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Encyclopedia > Obesity
Obesity
Classification & external resources
An obese man from the painting, "The Tuscan General" by Alessandro del Borro, 17th century.
ICD-10 E66.
ICD-9 278
DiseasesDB 9099
MedlinePlus 003101
eMedicine med/1653 
MeSH C23.888.144.699.500

Obesity is a condition in which the natural energy reserve, stored in the fatty tissue of humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality. Image File history File links Download high resolution version (1000x1690, 122 KB) Description: Title: de: Porträt eines dicken Herrn, des sogen. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... It has been suggested that Subcutaneous fat be merged into this article or section. ... Human beings are defined variously in biological, spiritual, and cultural terms, or in combinations thereof. ... Subclasses Allotheria* Order Multituberculata (extinct) Order Volaticotheria (extinct) Order Palaeoryctoides (extinct) Order Triconodonta (extinct) Prototheria Order Monotremata Theria Infraclass Marsupialia Infraclass Eutheria The mammals are the class of vertebrate animals characterized by the production of milk in females for the nourishment of young, from mammary glands present on most species...


Obesity is both an individual clinical condition and is increasingly viewed as a serious public health problem. Excessive body weight has been shown to predispose to various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea, and osteoarthritis.[1] Public health is concerned with threats to the overall health of a community based on population health analysis. ... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ... Some steps an individual can take to reduce the risk of cardivascular disease include: Not smoking Maintaining a healthy body mass index Maintaining a diet conducive to cardovascular health, for example the polymeal Getting regular cardiovascular exercise Diet a low energy diet Exercise aerobic exercise, which will increase the strength... See diabetes mellitus for further general information on diabetes. ... It has been suggested that Obstructive sleep apnea following pharyngeal flap surgery be merged into this article or section. ... Osteoarthritis (OA, also known as degenerative arthritis or degenerative joint disease, and sometimes referred to as arthrosis or osteoarthrosis or in more colloquial terms wear and tear), is a condition in which low-grade inflammation results in pain in the joints, caused by wearing of the cartilage that covers and...

Contents

Cultural and social significance

Etymology

Obesity is the nominal form of obese which comes from the Latin obēsus, which means "stout, fat, or plump." Ēsus is the past participle of edere (to eat), with ob added to it. In Classical Latin, this verb is seen only in past participial form. Its first attested usage in English was in 1651, in Noah Biggs's Matæotechnia Medicinæ Praxeos.[2] Latin is an ancient Indo-European language originally spoken in Latium, the region immediately surrounding Rome. ... Classical Latin is the language used by the principal exponents of that language in what is usually regarded as classical Latin literature. ... The English language is a West Germanic language that originates in England. ...


History

In several human cultures, plumpness was associated with physical attractiveness, strength, and fertility. Some of the earliest known cultural artifacts, known as Venus figurines, are pocket-sized statuettes representing an obese female figure. Although their cultural significance is unrecorded, their widespread use throughout pre-historic Mediterranean and European cultures suggests a central role for the obese female form in magical rituals, and suggests cultural approval of (and perhaps reverence for) this body form. This is most likely due to their ability to easily bear children and survive famine. This article or section does not cite its references or sources. ... The magnitude of physical strength, often referred to as just strength, determines the ability of a person or animal to exert force on physical objects using muscles. ... Fertility is a measure of reproduction: the number of children born per couple, person or population. ... I archaeology, an artifact or artefact is any object made or modified by a human culture, and often one later recovered by some archaeological endeavor. ... External links Venus figures from the Stone Age Images of women in ancient art http://perso. ... Rodins The Thinker is a man leaning onto the top of his penis. ... A belief in magic as a means of influencing the world seems to have been common in all cultures. ... A famine is a social and economic crisis that is commonly accompanied by widespread malnutrition, starvation, epidemic and increased mortality. ...


A large, well-fed body was occasionally considered a symbol of wealth and social status in cultures prone to food shortages or famine. Well into the early modern period in European cultures, it often served this role. But as food security was realised, it came to serve more as a visible signifier of "lust for life", appetite, and immersion in the realm of the erotic. Wealth from the old English word weal, which means well-being or welfare. The term was originally an adjective to describe the possession of such qualities. ... Social status is the standing, the honour or prestige attached to ones position in society. ... Eroticism is an aesthetic focused on sexual desire, especially the feelings of anticipation of sexual activity. ...


This was especially the case in the visual arts, such as the paintings of Rubens (1577–1640), whose regular use of the full female figures gives us the description Rubenesque for plumpness. Obesity can also be seen as a symbol within a system of prestige. "The kind of food, the quantity, and the manner in which it is served are among the important criteria of social class. In most tribal societies, even those with a highly stratified social system, everyone - royalty and the commoners - ate the same kind of food, and if there was famine everyone was hungry. With the ever increasing diversity of foods, food has become not only a matter of social status, but also a mark of one's personality and taste."[3] Rubens and Isabella Brant in the Honeysuckle Bower Alte Pinakothek Peter Paul Rubens (June 28, 1577 – May 30, 1640) was the most popular and prolific Flemish and European painter of the 17th century. ...


Contemporary culture

In modern Western culture, the obese body shape came to be widely regarded as unattractive. Many negative stereotypes are commonly associated with obese people, such as the belief that they are lazy, stupid, or even evil, gluttony being the second of the seven deadly sins. Along these lines, some ultra-radical religious sects have alleged that obese people lack souls. Obese children, teenagers and adults face a heavy social stigma. Obese children are frequently the targets of bullies and are often shunned by their peers. Obesity in adulthood can lead to a slower rate of career advancement. Most obese people have experienced negative thoughts about their body image, and many take drastic steps to try to change their shape. Gluttony can also refer to a character named Gluttony - a homonculus from the anime series Full Metal Alchemist Gluttony is the over-indulgence and over-consumption of food, drink, or intoxicants to the point of waste. ... Seven sins redirects here. ... This page is about the core essence of a being. ...


Not all contemporary cultures disapprove of obesity. There are many cultures which are traditionally more approving (to varying degrees) of obesity, including some African, Arabic, Indian, and Pacific Island cultures. Especially in recent decades, obesity has come to be seen more as a medical condition in modern Western culture. [citation needed]


Recently emerging is a small but vocal fat acceptance movement that seeks to challenge weight-based discrimination. Obesity acceptance and advocacy groups have initiated litigation to defend the rights of obese people and to prevent their social exclusion. This article or section does not cite its references or sources. ... Manifestations Slavery · Racial profiling · Lynching Hate speech · Hate crime · Hate groups Genocide · Holocaust · Pogrom Ethnocide · Ethnic cleansing · Race war Religious persecution · Gay bashing Movements Discriminatory Aryanism · Neo-Nazism · Supremacism Fundamentalism · Kahanism Anti-discriminatory Abolitionism · Civil rights · Gay rights Womens/Universal suffrage · Mens rights Childrens rights · Youth rights...


Popular culture

In cartoons, obesity is often used for comic effect.
In cartoons, obesity is often used for comic effect.

