1. Obesity: The Growing Problem By Becky C. Olomon MPH 500 / Professor Madeline Angela Meyer Concordia University Nebraska June 25, 2013

2. Table of Contents Section TitleSlide No. Biostatistics of Obesity3 Epidemiology of Obesity6 Biology of Obesity10 Social Aspects of Obesity13 Psychological Aspects of Obesity15 Environmental Factors of Obesity16 Governmental Policy and Recommendations17 Live Healthier

3. Overweight or obese individuals can be found in every age group, sex, ethnicity, region and country. Various departments worldwide collect this data. BMI, Body Mass Index, measurements are the standard statistic reported around the world and in the United States for obesity studies. Biostatistics on Obesity Live Healthier

4. Biostatistics: How Obesity is Measured When calculating BMI measurements today the standard formula worldwide is: weight (kg) / [height (m)] 2. (CDC 2012). A BMI of 25 to 30 constitutes overweight. A BMI over 30 constitutes obese. Live Healthier

5. Biostatistics of Obesity: Correlating Data Various other measurements and information are frequently taken with BMI data. These are used for comparison with other studies to discover and report prevalence and correlations with other factors. Live Healthier

6. Epidemiology is "the study of the distribution and determinants of disease frequency in human populations" (Schneider 2011). Epidemiologists examine the "who, when, where and why" of diseases. When: "The number of people considered extremely obese in the United States has more than tripled since 1960" (Power p. 21). The World Health Organization reports that obesity worldwide has nearly doubled since 1980 (WHO 2013). Epidemiology of Obesity: Live Healthier

7. Epidemiology of Obesity: Who In The CDC has reported that today over one third of Americans are overweight. Socioeconomic status appears to be correlated to risk for obesity. Live Healthier

8. In 2008 the WHO estimated the prevalence of obesity worldwide exceeded 1.4 billion. Of those, 200 million men were considered obese and 300 million women were categorized obese. In 2011, the WHO estimated that over 40 million children under the age of 5 were overweight. Epidemiology of Obesity: Where

9. Addressing the “Why” question of epidemiology, will lead us to the biology of obesity. There is a worldwide debate as to what causes us to gain weight. "Obesity is a complex disorder with a deceptively simple ultimate cause: the prolonged consumption of calories in excess of those expended" (Power 41). Epidemiology of Obesity: Why? Live Healthier

10. Biology of Obesity: Organs and Systems Involved Despite being the defining organ of obesity, the functions of adipose tissue are rarely discussed in relation to the disease. Adipose tissue is not simply energy and triglyceride storage for the body. It covers nerves, is found under skin and between muscles and vital organs (Power 2009). Adipose tissue also serves as an insulator and a cushion for the body. Live Healthier

11. Biology of Obesity: What Obesity is superficially a problem between excess energy being taken in and not expended (Trayhurn 2005). Organisms should be thought of as biological systems that cycle energy through themselves (Power 138). There are multiple biological processes of which may affect the rate of energy usage. Live Healthier

12. Once a patient has a weight problem, there are relatively few medical treatments that can be offered. Weight loss surgeries are recommended for the most severe of cases. These poses severe health risks, as any major surgery would. The two most common surgeries for obesity treatment are gastric bypass surgery and laparoscopic adjustable gastric banding (LAGB) (Mayo 2012). Biology of Obesity: Treatments Live Healthier

13. Social Concerns of Obesity American's perception is that while obesity is a problem, it is not their personal problem. Science and healthcare are making great strides in medicines to combat diabetes, high cholesterol and heart conditions. Convincing people that their weight is an issue is a harder task than ever before. Live Healthier

14. Social Concerns of Obesity Social stigma has decreased as a larger and larger percentage of the nation has gained weight. Clothing manufacturers are making larger sizes so that obese individuals are more able to dress like the rest of the population. Alarmingly, younger respondents (those between 20 and 34 years of age) were 13% less likely to accurately describe themselves as overweight (Johnson-Taylor et al 2008). Live Healthier

15. Psychological Concerns of Obesity: Subject's perceptions of how hard it will be to lose weight verses the rewards are also a challenge. Self efficacy and a person's past attempts and failures plays a large role into how hard they believe achieving weight loss will be. Live Healthier

16. The primary way the environment effects weight is whether or not the environment is conducive for physical activity. Temperatures and weather conditions can affect outdoor activity. In city environments, the amount of time a person can spend walking and doing outdoor activities can be greatly influenced by the air quality. Environmental Factors Effecting Obesity Live Healthier

