Obesity in AmericaObesity in America

Medical EthicsMedical Ethics

Fall 2007Fall 2007

Nicole ReskeNicole Reske

Obesity Trends in AmericaObesity Trends in America

http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm

Obesity leads to a higher risk of…Obesity leads to a higher risk of…

Hypertension Hypertension Dyslipidemia (for example, high total cholesterol or Dyslipidemia (for example, high total cholesterol or

high levels of triglycerides) high levels of triglycerides) Type 2 diabetes Type 2 diabetes Coronary heart disease Coronary heart disease Stroke Stroke Gallbladder disease Gallbladder disease Osteoarthritis Osteoarthritis Sleep apnea and respiratory problems Sleep apnea and respiratory problems Some cancers (endometrial, breast, and colon) Some cancers (endometrial, breast, and colon)

http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm

What is Obesity?What is Obesity?

Obesity is defined as “an excessive amount of Obesity is defined as “an excessive amount of body fat or adipose tissue in relation to lean body body fat or adipose tissue in relation to lean body mass”mass”

Body mass index is used to express weight status Body mass index is used to express weight status – it uses a ratio of weight to height– it uses a ratio of weight to height

Keep in mind, BMI is not always accurateKeep in mind, BMI is not always accurate

F as in Fat: How Obesity Policies are Failing in America pg. 9

Picture: http://health.howstuffworks.com/bmi3.htm

Body Mass IndexBody Mass Index

BMI = BMI =

o Below 18.5 = Below 18.5 = UnderweightUnderweight

o Between 18.5-24.9 = Between 18.5-24.9 = Healthy weightHealthy weight

o Between 25-29.9 = Between 25-29.9 = OverweightOverweight

o Over 30 = ObeseOver 30 = Obese

x2inches)in (height

pounds)in (weight 703

http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/index.htm

Children are at risk too…Children are at risk too…

http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/prevalence.htmhttp://www.cdc.gov/nccdphp/dnpa/obesity/childhood/prevalence.htm

Prevalence of Overweight Children

NHANES: National Health and Nutrition Examination Survey

Is obesity an epidemic?Is obesity an epidemic?

Epidemic: affecting many persons at the same time, Epidemic: affecting many persons at the same time, and spreading from person to person in a locality and spreading from person to person in a locality where the disease is not permanently prevalent. where the disease is not permanently prevalent.

Disease: a disordered or incorrectly functioning Disease: a disordered or incorrectly functioning organ, part, structure, or system of the body resulting organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, from the effect of genetic or developmental errors, infection, poisons, infection, poisons, nutritional deficiencynutritional deficiency or or imbalance, toxicity, or unfavorable environmental imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.factors; illness; sickness; ailment.

www.dictionary.com

Not an epidemic but a disease…Not an epidemic but a disease…

Speaking in terms of definitions, obesity is not Speaking in terms of definitions, obesity is not considered an epidemicconsidered an epidemic

But it can be considered a diseaseBut it can be considered a disease

Picture: http://www.longwoodsystems.com/

Is the state currently involved in Is the state currently involved in preventing obesity?preventing obesity?

Actually, it is (well it’s trying)Actually, it is (well it’s trying)

Picture: http://www.crwflags.com/fotw/flags/us-mi.html

National Governors AssociationNational Governors Association

NGA launched Healthy States Grant ProgramNGA launched Healthy States Grant Program It has provided 13 states up to $100,000 for It has provided 13 states up to $100,000 for

community or worksite wellness effortscommunity or worksite wellness efforts Michigan is included as one of these statesMichigan is included as one of these states

Picture: http://www.nga.org/portal/site/nga

Snack TaxesSnack Taxes

Currently 17 states and D.C Currently 17 states and D.C have snack taxeshave snack taxes

