Predicting Obesity in Young Children - Essay Example

 Predicting Obesity in Young Children Obesity has been known since the prehistoric times. Since 1980, worldwide obesity has doubled. It is the fifth leading risk of global deaths, with an estimate of 2.8 million deaths in adults who are either overweight or obese (WHO, 2011). Obesity is a health condition in which there is an excess of adipose tissue leading to excessive body weight. Together with other communicable diseases, such as cardiovascular disease, certain types of cancer and chronic respiratory disease, obesity accounts for 60% of 58 million deaths annually (WHO, 2011). Deaths occur in both low and middle-income countries, and they can be prevented through inexpensive interventions. Obesity is a complex disease because it involves the interaction of genotype with environmental, social, behavioral, cultural, metabolic and genetic factors. In the USA, there has been a dramatic increase in obesity over the last few decades (Singh, Mohammad, Robert and Lava, 2011) .It can affect all ages including children and the elderly (Caprio, Daniels, Diewnowski, Kaufman, Palinkas, Rosenbloom and Schwimmer, 2008). There are many controversial issues surrounding the dramatic increase of this health condition. In the year 2010, for instance, no state had a prevalence of less than 20% (National health and Examination survey, 2010).Some people argue that, the government should take charge of the situation, as it did with seatbelt usage and smoking. Others say obesity is the responsibility of the individuals who are obese. This is the point of contention in this research. The position I will take is that it is the responsibility of the government to manage and control obesity. The government should enact laws to protect its citizens from this debilitating condition. Causes of obesity Studies of obese people have shown a direct link between genotype and obesity (Elks et al, 2010). There are genetic variations which are associated with adult obesity. The risk of obesity also increases in adults when one of the parents is obese; thus, the obesity status of the parent plays a crucial role (Whitaker, Wright, Pepe, Seidel and Dietz, 1993). This represents a good avenue for identification and timing of weight changes in life. The causes of obesity are reduced physical activity, increased urbanization; increased intake of salts, high-fat food, high-energy foods and intake of sugary soft drinks (Nielson and Popkin, 2004). Increased urbanization leads to utilization of free grounds for playing, consequently denying people places to play games. Physical activity is particularly important as it increases energy expenditure and it is a good tool in reducing weight if used well with dietary changes (NHLBI Obesity Education Initiative, 2000). Other caused of obesity are lack of supportive policies in transportation, food processing and education; and the distribution and marketing of commodities. Food marketing can have a negative consequence on the country’s diet and health, mostly affecting children. Marketing is overwhelming and is done in many forms that are called ‘stealth approaches’. It can erode the objective of a nation in strengthening healthier eating (Brownell, Kersh, Ludwig, Post, Puhl, Schwartz and Willett, 2010). BMI distribution of adipose tissue within the body is the most used indicator or predictor of obesity because it is easy to measure and relate to fatness (WHO, 2000). Body mass index (BMI) is given by weight in Kg divided by height in M2 (Angelo, 2010). People with BMIs of over 30 are considered obese (Angelo, 2010). However, BMI lacks sensitivity due to gender and ethnic differences that might affect differences in relative body fatness (WHO, 2000).Other methods of diagnosing obesity involves assessing of body fat content which is achieved indirectly through different methods such as dual energy X-ray absorptiometry (DEXA).This method is able to quantify total body fat content (Angelo, 2010). Another indicator used is skin fold thickness (TER), which provides an index of adipose tissues distribution in the subcutaneous layers (Peter, Louis, Robert and Claude, 1999). Calculation of Waist circumference is also being used as an indicator of fatness in the body as it is easier to correlate with BMI (Angelo, 2010). Classification of obesity Obesity can be classified on the basis of etiological criteria and anatomical phenotypes, as well as according to BMI intervals. There are three classes of obesity based on BMI. Class 1 lies between 30-34.9 kg/m2 and has a moderate risk, class 2 lies between 35- 39.9 kg/m2 and has high risk, and class 3 lies above 40kg/m2 and has an extreme risk (Angelo, 2010). In regard to anatomical classification, there is either visceral or peripheral obesity, and this classification is based on subcutaneous or visceral adipose layers (Angelo, 2000).These two types of obesity are determined by taking the ratio of waist circumference to hip circumference. Based on etiology, obesity can either be primary or secondary. Secondary obesity occurs after pharmacological treatments that use medicines such as antipsychotics, after the use of some antidepressants and after steroid use. Obesity can also be a phenotype of some disease conditions, such as polycystic ovary syndrome and hypothyroidism (Angelo, 2010). Risk factors associated with obesity Being obese may lead to the occurrence of other disease conditions. These risk factors include hip fractures, certain types of cancer such as colon, breast and endometrial cancer, peripheral artery diseases, coronary diseases, sleep apnea, gallstones, musculoskeletal disorders and gynecological abnormalities such as amenorrhea and menorrhagia (NHLBI Obesity Education Initiative, 2000). There is also a relationship between BMI and mortality, and people who have BMI between the age of 25 and 30 tend to live longer than