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Research Paper
Obesity in America
Rachel Fishkind
University of Maryland
"I pledge on my honor that I have not given or received any unauthorized assistance on this
assignment/examination."
Rachel Fishkind
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Introduction:
Obesity is a disease that impacts the lives and families of millions of people in the United
States, even though it is highly preventable. The World Health Organization attempts to define
the broad phrase of obesity: “an abnormal or excessive fat accumulation that presents a risk to
health” (Obesity , n.d.). They also describe that obesity is measured using a person’s body mass
index; body mass index is a person’s weight divided by their height squared. Weight is measured
in kilograms, and height is measured in meters. The World Health Organization states that if a
person has a body mass index that is over thirty, they are in the category of obese. Swan states
that obesity has many causes including inactivity, genetics, excess food consumption, and lack of
education. She discusses that many people argue that obesity is not a disease; however, it clearly
impedes the mental, physical, and even social health of an individual. Although obesity is
prevalent in many countries, it is most prominent in the United States. The CDC states in the
article, “Adult Obesity Facts”, that within the United States, 39.8% or 93.3 million people were
considered to be obese from 2015-2016. They also state that obesity is a serious detriment to the
economy; 147 billion dollars were spent on obesity in 2008. Totura and other researchers (2015)
found that 81% of people attribute obesity as the largest health problem the United States is
facing. Improving obesity in the United States would change the lives of people living with the
Background:
Obesity most definitely varies across different groups within the United States. Swan
found that from 2015-2016, within children, obesity was more prevalent in boys; however, in
adults over the age of twenty, obesity was more prevalent in women. This same study also found
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that obesity increases as age increases, being that 14.5% of youth are obese, and 30.5% of adults
are obese. Along with age and gender gaps associated with obesity, there are also racial and
ethnic gaps. Swan describes that in the United States, blacks and latinos have the highest rates of
obesity. Latino and black women have higher rates of obesity than their male partners, while
white women do not. Education is another huge factor in obesity in most populations: Swan
found that individuals with a college degree have an obesity rate of 22.7%, while individuals
without a high school diploma have an obesity rate of 35.6%. Swan describes that middle income
groups have the highest levels of obesity, compared to high and low income groups for men and
women across the United States. Regionally, obesity is the highest in the south at 32.4%, and the
midwest at 32.3%. Therefore, rural areas are much more affected by obesity than urban areas.
Within the United States, Obesity rates are constantly increasing due to many different
factors and lifestyle changes. Swan proves that urbanization, transportation, workplace, and
physical activity all contribute to the increase in obesity. Urbanization is causing an increase in
jobs that do not require manual labor, which was an easy access to physical activity for those
with very busy work schedules. New transportation such as uber and lyft are causing more
people to drive to places instead of walking. With the large emphasis on working in America,
Significance:
Obesity should be a focus of public health due to the fact that it is negatively impacting
the economy and the families affected. Spieker and Pyzocha (2016) describe that obesity
contributes to 20% of healthcare costs in the United States every year. Swan states that the
United States is spending almost one and a half trillion dollars on treating obesity every year.
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Spieker and Pyzocha also describe that obesity is leading to other diseases such as cardiovascular
diseases that are very costly to both the United States and the families affected. Since treatment
is so expensive, a lot of people may avoid treatment, or end up in debt if they do decide to seek
treatment. Treatment is also extremely unequal in the United States. Swan mentions that costs to
treat children with obesity on medicaid are 80% higher than costs to treat children on private
insurance. Therefore, children with a lower socioeconomic status are much more likely to have
issues with obesity; this is because they cannot attain affordable treatment. The sustainable
development goal that most relates to this issue is under goal ten: “to ensure equal opportunity
and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and
practices and promoting appropriate legislation, policies and action in this regard” (About the
Sustainable Development Goals, n.d.). This goal talks about reducing inequality and providing
equal opportunity; This would change the outcomes of millions of families in the United States
suffering from obesity. Obesity rates will not decrease in the United States until inequality within
healthcare is improved.
Economics is only one of the many issues that families in the United States face when
dealing with obesity. Obesity causes countless other fatal diseases. Swan states that obesity
disease, reproductive diseases, and respiratory disease. She describes that all of these diseases
contribute to the economic downfall of families affected by obesity. Treatment alone for these
diseases will put countless families into debt. These diseases will also prevent many people from
attending work. If one parent in a family can no longer bring in a stable income, the children will
also be affected. They may no longer have money for essentials such as food, running water,
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education, or healthcare. Swan states that another issue that goes along with obesity is stigma.