Various stereotypes of obese people have found their way into expressions of popular culture. A common stereotype is the obese character who has a warm and dependable personality, but equally common is the obese vicious bully. (Dudley Dursley from the Harry Potter book series is a perfect example of this.) Gluttony and obesity are commonly depicted together in works of fiction. In cartoons, obesity is often used to comedic effect, with fat cartoon characters having to squeeze through narrow spaces, frequently getting stuck or even exploding. Image File history File links PigsisPigs1. ... Image File history File links PigsisPigs1. ... For the term used in its original printing sense, see etymology below. ... Bullying involves the tormenting of others through verbal harassment, physical assault, or other more subtle methods of coercion such as manipulation. ... The Dursleys or the Dursley family are fictional characters in the Harry Potter stories created by J. K. Rowling. ... This article is about the Harry Potter series of novels. ... Gluttony can also refer to a character named Gluttony - a homonculus from the anime series Full Metal Alchemist Gluttony is the over-indulgence and over-consumption of food, drink, or intoxicants to the point of waste. ... A cartoon is any of several forms of illustrations, with varied meanings that evolved from one to another. ...


Another, more unusual example of obesity-related humour is Bustopher Jones, the fat cat, from the musical Cats, whose claim to fame is that he is a regular visitor to many gentlemen's clubs including Drones, Blimp's and the Tomb. Due to his constant lunching at these clubs, he is remarkably fat, "a twenty-five pounder... And he's putting on weight everyday." Bustopher Jones is one of the cats featured in Old Possums Book of Practical Cats. ... Cats is a musical composed by Andrew Lloyd Webber based on Old Possums Book of Practical Cats and other poems by T. S. Eliot. ...


Another popular character, Garfield, a cartoon cat, is also obese for humor. When his owner, Jon, puts him on diets, rather than losing weight, Garfield slows down his weight gain. Garfield is a comic strip created by Jim Davis, featuring the cat Garfield, the pet dog Odie, and their owner Jon Arbuckle. ...


It can be argued that depiction in popular culture adds to and maintains commonly perceived stereotypes, in turn harming self esteem of obese people. A charge of discrimination on the basis of appearance could be leveled against these depictions. In psychology, self-esteem or self-worth includes a persons subjective appraisal of himself or herself as intrinsically positive or negative to some degree. ... Manifestations Slavery · Racial profiling · Lynching Hate speech · Hate crime · Hate groups Genocide · Holocaust · Pogrom Ethnocide · Ethnic cleansing · Race war Religious persecution · Gay bashing Movements Discriminatory Aryanism · Neo-Nazism · Supremacism Fundamentalism · Kahanism Anti-discriminatory Abolitionism · Civil rights · Gay rights Womens/Universal suffrage · Mens rights Childrens rights · Youth rights...


On the other hand, obesity is often associated with positive characteristics such as good humor (the stereotype of the jolly fat man like Santa Claus), and some people are more sexually attracted to obese people than to slender people (see chubby culture, fat admirer). Look up humor in Wiktionary, the free dictionary. ... A typical depiction of Santa Claus. ... This article or section is incomplete and may require expansion and/or cleanup. ... The chubby community is a subculture in the gay community. ... Fat Admirers (or FAs) are people, usually male heterosexuals, who are sexually attracted to more heavy partners. ...


Effects on health

Obesity, especially central obesity (male-type or waist-predominant obesity), is an important risk factor for the "metabolic syndrome" ("syndrome X"), the clustering of a number of diseases and risk factors that heavily predispose for cardiovascular disease. These are diabetes mellitus type 2, high blood pressure, high blood cholesterol, and triglyceride levels (combined hyperlipidemia). An inflammatory state is present, which — together with the above — has been implicated in the high prevalence of atherosclerosis (fatty lumps in the arterial wall), and a prothrombotic state may further worsen cardiovascular risk. Central obesity (or apple-shaped or masculine obesity) occurs when the main deposits of body fat are localised around the abdomen and the upper body. ... Metabolic syndrome is a combination of medical disorders that affect a large number of people in a clustered fashion. ... Cardiovascular disease refers to the class of diseases that involve the heart and/or blood vessels (arteries and veins). ... For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ... Arterial hypertension, or high blood pressure is a medical condition where the blood pressure is chronically elevated. ... Hypercholesterolemia (literally: high blood cholesterol) is the presence of high levels of cholesterol in the blood [1]. It is not a disease but a metabolic derangement that can be secondary to many diseases and can contribute to many forms of disease, most notably cardiovascular disease. ... In medicine, hypertriglyceridemia (or Hypertriglyceridaemia) denotes high (hyper-) blood levels (-emia) of triglycerides, the most abundant fatty molecule in most organisms. ... In medicine, combined hyperlipidemia (or -aemia) is a commonly occurring form of hypercholesterolemia (elevated cholesterol levels) characterised by increased LDL and triglyceride concentrations, often accompanied by decreased HDL. On lipoprotein electrophoresis (a test now rarely performed) is shows as a hyperlipoproteinemia type IIB. The elevated triglyceride levels (>5 mmol/l... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ...


Apart from the metabolic syndrome, obesity is also correlated (in population studies) with a variety of other complications. For many of these complaints, it has not been clearly established to what extent they are caused directly by obesity itself, or have some other cause (such as limited exercise) that causes obesity as well. Most confidence in a direct cause is given to the mechanical complications in the following list: Positive linear correlations between 1000 pairs of numbers. ...

