Public Health and Professional Practice - Case Study Example

NJ122 Public Health and Professional Practice Obesity Introduction Obesity has taken the form of an epidemic world wide. Concern over obesity is enhanced as it contributes to increasing rates of type 2 diabetes, cardiovascular disease, stroke and some types of cancer, thereby leading to premature deaths. Though hereditary factors contribute to individuals becoming obese, environmental factors and life style factors also contribute in a large way to the increasing rates of obesity (Yang, Kelly & He, 2007). The epidemic nature of obesity and the severe consequences of obesity make the study of obesity relevant. Obesity The evaluation method of whether an individual is obese usually uses the Body Mass Index (BMI). This method involves the comparison of the weight of the individual to the height of the individual. In this calculation the weight of the individual in kilograms is divided by the square of the height of the individual measured in meters. Individuals are considered to be obese when their BMI is greater than or equal to thirty. There are three classes of obesity. Obese class I is when the BMI of the individual is between 30 and 34.99, while obese class II is when the BMI of the individual is between 35 and 39.99. Obese class III is when the BMI of the individual equals or exceeds 40. The World Health Organization has provided an assessment for risk of obesity through waist measurements. According to this risk measurement a waistline in excess of 94cm or 37 inches in men and 80cm or 32 inches in women is a risk for obesity (Department of Health, 2007). Though obesity on the whole is on the rise, the rate of increase in class III obesity is the highest. Since 1986 there has been a five fold increase in the prevalence of individuals with a BMI of 50 or greater (Klein, 2008). Such an increase in obesity over this time period shows that dramatic increase in obesity rates cannot be blamed on the genetic predisposition (Nesto, 2008). Epidemiology of Obesity The problem of obesity is a problem of modern times. Five decades ago there was hardly any concern for obesity and there are no statistics for it. In 2005 it was estimated that world wide the number of individuals who were obese was 400 million, while 1.6 billion adults were over weight. According to the World Health Organization (WHO) the number of overweight individuals around the world is expected to rise to 2.3 billion with more than 700 million obese individuals (BBC, 2008). According to WHO figures the United Kingdom ranks among the top ten nations with obesity problems. 24.2% of the population in the United Kingdom has obesity problems (BBC, 2008). This is against an estimation of obesity in 21% of women and 17% men in 1998 (Obesity - The Size of the Problem). The problem of obesity is not restricted to adults but extends to children and adolescents too. WHO estimation of obesity in children and adolescents around the world in 2005 was a minimum of 20 million children. Figure -1 (BBC, 2008). Figure – 2 (BBC, 2008). . Ascertaining prevalence of obesity in childhood is not easy, for there is no definite standard for childhood obesity worldwide. Growth in childhood obesity in the United Kingdom from 1995 to 2005 is provided in figure 3. Data from the National Child Measurement scheme across the United Kingdom show that in 2007-2008 by the age of 11, nearly thirty-three percent of children were overweight or obese (BBC, 2008). Figure 3 (BBC, 2008). The average increase in weight among the people in the United Kingdom has led to a change in the body shape as shown in figure 4 Figure -4 (BBC, 2008) The National Health Services in the United Kingdom (NHS) has put out obesity statistics for the year 2006. According to these figures in 2006, the percentage of adults classified as obese in England was 24%. These figures show an increase in the prevalence of obesity in 1993, which stood at 15%. The probability of men and women becoming obese in England was almost the sane, though women tended to be morbidly obese, three percent in comparison to the one percent in men. Waist circumference estimates in 2006 show that 37% of adults had an enhanced waist circumference in comparison to 23 % in 1993. Women showed a clear indication for greater tendency for waist circumference enhancement than men, with 41% women having increased wait circumference measurements, while increased wait circumference measurements in men was 32 %.