Obesity and Weight Management

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Obesity and Weight Management E S U M O O G R N S I S N A R L A C E R L O E E G L A A G S N E R O C F F T O O Y N T ± R Obesity and E Y P L O N R O Weight Management P W E I V E R R O F Text Choice 2 File E S U M AFTER STUDYING THE or the first time in history, more than half of the peopleO on the MATERIAL IN THIS CHAP- planet are overweight. Obesity, as headlines blareO and health TER, YOU SHOULD BE ABLE TO: experts warn, is emerging as the number-oneG R public health prob- F 1 S lem of the twenty-first century. In the UnitedN States alone, obesity annu- • List the factors besides I S 2 genetics that have con- ally leads to 400,000 premature deathsN and $90A billion in medical costs. tributed to the global Excess weight has become anR epidemic.L Two-thirds of American increase in overweight adults, up from fewer than half 20 years ago, are overweight. About one in and obesity. A C every three Americans is obese. One in six children and teenagers is over- • Define overweight and E weight; a similar proportion is at riskR of developing a weight problem.3 obesity, and describe the L four indicators of weight- Once viewed as a cosmetic problem,O fat now is recognized as a related health risks. E crippler and killer. Excess weightE weakens hearts; raises blood pressure; • Identify the main health clogs arteries; strainsG backs Land joints; increases the risk of diabetes, risks of excess weight. stroke, and certainA cancers;A and steals years of productive life. The ear- • Assess various lier the weightG gain, theS greater the danger it poses. Obesity at age approaches to weight twenty can Ncut 20 years off a person’s life. Even moderate overweight at loss. R age fortyE can subtract 3 to 7 years from life expectancy.4 • Design a personal plan O FederalC and world health leaders, medical organizations, nutri- for sensible weight F management. tionists,F and the food industry have mobilized to fight global fattening. T • Identify and describe OAccording to preliminary data, the tide may be turning: The percentage the symptoms and dan- of AmericansO who are obese does not seem to be increasing, although it gers associated with eat- Y N 5 ing disorders. remains at record levels. T ± This chapter explains how we grew so big, tells what obesity is and R E Ywhy excess pounds are dangerous, describes current approaches to P L weight loss, discusses diets that work (and some that don’t), offers prac- O N tical guidelines for exercise and behavioral approaches to losing weight, and examines unhealthy eating patterns and eating disorders. Regard- R O P less of your current weight, you will find insights and skills you will W need for healthy weight management throughout your life. E I V E FREQUENTLY R ASKED QUESTIONS FAQ: RIs my weight healthy? 120 FAQ: What if I eat to feel FAQ: Who develops eating dis- O better? 133 orders? 139 FFAQ: Why do we overeat? 125 FAQ: Can a person be fat and © David Oliver/Taxi/Getty Images © David Oliver/Taxi/Getty fit? 132 Text Choice 2 File Overweight (prevalence) The Global Epidemic 02040506010 30 70 80 90E 100 An estimated 1.1 billion people around the world—seven Black S in ten of the Dutch and Spanish, two in three Americans 60.1% U and Canadians, and one in two Britons, Germans, and Ital- 78% ians—are overweight or obese. In Europe, excess weight Hispanic 74.4%M ranks as the most common childhood disorder. Obesity O71.8% rates have quadrupled in Japan and are soaring in South White America. O67.5% “Globesity” is not restricted to industrialized G 57.5% societies. According to the International Obesity R Task Force, more than 115 million people in NObesity S developing countries suffer from obesity-related problems. Black I S 28.8% In many poor countries, obesity is common among city N A50.8% dwellers, while people in rural areas remain underweight Hispanic R L and malnourished. A 29.4%C In 2004, the World Health Organization adopted its 40.1% first global diet, exercise, and health strategy to combat White E R Men obesity. It recommends that governments promote public L 27.7% Women knowledge about diet, exercise, and health; offer informa- O30.6% tion that makes healthy choices easier for consumers to EFIGURE 6-1 Weight Problems by Race/Ethnic Group and make; and require accurate, comprehensible food labels.6 Gender E G L Although ultimately each individual decides what and how ASource: American Obesity Association, “Obesity