Obesity

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"The person who says it cannot be done ought to not interrupt the person doing it." -- Chinese Proverb.

The official death toll for those who perished in the bombing of the World Trade Center in New York City on 11 September 2001, is now set at slightly over 2,800. Adding those who perished in the Pentagon bombing, the total figure is between 2,900 and 3,000. The sudden, violent loss of people of all ages shocked the United States of America and the world. Multiple billions of dollars have been spent since to investigate how the deemed evil perpetrators accomplished deemed their wicked deeds and on preventive measures that will hopefully guarantee that such horrible loss will not be repeated.

Though this is not a thesis about terrorism. It is about a deemed threat that is guaranted to take the lives of between 100 and 200 times as many as died on that portentous day in 2001. For the reason that these deaths will not occur suddenly, for the reason that there are not any perceived violent visual images associated with them that are capable of being broadcast repeatedly to a TV-oriented public, most humans will be completely unaware of their happening.

How do we know this? For the reason that many humans died last year from the same epidemic, and most of the humans on this planet did not ever know it.

Between 300,000 and 600,000 Americans will die this year, not from terrorist acts, though from a chronic dis-ease growing so rapidly that it is now officially called an epidemic. May be shocked to find out what and how widespread it is.

The dilemma is obesity. A staggering 61 percent of American adults are overweight or obese. The United States officially views obesity as the number two cause of preventable death (behind smoking).

So serious is this dilemma, and so fatal are its consequences, that one would expect it to be on the lips of every American.

The American Heritage Dictionary defines "epidemic" as "a rapid spread, growth, or development". No word more aptly describes the current course of obesity prevalence. The World Health Organization (WHO) estimates that 300 million people worldwide are obese and another 750 million are overweight.

Smoking-related illnesses in the United States are blamed for the deaths of 400,000 people a year, and smoking is a high profile "public enemy." Yet conservative estimates place the number of deaths related to obesity at 300,000. Two highly respected public health doctors wrote an article that was published in 1993 that stated a high-end estimate of over 582,000 (J.M. McGuiness and W.H. Fouge, "Actual Causes of Death in the United States," JAMA, 1993, Nov. 10:270(18): 2207-12). The National Institutes of Health (NIH) place the high-end estimate at 587,000.

What is Obesity?


Obesity is characterized by the accumulation of fat tissue. Some health practitioners define obesity by the amount of fat content of the body.

Obesity is usually defined as a body fat content greater than 25% of the total weight for males, or greater than 30% of the total weight for females. The recommended body fat content for men is 15-18%; for women, it's 20-25%. These percentages vary with age, increasing as humans get older.

We do not perceive that it is for the reason that humans are completely unaware. We are sure that you have viewed the constant bombardment by television and print advertising about weight-loss products and programmes indicate that there's a colossal market.

Some experts estimate that 10-25% of teenagers and 20-50% of adults have a perceived weight problem. It's ironic that North Americans are heavier than ever despite the increasing focus over the past few decades on weight loss, exercise and reduced fat intake. For most people, diets mean denial and deprivation, and therefore cause overeating once the diet is stopped.

The World Health Organization adopted the weight classifications developed by the National Institutes of Health (NIH) through an expert panel convened in 1995 that reviewed data from approximately 394 studies to clinically assess the association between weight levels and dis-ease risk.

The panel recommended the use of Body Mass Index (BMI), a measure of weight in relation to height. An individual's BMI is calculated as his or her weight in pounds divided by the square of his or her height in inches times 703. (BMI is also calculated as weight in kilograms divided by the square of height in meters.) Using this measure, the weight categories are:

Underweight - <18.5
Normal-18.5 - 24.9
Overweight - 25.0 - 29.9
Obesity Class I - 30.0 - 34.9
Obesity Class II - 35.0 - 39.9
Obesity Class III - 40+

A single measurement that requires only two factors, weight and height, makes it possible to conduct surveillance on a worldwide basis. There are limitations to BMI, of course.

It is capable of being overestimated among persons who are very athletic and have large muscle mass, on the one hand, and underestimated among persons who have lost muscle mass, such as the ill and the elderly.

Indeed, over $30 billion USD are spent every year on weightloss products and/or programmes. Why are Americans overweight? Critics of the United States might be quick to point out how soft people have become. There's some perceived truth to that perception. Eric Schlosser has written a best-selling book, Fast Food Nation: The Dark Side of the All-American Meal. According to Schlosser, Americans spend more money eating in restaurants than they do on higher education or new cars. And most of those "restaurants" are of the fast-food variety. What Americans eat "has changed more in the last 40 years than in the previous forty thousand" (George Will, "Supersize Menace," 2002, Washington Post Writer's Group).

Before we completely condemn the Americans, we require to take a look at the deemed problem of obesity in the rest of the world. It is not, as the facts bear out, just "an American problem." The International Obesity Task Force (IOTF) reports: "The prevalence of obesity is rising to epidemic proportions at an alarming rate in both developed 'Westernised' and less developed countries around the world" (www.iotef.org, emphasis IOTF). In the United States for the first time in history a majority of adults are overweight, with statistics not much benevolent in Russia and Britain.

What Causes Obesity?


The International Obesity Task Force (IOTF) reveals obesity has increased between 10 and 50 percent in Europe in the past decade. Obesity has more than doubled in the United Kingdom in the same time frame. Regional studies of African countries' higher socioeconomic groups reveal a high prevalence of obesity. Data is difficult to come by from the Middle Eastern countries, though the limited information available shows that the problem is seriously higher in Middle Eastern, for women more than women in most Western countries. In Egypt, for example, 70% of adult women are overweight and half of men are, according to 1998 figures.

The United States is a country obsessed with thinness, yet increasing numbers of people are becoming fat. This seeming contradiction has become the subject of thousands of research studies. The one obvious explanation for the increasing obesity rate is that more people are consuming more calories than they are using, i.e., their energy consumption is greater than their energy expenditure. This is simple enough; what is not simple are the reasons this phenomenon has happened so quickly and to such a surprising extent. The causes of obesity fall into two general categories, genetics and environment. The current epidemic is almost certainly a combination of the two.

Genetics
The fat in a human's body is stored in fat cells distributed throughout the body. A normal human has between 25 and 35 billion fat cells, though this number is capable of increasing in times of excessive weight gain, to as many as 100 to 150 billion cells.

The number of fat cells in the body remains constant after their formation; the cells just expand and shrink in size during weight gain and loss.

This has been suggested as one reason weight loss is so hard to maintain for many people, and research is under way to determine methods or medications that will reduce the actual number of cells. Four critical periods have been identified during which time the number of fat cells a person has will increase: between 12 and 18 months of age; between 12 and 16 years of age, especially in females (in fact, the best single predictor of adult obesity is adolescent obesity); in adulthood when an individual gains in excess of 60% of their healthy weight, and during pregnancy.

Obesogenic Environment

This all suggests that, while one person might be born with a stronger tendency to gain weight than another, the circumstances must be applicable for this to happen. Genetics play a role, though the gene pool in the United States of America has not changed significantly in the few decades during which obesity has become so prevalent. Genetics are required to be combined with an environment conducive to gaining weight, an environment that has been termed "obesogenic", in order for the explosive increase in both childhood and adult overweight and obesity to have occurred.

Obesity is also a significant deemed problem in the wealthier Caribbean nations. Brazil reports the problem as increasingly common though surprisingly among lower income groups. The prevalence of overweight and obesity in Mexico is nearly equal to that in the US, though is growing at a much faster rate. Obesity in Japanese men has doubled since 1982.

While it is obvious that this is necessary in many western countries, the obesity issue in the Asia-Pacific region has thus far not been high on either public health or treatment agendas for countries in this region.

The IOTF reports that obesity exists in nearly 40 percent of Yugoslavians and in approximately 30 percent of Greeks. The problem afflicts more than 20 percent of Romanians and Czechs. England, Finland, Germany, Scotland and Slovakia are not far behind.

Even countries that have difficulty with providing enough food for their citizens are experiencing a significant problem with overweight and obesity. The number of overweight people in Ghana, for example, is only slightly less than the number of those who are underweight.

Ten to 12 nations in the developing world have levels of overweight and obesity exceeding those of the US. And in many low-to middle-income countries and people are getting fat at an accelerating rate.

It's not just a question of eating too much, though that is capable of being a factor. Actually, there are many contributing factors.

These can include: 1) low activity levels
2) genetics
3) body metabolism
4) social factors
5) economic factors
6) psychological/emotional factors One of Britain's top nutrition specialists has warned that obesity is threatening the health of a growing number of people world-wide.

How can this be true? Sometimes culture is a factor. Weight gain is associated with an image of prosperity and success in some countries.

Obesity is a sign of high social status and prosperity in the Polynesian and Micronesian societies of the Western Pacific region. "In 1991 for example, over 75% of urban males in Western Samoa were classified as obese" (ibid., emphasis IOTF).

It is a bitter irony that as developing countries continue their efforts to reduce hunger, some are also facing the opposing problem of obesity. Obesity carries a higher incidence of chronic illness including diabetes, heart dis-ease and cancer. And while some of the poor are becoming plumper, they are not necessarily favourably fed now.

Obesity often masks underlying deficiencies in vitamins and minerals. Some of the same factors that have led to American obesity contribute to the problem the world around.

The more modernised a country becomes the more its citizens own cars; and the people often travell only short distances. They do less walking or cycling. At home, the availability of modern appliances and ready-made foods has significant-ly decreased manual labour. Also, many of those ready-made foods are high in calories and fat.

In the workplace, many jobs have become more sedentary, requiring less physically demanding labour. In public places, there are more automatic doors, elevators and escalators, so people climb stairs less often.

Just a few years ago, such a statement was rare. Experts hesitated to draw attention to obesity when so many lives were crippled by hunger, and out of a total of 815 million hungry people around the world almost 780 million are in developing countries. Though startling data released in 1998 by the Worldwatch Institute challenged conventional wisdom: For the first time, the number of overweight individuals worldwide rivals those who are underweight. And sadly, developing nations have joined the ranks of countries encumbered by obesity.

