IOM Research Paper


Obesity is a considerable health problem in the modern Western world. This condition is increasingly prevalent in industrial countries. Its growing pervasiveness dictates the needs for some urgent interventions. A thorough understanding of obesity may contribute to avoiding its negative impacts. Obesity is a common cause of morbidity and mortality and it carries a financial burden for the person who is suffering from it as well. This paper covers the basic issues on obesity, namely epidemiology, consequences and recent recommendations.

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Current trends. The term ‘obesity’ was unknown to the English language until the 17th century. Obesity as excessive body weight was first recognized in the 18th century and more than 100 years later physicians started to consider this condition a disease. It was not until the 20th century that the World Health Organization obesity to be a global epidemic (Eknoyan, 2006). The prevalence  of obesity has doubled in the period from 1970’s to 2000’s (Hamdy, 2015). According to the World Health Organization, in 2014 over 39% of adults in the world were overweight and 13% were obese; its prevalence is highest in the Americas and Europe, women are more likely to be obese (WHO, 2015).

Numerous etiological factors are related to obesity – genetics, endocrine factors, pregnancy and lactation, race, gender, level of physical activity, dietary patterns, cultural and social factors (Hamdy, 2015). Some studies show an inverse relationship between risks of obesity and social status in industrialized nations. Lack of or low basic education limits the possibilities of being informed on the problems of obesity and its management, increased exposure to fast-food, low level of physical activities due to neighborhood conditions. Some recent papers suggest that among the social drivers of excess weight gain are marital or migration status, employemet condition, and family history. However, reliable data on how exactly do the social aspects influence obesity is still lacking. In general, there are reasons to believe that social models result in differences in levels of physical activity, eating and behaviors that are connected to obesity. Social determinants may be different for men and women. Men who live in poorer rental conditions with dependents tend to be overweight more often, while lower employment correlates with obesity more in case of women (Hernandez & Blazer, 2006). The following general environmental factors are recognized: “toxic environment” (increasing the sizes of portioned food and “super-sizing” of commercially available foods), social facilitation of eating (eating in a community prones to consuming more calories), parental feeding practices (breast feeding and proper parental feeding policy decreases the risks of childhood and adult obesity) (Hamdy; 2015; Hernandez & Blazer, 2006; WHO, 2015). In conclusion, the genetic and medical risk factors are generally well understood, but the relationship between the behavioral factors and obesity are quite complex and future research should focus on finding additional explanatory relationships.

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Consequences of Obesity. In the mid 19th century, Charles Dickens in The Posthumous Papers of the Pickwick Club was among the first to describe sleep apnea and death from obesity, today known as “Pickwickian syndrome” (Kryger, 2012). Obesity elevates the risks of death from hypertension, diabetes, coronary heart disease, stroke, cancer and pulmonary disorders. Obesity raises the rates of occurrence of gallbladder disease, hepatic steatosis, gout, osteoarthritis, sleep apnea, vascular disorders, depression (Jensen et al., 2013). Taking in account all of these problems combined, an obese individual has a 6- to 12-fold higher probability of death than a person with normal weight (Glickman et al., 2012; Hamdy, 2015). On average, severe obesity reduces men’s life expectancy by 20 years  women’s by 6 years (Hamdy, 2015).

The economical consequences of obesity are staggering. In 2008 the U.S. has spent 147 billion USD on obesity management. The patients increase their costs of healthcare by 46%, the need of more physicians visits by 27%, drugs prescription rate is 80% higher (Jensen et al., 2013; Hamdy, 2015). Obesity increases the risks of unemployment or of being disqualified from certain areas of employment (firemen, military) as well as work days loss due to medical conditions (Glickman et al., 2012). Obese teenagers are typically teased by their peers, which may lower their academical performance and thus result in lower academical achievements (Jensen et al., 2013; Glickman et al., 2012).

Obesity Prevention. There are some calculations which demonstrate that reducing the prevalence of obesity by 5% could save 9 billion USD of direct medical costs in the near term perspective, while medium-term benefits from avoiding comorbidities might approach 24.7 billion USD (Glickman et al., 2012). Moreover, current effective obesity treatment interventions continue to be elusive (Glickman et al., 2012; Hamdy, 2015). Because the consequences of obesity are aggravating and there are reasons to anticipate worsening of the situation in the nearest decades, primary prevention strategies are of paramount importance. The general approach focuses on development of a mass public educational program.

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A health promotion strategy should aim at changing the eating patterns, activity and behavioral models in order to achieve a balance between energy consumption and outgoing. The best prevention strategy might also depend on the food industry, organizers of out-door games, authorities (Hamdy, 2015). The targets for obesity prevention actions include activity and diet-related options. Activity-related targets lie in increasing physical activities (i.e., 150 minutes of moderate-intensity for adults or 75 minutes of intense physical activity per week) and decreasing the time spent on watching TV. Diet-related options are increasing consumption of legumes, fruit, vegetables, and nuts, and to limit caloty intake(i.e., exclude solid fats, alcohol, sugars) as well as decreasing consumption of sugar-sweetened beverages and stimulating the practices of breastfeeding of the newborns (Glickman et al., 2012).

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