Consequences of Childhood Obesity - Essay Example

Obesity in Adults Introduction Human body is adapted to function through energy and materials derived from the food. Thus any deviation from normal food intake or expenditure of the food taken can lead to several problems like malnutrition, obesity, vitamin deficiencies, etc. Of these, obesity is a growing concern all over the world, rampant across all countries, races, ethnicities, age groups and sexes. In is very important to address obesity and problems associated with it, because it is present in epidemic proportions and can contribute to severe morbidity and mortality. Hence, in this essay, 'obesity in adults' has been chosen as a food issue for discussion. Definition of obesity Obesity may be defined as as increase in weight by 10 percent more than what is recommended for weight and height. Obesity is a state of excess storage of body fat in the body. Although there is no clear cut measurement of obesity, Body mass index or BMI or Quetelet index is a reasonably good measure of obesity (BMI = weight/height2, where weight is in kilograms and height is in meters). Estimation of percentage of body fat is another measure for obesity (Uwaifo and Arioglu, 2009). In men, body fat >25% is suggestive of obesity and in women, >33% is an indication of obesity (Uwaifo and Arioglu, 2009). The most widely accepted definition of obesity is that by the WHO: "for adults, grade 1 overweight (commonly and simply called overweight) is a BMI of 25-29.9 kg/m2, grade 2 overweight (commonly called obesity) is a BMI of 30-39.9 kg/m2 and grade 3 overweight (commonly called severe or morbid obesity) is a BMI greater than or equal to 40 kg/m2" (Uwaifo and Arioglu, 2009). In children, BMI greater than 85th percentile is considered as over weight and that above 95th percentile is considered as obesity (Uwaifo and Arioglu, 2009). Extent of problem Obesity in children, adolescents and adults is a growing problem all over the world. There are reports that 16-33 percent of children and adolescents are obese (AACAP, 2008). The prevalence is much higher among adults. This condition is the easiest medical condition to recognize but very difficult to treat. According to statistics, atleast 100 million adults in the United States suffer from overweight or obesity. 31% of men and 33% of women above 19years of age are either overweight or obese (Uwaifo and Arioglu, 2009). The incidence in children is about 20-25% (Uwaifo and Arioglu, 2009). The prevalence of obesity is higher in certain minority groups like Mexican Americans, Pima Indians and African Americans either due to genetic and familial factors or due to sedentary lifestyles. The prevalence in both the sexes is equal (Uwaifo and Arioglu, 2009). Obesity usually begins at 5-6 years of age and then during adolescence. There are reports that obesity between 10- 13 years of age is likely to advance to adult obesity (AACAP, 2008). Causes of obesity Obesity is caused by primary causes and secondary causes. The primary causes of obesity are the most common and occur because of imbalance of calorie intake and calorie burnout. Some of the primary causes of obesity are poor eating habits, lack of play, sports and exercise, over eating or binge eating, eating while sitting in front of television and family history of obesity. These factors lead to an imbalance in calorie intake and calorie burnout (AACAP, 2008). The present generation of children are exposed to lot of junk food which is available at affordable rates. Binge eating and eating lot of fast foods has contributed significantly to obesity. Secondary causes of obesity are genetic syndromes like Cohen syndrome, prader-Willi syndrome, Laurence-Moon Biedl syndrome, Cohen syndrome, Down syndrome and Turner syndrome. Certain hormonal conditions also lead to obesity and they aare resistance or deficiency of growth hormone, hypothyroidism, leptin deficiency, Cushing syndrome, precociuos puberty, polysystic ovarian disease and prolactin secreting tumors. Some medications when used for a long period of time contribute to obesity and they are steroids like glucocorticoids, cortisol, sulfonyl ureas, oral contraceptives, clozapine, risperidone, tricyclic antidepressants, etc (Schwarz and Freemark, 2009). Such and other causes cause an imbalance in calorie intake and expenditure and cause some pathophysiological changes amounting to accumulation of fat in various parts of the body. An imbalance in energy intake and expenditure deposition of fat occurs. The imbalance occurs either due to sedentary lifestyle or due to dysfunction in the gut-brain-hypothalamic axis through ghrelin/leptin hormonal pathway. This pathway plays a major role in the control of appetite and excess energy intake. Excess energy