The Problem of Obesity Western Governors University Collegiate Level Reasoning and Problem Solving James Reed The Problem of Obesity Obesity is a major problem in American. Year after year, new diets are published, and new medications are hailed as wonder drugs that will take weight off with little physical effort, yet the problem still exists unabated. In testimony before the US Congress, Berzins (2001) asserted that, “[weight] is a complex result of heredity, culture and lifestyle. ” According to Rosin (2004), “About one-third of the U. S. opulation is 20 percent or more overweight and is therefore at risk of suffering high cholesterol, high blood pressure, and other cardiovascular diseases. ” Finding the best way to deal with obesity in America is also a problem. Since it is an open-ended problem, there is no certain solution. Some of the factors that impact the complexity of the problem of obesity are healthcare costs to treat obesity-related diseases, second-hand diseases which arise from obesity, such as diabetes and hypertension, and the fact that there has never been a successful treatment found for obesity.
Biases and assumptions about the topic of obesity include believing or not believing genes play a role in this condition, the idea that it is all right to eat more calories, as long as one is on a low fat diet, and perhaps the most cliched of all, that “Overweight persons are…unhealthy, unattractive, asexual, weak-willed, lazy and gluttonous” (Smith, 1996). In a certain way, we face persons and environments affected by obesity every day. Our whole American society, for example, places too much value on physical appearance.
But the obese themselves may include those with sedentary lifestyles who do not get the physical activity they need and then rely on television for entertainment. They may be partial victims of a culture filled with “quick fix” remedies for being overweight or a portion of the population who are constantly looking for a miracle cure. One major ambiguity regarding obesity in America is the differing definitions people apply to the term. Some would define a person who is visibly round, but not struggling to climb a flight of steps, obese. The clinical definition of besity is a Body Mass Index of 30 or higher, but most who use the word will not be referencing it in the clinical sense. There is no one clear cut definition of obesity in our society, which makes the word ambiguous. Another major ambiguity is that no consensus has been reached as for how great an impact the condition has on our health. Smith (1996) asserts that “…there is no evidence that obesity significantly decreases longevity. ” Conversely, Farley & Cohen (2004) exclaim “…at the rate Americans are dying, we’d better start treating obesity like an infectious epidemic. This inconsistent diagnosis serves to make the threat level of obesity ambiguous. Gaesser (2004) asserts that one does not need to be lean in order to be fit. He cites coronary artery disease, the number one killer in America, as an example. Logic should dictate that obesity would be a major cause of this problem, assuming fat on the body begets fat in the blood stream and arteries. But research done at the University of Tennessee, in which coronary angiograms of 4,500 men and women were analyzed, showed the risk of clogged arteries lessened as weight increased (2004). It’s just that body weight, and even body fat for that matter, do not tell us nearly as much about our health as lifestyle factors, such as exercise and the foods we eat” (Gaesser, 2004). Health problems can be corrected without losing any weight at all. The New England Journal of Medicine published a study in 1997 that showed 133 men and women with high blood pressure lowered their systolic blood pressure an average of 11. 4 mmHg simply by eating more fruits, vegetables and using low fat dairy products, yet they had no weight loss.
This shows that “a heavier-than-average person who is physically fit has a better chance of living a long life than does a thin coach potato” (2004), and supports his statement that one does not need to be lean in order to be fit Gaesser’s conclusion is that personal responsibility for one’s food choices and exercise regimen have more impact on health than obesity does. His assertion that one can be fit without being lean is pragmatic. Its limitation is that not many people will accept this prudent advice.
We value physical beauty, which is equated to being thin, too much in our society. Cohen and Farley (2004) point out that in 1991, researchers at St. Luke’s Hospital in New York estimated obesity killed 325,000 Americans annually. In addition to the human toll, the cost of caring for patients with obesity- related diseases exceeded $70 billion annually, for which the government pays about half (2004). Cohen and Farley feel the situation is so dire, “we’d better start treating obesity like an infectious epidemic” (2004).
They note that all methods the medical community has prescribed to fight obesity have failed, and that “most drugs tested as obesity cures have been so dangerous that the FDA has kept them off the market or withdrawn them after approval” (2004). The strength of their evidence is that it gives urgency to the issue. Cohen and Farley feel a favorite remedy of health professionals concerning obese patients is to recommend diet and exercise, which is prescribed to get a patient to a more desirable weight in the short run, but what this population needs is a healthy diet and physical activity as part of their everyday life.
