Obesity as a Leading Heath Problem
According to the American Heart Association, obesity is found in almost one-third of U.S. adults and 17% of U.S. children ages 2 to 19. Worldwide it was estimated in 2010 that there are approximately 500 million obese people and another 1.4 billion who are overweight. The number of obese individuals is estimated to rise to 700 million by 2015.1 Obesity is estimated to cause approximately 112,000 to 365,000 deaths per year. Its prevalence has increased since the 1970s in the U.S. (data from NHANES II and III) and in Europe.2 This increase has occurred across every age group, sex, race, and smoking status.3
Obesity is recognized as a significant public health hazard, as it increases the risks for multiple diseases, such as type II diabetes, cardiovascular disease, hyperlipidemia, hypertension, stroke, breast and colon cancer, and degenerative arthritis.4 The cost of treating obesity related conditions are estimated to range from 147 to 210 billion dollars per year. It decreases quality of life, functional capacity, and increases morbidity and mortality. Treatment has been shown to reduce morbidity and mortality.5 Therefore, preventing or treating obesity would be very beneficial on both an individual and societal basis.
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One of the controversies regarding whether to define obesity as a disease is the fact that there is not agreement as to the definition of obesity. Obesity can be defined as an excess of body fat that leads to increased morbidity and mortality. From an epidemiological standpoint, it may be defined as a BMI of greater than or equal to 30 kg of body weight per meter squared.2 This is a simple and easy to use calculation, as the data are readily available. The BMI is considered a marker for adiposity and is widely used to predict and evaluate disease risk. It is not an ideal measure, as it does not account for variations in body composition. Other methods to measure body fat and composition include waist circumference, skin fold thickness, waist to hip ratio, waist to height ratio, bioelectrical impedance, and dual energy X-ray absorptiometry. These metrics or techniques are not consistently available in all settings. In 2012 the AMA Council argued that the lack of a universally agreed upon metric limits the ability to define obesity as a disease and therefore, calling it a disease would not improve health outcomes.
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