While being severely obese has many health ramifications, those who are somewhat overweight face little increased mortality or morbidity. Some studies suggest that the somewhat "overweight" tend to live longer than those at their "ideal" weight. [4] This may in part be attributable to lower mortality rates in diseases where death is either caused or contributed to by significant weight loss due to the greater risk of being underweight experienced by those in the ideal category. Another factor which may confound mortality data is smoking, since obese individuals are less likely to smoke[citation needed]. Osteoporosis is known to occur less in slightly overweight people. The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... Cardiomegaly is a medical condition wherein the heart is enlarged. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ... Cor pulmonale is a medical term used to describe a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. ... Vein gymnastics in the barefoot park Dornstetten, Germany. ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. ... Menstrual cycle. ... Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... It has been suggested that heartburn be merged into this article or section. ... As its name signifies, Non-alcoholic steatohepatitis (NASH) or Nonalcoholic Fatty Liver Disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... In medicine, gallstones are crystalline bodies formed within the body by accretion or concretion of normal or abnormal bile components. ... A hernia is often likened to the failure of a tire. ... Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. ... This page is a candidate to be moved to Wiktionary. ... This article or section is not written in the formal tone expected of an encyclopedia article. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... Breast cancer is cancer of breast tissue. ... Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). ... This article or section is in need of attention from an expert on the subject. ... An integument is an outer protective covering such as the feathers or skin of an animal or rind or shell. ... Faded stretch marks Stretch marks are a form of scarring generally associated with pregnancy, obesity, and — to a lesser extent — puberty. ... Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin, usually present in the posterior and lateral folds of the neck, the axilla, groin, umbilicus, and other areas. ... Lymphedema (AmE), also known as Lymphoedema (BrE), or lymphatic obstruction, is a condition of localized fluid retention caused by a compromised lymphatic system. ... // As a medical term A carbuncle is an abscess larger than a boil, usually with one or more openings draining pus onto the skin. ... An intertrigo is an inflammation (rash) of the body folds (adjacent areas of skin). ... Hyperuricemia is the presence of high levels of uric acid in the blood. ... Osteoarthritis (OA, also known as degenerative arthritis or degenerative joint disease, and sometimes referred to as arthrosis or osteoarthrosis or in more colloquial terms wear and tear), is a condition in which low-grade inflammation results in pain in the joints, caused by wearing of the cartilage that covers and... Low back pain can be either an acute or chronic disabling condition. ... A stroke, also known as cerebrovascular accident (CVA),[1] is an acute neurological injury in which the blood supply to a part of the brain is interrupted. ... Definition Meralgia Paresthetica is a chronic disease of a single peripheral nerve: the lateral femoral cutaneous nerve, which typically becomes entrapped and unduly stimulated in some segment of muscle, tendon, ligament or bone. ... A headache is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... It has been suggested that Carpal tunnel be merged into this article or section. ... For other uses, see Dementia (disambiguation). ... Respiration can refer to: Cellular respiration, which is the use of oxygen in the metabolism of organic molecules. ... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos, short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... This article needs cleanup. ... In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means below) to perform needed gas exchange. ... The Pickwickian syndrome, also known as obesity hypoventilation syndrome, is the combination of severe obesity and hypoventilation. ... Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Clinical depression (also called major depressive disorder, or sometimes unipolar when compared with bipolar disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... In psychology, self-esteem or self-worth includes a persons subjective appraisal of himself or herself as intrinsically positive or negative to some degree. ... Body dysmorphic disorder (BDD) is a mental disorder, which involves a disturbed body image. ... In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the... Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. ...


Metrics

In the clinical setting, obesity is typically evaluated by measuring BMI (body mass index), waist circumference, and evaluating the presence of risk factors and comorbidities.[1] In epidemiological studies, BMI alone is used to define obesity. A graph of body mass index is shown above. ... In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the... Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ...


BMI

BMI, or Body Mass Index, was developed by the Belgian statistician and anthropometrist Adolphe Quetelet.[5] It is calculated by dividing the subject's weight in kilograms by the square of his/her height in metres (BMI = kg / m2) or (BMI = weight(lbs.) * 703 / height(inches)2). Illustration from The Speaking Portrait (Pearsons Magazine, Vol XI, January to June 1901) demonstrating the principles of Bertillons anthropometry. ... Lambert Adolphe Jacques Quételet (February 22, 1796 – February 17, 1874) was a Belgian astronomer, mathematician, statistician and sociologist. ...


The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:[6]

  • A BMI less than 18.5 is underweight
  • A BMI of 18.5 - 24.9 is normal weight
  • A BMI of 25.0 - 29.9 is overweight
  • A BMI of 30.0 - 39.9 is obese
  • A BMI of 40.0 or higher is severely (or morbidly) obese
  • A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity.[7] [8]

BMI is a simple and widely used method for estimating body fat.[9] In epidemiology BMI alone is used as an indicator of prevalence and incidence. Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time. ... In optics one considers angles of incidence. ...


BMI as an indicator of a clinical condition is used in conjunction with other clinical assessments, such as waist circumference. In a clinical setting, physicians take into account race, ethnicity, lean mass (muscularity), age, sex, and other factors which can affect the interpretation of BMI. BMI overestimates body fat in persons who are very muscular, and it can underestimate body fat in persons who have lost body mass (e.g. many elderly).[1] Mild obesity as defined by BMI alone is not a cardiac risk factor, and hence BMI cannot be used as a sole clinical and epidemiological predictor of cardiovascular health.[10]


Waist circumference

BMI does not take into account differing ratios of adipose to lean tissue; nor does it distinguish between differing forms of adiposity, some of which may correlate more closely with cardiovascular risk. Increasing understanding of the biology of different forms of adipose tissue has shown that visceral fat or central obesity (male-type or apple-type obesity) has a much stronger correlation, particularly with cardiovascular disease, than the BMI alone.[11] Central obesity (or apple-shaped or masculine obesity) occurs when the main deposits of body fat are localised around the abdomen and the upper body. ... Cardiovascular disease refers to the class of diseases that involve the heart and/or blood vessels (arteries and veins). ...


The absolute waist circumference (>102 cm in men and >88 cm in women) or waist-hip ratio (>0.9 for men and >0.85 for women)[11] are both used as measures of central obesity. Waist-to-hip ratio or Waist-hip ratio (WHR) is the ratio of the girth of waist and the girth of hip. ...


Body fat measurement

An alternative way to determine obesity is to assess percent body fat. Doctors and scientists generally agree that men with more than 25% body fat and women with more than 30% body fat are obese. However, it is difficult to measure body fat precisely. The most accepted method has been to weigh a person underwater, but underwater weighing is a procedure limited to laboratories with special equipment. Two simpler methods for measuring body fat are the skinfold test, in which a pinch of skin is precisely measured to determine the thickness of the subcutaneous fat layer; or bioelectrical impedance analysis, usually only carried out at specialist clinics.[citation needed] In biochemistry, fat is a generic term for a class of lipids. ... The subcutis is the layer of tissue directly underlying the cutis. ... Bioelectrical impedance analysis (BIA) is a commonly used process for estimating body composition. ...


Other measurements of body fat include computed tomography (CT/CAT scan), magnetic resonance imaging (MRI/NMR), and dual energy X-ray absorptiometry (DXA).[12] This article does not cite its references or sources. ... For the scientific journal entitled Magnetic Resonance Imaging, see Magnetic Resonance Imaging (journal). ... Dual energy X-ray absorptiometry (DXA, previously DEXA) is a means of measuring bone mineral density (BMD). ...


Gestalt

In practice, for most examples of overweight that may designate risk, both doctor and patient can see "by eye" whether excess fat is a concern. In these cases, BMI thresholds provide simple targets all patients can understand.[13]


Risk factors and comorbidities

The presence of risk factors and diseases associated with obesity are also used to establish a clinical diagnosis. Coronary heart disease, type 2 diabetes, and sleep apnea are possible life-threatening risk factors that would indicate clinical treatment of obesity.[1] Smoking, hypertension, age and family history are other risk factors that may indicate treatment.[1] Diabetes and heart disease are risk factors used in epidemiological studies of obesity. This article or section does not adequately cite its references or sources. ... See diabetes mellitus for further general information on diabetes. ... It has been suggested that Obstructive sleep apnea following pharyngeal flap surgery be merged into this article or section. ...


Causes

Overeating

In its simplest conception, obesity is only made possible when the lifetime energy intake exceeds lifetime energy expenditure by more than it does for individuals of "normal weight".


When food energy intake exceeds energy expenditure, fat cells (and to a lesser extent muscle and liver cells) throughout the body take in the energy and store it as fat. Food energy is the amount of energy in food that is available through digestion. ... The liver is an organ in some animals, including vertebrates (and therefore humans). ...


