In order to effectively address the health and business impact of overweight and obesity, it is important to understand what overweight and obesity are, their causes, and physical, psychological and social consequences.
Defining overweight and obesity
Overweight is an excessive amount of body weight compared to set standards. This excess body weight includes weight from muscle, bone, fat and water. Obesity refers to excessive amounts of body fat. Thirty-one percent of those who are overweight are obese. The Body Mass Index (BMI) is the set standard by which overweight and obesity are measured. The BMI is a mathematical formula based on an individual’s height and weight and is used to predict health risk associated with overweight and obesity.
Causes of overweight and obesity
Overweight and obesity occur when an individual consumes more calories than he burns. What causes this imbalance in calories consumed/calories burned may include genetic, environmental and/or psychological factors.
Genetic and medical factors
Studies have shown that there is a genetic predisposition to obesity unrelated to the lifestyle environment. There are some medical conditions such as hypothyroidism, depression and certain neurological problems that interfere with the body’s ability to maintain a healthy weight.
Environmental factors
Lifestyle factors, including how much an individual eats and how much physical activity he engages in, affect overweight and obesity. Americans tend to eat high-fat, high-calorie and convenience meals instead of healthy meals. In addition, Americans generally do not get enough physical activity. The Centers for Disease Control and Prevention reports that 40 percent of adults get no leisure-time physical activity and only 14 percent meet the standard of brisk walking for 30 minutes per day, five times per week. (Leisure-time Physical Activity Among Adults: United States, 1997-1998, Centers for Disease Control and Prevention)
In American culture, food also plays an important social role; food consumption is not simply a way for the body to obtain necessary nutrition. And unlike abstinence from alcohol or tobacco, abstinence from food is impossible, making changes in eating habits and lifestyle factors more difficult for some.
Psychological factors
Psychological factors influence eating habits. High-fat foods and diets high in noncomplex carbohydrates inhibit the release of stress-fighting hormones, supporting the theory that chronic stress can lead to a constant urge to eat such foods. Food cravings are the body’s attempt to alter brain chemistry in order to self-regulate hormonal imbalances created by stress. When stress is persistent, stress hormones maintain the stress response at a heightened level of alert, resulting in the formation of surplus fat cells, blood pressure elevation and salt retention. Individuals who habitually use food to deal with emotions lose the ability to regulate how they feel and the ability to maintain healthy ways of resolving problems and coping with life stresses.
Consequences of overweight and obesity
Obesity is the direct cause of death for 300,000 individuals each year. This number does not include deaths in which overweight and obesity are contributing factors. Overweight and obesity are linked to serious medical conditions.
Overweight and obesity are known risk factors for:
Diabetes |
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Total Cost $98 billion
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Stroke |
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Total Cost $26.2 billion
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Osteoarthritis |
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Total Cost $21.2 billion
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Heart disease |
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Total Cost $8.8 billion
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Cancer
(These numbers reflect the costs of breast, endometrial and colon cancers only) |
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Total Cost $7.3 billion
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High blood pressure |
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Total Cost $4.1 billion
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Gallbladder disease |
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Total Cost $3.4 billion |
Overweight and obesity are also associated with:
High blood cholesterol |
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Total Cost $60 billion
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Complications of pregnancy |
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Total Cost $20,000 to $1 million per birth |
Psychological disorders
(This number reflects costs associated with depression only) |
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Total Cost $23 billion |
References:
“Statistics Related to Overweight and Obesity,” www.niddk.nih.gov; “Executive Summary: Business, Babies and the Bottom Line,” www.wbgh.com; "Health and Disability Costs of Depressive Illness in a Major U.S. Corporation" by Benjamin G. Druss, MD, MPH, Robert A. Rosenheck, MD and William H. Sledge, MD. The American Journal of Psychiatry, Volume 157, No. 8, August 2000:1229-1235.)
Psychological and social effects
Psychological and social effects play a role both as cause and effect of overweight and obesity. Often the cause/effect relationship creates a neverending cycle of psychological distress.
How food affects mood is both biological and environmental. Habitual overeating can be a response to emotions, most notably stress. Guilt and out-of-control feelings commonly associated with overeating lead to overeating to reduce the feeling of stress, shame and guilt.
Overweight and obese individuals are often viewed by society as lazy or incompetent, even though this is not true. This makes overweight and obese individuals the target of real or perceived discrimination and prejudice, which continues the cycle of stress, shame, guilt and depression.
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