those with lower or higher BMIs (Horwich, Fonrow, Hamilton, MacLellan, Woo and Tillisch, 2001). Other complications include; impaired glucose metabolism, insulin resistance, type 2 diabetes in adolescences, hypertension and gastrointestinal disturbances, premature death, disability, breathing difficulties and psychological effects (NHLBI Obesity Education Initiative, 2000). Other effects are social stigmatization and discrimination (WHO, 2011). In terms of epidemiology and mortalities, about 65% of the total world population lives in areas where obesity kills people. It is estimated that 2.8 million deaths of adults annually of people who are overweight or obese, with 44% having diabetes complications, 23% having heart failures and 40% having certain types of cancer (WHO, 2000). In 2008, it is estimated that 1.5 billion people were overweight; these are people who are age of 20 and older. Among them, over 200 million were men; women were about 300 million. This number is expected to increase (WHO, 2011). Economic costs of obesity In terms of the economic costs of obesity, there are both direct and indirect, or social, costs. In the US it is estimated that indirect costs are $47.6 billion per year. There is a higher cost due to treating obesity and its associated health conditions such as type 2 diabetes, cardiovascular diseases, stroke and osteoporosis (Angelo, 2010). In addition high levels of absence from work among obese people, reduces productivity and this affects the economy of any country negatively (WHO, 2000).Other costs of obesity, includes lack of employment perhaps due to discrimination in work place. This reduces country’s national revenue and increases government expenditure on unemployment benefits. In 1998, the direct costs were $51.6 billion, and this is expected to increase (WHO, 2000). The government should take a leading role in the management of this health condition just as it has done in the case of seatbelts and smoking, rather than leaving it as a personal responsibility. Personal responsibility plays a major role when individuals take an active role and responsibility on the type of foods they take, as obesity is avoidable through behavioral change. Other opposing views in government intervention are that, it undermines personal responsibility and intrudes personal freedom. Despite all these opposing views, reconciling personal responsibility and government intervention can yield good results (Brownell et al, 2010).Government intervention to correct obesity is justified from several grounds. Its intervention will uphold the law, correct market failures and promote equity if for instance there has been discrimination against obese people in the provision of health care. The government should enact innovative legal approaches to address obesity. The law is a powerful tool that has great potential to address obesity. Although there are many gaps in the current regulatory mechanisms, this constitutes a good foundation for the establishment of a legal framework or law application to address obesity. These legal solutions can be considered at a local, federal or state level. There are two approaches that can be used. One of these approaches is the direct application of law to prevent those factors that increase obesity. This approach involves the provision of legal solutions to strengthen weak government regulatory mechanisms and to enhance efficiency of the current policies that control obesity (Pomeranz, Stephen, Stephen Lainie and Kelly, 2009). Role government in controlling obesity There are various initiatives which can be used is regulating speech in regard to persuasive marketing of calorie-dense foods and other poor nutritional foods (Pomeranz, Stephen, Stephen, Lainie and Kelly, 2009). The government can enact laws to compel industries to provide information to consumers on the health risks of the food items they sell. In the US for example, commercial speech helps the consumers to make the right decisions to buy healthy and safe food. In this case, the government should ban false commercial speech which does not convey information necessary for public decision making (Post, 2000). The government should also enforce food labeling. Through the revenue it collects, the government should also support those programs that are aimed at educating consumers on healthy eating. These programs will empower the public to avoid buying those commodities which cause overweight and obesity. Other mechanisms could be put in place to regulate consumers’ and sellers’ conduct to address the supply and demand of the commodities that are deemed to cause obesity. This could be carried out through imposing a higher tax on ingredients for those commodities which are said to cause obesity. The effect of this tax will be reduced amounts of processed commodities as manufactures will respond to the high tax. Demand for such commodities is also expected to reduce due to high price and this will significantly reduce the amount of commodity consumed. The government should also ensure there are no dangerous speeches by imposing fines. Limiting the amount of goods a minor can buy is also a solution that can be enforced through government agencies. This is achieved by limiting the number of retail shops that can be located in a given community and banning fast food shops to protect public health achieve this. The government can also make it illegal for children to buy items that have been proven to cause health problems (William, Donald and Alicia, 2009). Government’s role in research The government should also fund scientific research on goods that are deemed to cause obesity to determine how they cause obesity and also to understand the underlying physiology. Results from these studies will help in educating the public on dangers of such foods to avoid obesity and other related outcomes (William, Donald and Alicia, 2009). In