In all individuals, the excess energy utilized to generate fat reserves is minute relative to the total number of calories consumed. This means that very fine perturbations in the energy balance can lead to large fluctuations in weight over time. To illustrate, an obese 40 year old who carries 100 lb of adipose tissue has only consumed about 25 more calories per day than he has burned on average - or the equivalent of an apple every three days. In comparison a very lean 40-year-old who carries only 15 lb of body fat will have exceeded his daily energy expenditure by about four calories a day - the equivalent of an apple every 18 days.


Additional factors

Factors that have been suggested to contribute to the development of obesity include:

As with many medical conditions, the caloric imbalance that results in obesity often develops from a combination of genetic and environmental factors. Polymorphisms in various genes controlling appetite, metabolism, and adipokine release predispose to obesity, but the condition requires availability of sufficient calories, and possibly other factors, to develop fully. Various genetic abnormalities that predispose to obesity have been identified (such as Prader-Willi syndrome and leptin receptor mutations), but known single-locus mutations have been found in only about 5% of obese individuals. While it is thought that a large proportion of the causative genes are still to be identified, much obesity is likely the result of interactions between multiple genes, and non-genetic factors are likely also important. This article or section does not adequately cite its references or sources. ... A genetic disorder, or genetic disease is a disease caused, at least in part, by the genes of the person with the disease. ... Prader-Willi Syndrome is a genetic disorder in which seven genes (or some subset thereof) on chromosome 15 are missing or unexpressed (chromosome 15q partial deletion) on the paternal chromosome. ... This article or section does not cite its references or sources. ... Binge eating disorder is a psychiatric disorder in which a subject: periodically does not exercise control over consumption of food eats an unusually large amount of food at one time eats much more quickly during binge episodes than during normal eating episodes eats until physically uncomfortable eats large amounts of... The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ... Glycemic index (also glycaemic index, GI) is a ranking system for carbohydrates based on their immediate effect on blood glucose levels. ... In medicine, blood sugar is a term used to refer to levels of glucose in the blood. ... This article or section does not cite its references or sources. ... In medical terms, stress is a physical or psychological stimulus that can produce mental or physiological reactions that may lead to illness. ... A No Smoking sign Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. ... In biology, polymorphism can be defined as the occurrence in the same habitat of two or more forms of a trait in such frequencies that the rarer cannot be maintained by recurrent mutation alone. ... For other meanings of this term, see gene (disambiguation). ... The appetite is the desire to eat food, felt as hunger. ... Overview of the citric acid cycle The citric acid cycle, one of the central metabolic pathways in aerobic organisms. ... The adipokines or adipocytokines are a group of cytokines (cell-to-cell signalling proteins) secreted by adipose tissue. ... Leptin is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including the regulation of appetite and metabolism. ...


Some eating disorders are associated with obesity, especially binge eating disorder (BED). As the name indicates, patients with this disorder are prone to overeat, often in binges. A proposed mechanism is that the eating serves to reduce anxiety, and some parallels with substance abuse can be drawn. An important additional factor is that BED patients often lack the ability to recognize hunger and satiety, something that is normally learned in childhood. Learning theory suggests that early childhood conceptions may lead to an association between food and a calm mental state. This article includes a list of works cited but its sources remain unclear because it lacks in-text citations. ... Substance abuse refers to the overindulgence in and dependence on a psychoactive leading to effects that are detrimental to the individuals physical health or mental health, or the welfare of others. ... Satiety, or the feeling of fullness and disappearance of appetite after a meal, is a process mediated by the ventromedial nucleus in the hypothalamus. ... In education and psychology, learning theories help us understand the process of learning. ...


Tendencies of ethnic groups

Certain populations and individuals may be more prone to obesity than others, and the ability to take advantage of rare periods of abundance and use such abundance by storing energy efficiently was undoubtedly an evolutionary advantage in times when food was scarce. Individuals with greater adipose reserves were more likely to survive famine. This tendency to store fat is likely maladaptive in a society with adequate and stable food supplies. The thrifty gene hypothesis is a hypothesis proposed in 1962 by geneticist James Neel to explain the tendency of certain ethnic groups to tend towards obesity and diabetes. ... Adipose tissue is an anatomical term for loose connective tissue composed of energy in the form of fat, although it also cushions and insulates the body. ...


Neurobiological mechanisms

Scientists investigating the mechanisms and treatment of obesity may use animal models such as mice to conduct experiments.
Scientists investigating the mechanisms and treatment of obesity may use animal models such as mice to conduct experiments.

Flier[14] summarizes the many possible pathophysiological mechanisms involved in the development and maintenance of obesity. This field of research had been almost unapproached until leptin was discovered in 1994. Since this discovery, many other hormonal mechanisms have been elucidated that participate in the regulation of appetite and food intake, storage patterns of adipose tissue, development of insulin resistance. Since leptin's discovery, ghrelin, orexin, PYY 3-36, cholecystokinin, adiponectin, and many other mediators have been studied. The adipokines are mediators produced by adipose tissue; their action is thought to modify many obesity-related diseases. License This image has been released into the public domain by the copyright holder, its copyright has expired, or it is ineligible for copyright. ... License This image has been released into the public domain by the copyright holder, its copyright has expired, or it is ineligible for copyright. ... Animal model refers to a non-human animal with a disease that is similar to a human condition. ... Feral mouse A mouse (plural mice) is a rodent that belongs to one of numerous species of small mammals. ... Pathophysiology is the study of the disturbance of normal mechanical, physical, and biochemical functions that a disease causes. ... Leptin is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including the regulation of appetite and metabolism. ... The appetite is the desire to eat food, felt as hunger. ... It has been suggested that Subcutaneous fat be merged into this article or section. ... Insulin resistance is the condition in which normal amounts of insulin are inadequate to produce a normal insulin response from fat, muscle and liver cells. ... Ghrelin is a hormone that is produced by cells lining the stomach and stimulates the appetite. ... Orexins, also called hypocretins, are the common names given to a pair of highly excitatory neuropeptide hormones that were simultaneously discovered by two groups of reseachers in rat brains. ... In biology, the hormone called PYY 3-36 plays a critical role in decreasing appetites, making us aware of fullness of our stomach. ... Cholecystokinin (from Greek chole, bile; cysto, sac; kinin, move; hence, move the bile-sac (gall bladder)) is a peptide hormone of the gastrointestinal system responsible for stimulating the digestion of fat and protein. ... Adiponectin (also referred to as Acrp30, apM1) is a protein hormone that modulates a number of metabolic processes, including glucose regulation and fatty acid catabolism. ... The adipokines or adipocytokines are a group of cytokines (cell-to-cell signalling proteins) secreted by adipose tissue. ...


Leptin and ghrelin are considered to be complementary in their influence on appetite, with ghrelin produced by the stomach modulating short-term appetitive control (i.e. to eat when the stomach is empty and to stop when the stomach is stretched). Leptin is produced by adipose tissue to signal fat storage reserves in the body, and mediates long-term appetitive controls (i.e. to eat more when fat storages are low and less when fat storages are high). Although administration of leptin may be effective in a small subset of obese individuals who are leptin-deficient, many more obese individuals are thought to be leptin-resistant, and this resistance has been implicated in obesity in some people, is thought to explain in part why administration of leptin has not been shown to be effective in suppressing appetite in most obese subjects. It has been suggested that some sections of this article be split into a new article entitled Human stomach. ...