results in deposition of fat in various organs like muscle and liver resulting in decreased sensitivity of these tissues to insulin. There is enough research supporting the association between obesity and insulin resistance. Lipotoxicity due to fat accumulation leads to progressive decline in beta cell function and eventually leads to diabetes. Central obesity is more associated with diabetes. Intracellular triglycerides are markedly increased in muscle and liver tissues in obese individuals because the increased circulating FFAs are deposited in these organs. Raised free fatty acids contribute to hypertriglyceridemia which eventually leads to atherosclerosis and consequences like stroke and premature coronary artery disease. Resistance to insulin causes hyperinsulinemia and rise in insulin-like growth factor-I which increases blood pressure and causes hypertension (Schwarz and Freemark, 2009). Thus, energy imbalance leads to many pathophysiological changes amounting to many health-related problems in the body. Obesity runs in families probably due to genetic aspects or due to common lifestyle habits and shared diet (Galleta and Khandwalla, 2005). Depression, boredom and anger increase the intake of food and contribute to obesity. Sedentary habits, lack of exercise and physiological states like pregnancy and lactation contribute to obesity. Some genetic factors like leptin and slow metabolism also contribute to obesity (Balentine and Mathur, 2009). Another important factor which is worth mentioning is ethnicity (Balentine and Mathur, 2009). Implications of obesity among adults Obesity-related complications are rare in childhood, but as obesity advances to adolescence and adulthood, the complications gradually begin to rise. The acute complications which arise due to obesity are type-2 diabetes, hyperlipidemia, hypertension, ovarian hyperandrogenism and gynecomastia, accelerated growth and bone maturation, pancreatitis, cholecystitis and pseudotumor cerebri. Other complications include fatty liver, focal glomerulosclerosis and cirrhosis (SIGN, 2005). Obesity can also lead to sleep apnea, orthopedic problems like genu valgum, slipped capital femoral epiphysis and tibia vara. Liver dysfunction is another morbidity associated with childhood obesity. Other health problems include development of cardiovascular risk factors like hypercholesterolemia, insulin resistance, hypertriglyceridemia, reduced levels of HDL, hypertension, polycystic ovarian disease (SIGN, 2005). Obesity can also lead to psychosocial problems like lower self esteem, peer problems and social isolation which indirectly affect the health of the individual. Long term consequences of obesity include risk of adulthood obesity, coronary artery disease, atherosclerosis, stroke, gout, colorectal cancer, arthritis and psychosocial dysfunction (SIGN, 2005). Of all these complications those associated with lifespan are cardiac risk factors, although other problems indirectly affect health and contribute to mortality. the most important of these is premature coronary artery disease which is associated with high mortality. Thus, obesity causes many health related problems and causes decrease in lifespan. Strategies to tackle obesity Obesity is associated with significant mortality and morbidity and hence it is important to control and treat obesity. Most of the times, obesity can be managed with exercise and appropriate diet. For majority of over weight and obese people, the best treatment of obesity is to eat less and perform more exercises and physical activity. Decreasing calorie intake by 500 calories or expending extra 500 calories during exercise sessions will help decrease weight by about a pound per week (Galleta and Khandwalla, 2005). Exercise of atleast 30 minutes for 5 times a week is essential to achieve weight loss. In children, weight loss must not be aimed at. Rather, the aim must be to reduce the rate of weight gain to such an extent that they fall into the expected profile gradually. There are many diet plans which can be used for weight reduction. According to Harvard Medical School (2007), a good diet plan is one which allows the user to follow the regimen for a long time and at the same time is good for both physical and mental health. Also, the diet plan must produce sustained weight loss without causing any adverse effects on the health of the user. There are many popular diets available which claim to decrease weight. Some of them are low carbohydrate diets, low fat diets, correct carbohydrates diet and perfect proportions and careful combinations diet. Low-carbohydrate diets like South Beach diet consists of high-protein meats, poultry, eggs and full-fat dairy products with no carbohydrates like rice, bread and pasta and also restriction