A 1999 United Nations study found obesity in all developing regions, and growing rapidly, even in countries where hunger exists. In China, the number of overweight people jumped from less than 10 percent to 15 percent in just three years. In Brazil and Colombia, the figure hovers around 40 percent, a level comparable to a number of European countries. Even sub-Saharan Africa, where most of the world's hungry live, is seeing an increase in obesity, especially among urban women. In all regions, obesity seems to grow as income increases.

The Chinese used to have a myth that fat children were healthier and stronger than their slimmer peers. However, medical experts are now warning that fat is unhealthy and that Chinese children are becoming fatter due to unhealthy dietary habits, insufficient exercise and other factors.

A recent survey on 4,542 local school children aged from 7 to 15 years showed that about 12.3 per cent of them were overweight.

"The obesity rate among boys is obviously much higher than for girls at all ages. About 17.1 per cent boys were obese though the figure for girls was only 7 per cent," said professor Cai Meiqing of the Shanghai Second Medical University, who conducted the survey.

The obesity rate for children was found to rise with age, reaching a peak at 10 years old and then declining. Professor Cai's survey showed that about 24.3 per cent of boys and 17 percent of girls were overweight at age 10, the largest age group for obesity in all children. One in five Australian children are now considered overweight. Australian Medical Association president Kerryn Phelps stated that today's youth risked becoming "Generation O for Obesity", and that responsibility fell squarely on parents' shoulders.

Perhaps one of the greatest contributors is the fact that more and more people live in urban centres. With cities comes crime, which prevents people from going out for exercise and/or leisure activities. There are also metabolic, genetic and psychological contributors to obesity. (These factors are conclusions drawn from international research done by the American Obesity Association.)

Alzheimer's Dis-ease and Fat


Physicians at Rush-Presbyterian-St. Luke.s Medical Center in Chicago, Illinois, USA have declared that they have reached a conclusion after examining 815 people aged 65 and older who did not have Alzheimer.s dis-ease at the beginning of a nearly four-year study, that humans who consumed the most saturated fat, the type of fat that comes from meat, poultry, dairy products and palm or coconut oils, had 2.3 times the risk of developing Alzheimer.s dis-ease compared with those who consumed the lowest amount of saturated fats.

At the end of the study the researchers found that 131 humans had developed Alzheimer.s dis-ease, the debilitating dis-ease that leads to memory loss and eventual physical incapacity.

Alzheimer's is a degenerative brain dis-ease that usually begins gradually, causing a human to forget recent events or familiar tasks. How rapidly it advances varies from person to person, though the dis-ease eventually leads to confusion, personality and behaviour changes and impaired judgment. Communication becomes more difficult as the dis-ease progresses, leaving those affected struggling to find words, finish thoughts or follow directions. Eventually, most people with Alzheimer.s dis-ease become unable to care for themselves. One in 10 humans over 65 and nearly half of those over 85 suffer from Alzheimer.s dis-ease. Today, 4 million Americans have the condition. That number is capable of increasing to 14 million by the year 2050 unless prevention methods are developed.

How is Obesity capable of causing Physical Death?


Obesity contributes greatly to the risk factor of a number of illnesses. Some that you most likely would guess are: Type 2 diabetes, coronary heart dis-ease, high blood pressure and osteoarthritis. Some that you might not be aware of include: birth defects, several types of cancer, carpal tunnel syndrome, chronic venous insufficiency, daytime sleepiness, deep vein thrombosis, end stage renal dis-ease, gallbladder dis-ease, gout, impaired immune response, impaired respiratory function, infections following wounds, infertility, liver dis-ease, low back pain, several obstetric and gynecological complications, generalised pain throughout the body, pancreatitis, sleep apnea, strokes, surgical complications and urinary stress incontinence.

Actually, this is only a partial list, as various researchers reported a host of additional problems. Of course, there are attendant psychological problems, such as lower self-esteem (in cultures that do not prize obesity) and clinical depression.

The staggering number of deaths caused or greatly contributed to by obesity is shocking in itself. Let's translate "61 percent of adult Americans" into actual numbers, so we have an idea of the scope of the problem. The NIH estimates that 120 million U.S. adults are overweight or obese. For perspective, that compares with 800,000 to 900,000 Americans who are infected with HIV, 9 million with cancer, 16 million with diabetes and 26 million with heart dis-ease.

Experts state that a combination of unhealthy diet and lack of exercise is making obesity a serious threat in the UK.

In the US, type two diabetes, which usually develops in obese people later in life, has been found in teenagers. You Are Capable of Overcoming Type Two Diabetes.

Obesity as a health problem has a close connection with cardio-vascular dis-eases, high blood pressure, high cholesterol levels in blood and diabetes. "Obesity is more harmful to children than to adults for the reason that it has a lifelong influence on their lives," said professor Cai Meiqing of the Shanghai Second Medical University.

It's difficult to get a handle on the total cost, for the reason that studies report only a fraction of the total amount. Though a 1998 study estimated the direct medical costs at $51.64 billion, and the NIH estimates that the cost is $100 billion (NIH statistics quoted by the American Obesity Association). See: Healthy Diet for Recovery and Longevity


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