Obesity: A preventable chronic disease

 

By Nana Achiaa, GCSOM, MBS 2019
Mentor: Darina Lazarova, PhD

Would you be surprised if I told you that in some parts of the world particularly Ghana, where I was born and raised, overweight denotes wealth? I grew up in a community in which men with big stomachs were respected more and were much likely to find a wife. As bizarre as it sounds, most mothers advise their daughters to marry a man like that even if it means that she will become the 5th or 6th wife. Most people believed that men with big stomachs are successful and more likely to provide for their family. On the other hand, overweight married women are perceived as lucky and happy, because they are economically stable. Disclaimer: I believed in this reasoning and I saw nothing wrong with it, in fact I wanted that for myself. This perception did not change until I moved to the U.S.

When I came to the U.S., I realize that wealth tends to be inversely correlated with obesity. Overweight and obesity is more likely to be seen among individuals who are at, or below, the level of poverty. A survey conducted in cities in the U.S. observed that the prevalence of overweight was higher in homeless than non-homeless. Indeed, this was contrary to my typical believe that skinny people were either poor or sick.

So why is obesity more prevalent in poor communities in the U.S.? Well, it is easier and cheaper to buy a full meal for less than $2 at McDonalds, than to get fresh produce from the grocery store for a home-cooked meal. The price of a healthy meal in the U.S. forces most people to consume processed and unhealthy foods. Alternatively, some individuals simply do not have enough knowledge on how to cook healthy foods on a budget.

Obesity is a chronic disease that affects two out three of the U.S. population. Today, more than 1.1 billion adults are overweight, of which 312 million are obese. According to estimates of the International Obesity Task Force, 1.7 billion people are exposed to health risks related to body weight, and the increase in Body Mass Index (BMI) is responsible for more than 2.5 million deaths annually, a number that is expected to double by 2030.

I know by now you’re probably wondering if you are considered overweight or a normal size. Overweight is measured by body mass index (BMI). Yes, you can easily make a Google search for BMI calculator and by entering your weight and height values you will find your BMI. According to the standard classification, a normal weight is a BMI of 18.5-<25, overweight is a BMI of 25-<30, and obese is a BMI of 30-40.

So, what do we know about the problem? Obesity is a major and increasing risk for multiple diseases including metabolic syndrome, cardiovascular diseases, cancer and type 2 diabetes. Therefore, it is vital to understand its etiology and how to prevent it. The epidemic prevalence of obesity can be linked to individual lifestyle, socioeconomic status and genetic factors. Too often, people make excuses about their size by saying it is genetic and there is nothing they can do to change it. Well, I am here to inform you that, this assertion may not be fully accurate. Current research has found that, although there are tons of genes that contribute to the susceptibility to obesity, these genes do not account for the dramatic rise in obesity over the world. Researchers observed that individuals with genetic variations associated with obesity were only about 15 lbs (7 kg) heavier than those with lower genetic risk. In my opinion, obesity can be addressed among all groups, even in individuals with genetic variations through physical activity and healthy eating habits. The effort is worth, as it has been reported that physically active individuals live longer than physically inactive individuals.







Obese and overweight individuals suffer from premature death due to obesity-related-illnesses. They also put an enormous burden on government expenditure. Studies have shown that 20.6% of the U.S. national health expenditures are spent on treating obesity-related-illnesses and the cost of the medical care is skyrocketing.

The prevalence of obesity is alarming and there is no single or simple solution. It is going to take actions at many levels of our society. What can all of us do as individuals to be healthier? First, we can eat more fruits and vegetables, and fewer foods rich in sugar and fat. While the U.S. has made some investment like incorporating physical activity in the school curriculum and by adding fruit to every child’s meal, there is more to be done. To make true advance, it is my opinion that healthy foods should be more affordable and every household should prepare home-cooked-meals. The government can provide incentives to existing fresh-produce markets and new markets should offer healthier foods. Supermarkets should be open in low-income areas. Additionally, the government can control the consumption of cigarettes, alcohols and unprocessed foods by increasing taxation on them. Yes, people need to make better choices, but first the government must change the choices in our schools and communities. And lastly, I challenge everyone to spread the knowledge that, obesity and overweight do not denote wealth.