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Epidemiology Corner

July 16, 2004

An Epidemic of Obesity

Obesity has become one of the most important health problems in Texas. More than 61 percent of adults and 35 percent of school age children are considered obese in Texas.1 The number of obese people is increasing2 rapidly and its rising limits are unpredictable.3 Obesity is responsible for a number of the most common medical ailments and must be considered a disease. Heart disease, type 2 diabetes, stroke and few types of cancer are just some of the serious health problems associated with obesity.

Obesity is the condition where an excess amount of fat is deposited in body. One may be overweight with muscle, bone or water deposition, without being obese. A certain amount of fat is required by everyone for stored energy and heat resistance. Women with more than 30 percent body fat and men with more than 25 percent body fat are considered obese.4 Women generally deposit fat in their hips and waist while men usually build up fat around their abdomen. Deposition of fat around the abdomen, defined as upper body obesity, is linked to higher cardiovascular risk than the deposition of fat in the hips which is called lower body obesity.5 Increased mortality is associated with the extent of obesity and with its duration.4

Obesity is caused by an excess of energy consumption (eating) over energy expenditure (physical activity.6 Some of the contributing factors to obesity are genetics, overeating, decreased physical activity and / or defective fat metabolism. Overeating is a leading contributor to obesity. Americans tend to eat foods rich in fat and most do not get enough physical activity to burn the extra fat.7 Some people eat in response to psychological conditions such as depression, grief or rage. The treatment of obesity includes diet adjustment, physical activity or both.4 The prime methodology to control obesity involves behavior modification related to diet and exercise. The behavior changes to control weight must be life-long changes. Some of the key components of obesity control in adults are:4

Body Mass Index (BMI) should be used to assess obesity. BMI is calculated by dividing the weight in pounds by the square of height in inches and multiplying by 703.[weight in lbs./(height in inches.)2 *703] In adults, a BMI of 30 or greater is considered obese.5

Body weight can be used to track weight loss. Abdominal fat loss can be estimated by measuring waist circumference.

Dietary fat and dietary carbohydrates should be lessened to reduce calorie intake.

Moderate levels of physical activity for 30 to 45 minutes, 3 to 5 days a week is highly recommended.

A targeted weight loss of 1 to 2 pounds per week over a period of six months should be the main strategy.

A permanent weight maintenance program should be adopted life-long after the initial six months of weight loss.

For more information on the obesity visit the CDC website Overweight and Obesity at https://www.cdc.gov/nccdphp/dnpa/obesity.

REFERENCES
1. Centers for Disease Control and Prevention. Texas Behavior Risk Surveillance 2001 https://www.cdc.gov/brfss
2. Strauss RS, Pollack HA. Epidemic increase in childhood overweight 1986 – 1998 JAMA 2001
3. Kimm SYS, Obarzanek E. Childhood obesity a new pandemic of the new mellinium Pediatrics 2002
4. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, Maryland: Dept. of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 1998
5. Centers for Disease Control and Prevention. Nutrition and Activity. Defining overweight and obesity. www.cdc.gov/nccdphp/dnpa/obesity
6. U.S. Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, 2001
7. Centers for Disease Control and Prevention. Nutrition and Activity. Factors contributing to obesity. www.cdc.gov/nccdphp/dnpa/obesity