Careers to Combat the Obesity Epidemic How You Can Make a Living Helping Others Achieve a Healthy Weight
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Weight loss and management plague more and more people each year (over one-third of American adults are obese according to the CDC.) In addition, it can be difficult to find the necessary help to turn things around and make lasting lifestyle changes. Read on for a comprehensive look into the obesity epidemic, learn about tips and resources for staying healthy, and explore career opportunities where you can help others achieve their personal weight goals.
Meet the Expert
Martina Cartwright is a registered dietitian (R.D.) with a Ph.D. in Nutritional Science and Biomolecular Chemistry. She has more than 17 years experience in medical education, research, and clinical practice. Dr. Cartwright is a well-known nutrition author and keynote speaker with 20 years' experience in obesity treatment and counseling. She is also an adjunct faculty member at the University of Arizona and works as a biomedical consultant in Scottsdale, Arizona.
The Current State of Obesity
According to the Center for Disease Control and Prevention, annual medical costs for obesity total $147 million. This increasingly common medical condition affects nearly one-third of the current American population, with a higher incidence seen amongst low-income populations. As waistlines continue to expand, the risk of illnesses such as diabetes, heart disease, stroke, and cancer continues to rise. Childhood obesity is a growing concern – children who are overweight early in life are not only much more likely to grow into obese adults but are also at high-risk for diseases previously only seen in aging populations.
While obesity is a global problem, the largest populations of obese individuals tend to be in developed countries where physical activity and access to affordable healthier food choices are low. In the following sections, readers will learn more about obesity, how it is defined; the underlying factors and causes; and the populations it is most likely to affect.
Obesity now affects1 on 6
children and adolescents in the United States.
Children born to obese mothers are twice as likely to be obese and to developtype 2 diabetes
later in life.
Adults with a BMI of25 to 29.9
are considered overweight, while adults with a BMI of 30 or more are considered obese.
The CDC estimates approximately112,000
deaths are associated with obesity every year.
The Harvard School of Public Health defines obesity as a way of describing when an individual has too much body fat. To be defined as obese, a person must have a body mass index (BMI) of 30 or greater, while those considered overweight have a BMI of 25-29.9. Higher BMIs can be categorized into classes, with individuals with a BMI of 40 or more a class III. According to a 2014 study published by The Lancet, America topped the list of countries with the highest percentages of obesity in the world, with China, India, Russia, and Brazil filling out the top five.
(BMI 18.5 to 24.9)
(BMI 25 to 29.9)
Obese Class I
(BMI 30 to 34.9)
Obese Class II
(BMI 35 to 39.9)
Obese Class III
(BMI 40 or more)
Overall, nearly 35 percent of all American adults are considered obese, though certain races have higher percentages: 47.8 percent of Black adults and 42.5 percent of Latino adults are obese. Socioeconomic status has been shown to play a large role in the likelihood of becoming obese. Researchers have highlighted numerous reasons for this disparity, including the higher cost of healthy foods, lack of access to fresh fruits and vegetables, and living in areas that are unsafe for undertaking physical activity.
Causes of Obesity
According to the Centers for Disease Control and Prevention, there are numerous causes for obesity. The most common factors are discussed below.
|Behavior||Regularly consuming high calorie foods and large portions and not getting the recommended weekly amount of physical activity, can soon add up to extra pounds.|
|Community Environment||Reports have shown that individual's communities, homes, schools, and workplaces can all have positive or negative effects on their health. As an example, communities without proper sidewalks or trails preclude individuals from walking or biking like those in cities with proper provisions.|
|Genetics||While genetic changes in populations don't occur quickly enough to be blamed for the epidemic, genes can play a role in how a person's body responds to activity and calorically dense foods. For instance, some people may be more likely to have higher levels of hunger due to genes.|
|Disease||A number of illnesses may cause weight gain, including Cushing's disease and polycystic ovary syndrome (PCOS).|
|Drugs||Certain medications can also cause individuals to gain weight. Common drugs linked to weight gain include antidepressants and steroids.|
Childhood obesity is climbing at an alarming rate – over the past three decades, the numbers have tripled. As of 2012, one in three American children is overweight or obese. In addition to the immediate health concerns presented, obesity experts have the concern that the next generation could be the first in modern history to live fewer years than their parents' generation. The first step to reversing the childhood obesity epidemic is education.
What Is Childhood Obesity?
Also known as pediatric obesity, childhood obesity occurs in both children and adolescents whose weight exceeds the healthy range for his or her height and age.
Childhood obesity is particularly dangerous because it is associated with many serious medical conditions that once only plagued adults, such as diabetes, high blood pressure, high cholesterol, and other illnesses. It can also lead to depression and a lack of self-esteem.