Neuroscientific approaches hinge on the action of the aforementioned mediators on the hypothalamus, the part of the brain that is thought to process signals related to metabolic state and energy storage and to shift the energy balance in either a positive or negative direction, primarily by acting on appetite and energy expenditure. Lesion studies in the 1940s and 1950s identified two regions of the hypothalamus — the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH) — as the brain's hunger and satiety centers, respectively. Specific lesions to a mouse's LH suppressed its appetite while damaging the VMH caused overeating. Drawing of the cells in the chicken cerebellum by S. Ramón y Cajal Neuroscience is a field that is devoted to the scientific study of the nervous system. ... The hypothalamus (from Greek ὑποθαλαμος = under the thalamus) is a region of the mammalian brain located below the thalamus, forming the major portion of the ventral region of the diencephalon and functioning to regulate certain metabolic processes and other autonomic activities. ... A lesion is a non-specific term referring to abnormal tissue in the body. ...


Studies of the distribution of the leptin receptor in the mid-1990s cast doubt upon this dual center theory of hunger and satiety. Leptin's effect on the arcuate nucleus melanocortin system is now considered central to the regulation of feeding and metabolism. The arcuate nucleus is an aggregation of neurons in the mediobasal hypothalamus, adjacent to the third ventricle and the median eminence. ...


Poverty link

Some obesity co-factors are resistant to the theory that the "epidemic" is a new phenomenon. In particular, a class co-factor consistently appears across many studies. Comparing net worth with BMI scores, a 2004 study[15] found obese American subjects approximately half as wealthy as thin ones. When income differentials were factored out, the inequity persisted — thin subjects were inheriting more wealth than fat ones. A higher rate of lack of education and tendencies to rely on cheaper fast foods is seen as a reason why these results are so dissimilar. Another study finds women who married into higher status are predictably thinner than women who married into lower status. Social class refers to the hierarchical distinctions between individuals or groups in societies or cultures. ... Fast food is food prepared and served quickly at a fast-food restaurant or shop at low cost. ...


Therapy

The mainstay of treatment for obesity is an energy-limited diet and increased exercise. In studies, diet and exercise programs have consistently produced an average weight loss of approximately 8% of total body mass on average (excluding study drop-outs). While not all dieters will be satisfied with this outcome, studies have shown that a loss of as little as 5% of body mass can create enormous health benefits. Measuring body weight on a scale Dieting is the practice of eating (and drinking) in a regulated fashion to achieve a particular, short-term objective. ... Lance Cpl. ...


A more intractable therapeutic problem appears to be weight loss maintenance. Of dieters who manage to lose 10% or more of their body mass in studies, 80-95% will regain that weight within two to five years. It appears that the homeostatic mechanisms regulating body weight are very robust (see leptin, for example), and vigorously defend against weight loss. Much important research is now being devoted to determining what factors can improve the currently dismal weight loss maintenance rates. Sociotherapy is a social science and form of social work, sociology and psychology that involves the study of groups of people, its constituent individuals and their behavior, using learned information in case and care management towards holistic life enrichment or improvement of social and life conditions. ... Body weight is simply the weight of anything, including humans. ... It has been suggested that Reactive homeostasis be merged into this article or section. ... Leptin is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including the regulation of appetite and metabolism. ...


Recent scientific research has cast some doubt over whether or not dieting actually improves health, with some studies indicating that dieting may in fact be more detrimental than remaining overweight.[16]


In a clinical practice guideline by the American College of Physicians,[17] the following five recommendations are made: Clinical practice guidelines are collections of practical information for use by doctors and other medical professionals. ... The American College of Physicians (ACP) is a national organization of doctors of internal medicine (internists) -- physicians who specialize in the prevention, detection and treatment of illnesses in adults. ...

  1. People with a BMI of over 30 should be counseled on diet, exercise and other relevant behavioral interventions, and set a realistic goal for weight loss.
  2. If these goals are not achieved, pharmacotherapy can be offered. The patient needs to be informed of the possibility of side-effects and the unavailability of long-term safety and efficacy data.
  3. Drug therapy may consist of sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may be used on a selective basis. Evidence is not sufficient to recommend sertraline, topiramate, or zonisamide.
  4. In patients with BMI > 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated. The patient needs to be aware of the potential complications.
  5. Those requiring bariatric surgery should be referred to high-volume referral centers, as the evidence suggests that surgeons who frequently perform these procedures have fewer complications.

Much research focuses on new drugs to combat obesity, which is seen as the biggest health problem facing developed countries. Nutritionists and many doctors feel that these research funds would be better devoted to advice on good nutrition, healthy eating, and promoting a more active lifestyle. Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... Sibutramine (Meridia® in the USA, Reductil® in Europe), usually as sibutramide hydrochloride monohydrate, is an orally administered agent for the treatment of obesity. ... Orlistat Xenical Orlistat (marketed as Xenical® by Roche), also known as tetrahydrolipstatin, is a drug designed to treat obesity. ... Phentermine is a drug primarily used as an appetite suppressant. ... Diethylpropion (Tenuate®) is a sympathomimetic stimulant drug marketed as an appetite suppressant. ... Fluoxetine hydrochloride is an antidepressant drug used medically in the treatment of depression, body dysmorphic disorder, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, hypochondriasis and panic disorder. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin and Zyban) is an antidepressant of the aminoketone class, chemically unrelated to tricyclics or selective serotonin reuptake inhibitors (SSRIs). ... Amphetamine (alpha-methyl-phenethylamine), is a stimulant that is now primarily used to treat narcolepsy and attention-deficit hyperactivity disorder. ... Methamphetamine (dextro-N-α-dimethyl-phenethylamine or desoxyephedrine and popularly shortened to crystal meth or ice [2] or simply meth) is an N-methylated analog of amphetamine hydrochloride. ... Sertraline hydrochloride (also labeled under numerous brand names: Zoloft, Sertralin, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is a popular orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ... Topiramate (brand name: Topamax®) is an anticonvulsant drug produced by Ortho-McNeil Neurologics, a division of Johnson & Johnson. ... Zonisamide (brand name Zonegran®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ... Bariatrics is the specialty of medicine dealing with the surgical treatment of obesity. ... Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... The updated USDA food pyramid, published in 2005, is a general nutrition guide for recommended food consumption. ...