States include: Arkansas, States include: Arkansas, California, Illinois, Indiana, California, Illinois, Indiana, Kentucky, Maine, Kentucky, Maine, Minnesota, Missouri, New Minnesota, Missouri, New Jersey, New York, North Jersey, New York, North Dakota, Rhode Isalnd, Dakota, Rhode Isalnd, Tennessee, Texas, Virginia, Tennessee, Texas, Virginia, Washington, and West Washington, and West VirginiaVirginia

Picture: http://www.greetingbaskets.com/html/uniqueandpractical.html

Obesity LiabilityObesity Liability States have begun to pass States have begun to pass

legislation to prevent individuals legislation to prevent individuals from suing the food industry for from suing the food industry for making them fatmaking them fat

States include: Arizona, States include: Arizona, Colorado, Florida, Georgia, Colorado, Florida, Georgia, Idaho, Illinois, Indiana, Idaho, Illinois, Indiana, Louisiana, Kansas, Kentucky, Louisiana, Kansas, Kentucky, Maine, MICHIGAN, Missouri, Maine, MICHIGAN, Missouri, New Hampshire, North Dakota, New Hampshire, North Dakota, Ohio, Oregon, South Dakota, Ohio, Oregon, South Dakota, Texas, Tennessee, Utah, Texas, Tennessee, Utah, Washington, Wisconsin, Washington, Wisconsin, WyomingWyoming

Picture: http://www.dailyspeculations.com/wordpress/?cat=263

Diets influenced by subsidized foods…Diets influenced by subsidized foods…

http://www.rwjf.org/files/research/fasinfat2007.pdf

Corn, wheat, soybeans, rice, and cotton are “program crops” that receive government subsidies from 10 to 25 billion a year

Obesity adds risk to pregnancyObesity adds risk to pregnancy

Obese women are Obese women are more likely to have more likely to have children withchildren with Spina bifidaSpina bifida OmphaloceleOmphalocele Heart defectsHeart defects

Obese women are also more likelyto deliver premature and need an emergency C-section

http://www.rwjf.org/files/research/fasinfat2007.pdfPicture: http://www.wichitatreehouse.com/

Health care costs increase for businessesHealth care costs increase for businesses

Obese workers have 21% Obese workers have 21% higher health care costshigher health care costs

Obese workers lost Obese workers lost 183.63 workdays per 100 183.63 workdays per 100 full time employees full time employees compared to 14.19 in compared to 14.19 in normal employeesnormal employees

Obese workers also have Obese workers also have higher workers higher workers compensation ratescompensation ratesPicture: http://www.lesgilbertson.com/workcomp.htm

F as in Fat: How Obesity Policies are Failing in America

America’s OpinionAmerica’s Opinion 85% of America’s believe 85% of America’s believe

obesity is an epidemicobesity is an epidemic 56% support government 56% support government

funding to combat obesityfunding to combat obesity Despite rising obesity Despite rising obesity

many Americans are many Americans are aware of steps to avoid aware of steps to avoid obesityobesity

As income level increases As income level increases the desire for government the desire for government involvement decreasesinvolvement decreases

Survey conducted by Greenberg Quinlan Rosner Research, Inc found in F as in Fat: How Obesity Polices are Failing in America

Picture: http://www.thisnext.com/item/DF338374/Dunkin-Donuts-Breakfast

The Right ActionThe Right Action

Obesity leads to Obesity leads to many undesirable many undesirable effectseffects

Most Americans Most Americans agree that there is a agree that there is a obesity epidemic and obesity epidemic and that the government that the government to some level should to some level should be involvedbe involved

But what is the right But what is the right action to eliminate or action to eliminate or reduce the reduce the prevalence of obesity prevalence of obesity in society? in society?

Picture: http://www.lib.washington.edu/subject/Drama/nwdc1.html

Should government be involved Should government be involved at all?at all?

