Bariatric Surgery
Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem

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ABSTRACT

This paper provides an overview of the evidence on the current epidemic of obesity in the United States. The prevalence of overweight and obesity now exceeds 60% among US adults, and the rate is rapidly increasing among children and adolescents. Dismal medical, social, and economic consequences are already apparent and likely to worsen without multipronged intervention. Increased rates of hypertension, diabetes, and dyslipidemia, among other medical conditions, threaten to shorten the longevity of the American populace by as much as 5 years. The incidence of depression is increasing and experts suggest this is linked with the increased prevalence of obesity. The cost of obesity-related medical care has increased astronomically since 1987, in addition to lost productivity and income. Novel multidisciplinary, preventive, and therapeutic approaches, and social changes are needed that address the complex interplay of biologic, genetic, and social factors that have created the current obesity epidemic.

Section snippets

Identifying Persons Who Are Overweight and Obese

Overweight and obesity are characterized by an increase in body fat. The NHLBI guidelines classify overweight and obesity based on body mass index (BMI), calculated as weight in kilograms divided by the square of height in meters. Using this classification, a healthy or desirable BMI is between 18.9 and 24.9.2 A person is considered overweight if the BMI is between 25.0 to 29.9 and obese if the BMI is greater than or equal to 30.0. Persons who are obese can be further classified into stage I

Consequences of Overweight and Obesity

The high prevalence of overweight and obesity has an adverse effect on the health of the population, psychosocial functioning, and quality of life for individuals and families, and the economic stability of the nation.

Potential Causes of Overweight and Obesity

Understanding the causes of overweight and obesity is one of the first steps in halting the epidemic. Weight gain is the normal physiologic response that occurs when energy intake exceeds energy expenditure.42 Overweight and obesity will result when this energy imbalance persists.

Eating is the primary method of energy gain. However, eating serves a social and emotional function in addition to the biologic function.43., 44. Hunger, satiety, and thought influence the amount of food a person will

Summary

The current “epidemic” of overweight and obesity threatens to overtake the nation like a tsunami, wreaking havoc on medical, social, and economic health of the United States. More than 60% of adults and the highest percentage of children and adolescents in history are overweight or obese. Although obesity is increasing for all sociodemographic groups, there do appear to be important subgroup differences, particularly among women and African Americans. These differences seem to be associated

References (50)

  • Grantmakers in Health
  • National Heart Lung and Blood Institute

    Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults

    (1998)
  • US Preventive Services Task Force

    Screening for obesity in adults: recommendations and rationale

    (2003)
  • R.S. Stafford et al.

    National patterns of physician activities related to obesity management

    Arch Fam Med

    (2000)
  • US Department of Health and Human Services

    The Surgeon General's call to action to prevent and decrease overweight and obesity

    (2001)
  • R.H. Eckel et al.

    Report of the National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases Working Group on the pathophysiology of obesity-associated cardiovascular disease

    Circulation

    (2002)
  • P. Deurenberg et al.

    Body mass index and percent body fat: a meta analysis among different ethnic groups

    Int J Obes Relat Metab Disord

    (1998)
  • D. Gallagher et al.

    How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

    Am J Epidemiol

    (1996)
  • T. Erselcan et al.

    Comparison of body composition analysis methods in clinical routine

    Ann Nutr Metab

    (2000)
  • K.J. Ellis

    Human body composition: in vivo methods

    Physiol Rev

    (2000)
  • M. Bolanowski et al.

    Assessment of human body composition using dual-energy x-ray absorptiometry and bioelectrical impedance analysis

    Med Sci Monit

    (2001)
  • Centers for Disease Control and Prevention

    Health risks in the United States: Behavioral Risk Factor Surveillance System

    (2005)
  • A.H. Mokdad et al.

    Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001

    JAMA

    (2003)
  • National Center for Health Statistics

    Health, United States, 2004 With Chartbook on Trends in the Health of Americans

    (2004)
  • S.J. Olshansky et al.

    A potential decline in life expectancy in the United States in the 21st century

    N Engl J Med

    (2005)
  • Cited by (0)

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