Medication most commonly prescribed for diet/exercise-resistant obesity is orlistat (Xenical, which reduces intestinal fat absorption by inhibiting pancreatic lipase) and sibutramine (Reductil, Meridia, an anorectic). In the presence of diabetes mellitus, there is evidence that the anti-diabetic drug metformin (Glucophage) can assist in weight loss — rather than sulfonylurea derivatives and insulin, which often lead to further weight gain. The thiazolidinediones (rosiglitazone or pioglitazone) can cause slight weight gain, but decrease the "pathologic" form of abdominal fat, and are therefore often used in obese diabetics. Orlistat Xenical Orlistat (marketed as Xenical® by Roche), also known as tetrahydrolipstatin, is a drug designed to treat obesity. ... The pancreas is an organ in the digestive and endocrine system that serves two major functions: exocrine (producing pancreatic juice containing digestive enzymes) and endocrine (producing several important hormones, including insulin). ... A lipase is a water-soluble enzyme that catalyzes the hydrolysis of ester bonds in water–insoluble, lipid substrates. ... Sibutramine (Meridia® in the USA, Reductil® in Europe), usually as sibutramide hydrochloride monohydrate, is an orally administered agent for the treatment of obesity. ... Anorectics, anorexigenics or appetite suppressants are drugs that reduce the desire to eat (anorectic, from the Greek an- = not and oreg- = extend, reach). (Anorectic is also a term for an anorexic person, a person suffering from Anorexia nervosa. ... For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ... An anti-diabetic drug or oral hypoglycemic agent is used to treat diabetes mellitus. ... Metformin (INN, trade names Glucophage, Diabex, Diaformin, Fortamet, Riomet, Glumetza and others) is an anti-diabetic drug from the biguanide class (its other members are the withdrawn agents phenformin and buformin). ... Weight loss, in the context of medicine or health, is a reduction of the total body weight, which can mean loss of fluid, muscle or bone mass, or fat. ... Sulfonylurea derivatives are a class of antidiabetic drugs that are used in the management of diabetes mellitus type 2 (adult-onset). They act by increasing insulin release from the beta cells in the pancreas. ... Insulin (from Latin insula, island, as it is produced in the Islets of Langerhans in the pancreas) is a polypeptide hormone that regulates carbohydrate metabolism. ... The medication class of thiazolidinedione was introduced in the late 1990s as an adjunctive therapy for diabetes mellitus (type II) and related diseases. ... Rosiglitazone is an anti-diabetic drug from the thiazolidinedione class. ... In medicine and pharmacology, pioglitazone is a member of the drug class of the thiazolidinediones. ... For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ...


Increasingly, bariatric surgery is being used to combat obesity. The most common weight loss surgery in Europe and Australia is the adjustable gastric band where a silicone ring is placed around the top of the stomach to help restrict the amount of food eaten in a sitting. This surgery has been FDA approved in the United States since 2001 but has been being used in other parts of the world since the early 1990s. It is considered the safest and least invasive of the available weight loss surgeries such as Roux-en-Y gastric bypass surgery (RNY), biliopancreatic diversion, and stomach stapling (also known as "vertical banded gastroplasty", VBG). Unlike those more invasive techniques the band surgery does not cut into or reroute any of the digestive tract and is completely reversible. Removing the implant returns the stomach to its pre-surgical norm. All of these surgeries can be done laparoscopically. The more invasive of the surgeries usually bypass or remove some portion of the patient's intestines which causes malabsorption and dumping. Bariatrics is the specialty of medicine dealing with the surgical treatment of obesity. ... Adjustable gastric banding is a form of restrictive weight loss surgery (bariatrics) designed for obesity patients with a body mass index (BMI) of 40 or greater - or between 35 – 40 with those who have co-morbidities that are known to improve with weight loss. ... Gastric bypass surgery, or Roux-en-Y gastric bypass surgery, is a procedure almost exclusively used in surgical weight-loss applications to correct morbid obesity. ... Stomach stapling is a popular term for vertical banded gastroplasty (VBG), one technique of bariatric surgery for managing morbid obesity. ... Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Gastric dumping syndrome, or rapid gastric emptying, happens when the lower end of the small intestine, the jejunum, fills too quickly with undigested food from the stomach. ...


All of these surgeries come with risk to the patient. For instance a recent study by the U.S. Department of Health and Human Service showed a 40% complication rate within 180 days of bariatric surgery.[18] Moreover these surgeries do not guarantee either successful weight loss or reduced morbidity and mortality. Patients are also required to make lifelong changes to their diet if they are to keep the lost weight off in the long term. Therefore, as with any major surgery, patients needs to carefully evalute the long term ramifications of their choice.


Public health and policy

Graphic chart comparing obesity percentages of the total population in OECD member countries.
Graphic chart comparing obesity percentages of the total population in OECD member countries.

Download high resolution version (1467x901, 119 KB) This chart compares obesity figures in the population of OECD countries; it shows the percentage of total population (aged 15 and above) with a body-mass index greater than 30. ... Download high resolution version (1467x901, 119 KB) This chart compares obesity figures in the population of OECD countries; it shows the percentage of total population (aged 15 and above) with a body-mass index greater than 30. ... The Organisation for Economic Co-operation and Development (OECD), (in French: Organisation de coopération et de développement économiques, OCDE) is an international organisation of those developed countries that accept the principles of representative democracy and a free market economy. ...

Prevalence

United Kingdom

The Health Survey for England predicts that more than 12 million adults and 1 million children will be obese by 2010 if no action is taken.[19][20] The prime minister has urged people to take more responsibility for their fitness and diet.[21]

United States

The prevalence of overweight and obesity in the United States makes obesity a leading public health problem. The United States has the highest rates of obesity in the developed world. From 1980 to 2002, obesity has doubled in adults and overweight prevalence has tripled in children and adolescents.[22] From 2003-2004, "children and adolescents aged 2 to 19 years, 17.1% were overweight...and 32.2% of adults aged 20 years or older were obese."[22] The prevalence in the United States continues to rise.[22] The prevalence of obesity has been continually rising for two decades.[23] This sudden rise in obesity prevalence is attributed to environmental and population factors rather than individual behavior and biology because of the rapid and continual rise in the number of overweight and obese individuals.[24] The current environment produces risk factors for decreased physical activity and for increased calorie consumption. These environmental factors operate on the population to decrease physical activity and increase calorie consumption. A developed country is a country that has achieved (currently or historically) a high degree of industrialization, and which enjoys the higher standards of living which wealth and technology make possible. ...


Environmental factors

While it may often appear obvious why a certain individual gets fat, it is far more difficult to understand why the average weight of certain societies have recently been growing. While genetic causes are central to understanding obesity, they cannot fully explain why one culture grows fatter than another.


This is most notable in the United States. In the years from just after the Second World War until 1960 the average person's weight increased, but few were obese. In the two and a half decades since 1980 the growth in the rate of obesity has accelerated markedly and is increasingly becoming a public health concern. Mushroom cloud from the nuclear explosion over Nagasaki rising 18 km into the air. ... Public health is concerned with threats to the overall health of a community based on population health analysis. ...


There are a number of theories as to the cause of this change since 1980. Most believe it is a combination of various factors.