The non-consequentialist The non-consequentialist would say no, it interferes would say no, it interferes with our autonomy and with our autonomy and our confidentiality to live our confidentiality to live the way we prefer and the way we prefer and make our own food make our own food choiceschoices

Picture: http://www.takechargeonlinetherapy.com/PrivacyPolicy.htm

UtilitarianUtilitarian

The utilitarian would The utilitarian would say that in any case say that in any case where government where government involvement increases involvement increases the amount of health the amount of health and happiness it should and happiness it should be allowed to interferebe allowed to interfere

It would mean better It would mean better health, productivity, health, productivity, lower health lower health insurance costs, insurance costs, longer life longer life expectancyexpectancy

Picture: http://www.theonion.com/content/node/30263

How far should the government How far should the government be allowed to interfere?be allowed to interfere?

Should they control Should they control what we eat?what we eat?

Regulate what is sold Regulate what is sold in stores?in stores?

Provide financial Provide financial incentives for people incentives for people under a certain under a certain weight or BMI?weight or BMI?

Picture: http://sc94.ameslab.gov/TOUR/whitehouse.html

Complications of government Complications of government involvement in what we eatinvolvement in what we eat

Eating habits may be Eating habits may be more than lack of more than lack of will powerwill power

Comfort food – Comfort food – depressiondepression

Many people many Many people many different diets – different diets – vegan, vegetarian, vegan, vegetarian, allergies, diabeticsallergies, diabetics

Affect food market – Affect food market – loss of revenue or loss of revenue or even jobseven jobs

Food lobbyists in Food lobbyists in D.C. giving money D.C. giving money for campaignsfor campaigns

Picture: http://www.icanefile.org/index2_0.asp?caller=347

So what do we do?So what do we do?

In my opinion, we In my opinion, we need to make small need to make small choices that will choices that will affect the manyaffect the many

Picture: http://www.pensionriskmatters.com/articles/retirement-planning/

Like what? Like what?

We need to begin to We need to begin to subsidize the local farmer – subsidize the local farmer – those who participate in those who participate in farmers marketsfarmers markets

This is a good way to get This is a good way to get fruits and vegetables to fruits and vegetables to many people without the many people without the large costs of shipping and large costs of shipping and handling and by cutting out handling and by cutting out the middle manthe middle man

Picture: http://lancaster.unl.edu/food/ftjul06.shtml

What else?What else?

We also need to We also need to control the large control the large corporations of corporations of America that have a America that have a monopoly on the monopoly on the market like PepsiCo market like PepsiCo Inc. and the Inc. and the ingredients that they ingredients that they are putting into their are putting into their productsproductsPicture: http://www.pepsi.com/pepsi_brands/product_info/index.php

Put a stop to HFCS!Put a stop to HFCS!

We need to stop We need to stop producing HFCS!producing HFCS!

HFCS is a caloric HFCS is a caloric sweetener that leaves sweetener that leaves you feeling more you feeling more hungry then when you hungry then when you first started eating first started eating which increases your which increases your appetite and desire to appetite and desire to eateat

Don’t buy foods with Don’t buy foods with HFCS – perhaps this HFCS – perhaps this will affect the marketwill affect the market

Picture: http://www.nytimes.com/2006/07/02/business/yourmoney/02syrup.html?_r=1&oref=slogin

Realize Your PowerRealize Your Power

Consumers have a Consumers have a large influence on large influence on the market!!the market!!

If there is a large If there is a large demand there are demand there are business people out business people out there ready to make there ready to make it happen!it happen!

Buy healthy foods – Buy healthy foods – we will see more of we will see more of themthem

Picture: http://www.ers.usda.gov/AmberWaves/November06/DataFeature/

OverallOverall Although obesity Although obesity

cannot technically be cannot technically be considered an epidemic considered an epidemic it needs to be given it needs to be given attentionattention

Happenings on both Happenings on both the federal, state and the federal, state and individual level in individual level in order for things to get order for things to get betterbetter

Picture: http://mwcfootball.wordpress.com/2007/08/06/its-official-utes-to-open-2008-at-michigan/