Monday, March 22, 2010

Obesity: A matter of willpower?

People who died obese: Carol Yager peak weight 1,600 lbs died at 34, Rock 'n' roll legend Elvis Presley died of a heart attack at 42, two-time Academy Award winning actor Marlon Brando, Rapper Christopher Rios “Big Pun.” Others who have battled with obesity: Khaliah Ali, Kirstie Alley, Roseann Barr, Joseph R. Gannascoli, Jennifer Holliday, Jennifer Hudson, Randy Jackson (American Idol), Star Jones, Wynonna Judd, Ricki Lake, Courtney Love, “Monique,” Jack Osbourne, Marie Osmond, John Popper, Al Roker, Sherry Shephard, Raven Symone, Carnie Wilson, Oprah Winfrey to name a few.

President Obama said, obesity is the “most urgent” health issue facing the country. At last count, there are over 64 million adult Americans who are obese and thousands of deaths have been associated with this condition. The Center for Disease Control reported Blacks had 51 percent higher prevalence of obesity, and Hispanics had 21 percent higher obesity prevalence compared with whites. A recent study even found that 3-year-olds who were obese already had one of the symptoms of heart disease ( and the Daily FLOTUS).

The common morbidities associated with obesity include: (a) coronary heart disease, (b) hypertension and stroke, (c) type 2 diabetes, (d) high cholesterol levels, (e) high blood pressure, (f) abnormal glucose tolerance, and (g) certain types of cancer. The other health related consequences for obesity include: (a) asthma, (b) sleep apnea, and (c) social discrimination, (d) low self-esteem, (e) poor grades, and (f) social functioning for children. Data from National Health and Nutrition Exam Surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased: for children aged 2–5 years, prevalence increased from 5.0% to 12.4%; for those aged 6–11 years, prevalence increased from 6.5% to 17.0%; and for those aged 12–19 years, prevalence increased from 5.0% to 17.6%.

President Obama signed a Presidential Memorandum in conjunction with Mrs. Obama’s “Let’s Move” strategy, to launch a nationwide campaign tackling childhood obesity. The President states, “We think that this has enormous promise in improving the health of our children, in giving support to parents to make the kinds of healthy choices that oftentimes are very difficult in this kind of environment.” The memorandum creates a 90-day plan creating a task-force to provide “optimal coordination” between private sector companies, not-for-profits, agencies within the government and other organizations to address the problem of childhood obesity (

Obesity is associated with many factors. Below are a few reasons obesity has become a matter of social concern:

• Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity.
• Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status.
• Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions

Until recently, the medical profession has failed obese people. Many doctors still believe obesity is simply a matter of will power. As long ago as the 1970s, studies showed that doctors felt fat people deserved everything they got. Others showed perceptions of fat people as being weak and less intelligent than thin people. Many studies have confirmed that fat people fare less well in interviews than equally qualified thin people; that they are promoted less frequently; and, are less likely to be made leaders, according to Felding

The American Psychiatric Association has never regarded overeating or excess weight as a psychiatric disorder, and most obese people do not qualify for a psychiatric diagnosis. In fact many studies find no clear relationship between mental health and weight. Nevertheless there are Psychological disorders which obesity may trigger, which include: depression, eating disorders, distorted body image, and low self-esteem. There are several research studies that suggest obese patients report unexpectedly high rates of depressive and anxiety disorders, and that clinician should be careful to screen for these conditions, even if they are not suggested by the initial complaint.

Obese people have been found to have higher rates of depression. For example, David A. Kats, MD and colleagues at the University of Wisconsin-Madison assessed quality of life in 2,931 patients with chronic health conditions including obesity. They found that clinical depression was highest in very obese participants (Body Mass Index (BMI) over 35). Depression that is elevated to indicating psychiatric morbidity was more often seen in the obese, and that obese individuals, even those who are seen for treatment of a condition unrelated to their weight, are at increased risk of suffering from eating disorder. This research suggests it is crucial to assess among other presenting problems patient’s attitudes toward his or her weight, shape and identity. Clinicians should determine if the patient’s obesity is a source of low self confidence, and does the patient avoid particular day to day activities.

Treatments for obesity include self-help groups like Overeaters Anonymous and commercial programs like Weight Watchers. A common approach is behavioral therapy often in groups directed by a dietitian or clinician. The focus for therapy are self-monitoring and stimulus control. Self-monitoring means carefully recording weight, physical activity, type of food, and the amount of food eaten. Stimulus control means avoiding occasions of temptation. Exercise is also important, not only to expend energy, but to set the weight balance point at a lower level. Cognitive therapy may help dieters repel self-defeating thoughts and reject unrealistic goals (they will not likely achieve an “ideal” body weight). Psychotherapy or pharmacology can relieve depression and anxiety and help obese people live as full a life as possible no matter what their weight.

Healthy Eating Tips:

1. Provide plenty of vegetables, fruits, and whole-grain products.
2. Include low-fat or non-fat milk or dairy products.
3. Choose lean meats, poultry, fish, lentils, and beans for protein.
4. Serve reasonably-sized portions.
5. Encourage your family to drink lots of water.
6. Limit sugar-sweetened beverages.
7. Limit consumption of sugar and saturated fat.

Other Resources:

Kirstie Alley's Diet Plan
U.S.D.A. Certified Organic Weight Loss Product - Organic Liaison.

Child Obesity Exercises
Burn Up To 60% of your child's fat Only at Shaun T's Fit kids®

Kids Lose Weight in NYC
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