Obese people may be too afraid to go to the gym because of the judgement they will face. Swan
concludes that obesity will absolutely impact the future generations of the family. Obesity causes
cycles of poverty that are very difficult to escape. Obese parents also tend to have obese children,
There are many contributors to obesity from the individual level to the societal level.
Swan states that on the individual level, eating unhealthy, not exercising, and smoking can
absolutely lead to obesity. Families will contribute to obesity by overfeeding children at a young
age. This will cause bad habits in the future, and children will never learn to eat the right way.
Communities and institutions can also be a large contributor to obesity if school systems are not
providing healthy meals. Eisenberg and Burgess (2019) state that schools should be replacing
processed foods with healthy alternatives so children learn at a young age how to eat well. They
also describe that along with healthy options at schools, they must provide education on
preventing obesity. Many children do not know the consequences of obesity and educating them
from a young age is a great start to tackling obesity. Society is considerably the largest
contributor to obesity. Swan describes that norms in America such as eating fast food every day
and working all day greatly contribute to obesity. There are also poor healthcare policies in place
at the societal level, preventing many people from acquiring access to treatment. When obesity is
not treated, it leads to the fatal, costly diseases that are an economic burden.
More attention needs to be attributed to this issue due to the economic cost that goes
along with it. Since obesity contributes to 20% of healthcare costs each year, tackling the issue
would save an immense amount of money and boost the economy: “estimates of future direct
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(medical) and indirect (nonmedical) costs related to obesity suggest rising expenditures that will
impose a significant economic burden to individuals and society as a whole” (Spieker and
Pyzocha, 2016). Therefore, individuals and society would benefit from treatment for obesity.
Families would not have to deal with the economic burden of obesity and society would save a
substantial amount of money that would be used for other non-preventable health issues.
Although obesity is a large issue in the United States, there have been prevention programs and
Current effort:
Some interventions within the United States include cognitive behavioral therapy,
nutritious school lunches, monitoring of fast food chains, and offering increased access to
medicaid. These interventions have been proven to be helpful; however, some have been much
more effective than others, one of the most effective being improved nutritious practices in
schools.
One intervention that has been put in place in the United States to improve school
lunches is known as the CATCH eat smart program. The CATCH website describes that they are
targeting obesity at three different levels: In the classroom, in the cafeteria, and in physical
education. CATCH was created in 1988 as a research program to improve child health in the
United States. The program is targeting children in schools all across the United States in order
to prevent problems such as obesity before they occur. It is well known in the health world that
prevention is much more successful than treatment, which is why they are targeting children and
not adults with obesity. A study conducted from 1999 to 2005 by Nansel and other researchers
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found that programs similar to CATCH that implement a healthy lifestyle to children in schools
A study was published in 2008 by Nansel and other researchers to study the impact of a
nutritious diet and physical activity for young students. This research was a case study conducted
in Georgia at the Brown Mills elementary school from 1999 to 2005. They used standardized test
scores to operationalize the dependent variable. They took the average of the students
standardized test scores before the treatment, and then the average after each year of receiving
better physical activity and a more nutritious diet. They found a positive correlation between
their standardized test scores and receiving the treatment. Before the program was implemented,
standardized test scores averaged around 52%. After the program was implemented, standardized
test scores averaged around 65%. This clearly proves that improved nutrition and activity led to
students being more productive with their school work. Nansel and other researchers explained
that this program was targeting children in schools. Targeting children is a great way to attack
obesity because it will stop the cycle of ongoing obesity through the generations. Targeting
children also proves the important lesson that prevention is always better than a cure. If programs
target adults with obesity, they are only helping to treat the issues, but when they target children,
Although there are challenges to fully integrating this program into schools, it is
definitely possible to do so. Nansel and other researchers describe that the only way this program
will succeed will be if all of the systems such as family, schools, public health workers, and the
community work together to promote change. This program is not costly which will allow it to
spread to areas that may not have great healthcare. One issue surrounding this study was that it
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did not study individuals and it could not control other historical factors that may have affected
test scores. This prevents the researchers from knowing the trends in test scores compared to
nutrition for each individual student. One important issue that this article leaves unaddressed is
about children who are not in school, and how they will fight obesity. At an individual level,
those children will to prioritize school and make the decision to show up every day. At the
societal level, laws need to be put in place to make sure that all children are attending school.
