Facing up to widespread obesity

There’s really no way to sugarcoat it: Obesity has become an epidemic in America. Children and adults today weigh more than ever. About two-thirds of American adults are overweight or obese. And overweight people develop life-threatening conditions and often experience discrimination and depression.
How did Americans get this way? We eat super-sized food. A hamburger 50 years ago contained 210 calories. Today, a hamburger contains more than 600 calories. We eat more processed foods, which are higher in calories and fat and lower in fiber. We’re also less active. Many adults work long hours. Many children are less active than they should be and have fewer sports programs in schools. Plus, children and adults spend too much time in front of TV and computer screens.
Many trusted sources have warned us about the dangers of being overweight. The Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity tells us that being overweight or obese increases the risk of conditions such as hypertension, osteoarthritis, dyslipidemia, type 2 diabetes, coronary artery disease, stroke, gallbladder disease, sleep apnea, other respiratory problems, and endometrial, breast, and colon cancers.
The National Heart, Lung, and Blood Institute advises us that the more body fat we carry, the greater the risk of developing these dangerous conditions. And according to the Administration on Aging, we pay a heavy price for living with and treating these conditions: Obesity takes at least 300,000 lives and costs nearly $100 billion in the United States every year.
Today, overweight children are being diagnosed with many of these conditions, even ones that typically don’t affect children, such as gallbladder disease. Being overweight can affect children’s mental well-being, as well. Depression in obese children and adolescents is seven times higher than in healthy-weight children, and 80% of obese teens become obese adults.
What can we do? The continuing-education article in the June issue, “End the epidemic of childhood obesity…one family at a time,” discussed the causes of childhood obesity as well as tips for prevention and intervention. Many of these tips work with adults, too. To combat overweight and obesity, the acting Surgeon General, Dr. Steven Galson, has issued a call to action. The basic principles of his call include focusing on health and not appearance; balancing healthful eating with regular physical activity; researching the causes, prevention, and treatment of overweight and obesity; and making an effort to identify and implement effective and culturally appropriate interventions.
In 2005, researchers released controversial findings linking obesity with the projection that life expectancy would decrease over the next 50 years by 2 to 5 years. The researchers also predicted that minorities would be the most vulnerable because of their limited access to health care. Healthcare professionals and the public assailed the study, and the authors were labeled scaremongers. Their methods were attacked as being presumptive, not scientific. But in the last 20 years, the rate of obesity in children has tripled. Today, non-Hispanic Black women have the highest rate of obesity (45.3%), followed by Hispanic women (34.5%).
No one wants to be told he or she is overweight, let alone obese. But calling an overweight person “pleasingly plump” isn’t an act of kindness. As nurses, we should be respectful and sensitive, but we also must be honest to help patients deal with weight problems. We should advocate healthy behaviors for patients, friends, family members, and co-workers. And we should use evidence to be advocates for a healthier tomorrow.

Pamela F. Cipriano, PhD, RN, FAAN, CNAA-BC
Editor-in-Chief


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