17. Regulations of Obesity: Governments "People spend one-third to one-half of their waking lives in institutional settings" (Schneider 2011). For many around the world, this now also means they are more sedentary than ever before. Few school or workplace cafeterias are conscious enough to ensure that the food being served is balanced and nutritious. Most companies and government agencies, left to their own devices, will only provide the health and dietary services they are required and at the lowest cost possible. Live Healthier

18. What the government should/could do: Practically everyone has a recommendation for weight loss. However, most of these treatments do not withstand scientific experimentation and scrutiny. Government agencies, such as the CDC, use statistics they gather to make recommendations on public policies that effect weight. States with the worst obesity rates are enacting programs to combat their resident's growing girth. Live Healthier

19. Resources: Center for Disease Control (2013). Retrieved from http://www.cdc.gov/obesity/data/adult.htmlhttp://www.cdc.gov/obesity/data/adult.html Billie Giles-Corti, Sally Macintyre, Johanna P. Clarkson, Terro Pikora, and Robert J. Donovan (2003) Environmental and Lifestyle Factors Associated With Overweight and Obesity in Perth, Australia. American Journal of Health Promotion: September/October 2003, Vol. 18, No. 1, pp. 93-102. Harvard School of Public Health. Adult Obesity. Retrieved from http://www.hsph.harvard.edu/obesity-prevention- source/obesity-trends/obesity-rates-worldwide/http://www.hsph.harvard.edu/obesity-prevention- source/obesity-trends/obesity-rates-worldwide/ Johnson-Taylor, Wendy. Fisher, Rachel A. Hubbard, Van S. Starke-Reed, Pamela. Eggers, Paul S. (February 12, 2008). The change in weight perception of weight status among the overweight: Comparison of NHANES III (1998-1994) and 1999-2004 NHANES. The International Journal of Behavioral Nutrition and Physical Activity. Retrieved from http://www.ijbnpa.org/content/pdf/1479-5868-5-9.pdf http://www.ijbnpa.org/content/pdf/1479-5868-5-9.pdf Kumanyika, S. Jeffery, RW. Morabia, A. Ritenbaugh, C. Antipatis, VJ. (2002). Obesity Prevention: the case for action. International Journal of Obesity. Retrieved from http://www.bvsde.paho.org/texcom/cd050644/kumanyik.pdfhttp://www.bvsde.paho.org/texcom/cd050644/kumanyik.pdf National Health and Nutrition Examination Survey 1999–2012 Survey Content Brochure. (2012). Retrieved From http://www.cdc.gov/nchs/data/nhanes/survey_content_99_12.pdf http://www.cdc.gov/nchs/data/nhanes/survey_content_99_12.pdf Power, Michael L. and Schulkin, Jay. The Evolution of Obesity. (2009) The Johns Hopkins University Press. Baltimore, Maryland.

20. Resources: Schneider, Mary-Jane PhD. (2011). Introduction to Public Health. Sudbury, Massachusetts. Jones and Bartlett Learning. Sweeting, Helen N. (October 26, 2007). Measurement and Definitions of Obesity in Childhood and Adolescense: A field guide for the Uninitiated. Nutrition Journal. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2164947/ The Mayo Clinic Staff. (August 3, 2012). Obesity: Treatments and Drugs. The Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/obesity/DS00314/DSECTION=treatments-and-drugs http://www.mayoclinic.com/health/obesity/DS00314/DSECTION=treatments-and-drugs Toft, U. Overweight men's motivations and percieved barriers towards weight loss. (September 2006). European Journal of Clinical Nutrition. Retrieved from http://www.nature.com/ejcn/journal/v61/n4/full/1602537a.html Trayhurn, Paul. (2005). The Biology of Obesity. Neuroedocrine and Obesity biology Unit, University of Liverpool. Retrieved from http://journals.cambridge.org/action/displayAbstract?fromPage= online&aid=902384 Unknown, Author. (January 3, 2012). Obesity and Cancer Risk. National Cancer Institute at the National Institute of Health. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Risk/obesity Unknown, Author. (2012). Overweight and Obesity Statistics. US Dept of Health and Human Services. Retrieved from http://win.niddk.nih.gov/publications/PDFs/stat904z.pdf Unknown Author. (2013) Health Topics: Obesity. World Health Organization. Retrieved from http://www.who.int/topics/obesity/en/ Yach, Derek. Stuckler, David. Brownell, Kelly D. Epidemiologic and economic consequences of the Global epidemics of obesity and Diabetes. (2006). Nature Publishing Group. Retrieved From http://conferences.dce.ufl.edu/docs/NEW/Addiction/Web%20Presentations/Brownell%20Yach.NatureMed06.pdf