(NHS, 2008). Based on BMI and increased waist circumference measurements to assess risk for health problems it was found that 20% of the men were at increased risk, while 13% were at high risk and 21% were at very high risk for health related problems due to obesity. At the same time the risk assessment for health related problems due to obesity in women in 2006 was 14% of women being at increased risk, 16% of women at high risk and 23% of women at very high risk (NHS, 2008). Moving on to the obesity scenario in children in 2006, sixteen percent of children between the ages of two and fifteen were classified as being obese. In 1995 the number of children between the ages of two and fifteen classified as obese was eleven percent and the figures of 2006 show an overall increase in five percent over the1995 figures. In spite of this increase in overall figures there was a drop in the obesity figures for girls between the ages of two and fifteen between the years of 2005 and 2006 from eighteen percent to fifteen percent. No such drop in obesity percentages was seen in the obesity figures for boys between the ages of two and fifteen. Evaluation of the statistics on obesity in children shows that girls had a greater tendency for obesity than girls seventeen percent in boys in comparison to fifteen percent in girls. Among the children between the ages of eight and fifteen classified as obese in 2006 66% of the girls and 60% of the boys believed they were weighed too much (NHS, 2008). The Futures Choices project of the Government of the United Kingdom predicts that failure to take adequate prevention measures against obesity will lead to 60% of men, 50% of women and 25% of children being obese by the year 2050 (Department of Health, 2008). Factors for Increasing Rates of Obesity There genetic link to obesity, but according to Nesto, 2008, the large increase in obesity cannot be explained away by mere genetic factors, for the increase in obesity rates do not match the increase in population, particularly in countries like United Kingdom the developed world. This calls for assessment of other environment and lifestyle factors to find the cause of the increased rates in obesity. The main contributory factors to sudden spurt in obesity are increased intake of foods rich in calories and the reduced physical activity. Dietary surveys in the United Kingdom show that there is an increase in the practice of eating food outside. In 2000 675 restaurant meals were consumed in the United Kingdom, which is an increase of 13% from 1995. In 2001 approximately two billion meals were consumed in the restaurants in the United Kingdom. Meals and snacks consumed outside the home are richer in fat and calorie content. In addition to consuming richer foods, people in the United Kingdom are consuming more sugared drinks, adding to the calories consumed. The increase in calorie intake is not matched by increased physical activity. In reality there is a decrease in the average physical activity in the United Kingdom. It is this combination of increased intake of foods rich in fat and calories combined with a decline in the physical activity in the United Kingdom that has led to a situation where the obesity rates in the country are climbing. (Department of Health, 2008). Consequences of Obesity Obesity is a known risk factor for several diseases and conditions, which include hypertension, diabetes, dyslipidemia, coronary heart disease, obstructive sleep apnea, gastroesophageal reflux disease, gallstones, asthma, pseudotumor cerebri, certain cancers like breast cancer, colon cancer, cervical cancer and uterine cancer, major depression and suicidality, early onset of puberty in girls. Obesity is associated with high rates of morbidity and mortality. From overall perspective obesity increases early mortality which is comparable to the mortality rates seen due to smoking (Donohoe, 2007). An example of the association of obesity with dreaded diseases can be seen in breast cancer in women. In the United Kingdom six thousand of the newly diagnosed breast cancers in post-menopausal women are due to the women being overweight, of which 4.800 are found to be due to obesity (Nelson, 2007). Obesity Preventive Measures in the United Kingdom In October 2007, the United Kingdom Government set new long-term goals for the prevention of obesity. Though the government would like to arrest the rise in obesity in all segments of the population the initial focus of the health authorities will be on children with the long term aim of reducing obesity in children by 2020 to the obesity level in children to the levels of 2000 (Department of Health, 2007). The focus of the activity to prevent obesity consists on addressing the two non-genetic factors that have led to the increase in obesity in the country, which are the unhealthy dietary practices and the reduction in physical activity. Thus the Department of Health is focusing on activities