1. Obesity in America Medical Ethics Fall 2007 Nicole Reske

2. Obesity Trends in America http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm

3. Obesity leads to a higher risk of… Hypertension Hypertension Dyslipidemia (for example, high total cholesterol or high levels of triglycerides) Dyslipidemia (for example, high total cholesterol or high levels of triglycerides) Type 2 diabetes Type 2 diabetes Coronary heart disease Coronary heart disease Stroke Stroke Gallbladder disease Gallbladder disease Osteoarthritis Osteoarthritis Sleep apnea and respiratory problems Sleep apnea and respiratory problems Some cancers (endometrial, breast, and colon) Some cancers (endometrial, breast, and colon) http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm

4. What is Obesity? Obesity is defined as “an excessive amount of body fat or adipose tissue in relation to lean body mass” Obesity is defined as “an excessive amount of body fat or adipose tissue in relation to lean body mass” Body mass index is used to express weight status – it uses a ratio of weight to height Body mass index is used to express weight status – it uses a ratio of weight to height Keep in mind, BMI is not always accurate Keep in mind, BMI is not always accurate F as in Fat: How Obesity Policies are Failing in America pg. 9 Picture: http://health.howstuffworks.com/bmi3.htm

5. Body Mass Index BMI = o Below 18.5 = Underweight o Between 18.5-24.9 = Healthy weight o Between 25-29.9 = Overweight o Over 30 = Obese http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/index.htm

6. Children are at risk too… http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/prevalence.htm http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/prevalence.htm Prevalence of Overweight Children NHANES: National Health and Nutrition Examination Survey

7. Is obesity an epidemic? Epidemic: affecting many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent. Epidemic: affecting many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent. Disease: a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment. Disease: a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment. www.dictionary.com

8. Not an epidemic but a disease… Speaking in terms of definitions, obesity is not considered an epidemic Speaking in terms of definitions, obesity is not considered an epidemic But it can be considered a disease But it can be considered a disease Picture: http://www.longwoodsystems.com/

9. Is the state currently involved in preventing obesity? Actually, it is (well it’s trying) Picture: http://www.crwflags.com/fotw/flags/us-mi.html

10. National Governors Association NGA launched Healthy States Grant Program NGA launched Healthy States Grant Program It has provided 13 states up to $100,000 for community or worksite wellness efforts It has provided 13 states up to $100,000 for community or worksite wellness efforts Michigan is included as one of these states Michigan is included as one of these states Picture: http://www.nga.org/portal/site/nga

11. Snack Taxes Currently 17 states and D.C have snack taxes Currently 17 states and D.C have snack taxes States include: Arkansas, California, Illinois, Indiana, Kentucky, Maine, Minnesota, Missouri, New Jersey, New York, North Dakota, Rhode Isalnd, Tennessee, Texas, Virginia, Washington, and West Virginia States include: Arkansas, California, Illinois, Indiana, Kentucky, Maine, Minnesota, Missouri, New Jersey, New York, North Dakota, Rhode Isalnd, Tennessee, Texas, Virginia, Washington, and West Virginia Picture: http://www.greetingbaskets.com/html/uniqueandpractical.html

12. Obesity Liability States have begun to pass legislation to prevent individuals from suing the food industry for making them fat States have begun to pass legislation to prevent individuals from suing the food industry for making them fat States include: Arizona, Colorado, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Kansas, Kentucky, Maine, MICHIGAN, Missouri, New Hampshire, North Dakota, Ohio, Oregon, South Dakota, Texas, Tennessee, Utah, Washington, Wisconsin, Wyoming States include: Arizona, Colorado, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Kansas, Kentucky, Maine, MICHIGAN, Missouri, New Hampshire, North Dakota, Ohio, Oregon, South Dakota, Texas, Tennessee, Utah, Washington, Wisconsin, Wyoming Picture: http://www.dailyspeculations.com/wordpress/?cat=263

13. Diets influenced by subsidized foods… http://www.rwjf.org/files/research/fasinfat2007.pdf Corn, wheat, soybeans, rice, and cotton are “program crops” that receive government subsidies from 10 to 25 billion a year

14. Obesity adds risk to pregnancy Obese women are more likely to have children with Obese women are more likely to have children with Spina bifida Spina bifida Omphalocele Omphalocele Heart defects Heart defects Obese women are also more likely to deliver premature and need an emergency C-section http://www.rwjf.org/files/research/fasinfat2007.pdf Picture: http://www.wichitatreehouse.com/

15. Health care costs increase for businesses Obese workers have 21% higher health care costs Obese workers have 21% higher health care costs Obese workers lost 183.63 workdays per 100 full time employees compared to 14.19 in normal employees Obese workers lost 183.63 workdays per 100 full time employees compared to 14.19 in normal employees Obese workers also have higher workers compensation rates Obese workers also have higher workers compensation rates Picture: http://www.lesgilbertson.com/workcomp.htm F as in Fat: How Obesity Policies are Failing in America