  • Lack of activity: obese people appear to be less active in general than lean people, and not just because of their obesity. A controlled increase in calorie intake of lean people did not make them less active; correspondingly when obese people lost weight they did not become more active. Weight change does not affect activity levels, but the converse seems to be the case.[25]
  • One of the most important is the much lower relative cost of foodstuffs: massive changes in agricultural policy in the United States and Europe have led to food prices for consumers being lower than at any point in history. Sugar and corn syrup, two huge sources of food energy, are some of the most subsidized products by the United States government.[citation needed] This can raise costs for consumers in some areas but greatly lower it in others. Current debates into trade policy highlight disagreements on the effects of subsidies.
  • Increased marketing has also played a role. In the early 1980s in America the Reagan administration lifted most regulations pertaining to sweets and fast food advertising to children. As a result, the number of advertisements seen by the average child increased greatly, and a large proportion of these were for fast food and sweets.[26]
  • Changes in the price of petrol (i.e. gasoline) are also believed to have had an effect, as unlike during the 1970s it is now affordable in the United States to drive everywhere — at a time when public transit goes underused. At the same time more areas have been built without sidewalks and parks.
  • A social cause that is believed by many to play a role is the increasing number of two income households in which one parent no longer remains home to look after the house. This increases the number of restaurant and take-out meals.
  • Urban sprawl may be a factor: obesity rates increase as urban sprawl increases, possibly due to less walking and less time for cooking.[27]
  • Since 1980 both sit-in and fast food restaurants have seen dramatic growth in terms of the number of outlets and customers served. Low food costs, and intense competition for market share, led to increased portion sizes — for example, McDonalds french fries portions rose from 200 calories (840 kilojoules) in 1960 to over 600 calories (2,500 kJ) today.
  • Increased food production is a probable factor. The U.S. produces three times more food than U.S. residents eat.
  • Increasing affluence itself (including many of the above factors as accompaniments of affluence) may be a cause, or contributing factor since obesity tends to flourish as a disease of affluence in countries which are developing and becoming westernised [5]. This is supported by a dip in American GDP after 1990, followed by a substantial increase. U.S. obesity statistics followed the same pattern, offset by two years.[6]
  • An aging population may also be a major factor, as the likelihood of becoming obese increases with age. Beyond their twenties, the older a person becomes the slower their metabolism becomes, reducing the amount of calories required to sustain the body, thus if a person does not reduce their intake of food with age, they will become obese over time. As the average age of individuals within a society increases, the rate of obesity also increases. This situation is exacerbated by the baby boom generation, which represents a disproportionately large portion of the population in many countries and is currently nearing the latter end of the typical lifespan in affluent nations, and therefore is in the high-risk zone for obesity.

Interestingly an increase in the number of Americans who exercise and diet occurred before the increase in obesity, and some scholars have even argued that these trends actually encouraged obesity. Nearly all diets fail, with participants resuming their previous eating habits or even engaging in binge eating. Many then see an overall increase in their weight. If the diet is then repeated and abandoned again, a pattern of rising and falling weight is established, known as weight cycling. Similarly those who work out but then stop can end up being heavier than those who never exercised. Magnification of typical sugar showing monoclinic hemihedral crystalline structure. ... Corn syrup, whose chemical formula is C6H12O6, is a syrup made from corn starch and composed mainly of glucose. ... In economics, a subsidy is generally a monetary grant given by a government to lower the price faced by producers or consumers of a good, generally because it is considered to be in the public interest. ... Ronald Wilson Reagan (February 6, 1911 – June 5, 2004) was the 40th President of the United States (1981–1989) and the 33rd Governor of California (1967–1975). ... Fast food advertising is the promotion of fast food products and ventures through a variety of media. ... Fast food is food prepared and served quickly at a fast-food restaurant or shop at low cost. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Gasoline is a petroleum-derived liquid mixture consisting mostly of hydrocarbons and enhanced with benzene or iso-octane to increase octane ratings, used as fuel in internal combustion engines. ... A taxi serving as a bus Public transport comprises all transport systems in which the passengers do not travel in their own vehicles. ... This article or section does not cite its references or sources. ... A BlueGene supercomputer cabinet. ... A kitchen is a room used for food preparation. ... Microwave oven A microwave oven, or microwave, is a kitchen appliance employing microwave radiation primarily to cook or heat food. ... Frozen food is food preserved under the process of freezing. ... A snack food is seen in Western culture as a type of food that is not meant to be eaten as part of one of the main meals of the day (breakfast, lunch, supper). ... Toms Restaurant, a restaurant in New York made familiar by Suzanne Vega and the television sitcom Seinfeld A restaurant is an establishment that serves prepared food and beverages to order, to be consumed on the premises. ... Take-out, carry-out ( in American English ) or take-away ( in British English ) is food purchased at a restaurant but eaten elsewhere. ... Urban sprawl (also: suburban sprawl), a term with pejorative implication, refers to the unplanned, rapid and expansive growth of a greater metropolitan area, traditionally suburbs (or exurbs) over a large area. ... Fast food is food prepared and served quickly at a fast-food restaurant or shop at low cost. ... Toms Restaurant, a restaurant in New York made familiar by Suzanne Vega and the television sitcom Seinfeld A restaurant is an establishment that serves prepared food and beverages to order, to be consumed on the premises. ... McDonalds Corporation (NYSE: MCD) is the worlds largest chain of fast-food restaurants [1]. Although McDonalds did not invent the hamburger or fast food, its name has become nearly synonymous with both. ... French fried potatoes, commonly known as French fries or fries (North America) or chips (United Kingdom, Republic of Ireland and Commonwealth) are pieces of potato that have been chopped into batons and deep fried. ... The joule (IPA pronunciation: or ) (symbol: J) is the SI unit of energy. ... Diseases of affluence are those diseases which are thought to be a result of increasing wealth in a society. ... A US postage stamp depicting the increase in birth rate that country experienced after World War II. As is often the case with a large war, the elation of victory and large numbers of returning males to their country triggered a baby boom after the end of World War II... The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... Measuring body weight on a scale Dieting is the practice of eating (and drinking) in a regulated fashion to achieve a particular, short-term objective. ...


Public health and policy responses

On top of controversies about the causes of obesity, and about its precise health implications, come policy controversies about the correct approach to obesity. The main debate is between "personal responsibility" advocates, who resist regulatory attempts to intervene in citizen's private dietary habits, and "public interest" advocates, who promote regulations, on the same public health grounds as the restrictions applied to tobacco products. In the U.S., a recent bout in this controversy involves the so-called Cheeseburger Bill, an attempt to indemnify food industry businesses from what some consider to be frivolous lawsuits by obese clients. Look up policy in Wiktionary, the free dictionary. ... The Personal Responsibility in Food Consumption Act, also known as the Cheeseburger Bill, was passed by the U.S. House of Representatives in March 2004, and (as of November, 2004) awaits a Senate vote. ...


"Personal responsibility" advocates work on the basis that, as the microbiologist Rene Dubos once said, health ought not to be considered an end in itself, but "the condition best suited to reach goals that each individual formulates for himself" [7]. Any other definition permits authorities to curtail the autonomy of the self-determining individual, imposing quantity over quality of life onto them, undermining his civil liberties. As much as principled doctors, personal responsibility arguments have also been offered by food producer lobbies. In 1961, for example, as President John F Kennedy raised concerns about a lack of fitness in American society, a spokesman for the U.S. Dairy industry, Frank R. Neu, wrote advertorials warning We May Be Sitting Ourselves To Death.[28] Not food regulation, but personal exercising, is mooted as the solution. A Microbiologist is a biologist that studies the field of microbiology. ... Dr. René Jules Dubos (February 20, 1901 - 1982) was a French born American microbiologist, pathologist, environmentalist and Pulitizer Prize winning author. ... JFK redirects here. ... An advertorial is an advertisement written in the form of an objective opinion editorial, and presented in a printed publication —usually designed to look like a legitimately and independent news story. ...