Our sedentary lifestyle contributes greatly to the obesity “epidemic. ” Cohen and Farley assume that more government involvement will be a better way of dealing with obesity in America. They assume that if the number of sidewalks and bike paths are increased, people will be more inclined to exercise and drive less. However, just because more of these will be built does not ensure they will be used by the public. They believe the government should impose a tax on food they deem detrimental to our health, regulate the ways this food is advertised, and limit its accessibility.
However, at a time when both houses of congress are controlled by the Republicans, a party whose philosophy is “they who govern least govern best,” it is unrealistic to think that additional taxes and bureaucracy will be considered an effective strategy. The authors propose a three step solution to the problem. First, initiate a “twinkie tax” on sodas and junk food. Next, the food industry should be regulated, even if it only comes in the form of banning junk food ads aimed at children. Finally, limit the places where unhealthy foods are available “…through zoning and planning” (2004).
The limitations of these suggestions are numerous. Americans feel overtaxed already, hence the Republican revolution we have seen in recent years. Secondly, people do not like being told what is right or wrong for them, which is what regulation insinuates. Third, in a capitalist society, why should any legitimate enterprise be subject to such an arbitrary stipulation as limiting where it can do business? Smith (1996) is the executive director of the National Association to Advance Fat Acceptance. Naturally, she argues that attempts at weight loss, through dieting or drug treatments, re usually not successful, citing a study that shows 95 percent of dieters fail to maintain weight loss over a five year period. This strong evidence corroborates her opinion that dieting is not an effective long-term tool in fighting obesity. Smith is very persuasive in stating that “…the diet industry’s advertising and marketing strategy is based on the creation and perpetuation of fear, biases and stereotypes. People of all sizes are being misled about the extent and severity of the health risks associated with being fat and are told that being thin is the only way to good health and that dieting makes people thin” (1996).
She calls for obesity researchers to stop their attempts to make fat people thin and to focus on ways people can be healthier while carrying extra weight. While the government has tried to make diet companies give accurate reflections of what clients can expect from their products, Smith believes it can do more. She calls for a federal labeling and advertising act, similar to the one which was enacted for cigarettes in the early 1970s, that would ban radio and television commercials for weight loss products and diets.
Additionally, she calls for a warning label on all diet products to call attention to their history of long-term ineffectiveness. One limitation to Smith’s solution is how realistic it is. A total ban on advertising would be fought tooth and nail by the diet industry, which would make the credible argument that they are only providing a product which the American public has overwhelmingly supported. Also, fighting this ban would be broadcast media, who would stand to lose millions in advertising revenue. This problem does not carry the same weight with the American public as the health risks of smoking.
Contrary to Smith, Poston and Shinn (2003) believe that obesity is a serious health problem with its basis being found in food portions and lack of exercise. They cite that 55 percent of American adults are estimated to be overweight or obese (2003). The duo dispute the notion that heredity plays a significant part in determining if one will become obese, stating, “no research has established the existence of genes necessary for the development of obesity” (2003). The authors provide evidence that over-consumption is the biggest contributor to America’s weight problem.
The USDA recommended serving of meat is 3 ounces, about the size of a deck of cards. Yet restaurants servings, and even cookbooks found in our homes, are almost always double this amount. However, even if you forgo dinner for the movies, “a medium size movie theatre popcorn consists of 16 cups,” when the standard serving is three (2003). There is no escape from the oversized threat. Shinn and Poston present evidence that can be interpreted two different ways. They cite less than 10 percent of American adults engage in regular physical activity, and nearly 60 percent describe a sedentary lifestyle.
While they use these numbers to stress our need to increase exercise, the same evidence can be used to demonstrate that exercising is not a priority, or even a major concern, for American adults. In order to curve our oversized portions and spectator lifestyle, the authors conclude we should keep a journal of foods eaten and size of the portion, make physical activity a daily routine, and start keeping an exercise log. The obvious limitation to this solution is that if American’s do not see exercising as a priority, their sloth will also preclude them from the extra work of keeping copious notes regarding diet and exercise.
Any discussion about obesity in America must include a look at junk food and fast food and their perceived role with our battle of the bulge. Rosin (2004) notes the work of Dr. Kelly Brownell, Director of Yale’s Center for Eating and Weight Disorders, who has declared, “To me, there is no difference between Joe Camel and Ronald McDonald. ” Rosin states that roughly one-third of our population is at least 20 percent overweight and thus run a higher risk of obesity-related diseases, such as high cholesterol, hypertension and high blood pressure.
However, she disagrees with Brownell’s belief that a fat tax should be instituted to discourage people from eating fatty foods. Rosin makes a strong case for an alternative to fat taxes by citing an experiment that used alternative pricing for various foods. Researchers in Minnesota reduced the prices at a vending machine for all snacks that had less than 3 grams of fat by 50 percent. The sale of these snacks increased by 80 percent over the next three weeks while fatty snack sales dipped slightly.
