The Complex Issue of Obesity
PREMIUM CONTENT for MEMBERS ONLY
In the United States, over 40% of adults are considered obese and in the United Kingdom nearly a quarter of all adults have obesity. The worldwide prevalence of obesity tripled between 1975 and 2016. Considering the rates of obesity have skyrocketed in the past few decades it has officially been considered an epidemic, or even a pandemic, by health officials. The World Health Organization (WHO) defines overweight and obesity as abnormal or excessive fat accumulation that may impair health. This criterion is somewhat ambiguous and can range in levels of extremity and mean different things medically and physically for each individual who is considered obese. That being said, those who are considered overweight or obese tend to be at a higher risk for various negative health outcomes such as high blood pressure, high LDL cholesterol, type 2 diabetes, coronary heart disease, stroke, osteoarthritis, sleep apnea and cognitive decline.
“Obesity is common and there are many misconceptions around the issue which have fueled negative social stigmas and increased mental health issues around body image.”
There are many reasons why rates of obesity have risen including increased availability of high calorie and high-glycemic-index foods, sedentary behavior and the development of environments that promote unhealthy decisions, also called ‘obesogenic environments’. Obesogenic environments have been defined as ‘the sum of influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals or populations’. Obesity is common and there are many misconceptions around the issue which have fueled negative social stigmas and increased mental health issues around body image. Although consuming less calories and exercising more are important factors in treating obesity, there are several unrelated factors such as psychological stress, insufficient sleep, endocrine (hormone) disruptors and the use of certain medications that can play a significant part in obesity which are often overlooked. The issue of obesity is a rather complex problem that encompasses a wide range of socioeconomic factors that will require a multifaceted solution. The 2014 McKinsey report described that “overcoming obesity will require multiple solutions, involving many sectors from policy and practice through to industry and consumers. The report describes how we need to ‘reset the default’ in order to normalize and make healthy behaviors easier, relying less on the individual”. According to WHO, obesity is no longer just a problem for individuals, it is a global epidemic that is affecting much of the world and is not just an issue for industrialized countries, but also a growing concern in developing countries.
“55% of obese children will become obese adolescents and 80% of obese adolescents will become obese adults.”
Not only is obesity in adults increasing, but childhood obesity is also growing at an alarming rate. Worldwide, the number of children and adolescents with obesity has increased tenfold since 1975. This is especially concerning because 55% of obese children will become obese adolescents and 80% of obese adolescents will become obese adults. The earlier a child suffers from obesity, the earlier the health problems develop and the more likely they are to develop health problems as an adult such as fatty liver disease, type 2 diabetes, asthma, sleep apnea, and orthopedic problems.
“The burden of obesity places considerable strain on healthcare systems and contributes to increasing health inequality and distribution of health resources between different communities.”
There are a variety of strategies aimed at the prevention and treatment of obesity which have largely focused on pharmacological, educational, and behavioral interventions, which have had limited success overall. Addressing the rising global issue of obesity will require a better understanding of how people interact with their environments and how those environments impact their food intake and health choices on a daily basis. According to a 2012 review on the influence of food marketers on consumer behavior, pricing is one of the most powerful factors in purchasing and consumption decisions. It was shown that the less expensive a food product is, the more consumers tend to eat of it and at a more rapid pace. Food marketing is highly effective in deciding the quantity and type of food consumers purchase. For example, using buzz words such as ‘low-fat’ and ‘diet’ give the false impression that the product is healthy which may decrease previously associated guilt and actually increase intake. As the price of groceries goes up with rising levels of inflation, there is an even greater divide between the accessibility of healthy, fresh food. Cooking nutritious homemade meals requires time, energy and money which is a privilege that many do not have. Take-out and fast food have become fixtures of the US food system and eating culture due to their convenience, but tend to be highly processed and lacking in nutritious value. A ‘concentration effect’ has been observed where there is a clustering of fast food and takeaway outlets in more deprived areas which attracts low-income consumers looking for cheap and energy-dense meals. The burden of obesity places considerable strain on healthcare systems and contributes to increasing health inequality and distribution of health resources between different communities which is an important factor to consider when looking for solutions to this issue.
“Culinary medicine uses food and diet to prevent and treat disease to maintain well-being.”
One of the more holistic methods being used is called culinary medicine which is described as “a new evidence-based field in medicine that blends the art of food and cooking with the science of medicine.” Culinary medicine uses food and diet to prevent and treat disease to maintain well-being. The idea is to educate people on using food as medicine to enable and empower them to make healthy choices to achieve desired health outcomes. One of the main premises of culinary medicine is to ensure that there is pleasure in the environment and experience around eating and preparing healthy food and is not just seen as an undesirable substitute to unhealthy food. Using food as medicine is definitely not a new concept (it was already taught by Hippocrates more than 2000 years ago) and has been proven to be just as effective at treating certain conditions as medication. For example, anti-inflammatory diets such as the Mediterranean diet which emphasizes intake of fruits, vegetables, olive oil and whole grains, has been shown to provide relief for rheumatoid arthritis. Although culinary medicine may be an effective method for certain individuals and communities, it is not seen as a realistic large-scale solution right now. This kind of specialized nutrition training that encompasses the psychology of eating, preparation of food, and economics is hard to find; most medics and doctors get little to no nutritional training in medical school. Overall, this method is not a realistic universal solution due to its costliness and need for lots of resources, making it inaccessible to most of the communities carrying the heaviest burdens of the obesity epidemic.
“Tackling such a complex global issue like the obesity epidemic will require multiple solutions in various sectors from legislative reform to policy around industry and consumer choice.”
Tackling such a complex global issue like the obesity epidemic will require multiple solutions in various sectors from legislative reform to policy around industry and consumer choice. Fresh, healthy foods are almost always more expensive than highly processed unhealthy foods that have extensive shelf-lives and sadly are often subsidized by the government. One of the more effective, large-scale solutions would be to change pricing and taxation to make fresh produce and other nutrient-dense foods more affordable and accessible for everyone, especially in lower-income, resource-deprived communities. Despite extensive research continuously coming out proving obesity is a global issue, many of the most common myths fuel the stigma that puts blame on the individual for “being lazy” or making poor diet choices. Tackling the complex issue of obesity will require major political action, not just individual action, in order to rebuild the food system in a way that makes healthy food accessible to all.
Juliette Frank is a recent UCLA graduate with a degree in Public Affairs and Food Studies. Her interests include the interrelation between food systems, digestive health, and the environmental impacts of food production. She believes the intersectionality of food has long been overlooked and is the key connection between the health of humans, animals, and the environment. She is passionate about reforming the food system as It is one of the most accurate determinants of the health inequities present in our society, making it one of the most effective places to start in healing the people and the planet from a long history of damage.