Page 82 Complete Your CE Test Online - Click Here ● ● The prevalence of obesity was higher among non-Hispanic black, Hispanic, and non-Hispanic white adults than among non-Hispanic Asian adults. Despite the ongoing concern about obesity appearing in print, in the media, and on celebrity talk shows, there has been no significant change in its prevalence since 2009, and the prevalence of obesity among adults continues to be greater than one-third of the population[27] . Children: Obesity in children in the United States continues to exist in alarming numbers. Statistics provided by the CDC show that[27] : ● ● Childhood obesity has more than doubled in children in the past 30 years. ● ● Adolescent obesity has more than quadrupled in the past 30 years. ● ● The percentage of children ages six to 11 years old who were obese increased from 7% in 1980 to almost 18% in 2014. ● ● The percentage of adolescents aged 12 to 19 years who were obese increased from 5% in 1980 to 21% in 2014. ● ● In the year 2014, more than 17% of children and adolescents were overweight or obese. Causes and risk factors of obesity What causes obesity? What factors contribute to its development? Historically, most people, including most healthcare professionals, believed that obesity was caused by a lack of self-control and bad eating habits. Many of these same people continue to view obese persons with disdain, assuming that they simply prefer eating to losing weight. Today, however, research has indicated that there may be a variety of factors that contribute to obesity. Although it is accurate to say that many Americans eat too much, consume too many high-calorie, high-fat foods, and fail to exercise enough, current research indicates that genetics and other issues also play a role in the development of obesity[25] . Here is a summary of some of the factors that may contribute to the development of obesity[9,25,29,30,31] : ● ● Genetics and family history can contribute to the development of obesity. As with many, if not most diseases and disorders, genetics may be a contributing factor. Research is underway to identify the impact of genes on the problem of obesity. However, clients should not “blame” their genes on their obesity and assume that they can do nothing to lose weight. Both genetics and behaviors may be needed for obesity to exist. ● ● Other medical and/or mental health conditions may contribute to obesity. Examples of such conditions include depression, anxiety disorders, severe stress (i.e. people eat when confronted with stressful situations), thyroid disorders, Cushing’s disease, and polycystic ovary syndrome. Binge-eating disorder may also lead to significant weight gain and obesity. ● ● Various medications may cause weight gain as a side effect by increasing appetite or altering the client’s metabolism. Examples of such medications include some antidepressants, steroids, and some anti-cancer drugs such as Tamoxifen. ● ● Weight gain may be a result of too little physical activity. Americans have a variety of choices for leisure and work-related activities that require nothing more than pressing buttons on the television remote to access hundreds of channels or using a computer, iPhone, or iPad. ● ● Eating habits affect the rates of obesity to a significant extent. The portions Americans serve in their homes and eat in restaurants far exceed healthy diet recommendations. Even though fast food restaurants now offer more healthy choices such as salads and grilled sandwiches, many of the choices are items high in fat and calories. Supersized hamburgers and French fries are the items selected by many people who frequent fast food restaurants. ● ● Social habits and culture influence what and how much is eaten. Food and drink are part of holiday celebrations, social gatherings, and even events such as going to the movies where popcorn and soft drinks are purchased in large quantities. Culture also plays a significant part in dietary habits. Foods that are important to cultural customs may be high in fat and calories. Modifying such foods to make them more “healthy” may be offensive to certain cultures. Consequences of obesity in adults Obesity has serious health and economic consequences. The health problems linked to being overweight or obese have a marked economic impact on the United States healthcare system. Costs may be direct and indirect. Examples of direct costs include preventive measures, diagnostic procedures, and treatment services. Indirect costs are related to morbidity (the value of income lost from decreased or restricted productivity and activity and absenteeism) and mortality (the value of future income that is lost by premature death). According to the CDC, the annual nation-wide costs of obesity-related absenteeism range between $3.38 billion and $6.38 billion[30] . The health consequences related to overweight and obesity are staggering. Clinical research shows that being overweight or obese significantly increases the risk for the following health problems[9,30] : ● ● Cardiovascular disease: Excess fat contributes to the development of atherosclerosis, the buildup of fat and plaque within the arteries. This narrows the lumen of blood vessels, which decreases the volume of blood that can moves through these vessels. Diminished blood flow means that the heart does not receive adequate amounts of oxygen and other nutrients, which can lead to heart attack. ● ● Cerebrovascular disease: Persons who are obese generally have higher deposits of fat and plaque in their blood vessels, including the cerebrovascular vessels. This leads to narrowed, and/ or blocked blood vessels, which impairs blood flow. This decreases the amount of oxygen and other nutrients that the brain receives, which can lead to stroke. ● ● Elevated cholesterol (dyslipidemia): High total cholesterol or high levels of triglycerides are linked to overweight and obesity[9] . ● ● Gynecological issues: Obesity can negatively impact fertility and cause menstruation problems[9] . ● ● Hypertension: Elevated blood pressure contributes to the risk of heart disease and stroke. Obesity and diets high in saturated fats and sodium significantly increase the risk of hypertension[9] . ● ● Liver and gallbladder disease: Obesity has been linked to the development of liver and gallbladder disease. Foods high in fat and calories have been shown to exacerbate these kinds of disorders[9,30] . ● ● Malignanices: Overweight and obesity may increase the risk for the development of a number of cancers. To date, obesity has been linked to an increased risk for breast, colon, and endometrial malignancies[9,30] . ● ● Osteoarthritis: Excess weight places more stress and pressure on affected joints[9,30] . ● ● Sleep apnea and respiratory problems: Excessive weight, especially around the diaphragm and abdomen contributes to respiratory difficulties as well as sleep apnea compared to persons who are not obese[9,30] . ● ● Type 2 diabetes: Obesity is linked to the development of type 2 diabetes. Even an increased percentage of body fat (without being obese) in the abdominal region increases this risk[9] . Two recent studies further support the dangers of obesity. According to the results of a study published online in the August 15, 2013 issue of the American Journal of Public Health one in five deaths in the United States is linked to excess weight[32] . In this study, obesity appears to have an especially negative effect among black women, with almost 27% of deaths associated with overweight or obesity compared to nearly 22% in white women. Among black men, nearly 5% of deaths and among white men almost 16% of deaths were linked to overweight or obesity[32] . According to another study published online on October 16, 2013 in Family Practice, persons whose weight falls into a higher category of BMI and obesity have an increased risk for multiple chronic diseases (multi-morbidity)[33] . Multi-morbidity was defined as “the presence of two or more current conditions of a possible 11 conditions, including coronary heart disease, stroke, asthma, sleep apnea, type 2 diabetes, malignancies, gallbladder problems, back pain, osteoarthritis, and other joint problems and pain[33] .