Obesity in American dominates summer television. Powerful and pervasive images reflect the enormity of the problem. Shaquille ONeill is just one of the celebrities facing the reality of the obesity epidemic. He seeks to use his celebrity to improve the health of 6 South Florida teens feared to become the first generation to die at a younger age than their parents secondary to preventable, weight-related morbidities.
Approximately 300,000 adult deaths in the US each year are attributable to unhealthy diet, physical inactivity, and sedentary lifestyle. The total cost of obesity is estimated at $117 billion dollars, with $8.8 billion attributed to the cost of obesity related heart disease. Americans spend $33 billion annually on weight-loss products and services, yet collectively, our waist lines are expanding.
Environmental influences affecting obesity include passive entertainment options, fast food, food additives not designed to be digested normally in humans, effects of medication, sedentary jobs, extended commutes, stress, and lack of leisure time. Health care providers are increasingly expected to prescribe medications designed to treat the disorders created by the stressful and sedentary approach to our world instead of encouraging patients to eliminate stressors.
Diet, exercise, behavioral therapy and anti-obesity drugs are first-line treatment, for severe obesity but these have limited short-term success and almost nonexistent long-term success. The monolithic emphasis in traditional health care is that the individual has conscious control over their weight. This results in antiquated and restrictive treatments to lose weight with little long term efficacy.
Bariatric surgery has become a popular treatment, with greater than 40,000 operations performed annually. Patients seek the prospect of an improved self-image and quality of life through aggressive surgical intervention. Bariatric surgery is an option for many, but is this the long term solution? Is bariatric surgery to be the “cure?” Should health care providers encourage obese individuals to breathe easier because surgical intervention will be available when they become overweight enough?
Obesity must be confronted head-on and environments must be redesigned to center on proactive systems that emphasize prevention. Physical activity should be conveyed as normal and natural activity. School systems must be reminded that physical education is not an “optional” or extravagant program. Most health care agencies embrace the tenets of Health People 2010 and talk the talk of conquering obesity. The goals are not being achieved as the numbers of overweight Americans are not decreasing.
The stereotypical representation of obesity reflects negative images including lack of control, poor hygiene, laziness, and limited self-discipline. Studies cite a reluctance of obese individuals to seek medical care and report health care providers conducting questionable practices with obese patients (Puhl, & Brownell, 2003). How are we to meet the needs of obese individuals if we blame them for their affliction?
There is a need to accept the differences in each other and look to transform our world into places that embrace strategies to minimize obesity. This includes limiting passive entertainment, sedentary lifestyle, fast food, and industries that benefit from the desire to see “skinny” as the norm. Community growth should include strategies that enable people to naturally engage in physical activity.
Most obese individuals are not going to benefit from the intervention of a 7 foot basketball star. But, it is not hopeless. Shaquille ONeill reminds us that tackling obesity is not a solitary endeavor. The health care of our community is dependent on the commitment of health care providers to redefine our vision and establish proactive approaches to conquer obesity.
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