Public Health Problem - Obesity

Obesity is the medical condition, whereby excess body fat accumulates having an adverse effect on health, and reducing life expectancy or increasing chances of health problems (such as cardiovascular diseases, type 2 diabetes and certain types of cancer). Obesity is commonly found by calculating body mass (weight divided by height squared) and is classified in 3 main classes; Class 1 is between a BMI of 30 and 34.9, Class 2 is between 35 and 39.9 and Class 3 (the most severe) is a BMI above 40. It is most common due to a lack of physical activity and an increase in food intake, however genetics and external factors such as toxins can lead to obesity. It is a huge and currently growing public health problem, as it is the leading preventable cause of death in adults due to increasing food intake across the world, leading to increased numbers of obese people, including children (with over 10% of children in the world being overweight or obese), and becoming one of the most serious heath concerns of the 21st century.

1. Context of the problem on a global scale

Recent predictions by the World Health Organization (WHO) suggest that obesity may soon replace other public health concerns, such as malnutrition and infectious diseases due to the significant impact on health. Obesity is currently a huge problem due to its prevalence, costs and health effects. Compared with data from the 20^th century, obesity was rare and only in 1997 did the WHO recognize it as a global pandemic, with over 500 million people being obese in 2008 (according to WHO estimations). Obesity was once considered a problem of the developing world, however recently it has become increasingly present in devolving nations such as China (with overall rates at 5% but certain cities have obesity rates exceeding 20%) and India (where morbid obesity affects upwards of 5%of the population. Not only is obesity a problem on a global scale due to prevalence but also due to the impact on healthcare and its economic effects (due to disadvantages at work and constant need of medical assistance for obese people). In 2005 the medical costs attributed to obese patients in the US exceed $190 billion (nearly 20% of the medical expenses) and in Australia cost over A$21 billions.

2.Future risks

Excessive body weight has been linked to numerous diseases, including cardiovascular diseases, type 2 diabetes and certain types of cancer (such as gastric cancer and liver cancer). If obesity rates continue to climb (as they are doing so currently) they could pose serious threat to public health and the health of the community as it would lower life expectancy. Moreover, more deaths would be due to typical ageing (brought on by diseases in later years) than normal ageing. For example, in the US it is estimated nearly 300,000 deaths are caused due to obesity and 1 million deaths are attributed to this problem in Europe. Additionally it has serious consequences on the individuals physical health as obesity can lead to high blood pressure, high cholesterol levels, cancer (with obesity and physical inactivty contriubting to upwards of 30% of deaths by cancer) and type 2 diabetes. It can also lead to cardiovascular diseases (such as myocardial infarction), neurological diseases (such as stroke, migraines and dementia) and psychiatric problems (such as prolonged depression).

3. Etiological risks

A recent review (in 2006) found 10 possible causes or factors leading to obesity that included; lack of sleep, endocrine disruptors (such as pollutants), increased use of medication, genetics (controlling metabolism), lack of physical exercise and excessive food intake. The biggest factor contributing to excess body weight is diet, which has changed dramatically over the past few years, to include high levels of salt and fat content, in popular food and drinks, such as coke and McDonald’s, which can now be found almost all over the world. A study conducted recently found that between 1971 and 2000 obesity rates increased (in the US) from 14.5% to 30%, which correlated to an increase of about 300 calories per day. Another huge contribution is from physical inactivity with WHO predictions, estimating that nearly 30% of the world’s population don’t get sufficient amounts of exercise, due to the sedentary lifestyle thanks to newer technologies available in the home and as transport. In children, this increase in physical inactivity can be attributed to the popularity of technology such as the television and gaming consoles (including the PlayStation and the Xbox).

4. Public health intervention strategies, programs, or policies used to solve this problem

Public Health Organisations from across the world have been trying to tackle the problem of obesity by starting new campaigns and promoting healthy weight loss and exercise problems. Majority of the campaigns, however, focus on educating the public and educating children, so as to ensure they know how to maintain a healthy lifestyle. Key examples include; the ‘Five a day’ campaign that helped to promote popularity of fruits and vegetables and educate the public on the levels of fruit and vegetable they need. The ‘Be Food Smart’ campaign in the UK (launched by Change4Life) helped create a series of adverts to educate the public on healthy levels of salt content and to show them the amount of fat and salt in popular foods. Another big food campaign launched in Northern Ireland, hopes to introduce better food labelling regulations and educate the public on the dangers of obesity. These campaigns have helped to educate people on how to maintain a healthy lifestyle and get sufficient levels of exercise and fruits and vegetables. There are also schemes to promote healthy living through exercise such as the city of Bogota (Columbia), where 113 km of roads are blocked every Sunday and on holidays to encourage people to walk. This has also been tackled by various cities in Europe, which now have pedestrian zones to encourage more people to walk. Thus through successful campaigns public health agencies have tried to promote healthy eating and exercise in order to tackle the growing problem of obesity.