that improve diet and increase physical activity across all segments of the population. A new Food and Health plan has been initiated. As part of this plan the factors that play a part in what is consumed is being studied. This includes evaluating the food supply, production and preparation. And access to healthy foods and disseminating information on good eating habits. The Welfare Food Scheme active in the schools in the United Kingdom has targeted improving the dietary habits of children by increasing the intake of fruits and vegetables and reducing the intake of unhealthy foods like sugared soft drinks and fat rich roods (Department of Health, 2008). The Department of Health’s physical oriented programs are Sport and Physical Activity Board (SPAB) and Local Exercise Action Plan (PLAN). The SPAB is a joint effort of the Department of Health and the Department of Culture, Media and Sport. SPAB is expected to increase physical activity levels through the coordinated efforts of school sports activities and club level sports activities. The focus of LEAP is on the clinical based programs on the management of weight and diabetes through physical activities that include walking, cycling and swimming (Department of Health, 2008). Conclusion Obesity is a major health concern in the modern world brought on through the combination of poor dietary habits and poor life styles. Obesity prevalence rates have been climbing in the United Kingdom and worldwide. These increases in rates are not restricted to adults only, but are also seen in children and adolescents. The consequences in terms of diseases and conditions that are contributed to by obesity and the morbidity and mortality that could result make prevention of obesity a top priority. The focus of the health authorities in the United Kingdom is in reducing the obesity rates in children and adults. The health authorities’ attempts to reduce obesity rates are two pronged. One prong aims to improve the dietary practices in the United Kingdom, while the other program targets increased physical activity. Programs for reducing obesity in adults are in place and the focus is now in meeting the ambitious target of containing the obesity rates in children to the levels of 2000 by 2020. Literary References BBC 2008, ‘Obesity: in statistics’, BBC News [Online] Available at: http://news.bbc.co.uk/2/hi/health/7151813.stm (Accessed February 22, 2009). BBC, 2008 ‘UK is warned over obesity levels’, BBC News [Online) Available at: http://news.bbc.co.uk/2/hi/health/7777108.stm (Accessed February 22, 2009). Department of Health. 2007, ‘Definitions of overweight and obesity’. Obesity. [Online] Available at: http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_4133948 (Accessed February 22, 2009). Department of Health. 2007, ‘Long-term ambition on obesity’, Obesity. [Online] Available at: http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_079307 (Accessed February 22, 2009). Department of Health. 2008, ‘Obesity General Information, [Online] Available at: http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_078098 (Accessed February 22, 2009). Department of Health. 2008, ‘Obesity: defusing a health time bomb’, Annual Reports [Online] Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/AnnualReports/Browsable/DH_4875027(Accessed February 22, 2009). Donohoe, M. 2007, ‘Weighty Matters: Public Health Aspects of the Obesity Epidemic’, Medscape Ob/Gyn & Womens Health [Online] Available at: http://www.medscape.com/viewarticle/566056 (Accessed February 22, 2009). Klein, S. (2008). ‘Obesity as a Chronic Disease: Epidemiology, Morbidity, and Mortality’, Managing Obesity as a Chronic Disease: A Pathophysiologic Approach to Cardiometabolic Risk Reduction, Medscape CME [Online] Available at: http://cme.medscape.com/viewarticle/567413 (Accessed February 22, 2009). Nesto, W. R. 2008, ‘Epidemiology and Pathophysiology of Obesity’, Chronic Management of Obesity: A Comprehensive Approach to Reducing CV Risk Medscape CME [Online] Available at: http://cme.medscape.com/viewarticle/573688 (Accessed February 22, 2009). Nelson, R. 2007, ‘High Body Mass Index Increases Risk of Developing Cancer’, Medscape Medical News [Online] Available at: http://cme.medscape.com/viewarticle/566108 NHS. 2008, ‘Statistics on obesity, physical activity and diet: England, January 2008’, The Information Centre [Online] Available at: http://www.ic.nhs.uk/pubs/opadjan08 (Accessed February 22, 2009). ‘Obesity - The Size of the Problem’, Patient UK [Online) Available at: http://www.patient.co.uk/showdoc/40000874/ (Accessed February 22, 2009). Yang, W., Kelly, T. & He, J. 2007, ‘Genetic epidemiology of obesity’, Epidemiology Review, vol.29, pp.49-61. Read More