As obesity rates surge in America, we’re facing a ticking health time bomb. Brace yourselves, America, it’s time to confront this epidemic head-on. Are we ready to challenge the status quo and defuse this ticking bomb?
Obesity is a condition where a person has excess body fat that may impair health. Obesity is usually measured by body mass index (BMI), which is a ratio of weight to height. A person with a BMI of 30 or more is considered obese, while a person with a BMI of 25 to 29.9 is considered overweight. Obesity can increase the risk of many chronic diseases, such as diabetes, heart disease, stroke and some cancers.
Obesity is a common, serious and costly problem in America. According to the National Health and Nutrition Examination Survey (NHANES), the prevalence of obesity among adults was 41.9% in 2017-2020, up from 30.5% in 1999-2000. The prevalence of severe obesity, defined as a BMI of 40 or more, also increased from 4.7% to 9.2% during the same period.
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Obesity affects some groups more than others. Non-Hispanic Black adults had the highest age-adjusted prevalence of obesity (49.9%), followed by Hispanic adults (45.6%), non-Hispanic White adults (41.4%) and non-Hispanic Asian adults (16.1%). The obesity prevalence was higher among adults aged 40 to 59 years (44.3%) than among those aged 20 to 39 years (39.8%) or 60 and older (41.5%). The association between obesity and income or education level is complex and differs by sex and race/ethnicity.
Obesity is also a concern among children and adolescents. According to NHANES, the prevalence of obesity among children and adolescents aged 2 to 19 years was 19.3% in 2017-2020, up from 13.9% in 1999-2000. The prevalence of severe obesity among this age group also increased from 3.6% to 6.1% during the same period.
Obesity among children and adolescents can have immediate and long-term health consequences. Obese children are more likely to have high blood pressure, high cholesterol, type 2 diabetes, asthma, sleep apnea, fatty liver disease and psychological problems than their normal-weight peers. Obese children are also more likely to become obese adults and face increased risks of chronic diseases and premature death.
Causes and Prevention of Obesity
Obesity is a complex and multifactorial condition that results from an imbalance between energy intake and expenditure. Many factors can influence this balance, such as genetics, metabolism, hormones, behavior, environment, culture and socioeconomic status.
To prevent or treat obesity, it is important to adopt a healthy lifestyle that includes a balanced diet and regular physical activity. The Dietary Guidelines for Americans recommend eating a variety of nutrient-dense foods from all food groups, limiting added sugars, saturated fats and sodium, and staying within calorie needs. The Physical Activity Guidelines for Americans recommend that adults do at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with muscle-strengthening activities on two or more days per week. Children and adolescents should do at least 60 minutes of moderate-to-vigorous physical activity per day, including aerobic, muscle-strengthening and bone-strengthening activities.
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In some cases, lifestyle changes may not be enough to achieve or maintain a healthy weight. In these situations, medical interventions may be needed, such as medication or surgery. Medication can help suppress appetite, increase metabolism or reduce fat absorption. Surgery can alter the digestive system to limit food intake or absorption. However, these interventions have potential side effects and complications and should only be used under the guidance of a health care professional.
Recent Studies on Obesity
Obesity is an active area of research that aims to understand its causes, consequences and treatments. Some of the recent studies on obesity in America are:
• A randomized trial that compared the effects of once-weekly semaglutide, a glucagon-like peptide-1 receptor agonist that lowers blood glucose and body weight, with placebo in adolescents with obesity. The trial found that semaglutide plus lifestyle intervention resulted in a greater reduction in BMI than lifestyle intervention alone after 56.
• A case series that reported two children with severe obesity and pathogenic variants in the leptin gene (LEP) that rendered leptin inactive and antagonistic to the leptin receptor. The case series showed that these children had no response to initial treatment with metreleptin, a recombinant human leptin analog, but haechanisms by which adipose tissue glucose transport and GLUT4 levels affect systemic insulin sensitivity and energy balance, and discussed the implications for the pathogenesis and treatment of obesity and diabetes.
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• A perspective article that explored the experience of patients living with obesity and the current understanding of weight and treatments for weight loss. The article featured a video that illustrated the challenges and stigma that patients with obesity face, and the potential benefits of lifestyle interventions, medication and surgery.
Some of the studies done in 2023 about obesity and related health problems are:
• A perspective article that examined the equity and obesity treatment gap in Medicaid programs. The article argued that expanding Medicaid coverage of comprehensive lifestyle interventions and medication for obesity treatment could help reduce health disparities and improve outcomes for low-income populations.
• An editorial that explained the science behind a rare form of obesity caused by antagonistic leptin variants. The editorial described how these variants interfere with the normal function of leptin, a hormone that regulates appetite and energy balance, and how a novel combination therapy can overcome this interference.
• A lecture that discussed the role of adipocyte regulation of insulin sensitivity and the risk of type 2 diabetes. The lecture presented new findings on how glucose transport and GLUT4 levels in fat cells affect systemic insulin sensitivity and energy balance, and how these mechanisms can be targeted for obesity and diabetes prevention and treatment.
These studies provide new insights into the biology, management and prevention of obesity and its related complications. More research is needed to develop effective and personalized strategies to address this major public health issue.
Obesity is a growing health concern in America that affects millions of adults and children. Obesity can increase the risk of many chronic diseases and reduce the quality and length of life. Obesity is caused by a complex interplay of genetic, metabolic, hormonal, behavioral, environmental, cultural and socioeconomic factors.
To prevent or treat obesity, it is important to adopt a healthy lifestyle that includes a balanced diet and regular physical activity. In some cases, medical interventions such as medication or surgery may be needed. Recent studies on obesity have advanced the knowledge of its causes, consequences and treatments. More research is needed to develop effective and personalized strategies to address this major public health issue.