The strength of this evidence is that it indicates people may eat healthier snacks when given incentives. While these results seem promising, a limitation to Rosin’s conclusion is the assumption that these sales figures will remain steady. It is one thing to try something new every once is a while, but another to incorporate this into a daily routine. Buchholz (2005) feels that fast food is getting a bad rap. He notes that currently, Americans eat about 200 calories a day more than they did in the 1970s. Where are these calories coming from?
Buchholz cites a US Department of Agriculture “Continuing Survey of Food Intakes by Individuals” study, in which information on how food was purchased, prepared and where it was eaten is disseminated in conjunction with demographics. “The survey shows that the answer is as close as the nearest salty treat. Americans are not eating bigger (meals), but they are noshing and nibbling like never before” (2005). In the late 1980s, we as a society ate less than one ounce of snacks per day. However, by 1994 this number had risen to 1. 6 ounces. “Where do Americans eat most of their between-meal calories?
Mostly at home,” Buchholz finds (2005). Those attacking fast food also note the portion sizes of “super sized meals. ” Yet Buchholz is convincing in citing a February, 2003 study in the Journal of the American Medical Association that concluded the “…most surprising result [was] the large portion size increases for food consumed at home—a shift that indicates marked changes in eating behavior in general” (2005)–which supports his theory that fast food is not the primary cause of obesity. Buchholz’s conclusion is that if we want a burger for lunch, we should go ahead and have one, since the weight risks of fast food appear murky.
This is good news for fast food coinsurers, but the premise is limited because it does not mention anything about exercise, which must be incorporated into people’s lives if they are to be healthy. In looking at obesity in America, we must also look at how large size persons are viewed, and how they view themselves. Berzins (2001) states that prejudice against fat persons, or sizeism, is a very common problem faced by our heavier population. She relates how children as young as three, when asked to pick a friend who is either handicapped, disfigured or fat, will almost always select the fat child last.
Particularly sad is how one young boy, himself overweight, stated he choose the fat friend last “because he looks just like me” (2001). Berzins wants the government to do more to help those who are overweight with their perception of self, and how others perceive them. Unfortunately, this is much easier said than done. She implores the adaptation of a policy that will “…promote…respect for a wide range of body sizes and shapes” (2001). This assumption that the government can change attitudes with policy is setting it up to fail. The history of cinema and television is filled with actors who have made careers ut of their portly physiques. From “Fatty” Arbuckle in the 1920s, to Chris Farley and Rosie O’Donnell, overweight people have always gotten laughs with self-deprecating humor. If fat people don’t treat themselves with respect, nobody else will. Berzins concludes consumer protections from the government will help. “Ensure that prescription weight loss drugs such as Phen-Fen are prescribed as directed and not exploited for cosmetic or economic reason” (2001), she insists. The limitation is how can this be ensured when you are dealing with egos who will pay anything to look thin and doctors who are willing to oblige?
Abuse of medicine is as old as the medical profession itself. Levine (1999) tackles the much deeper question of why people overeat. She points out that food is a major part of our lives, not just a means by which we survive. “Think about it. What do most people do when they get together? They eat. They eat brunch…lunch…dinner. What do we think of when we get together for Easter, Passover, Christmas, Thanksgiving, etc? What are we going to eat? ” (1999). Levine feels that food is medicinal. Eating is to some is what a cigarette or a shot of booze is to others.
She tells the story of Michael Hebranko, who was listed in the Guinness Book of Records for losing the most weight in the shortest amount of time, 735 pounds in just a year and a half. Asked why he gained all that weight back plus a little more, he answered, “I took care of the outside problem instead of the inside one” (1999). “Overeating,” Levine assumes, “has more to do with unconscious wishes and fears than anything else. Truly! Even though you are certain you want to be thin, if you are consistently overeating, unconscious wishes and fears of being thin most likely exist” (1999).
The weakness of this assumption is that it is an unproven hypothesis. If there were scientific merit to support it, then it would be stronger. But all psychoanalysis is open to interpretation and uncertainty. Levine proposes a “compromise solution,” a psychoanalytic term describing how our egos find middle ground to produce the least anxiety when trying to solve a problem. Her solution–stay fat. The best solution is no solution at all. A blatant limitation is that this gives no hope to those who overeat. According to Levine, they have no control over their destiny and will never be thin, so why try?