The CATCH website describes that this program will continue to spread across the United States
and to other countries: “CATCH has been expanded beyond elementary school and now has
programs and health education curriculum for early childhood through middle school, including
There were many important lessons learned from this research study, most importantly
being that CATCH will not be possible unless all levels of the community work together to
implement it, “During development of the CATCH program, those who were going to use the
program (e.g., teachers, food service employees, administrative staff, students, parents) were
included in the planning and design. Their inclusion was essential to ensure program
acceptability” (Catchglobal, n.d.). In the future, CATCH needs to put more effort into integrating
all members of the community if they want their program to be as successful as possible. In the
research study, Nansel and the other researchers also mentioned that the principle, families, and
Discussion:
I personally believe that CATCH is a great start to solving obesity in America. CATCH is
a fantastic program because it helps to solve the issues of inequality within the treatment of
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obesity. This relates again to the sustainable development goal of improving inequality and
providing equal opportunity for treatment. Since everyone in the school will be impacted by
CATCH in the exact same way, it provides equal opportunity and equal treatment to elementary
school students. I think that CATCH needs to spread to more areas in the country so that more
children are given this amazing opportunity. The CATCH program believes that all sections of
the community need to work together to create change, and I completely agree with this. If the
schools were doing a great job at providing education and physical activity, but parents were
providing their children with fatty foods, change would not occur. Another issue that must be
solved has to do with the inequity in the healthcare system. Until treatment is accessible to all
people at a reasonable price, many people will continue to die due to the repercussions of
education, physical activity, nutritious meals, and treatment to all children affected by obesity. I
believe that it is important to target children because this attacks the issues before they even
begin. When children learn healthy lifestyles in school, they will be more likely to be healthy in
the future, and they will be more likely to raise healthy children. Although providing treatment
for obesity is important, prevention will be the only way to bring about large change in America.
Conclusion:
Obesity is a disease that is destroying the lives of millions of American’s each year.
Obesity must be a focus of public health due to the fact that it is preventable, and also having a
large negative impact on the United States economy. The best way to fight obesity is to target
young children in school, so that they gain important knowledge about preventing obesity from a
young age. The most important thing to remember when treating obesity is that prevention is
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better than a cure, and if American’s all work together to solve the obstacle it is absolutely
feasible to do so.
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References
About the Sustainable Development Goals - United Nations Sustainable Development. (n.d.).
https://www.un.org/sustainabledevelopment/sustainable-development-goals/.
Adult Obesity Facts. (2018, August 13). Retrieved November 11, 2019, from
https://www.cdc.gov/obesity/data/adult.html.
Eisenberg, D. M., & Burgess, J. D. (2015, July). Nutrition Education in an Era of Global Obesity
https://journals.lww.com/academicmedicine/fulltext/2015/07000/Nutrition_Education_in
_an_Era_of_Global_Obesity.11.aspx.
Nansel , T. R., Huang , T. T., Rovner , A. J., & Sanders-Butler , Y. (2008, June 24). Association
of school performance indicators with implementation of the Healthy Kids, Smart Kids
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/5A74BAB7A
616F3C62BE9A92CCDADDBA7/S1368980009005898a.pdf/association_of_school_perf
ormance_indicators_with_implementation_of_the_healthy_kids_smart_kids_programme
_case_study.pdf.
https://www.who.int/topics/obesity/en/.
Spieker , E. A., & Pyzocha, N. (2016). Economic Impact of Obesity. Retrieved November 13,
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2019, from
https://www.primarycare.theclinics.com/article/S0095-4543(15)00093-7/fulltext.
Swan, J. (2019). Obesity in America Management and Treatment in Children, Adolescents, and
https://wildirismedicaleducation.com/courses/608/Obesity-CEU-Wild-Iris-Medical-Educ
ation.pdf.
Totura, C. M. W., Figueroa, H. L., Wharton, C., & Marsiglia, F. F. (2015, April 25). Assessing
https://www.sciencedirect.com/science/article/pii/S2211335515000455.