16. America’s Opinion 85% of America’s believe obesity is an epidemic 85% of America’s believe obesity is an epidemic 56% support government funding to combat obesity 56% support government funding to combat obesity Despite rising obesity many Americans are aware of steps to avoid obesity Despite rising obesity many Americans are aware of steps to avoid obesity As income level increases the desire for government involvement decreases As income level increases the desire for government involvement decreases Survey conducted by Greenberg Quinlan Rosner Research, Inc found in F as in Fat: How Obesity Polices are Failing in America Picture: http://www.thisnext.com/item/DF338374/Dunkin- Donuts-Breakfast

17. The Right Action Obesity leads to many undesirable effects Obesity leads to many undesirable effects Most Americans agree that there is a obesity epidemic and that the government to some level should be involved Most Americans agree that there is a obesity epidemic and that the government to some level should be involved But what is the right action to eliminate or reduce the prevalence of obesity in society? But what is the right action to eliminate or reduce the prevalence of obesity in society? Picture: http://www.lib.washington.edu/subject/Drama/nwdc1.htm l

18. Should government be involved at all? The non-consequentialist would say no, it interferes with our autonomy and our confidentiality to live the way we prefer and make our own food choices The non-consequentialist would say no, it interferes with our autonomy and our confidentiality to live the way we prefer and make our own food choices Picture: http://www.takechargeonlinetherapy.com/PrivacyPolicy.htm

19. Utilitarian The utilitarian would say that in any case where government involvement increases the amount of health and happiness it should be allowed to interfere The utilitarian would say that in any case where government involvement increases the amount of health and happiness it should be allowed to interfere It would mean better health, productivity, lower health insurance costs, longer life expectancy It would mean better health, productivity, lower health insurance costs, longer life expectancy Picture: http://www.theonion.com/content/node/30263

20. How far should the government be allowed to interfere? Should they control what we eat? Should they control what we eat? Regulate what is sold in stores? Regulate what is sold in stores? Provide financial incentives for people under a certain weight or BMI? Provide financial incentives for people under a certain weight or BMI? Picture: http://sc94.ameslab.gov/TOUR/whitehouse.html

21. Complications of government involvement in what we eat Eating habits may be more than lack of will power Eating habits may be more than lack of will power Comfort food – depression Comfort food – depression Many people many different diets – vegan, vegetarian, allergies, diabetics Many people many different diets – vegan, vegetarian, allergies, diabetics Affect food market – loss of revenue or even jobs Affect food market – loss of revenue or even jobs Food lobbyists in D.C. giving money for campaigns Food lobbyists in D.C. giving money for campaigns Picture: http://www.icanefile.org/index2_0.asp?caller=347

22. So what do we do? In my opinion, we need to make small choices that will affect the many In my opinion, we need to make small choices that will affect the many Picture: http://www.pensionriskmatters.com/articles/retirement-planning/

23. Like what? We need to begin to subsidize the local farmer – those who participate in farmers markets We need to begin to subsidize the local farmer – those who participate in farmers markets This is a good way to get fruits and vegetables to many people without the large costs of shipping and handling and by cutting out the middle man This is a good way to get fruits and vegetables to many people without the large costs of shipping and handling and by cutting out the middle man Picture: http://lancaster.unl.edu/food/ftjul06.shtml

24. What else? We also need to control the large corporations of America that have a monopoly on the market like PepsiCo Inc. and the ingredients that they are putting into their products We also need to control the large corporations of America that have a monopoly on the market like PepsiCo Inc. and the ingredients that they are putting into their products Picture: http://www.pepsi.com/pepsi_brands/product_info/index.php

25. Put a stop to HFCS! We need to stop producing HFCS! We need to stop producing HFCS! HFCS is a caloric sweetener that leaves you feeling more hungry then when you first started eating which increases your appetite and desire to eat HFCS is a caloric sweetener that leaves you feeling more hungry then when you first started eating which increases your appetite and desire to eat Don’t buy foods with HFCS – perhaps this will affect the market Don’t buy foods with HFCS – perhaps this will affect the market Picture: http://www.nytimes.com/2006/07/02/business/yourmoney/02syrup.html?_r=1&oref=slogin

26. Realize Your Power Consumers have a large influence on the market!! Consumers have a large influence on the market!! If there is a large demand there are business people out there ready to make it happen! If there is a large demand there are business people out there ready to make it happen! Buy healthy foods – we will see more of them Buy healthy foods – we will see more of them Picture: http://www.ers.usda.gov/AmberWaves/November06/DataFeature/

27. Overall Although obesity cannot technically be considered an epidemic it needs to be given attention Although obesity cannot technically be considered an epidemic it needs to be given attention Happenings on both the federal, state and individual level in order for things to get better Happenings on both the federal, state and individual level in order for things to get better Picture: http://mwcfootball.wordpress.com/2007/08/06/its-official-utes-to-open-2008-at-michigan/