addition, more research should be funded into the role of obesity -related gene variants, as this could be a good target for the development of therapeutic intervention measures such as gene therapy in genetic- related obesity. This is particularly important, as it leads to making of informed decisions. The state can also compel companies to admit liability if they produce products that will be over consumed and lead to obesity. These products include sugared beverages which have shown to have addiction (carbohydrate craving) and to cause obesity (Pomeranz, Stephen, Stephen, Lainie, and Kelly, 2009). There are various innovations that can be used to address regulatory gaps. For example, innovative litigation is used today by advocates to address issues such as people’s injuries, caused by various products (Teret, 1986). Through this method, the consumer is also informed which foods are harmful based on the epidemiological data collected or from emerging cases of harm. A performance- based approach and industry mandates are also helpful methods, and these can be implemented by rewarding companies that educate the consumers on the side effects of products they are selling, as in the case of cigarettes. The government can also compel industries to place warnings on commodities they are selling to protect the public’s health. Those businesses that do not place warning labels on their products should be fined. This strategy will help consumers make informed decisions on the commodities they buy (Pomeranz, Stephen, Stephen, Lainie, and Kelly, 2009). Preemption is the ability of a federal government to prevent certain activities of a lower level government. It can significantly impact the ability of a lower level government to enact laws to protect consumers. On the other hand, it can promote public health goals if strong federal laws are enacted to protect public health (Pomeranz, Stephen, Stephen, Lainie, and Kelly, 2009). Monitoring and evaluation systematic processes can help to rectify obesity in the early stages of life. The government can achieve this through formation of monitoring and evaluation departments or by using the already- existing facilities such as hospitals and quality assurance bodies. Monitoring will be important, as it will provide the government with an overview of the situation while evaluation will be critical in providing an in-depth analysis of the situation threshold (William, Donald and Alicia, 2009). Other multidisciplinary interventions include creating an environment for physical activities, providing local facilities, encouraging walking and cycling to work, and forming social networks that facilitate physical activity. Physical activity has both indirect and direct benefits. It should be considered as a good management strategy as it increases energy expenditure (NHLBI Obesity Education Initiative, 2000). The government should also set up specialized care facilities to address obesity. These facilities will have the responsibilities of assessing and managing obesity. The facilities should also be equipped with well-trained staff. Conclusion The law should be considered a very important component in addressing obesity, but individuals also have a role to play. With new scientific advances, gaps in current regulatory mechanisms and the ever-increasing toxic foods, enacting laws is a good approach to address this problem as it considers the rights and responsibilities of both consumers and industries. Laws should addresses the factors that increase obesity such as nutrient-poor commodities, accessibility of sugared foods, absence of information on products sold, and the addictive nature of some food commodities. Since the 19th century, the protection of public health has been the responsibility of government since and therefore the government should never fail to discharge these responsibilities to protect consumers. The government’s role in fighting this disease is irreplaceable. This problem should be addressed in a new perspective by establishing innovative strategies, and the approach to law should also be explored (William, Donald and Alicia, 2009). References Angelo, D. P. (2010). Definitions And Classification of obesity. doi: 10.1016/B978-0-12-374387-9000209-9 Brownell, K.D., Kersh, R., Ludwig, D.S., Post, R.C., Puhl, R.M., Schwartz, M.B., and Willett, W.C (2010). Personal Responsibility And Obesity: A Constructive Approach To A Controversial Issue. Health Affairs , 29 (3), 379-387. doi: 10.1377/hlthaff.2009.0739 Caprio, S., Daniels, S.R., Diewnowski, A., Kaufman, F.R., Palinkas, L.A., Rosenbloom, A.L and Schwimmer, J.B. (2008). Influence of race , ethinicity and culture on childhood obesity:Implications for prevention and Treatment. Diabetes care , 31 (11), 2211-2221. doi:10.2337/dco8-9024 Elks, C.E., Loos, R.J.F, Sharp, S.J., Langerberg, C., Ring, S.M., Timpson, N.J., Ness, A.R., Smith, G.D, Dunger, D.B., Wareham, N.J.and Ong, k.k. (2010). Genetic markers of Adult Obesity Risk Are Associated With Greater Early Infancy Weight Grain and Growth. PLoS Med , 7 (5). doi:10.1371/journal.pmed.1000284 Horwich, T.B., Fonrow, C., Hamilton, M.A., MacLellan, W.R., Woo, M.A and Tillisch, J.H. (2001). The relatioship Between Obesity and Mortality in Patients With Heart Failure. J. Am.Coll.Cardiol. , 38, 789-795.Retrieved from http://content.onlinejacc.org /cgi /reprint/38/3/789.pdf National health and Examination survey. (2010).Overweight and Obesity: Retrieved from http://www.cdc.gov/obesity/data/trends.html NHLBI Obesity Education Initiative. (2000). 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Preventive medicine, 22, 167-177. doi: 10.1056/neljm19970925337301 William, H.D., Donald, E.B. and Alicia, S.H (2009). Public Health Law and the Prevention and Control of obesity, CDC. The Milbank quarterly, 87 (1), 215-227. Retrieved from http://www.cdc.gov.phlp/docs/obesityprevention.pdf Read More