in Minority Populations,” much to eat, policy makers agree that governments also www.obesity.org.A 7 must act to reverse the obesity epidemic. G S Exposure to a Western lifestyle seems to bring out sus-N ceptibility to excess weight. Obesity is much more com-E R mon among the Pima Indians of Arizona compared to O Pimas living in Mexico, who have maintained a more C tra- F today, but they’re 30 to 50 percent heavier than “fat” kids ditional lifestyle, with more physical activity andF a diet were a decade ago. lower in fat and richer in complex carbohydrates. NativeT The percentage of obese teenagers has tripled in the Hawaiians who follow a more traditional dietO and lifestyle last 20 years. Young adults are becoming obese 28 percent 8 also have lower rates of obesity and cardiovascular disease.O faster than those born in the early 1960s.12 By middle age, Y 13 N 70 percent of Americans are overweight or obese. The T ± percentage of those who are more than 100 pounds over- Supersized Nation R weight is increasing even faster than obesity itself.14 Y “Overweight and obesity are literally killing us,” Secre- Over the last four decades, the percentageE of obese adults tary of Health and Human Services Tommy Thompson in the United States has jumpedP from 13L to 31 percent. An declared in launching a national war on excess weight in estimated 129.6 million AmericansO areN at unhealthy 2004.15 Deaths due to poor diet and physical inactivity rose weights.9 O by 33 percent over the past decade. Only tobacco causes Although moreR men than women are overweight, more preventable deaths. more adultP women (38 percent) are obese than Not all Americans are equally likely to be overweight men (28 percent). Non-HispanicW black women or obese. As Figure 6-2 shows, the southern states have the have the highest obesity rateE (50 percent), compared with highest concentration of obese residents. Mississippi is 40 percent of Hispanic womenI and 30 percent of white home to the county with the highest percentage of people women.10 (See FigureV 6-1.) In some Native American com- with a body mass index (BMI) between 30 and 40. (Recall munities, up to 70 percentE of all adults are dangerously from Chapter 4 that BMI is defined as the ratio between overweight. DifferencesR in metabolic rates may be one weight and height that correlates with percentage of body factor. fat.) States also vary in their efforts to control obesity. Weight problems are starting earlier than ever. One in According to an ongoing evaluation program at the Uni- ten preschoolersR and one in five grade schoolers are seri- versity of Baltimore, no states deserve an A, while only ously overweight.O 11 According to federal estimates, some 6 one—Arkansas—earned a B because it leads the country in millionF American youngsters are so heavy that their health passing laws to control obesity. Ten states, including Cali- is in jeopardy. Another 5 million are on the threshold of fornia, Illinois, and Maryland, got C’s for their efforts, this danger zone. Not only are more children overweight while 16 earned a D and 23 failed completely.16 Text Choice 2 File E S U M O O G R N S I S N A R L A C E R L O E E G L A A G S N E R O C F F T O O The government has launched an inno- Y N vative public awareness and education campaign called “Healthy Lifestyles & T ± Disease Prevention” (see Website: www.smallstep.gov) that encourages R consumers to make small activity and dietary changes to shed excess pounds. E Y Among its recommendations: P L ● N Do sit-ups in front of the TV. O How Did We Get So Fat? R O A variety of factors, ranging from heredity to environment to behavior, played a role in the increase in overweight and P obesity. They include: ❖ W Small Steps to a Lower Weight Genetics. E involved in appetite and metabolism, they have not ● I ● Eat half your dessert. Bike or skate to class or work f V Although scientists have identified genes ● instead of driving. E ● Don’t eat late at night. ● More carrots, less cake. R Buy 100% fruit juices over soda and sugary drinks. R O F ● ● Eat before you get too hungry. found a genetic cause for obesity. It may be that various Use nonfat or lowfat sour cream, genes contribute a small increase in risk or that rare mayo, sauces, dressings, and other abnormalities in many genes create a predisposition to● condiments. ❖ Text Choice 2 File weight gain and obesity. Try a new fruit or vegetable (ever Prenatal factors.
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