of saturated and trans foods which are mainly seen in animal foods. However, the diet encourages unsaturated form of fats which are derived from nuts and fish (Harvard Medical School, 2007). Low fat diets like Dr. Dean Ornish's "Eat More, Weigh Less" plan recommend whole-grain, vegetarian, very low-fat diet with decrease of cholesterol intake which is bad for heart. The diet plan also recommends stress management, exercise and group support (Harvard Medical School, 2007). Correct carbohydrates diet recommends intake of foods with low glycemic index so that there is slow release of glucose into the blood preventing sudden bursts of insulin which causes hunger (Harvard Medical School, 2007). Core of this diet is plenty of fruits, vegetables and whole grains. Perfect proportions and Careful Combinations diets contain 40% carbohydrate, 30% fat and 30% protein along with recommendations for exercise and food supplements (Harvard Medical School, 2007). Calorie-density diets consist of foods which have minimal calorific value but fill the belly. Low fat milk, fruits, vegetables, beans, cooked grains, soups, stews and beans have high water content, are filling and yield low calories. The automatic diet proposes that "there are seven keys to weight loss which are feelings of healing, right thinking, no-fail environment, intentional exercise, circle of support and mastery over food and impulse eating." This diet program uses behavior modification technique to reduce weight (Harvard Medical School, 2007). While selecting a diet for weight reduction, it is important to select a diet which is good for heart, bones, colon and over all health. Also, the food must be appealing and satisfying. Otherwise, adherence to the diet regime will be difficult. Research has shown that adherence is the only factor which influences weight reduction in these popular diets. According to WHO (2009), obesity can be tackled by creating a population based environment through implementation of various public policies that promote the availability of high fiber, low fat foods and also there are ample opportunities for physical activity. According to the National Health and Examination Survey (cited in Balentine and Mathur, 2009), exercise and physical activity help burn calories and thus help decrease in weight. the amount of calories burnt depends ion the intensity, type and duration of exercise. Exercise also helps in the control of blood sugar levels, decreases triglycerides or good "HDL" levels, decreased blood pressure, reduces abdominal obesity and decreases the risk of heart disease. The general exercise recommendations are moderate exercise of 20-30 minutes for 5-7 days a week. the exercise could be stationary bicycling, walking, jogging or swimming. Exercise can also be broken down into sessions of 10 minutes. Any exercise must be started slowly and gradually built up (Balentine and Mathur, 2009). Conclusion Obesity is a major health hazard that is associated with significant morbidity and mortality. There are several risk factors and causes for obesity, while the most common one is imbalance ion the calorie intake and burn out. The best way to tackle obesity is the decrease intake of food and increase physical activity. There are several diets which have been recommended for weight loss. Most of the diets have similar effects and weight loss occurs only when one adheres to a regime for some time. Along with appropriate diet, physical activity is indispensable. References American Academy of Child and Adolescent Psychiatry or AACAP. (2008). Obesity In Children And Teens. Retrieved on 24th April, 2010 from www.aacap.org/cs/root/.../obesity_in_children_and_teens Balentine, J,R, and Mathur, R. (2009). Obesity. MedicineNet.com. Retrieved on 24th April, 2010 from http://www.medicinenet.com/obesity_weight_loss/article.html Galletta, G.M. and Khandwala, H.K. (2005). Obesity. Emedicine Health. Retrieved on 24th April, 2010 from http://www.emedicinehealth.com/obesity/page2_em.htm Harvard Medical School (2007). Popular Diets: Obesity. Harvard Health Publications. Retrieved on 24th April, 2010 from http://www.aolhealth.com/obesity/learn-about-it/popular-diets Schwarz, S.M., and Freemark, M. (2006). Obesity. Emediicne from WebMD. Retrieved on 24th April, 2010 from http://emedicine.medscape.com/article/985333-overview SIGN. (2005). Consequences of childhood obesity. Retrieved on 24th April, 2010 from www.sign.ac.uk/guidelines/fulltext/69/section3.html Uwaifo, G.I., and Arioglu, E. (2009). Obesity. Emedicine from WebMD. Retrieved on 24th April, 2010 from http://emedicine.medscape.com/article/123702-overview WHO (2009). Obesity and Overweight. Retrieved on 24th April, 2010 from http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/ Read More