We would not tell someone who suffers from chronic depression they would never be happy so just get used to it. When it comes to a solution, I feel Gaesser’s assertion that personal responsibility is the biggest determining factor regarding obesity is correct. One may have the desire to be healthy, but without the discipline to do what is necessary, it will remain a desire. My solution is to simply educate the general public that thin is not healthy, explain proper diet and exercise are the best prevention for, and course of action against, obesity.
This can be done through Public Service Announcements, school health programs, and work-related wellness programs. The limitation to this proposal is, as stated before, not everyone will heed this simple approach to good health. It calls for some work, which doesn’t coexist well with a sedentary lifestyle, which the majority of Americans report leading. Smith’s suggestion that placing warning labels on diet products, which would warn of the ineffective longevity of the same, would be a beneficial step to adopt, since there is such a misconception that dieting is an effective tool in battling weight.
The warning labels are in fact a type of education, which I advocate. However, there is no guarantee a warning would influence everyone. Shinn & Poston’s meticulous program of keeping information on food intake and exercise is also a valid approach to see how easy it is to get off track while trying to take proper care of oneself. Taken in conjunction with other measures, these steps may help many cease the endless cycle of weight loss due to dieting, and the almost inevitable weight gain, or yo-yo dieting.
Limitations include the resistance of diet companies to be forthcoming about their product’s long term effectiveness, and the extra work required to keep diet and exercise records. To encourage healthier eating habits, at least where snacking is concerned, I propose tweaking the experiment Rosin described in which healthier snacks were provided at a discount. Keep the ten best-selling fatty snacks and candy bars in public vending machines, and then raise the amount of healthy options and offer a discount on them.
Limitations include only short-term positive results with this experiment, and certain reluctance by the operators of these machines to give up proven money makers and to provide discounts. Berzins hopes that the government will enact a policy in which all body types are respected. While we can never force people’s attitudes about others to change, we can teach self-respect for those who face weight issues. Diverse body types are inbedded in nature. Some people are always going to be larger than the general populace, but this does not mean they should be made to feel ashamed, inadequate or inferior.
She presents a Canadian model called “Vitality,” which was a nation-wide public awareness campaign with the slogan, “Enjoy eating well, being active, and feeling good about yourself,” which focuses on health instead of weight. Limiting the effectiveness of this theory is the fact that low self-esteem and weight issues commonly go hand in hand. It may well be just as difficult to change attitudes about self as it is to change attitudes about others. To help with the psychological issues of obesity, mentors, or life coaches should be available through the education program to offer encouragement and affirmation.
A limitation of this model might be that those helping would not be mental health professionals. My solution is strong because it contains my own opinion about educating the public and adaptations of some of the authors’ suggestions to create a more comprehensive approach than offered by any of the individual authors. I use Gaesser’s realistic assertion that one’s health is mostly an issue of self responsibility, and that it is more important to be fit at a larger weight than to be unfit and thin.
I also echo Smith’s declaration that dieting, in the long run, is not beneficial for the vast majority who use it, misguidedly, as a means for fitness and weight loss—a very realistic approach to this aspect of the problem. My inclusion of tax incentives to encourage food companies to produce healthier snacks and sell them at a reduced price is a strategy that will add to the others, confronting obesity from a variety of ways. I understand that this is still an open-ended problem, and others will have differing opinions on how to address obesity. My solution will be a useful approach, since there has never been a proven cure for obesity.
Ultimately, any person who understands their personal responsibility regarding diet and exercise habits will most likely be more successful in addressing their obesity problem. References Berzins, L. (2001). The government can help prevent eating disorders. In. A. Ojeda. Opposing Viewpoints Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Buchholz, T. (2005). Fast food is not the primary cause of obesity. In. A. Ojeda (Ed. ) At Issue Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Cohen, D. & Farley, T. 2004). Obesity is a serious health problem. In. A. Ojeda. Opposing Viewpoints Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Gaesser, G. ( 2004) The health risks of obesity have been exaggerated. In. A. Ojeda ( Ed. ) Opposing Viewpoints. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Levine, M. (1999). Why people overeat. In. A. Ojeda (Ed. ) Contemporary Issues Companion Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Poston, C. Shinn, E. (2003). The problem of obesity. In. A. Ojeda. Teen Decision Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Rosin, H. (2004). Junk-food taxes may encourage people to eat healthy foods. In. A. Ojeda (Ed. ). Health: Opposing Viewpoints. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC> Smith, S. (1996). Weight loss treatments are harmful and unnecessary. In. A. Ojeda (Ed. ) Opposing Viewpoints Series. Greenhaven Press. Retrieved on July 15, 2006 at http://galenet. galegroup. com/servlet/OVRC>