When it comes to childhood obesity, personal responsibility also means parental responsibility. A survey by the nonpartisan group Public Agenda found 68 percent of American parents said it was "absolutely essential" to teach their children good eating habits, but only 40 percent believe they had succeeded. Fewer parents say it is essential to teach their children about physical fitness (51 percent), but more believe they have succeeded (53 percent). Overall, parents said they found it difficult to protect their children from negative social messages on a range of topics, including bad nutrition.[29] An obese girl (identity protected) Childhood obesity is a medical condition that affects children. ...


On July 15, 2004, the United States Department of Health and Human Services announced a new policy from HHS' Centers for Medicare & Medicaid Services (CMS) removing language in the Medicare Coverage Issues Manual stating that obesity is not an illness. According to the press release "This step allows members of the public to request that Medicare review medical evidence to determine whether specific treatments related to obesity would be covered by Medicare. By law, Medicare covers specified medically necessary services for illness and injury. The prior manual language, because it stated that obesity was not an illness, could prevent Medicare from covering treatments for diseases related to obesity."[30] July 15 is the 196th day (197th in leap years) of the year in the Gregorian Calendar, with 169 days remaining. ... 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ...


Non-medical consequences

Besides increases in disease and mortality there are other implications of the present world trend in obesity. Among these are:

  • Increased pressure on airline revenues (or increased fares) due to lobbying efforts to increase seating width on commercial airplanes[31] [8] and due to higher fuel costs.[9]. (Extra weight of obese passengers is costing airlines and consumers US$275,000,000 per annum.)
  • Increased litigation by obese persons suing restaurants (over causation of obesity)[32] and airlines (over airline seating width)[10] [11]. Note that the Personal Responsibility in Food Consumption Act of 2005 was motivated by a need to reduce litigation from obesity activists.
  • Sizeable societal economic costs attributable to obesity, with medical costs attributable to obesity rising to 78.5 billion dollars or 9.1 percent of all medical expenditures in the U.S. as of 1998[33][12]. However, such studies do not necessarily consider that earlier mortality of obese people may save health costs associated with aging.

See also

Body image is a persons perception of his or her physical appearance. ... The chubby community is a subculture in the gay community. ... Measuring body weight on a scale Dieting is the practice of eating (and drinking) in a regulated fashion to achieve a particular, short-term objective. ... This article or section does not cite its references or sources. ... Fat Admirers (or FAs) are people, usually male heterosexuals, who are sexually attracted to more heavy partners. ... It has been suggested that this article or section be merged into feederism. ... Maintaining a cheesey diet is the practice of making choices about what to eat with the intent of improving or maintaining good health. ... Honey were killing the kids, is the name of a TV show on TLC that shows parents the consequences of allowing their children to develop poor eating habits. ... It has been suggested that this article or section be merged with body weight. ... Cheetos Junk food is a term describing food that is perceived to be unhealthy or having poor nutritional value, according to Food Stadards Agency. ... This is a list of the most obese humans ever recorded and, their maximum achieved weights and years they were alive. ... MOMO syndrome is an extremely rare genetic disorder which has been diagnosed in only four cases around the world. ... The National Weight Control Registry is a United States register of people (18 years or older) who have lost at least 14 kg (30 lb) of weight and kept it off for at least one year. ... Lance Cpl. ... The Pickwickian syndrome, also known as obesity hypoventilation syndrome, is the combination of severe obesity and hypoventilation. ... Super Size Me is an Academy Award-nominated 2004 documentary film, directed by and starring Morgan Spurlock, an American independent filmmaker. ... It has been suggested that this article or section be merged into Obesity. ...

References

  1. ^ a b c d e U.S. Dept. of Health and Human Services, National Institutes of Health, 'The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults 5 (2000) PDF
  2. ^ The Oxford English Dictionary (website)
  3. ^ Powdermaker H. "An anthropological approach to the problem of obesity." In: Food and Culture: A Reader. Ed. Carole Counihan and Penny van Esterik. New York: Routledge, 1997;206. ISBN 0-415-91710-7.
  4. ^ Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP Jr, Yaffe K (2005). "Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study". BMJ 330 (7504): 1360. PMID 15863436. 
  5. ^ Quetelet LAJ (1871). Antropométrie ou Mesure des Différences Facultés de l'Homme. Brussels: Musquardt.
  6. ^ World Health Organization. Technical report series 894: "Obesity: preventing and managing the global epidemic.". Geneva: World Health Organization, 2000. PDF. ISBN 92-4-120894-5.
  7. ^ NICE issues guidance on surgery for morbid obesity. National Institute for Health and Clinical Excellence (19th July 2002). Retrieved on 2007-03-08.
  8. ^ Bariatric Surgery. USC Center for Colorectal and Pelvic Floor Disorders. University of Southern California (2006). Retrieved on 2007-03-08.
  9. ^ Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 2002;75:978-85. PMID 12036802.
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The Oxford English Dictionary (OED) is a comprehensive multi-volume dictionary published by the Oxford University Press (OUP). ... 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the Anno Domini (common) era. ... March 8 is the 67th day of the year in the Gregorian Calendar (68th in leap years). ... 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the Anno Domini (common) era. ... March 8 is the 67th day of the year in the Gregorian Calendar (68th in leap years). ... The Lancet is one of the oldest and most respected peer-reviewed medical journals in the world, published weekly by Elsevier, part of Reed Elsevier. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... July 24 is the 205th day (206th in leap years) of the year in the Gregorian Calendar, with 160 days remaining. ... For the Manfred Mann album, see 2006 (album). ... August 25 is the 237th day of the year in the Gregorian Calendar (238th in leap years), with 128 days remaining. ... For the Manfred Mann album, see 2006 (album). ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Brian Wansink Brian Wansink (born 1960, Sioux City, Iowa) is an American professor of marketing and nutritional science. ... Michael Dale Mike Huckabee (born August 24, 1955 in Hope, Arkansas) was the governor of the U.S. state of Arkansas from 1996 to 2007. ...

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Obesity


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Obesity - Wikipedia, the free encyclopedia (6502 words)
Obesity is a condition in which the natural energy reserve, stored in the fatty tissue of humans and mammals is increased to a point where it is thought to be a significant risk factor in certain health conditions, leading to increased mortality.
Obesity is relatively rare among animals in the wild, but it is common in domestic animals (who may be overfed and underexercised), and increasingly in humans.
Obesity, especially central obesity (male-type or waist-predomimant obesity), is an important risk factor for the "metabolic syndrome" ("syndrome X"), the clustering of a number of diseases and risk factors that heavily predispose for cardiovascular disease.
  More results at FactBites »

 
 

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