“Obesity is a complex disease with many contributing factors. Neighborhood design, access to healthy, affordable foods and beverages, and access to safe and convenient places for physical activity can all impact obesity. The racial and ethnic disparities in obesity underscore the need to address social determinants of health such as poverty, education, and housing to remove barriers to health. This will take action at the policy and systems level to ensure that obesity prevention and management starts early, and that everyone has access to good nutrition and safe places to be physically active. Policy makers and community leaders must work to ensure that their communities, environments, and systems support a healthy, active lifestyle for all” (CDC1).
According to the CDC2:
- The prevalence of obesity was 42.4% in 2017~2018.
- From 1999–2000 through 2017–2018, the prevalence of obesity increased from 30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%.
- Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer that are some of the leading causes of preventable, premature death.
- The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight.
According to the World Health Organization3, “obesity has reached epidemic proportions globally, with at least 2.8 million people dying each year as a result of being overweight or obese.” A J-shaped relationship has been observed between continuous BMI and risk for hospitalization, ICU admission, and death. Risks were lowest at BMIs of 24.2 kg/m2, 25.9 kg/m2, and 23.7 kg/m2, respectively, and increased sharply with higher BMIs4.
Obesity is a central factor in the prevalence of hyperlipidemia, hyperinsulinemia, and hypertension (otherwise known as “metabolic syndrome”) which makes it a health concern beyond the risk of COVID-19.
As we focus attention on vaccination, masks, and physical distancing in the reopening of schools, businesses, and communities, in general, it is short-sighted to ignore the looming threat to the nation’s health presented by inactivity and obesity—a preventable epidemic. Nationally, we need a campaign to get Americans moving and eating healthier. It is not a cause for “fat shaming.” Rather, it is a call for solutions—for efforts to bring assistance to those who need it. It is a call to recognize what has largely been ignored during the COVID-19 pandemic—that America (like much of the world) has an obesity problem.
As many will say that “everyone should do their part and be vaccinated”, we should also be stressing that everyone do their part and strive to maintain a healthier body composition and more active lifestyles. The response to the present pandemic, however, has largely opposed such a movement. Little has been done to promote the role that obesity has played in the severity of symptoms and death rate of SARS-CoV2. Little has been said about the role of obesity and inactivity in the diseases known to elevate the risks of SARS-CoV2.
The American College of Sports Medicine promotes “exercise is medicine.” Indeed, it is the first medicine which physicians should prescribe. If it were, it is undeniable that the health concerns of this nation would dramatically decline. Even a modest decline in fat percentage is known to have a significant effect on one’s health. (I am not suggesting single-digit body compositions and six-pack abs.) Considering BMI (which can be a poor indicator of body fat, but is, nonetheless, an easily calculated marker of health risk—body weight in kilograms divided by the height in meters-squared), a modest target of 25-27 kg·m2 would appear reasonable and ideal (and, possibly, the healthiest—especially if it includes a modest gain in muscle mass, as well as a loss in fat mass).
Let us, for the health of the nation, have the open conversation about obesity and seek the necessary solutions to the problem rather than simply treating the resulting medical conditions—or, worse, denying the problem altogether.
Be your best today; be better tomorrow.
Carpe momento!
1https://www.cdc.gov/obesity/data/obesity-and-covid-19.html
2https://www.cdc.gov/obesity/data/adult.html
3https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity