Healthcare?

The Impact of Obesity on Healthcare Delivery
By D. Milton Stokes, RDVol. 16 No. 2 p. 34
Looking back at it all, we may wonder how the overweight and obesity epidemic began. How in the world could Americans have become so fat? How could humans (proportionally) be the fattest mammals? And, many people scramble to buy any gimmick promising to help shed pounds, build muscle mass, or increase metabolism to reverse the trend.
As revealed by the Centers for Disease Control and Prevention (CDC) 2000 data, more than 64% of American adults qualify as overweight or obese; 15% of adolescents (aged 12 to 19) are overweight; and 15% of children are overweight (aged 6 to 11).1 But, it does not end there. People in other countries are following suit and packing on the pounds. In The Hungry Gene: The Science of Fat and the Future of Thin, author Ellen Ruppel Shell identifies Brazil, Chile, Colombia, Peru, Uruguay, Paraguay, England, Finland, Russia, Bulgaria, Morocco, Mexico, and Saudi Arabia to be among the many other nations whose citizens are growing in portliness.2
One measure of weight status used today is Body Mass Index (BMI), which was derived from the discovery that weight of normal adults is proportional to height squared. A BMI of 24.9 or less is generally healthy; 25 through 29.9 is overweight; 30 through 39.9 is obesity; and 40 and above has been called extreme obesity or severe clinical obesity.
Fatness has been in vogue in certain periods of history, however. Look at statues of the merry Buddha, carvings of voluptuous and curvaceous Greek and Roman women, and hefty, celebrated sumo wrestlers (who remain today). Then, around the 18th century, 30 doctoral theses were written on the topic of obesity. In 1757, a Dutch doctor named Malcolm Flemyng identified obesity as a problem and blamed its growth on an inherent “inclination” instead of character. That is to say, perhaps, that it was not due to personal weakness where people took to excess by their own choosing, but rather a preprogrammed tendency.2
In examining the history further, we see that the outcry against excess weight came from the fashion industry, an expansion in athletics and sports, and with more women entering the workforce. Additionally, the insurance industry connected body weight with health, and for the first time, overweight and obesity had a commercial significance. Fatness equaled more financial risk.2
Researchers have attempted to pinpoint why we have seen such a stark increase in extra weight. The agricultural period resulted in a growth of more domesticated animals bearing more body fat, and, in turn, humans consumed more and more meat from those fatty animals. The industrialization of society led to increased efficiency and more labor-saving devices.2 Others contend that we watch too much television, eat portions of food in one sitting big enough for two people, and sell junk food to our kids in schools. Moreover, exercise and physical activity have been almost entirely eliminated from schools.
In the laboratory setting, scientists are scrambling to distinguish physiological causes of the body’s tendency to hold tight to fatty tissue—similar to Flemyng’s theory from the 18th century.2 Specifically, they are trying to verify whether or not something in body fat communicates with the brain. It appears that one of the communicators is leptin, a gene linked with obesity, and there may be a deficiency in leptin’s metabolic pathway.2-4

More tomorrow
LouAnnGood
www.FTFortMyers.com