According to surveys done by various organizations including the Center for Disease Control, the National Health and Nutrition Examination Surveys (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS), obesity in the United States is a serious and growing epidemic. In the United States, approximately 300,000 deaths a year are attributed to obesity (Pr Newswire, 1999). In comparison, Ohio is ranked 31st (ranked best to worst) in 1999, among 50 states plus Puerto Rico and the District of Columbia, for the number of adults who reported being overweight (as cited in the Ohio Behavioral Risk Factor Surveillance System report). The rapid increase in obesity suggests that there are a large number of changes in today’s society that are contributing to weight gain.
The clinical definition of obesity is usually expressed in terms of body mass index (BMI), which is derived by dividing one’s weight by the square of one’s height (Allison & Saunders, 2000). In 1997, the World Health Organization defined various classifications of overweight and obesity. Overweight is defined as a BMI greater than 25 and obesity is a BMI greater than 30 (Allison & Saunders). This classification was adopted by the National Institutes of Health and is now a worldwide standard (Allison & Saunders).
Although multiple factors can account for weight gain, the basic cause is an excess in energy intake over expenditure (Young & Nestle, 2002). According to research by Young & Nestle (2002) one cause is food consumed outside the home, which accounted for 34% of the food budget in 1970 but 47% by the late 1990’s (as cited in US Department of Agriculture & Economic Research Service, 1995). Another possibility is the size of food portions. Since the food industry has grown larger, and people are eating out more; marketing has become more concentrated, and larger numbers of new products have been introduced (as cited by Gallo, 1990).
Price competition has lead manufacturers to increase product size which not only draws attention to the product but increases there profits (Young & Nestle). Some examples are the larger portion of candy bars, the “supersizing” of menu items of fast food restaurants, the larger soft drink sizes and the bigger portion sizes in restaurants.
The trends that contribute to the suspected overall decrease in daily energy expenditure include television viewing, video games, computers at work and in the home, unsafe neighborhoods, labor-savings devices, reduced physical education programming in schools and communities, increased automobile use and the decreased use of public transportation (Schmitz & Jeffery, 2000).
“Prevalence is defined as the total number of people in a population that are known to be overweight or obese at a given point in time, usually expressed as a percent of the total population” (Allison & Saunders, 2000, Para 2). The increased prevalence of obesity can be examined in terms of sex, age, race, and place of residence. Men in the United States have a slightly higher combined prevalence of overweight and obesity. Women classified as overweight are more likely to be classified also as obese (Allison & Saunders).
The prevalence of obesity in adults tends to rise steadily from age 20 to age 60, at which prevalence begins to decline (Allison & Saunders). The three largest racial and ethnic groups in the United States that have the highest rates of overweight and obesity are European-American, African-American and Mexican-American (Allison & Saunders).
According to the Centers of Disease Control (2002), in 1991 only 4 of 45 participating states had obesity rates of 15-19% and none had rates greater than 20%. By the year 2000, all of the 50 states except Colorado had rates as high as 20% or greater. Obesity rates in Ohio are similar to those for the United States. In 1991 the Ohio obesity rate was 14.9%; by 2000 the rate was 21% (Centers of Disease Control).
Obesity has an impact on a person’s social and psychological wellbeing. In the 1960’s it was believed that obesity was in part, caused by certain psychological abnormalities (Allison & Saunders, 2000). In the 1990’s there was recognition that obesity is a result of complex interrelationships. There is a common perception that obese people have lower self esteem than do average people. Several studies indicate that this is incorrect, especially within some ethnic groups such as African American (as cited by Faith & Allison, 1996).
There is evidence, however, that being obese is seen as a sign of laziness or lack of self-control. “Being subjected to such negative stereotypes leads to a certain self-loathing, especially among young women” (Allison & Saunders, Para 12). Distaste and distortion of their own body size may lead obese individuals to avoid social interaction and seek weight loss (Allison & Saunders). Obesity has an impact on social aspects of an individual. As discussed, excess weight carries with it certain types of negative stereotypes including stupidity, laziness, dishonesty, and lack of ambition.
Obese people may make less money for doing the same job as nonobese people, or they may not be hired at all. According to Allison & Sanders article (2000), one study showed that as many as 44% of potential employers would not hire an obese person (as cited by Miller et al., 1995). Educational opportunities may also be affected by an individual’s weight. Allison & Saunders (2002) indicate that obese people were less likely to attend college, indicating discrimination in the admissions process.
Another social area affected by obesity is marriage. Women, especially, are affected by the stigma associated with obesity and are less likely to marry or marry someone of a lower social status (Allison & Saunders). Obesity may also be subjected to negative social attitudes by health care professionals. Of obese subjects, 78% reported being treated disrespectfully by health care providers because of their weight (Allison & Saunders).