Childhood obesity is also measured by Body Mass Index (BMI), although the calculations are slightly different than the adult equation. Rather than simply entering height and weight, as is the protocol with adults, children and teens use an age and gender-specific calculation, sometimes called BMI-for-age. Because children's bodies change so rapidly during these years, measurements need to be judged against the percentile ranges for their age and gender group.
According to the most recently conducted National Health and Nutrition Examination Survey, 16.9 percent of all American children are classified as obese. As with adult populations, certain ethnic groups tend to have a higher incidence of obesity with 20.2 percent of Black children and 22.4 percent of Latino children classified as obese. The State of Obesity cites that people of color often reside in economically challenged areas where there is less access to affordable healthy foods and safe places to exercise
Some parents struggle to identify their children as obese, especially when compared to peers rather than to medical standards of healthy weight. Parents of children struggling with weight gain can try a few different strategies to encourage healthy habits at an early age. The following table breaks down these strategies by age group:
|Newborn – Age 1||Studies have shown that breastfeeding may contribute to better weight management, as children who have been breastfed tend to be more aware of internal hunger signals and are better able to control portions. Additionally, flavors travel through breast milk; some research has shown that nursing mom's who eat fruits and veggies are more likely to have children that like them.|
|Ages 1 – 5||Food habits are formed in early childhood through introduction of a variety of textures, colors and flavors. This is the perfect age to instill good habits, both when choosing food and in being physically active. This is also a good time to begin limiting screen time.|
|Ages 6 – 12||Building upon the lessons taught earlier, parents can encourage physical activity through participation in individual or team sports, while family time can also involve fun physical activities such as bike rides or walking the family dog. Kids at this age can learn to make basic healthy foods and snacks on their own.|
|Ages 13 – 18||As adolescents gain more independence and try to emulate their peers, they may find themselves going through the fast-food drive-thru a bit too frequently. Encourage teens to pack their own lunches and learn how to make healthier versions of their favorite fast foods. Students at this age can also build upon their existing level of physical activity and use social media to motivate themselves to be more active. Studies have shown that individuals are influenced by others' exercise habits and perceived social support regarding exercise. Today, exercise apps allow users to track and showcase their own activity/accomplishments as well as compare their stats for friendly competitions with friends.|
According to a 2015 Gallup poll, 27.7 percent of American adults are now considered obese, up from 27.1 percent in 2013 and 25.5 percent in 2008. Unlike Centers for Disease Control estimates of obesity, the Gallup-Healthways Well-Being Index used respondents' self-reported height and weight to calculate body mass index (BMI). To be classified as obese, an adult's BMI must be 30 or above. Since the 2008 study, American seniors have seen the highest rise in obesity with a four percent increase.
Measuring Adult Obesity
Harvard's School of Public Health notes a variety of ways to measure adult obesity. The most common include:
|Body Mass Index (BMI)||These calculations are based on height and weight and can be determined using BMI tables and online tools.|
|Waist Circumference||This is often used to assess abdominal obesity and is based on the circumference of the abdomen at the natural waistline.|
|Waist-to-Hip Ratio||Also used to calculate abdominal obesity, this measurement is calculated by measuring the waist and largest part of the hips, then dividing waist by hip measurements.|
|Skinfold Thickness||Calipers are used to pinch a portion of skin and the layer of fat underneath at specific points on the body. A percentage of body fat can be calculated from these measurements.|
|Underwater weighing||Involves weighing individuals underwater to assess body volume, density, and fat percentage.|
Factors Affecting Adult Obesity
While obesity rates have not changed significantly since 2008, African Americans have the highest levels of obesity among major demographic groups, at 35.5 percent in 2014. The Latino population also has higher levels of obesity: with one study indicating a 77 percent obesity rate in Latino adults.
Obesity rates are also greater than 30 percent for middle-aged Americans earning less than $36,000 annually. Amongst the young and those earning at least $90,000 per year, the numbers drop to 17.7 and 23.1 percent, respectively.
Other factors leading to higher levels of obesity include access to healthcare, the ability and access to make healthy eating choices, access to safe areas to be physically active, and income.
Health Consequences of Obesity
In addition to diminished well-being, obesity has many other health consequences. The World Health Organization has identified numerous areas for concern, including:
|Effects of Obesity||Explanation|
|High Blood Pressure||The Framingham Heart Study found that excess body weight accounted for approximately one in four cases of high blood pressure in adults participating in the study. High blood pressure can lead to numerous other health problems such as coronary heart disease, heart failure, stroke, and kidney failure.|
|Heart Disease||As BMIs rise, so does the risk for heart disease. As plaque builds up inside arteries, it becomes more and more difficult for blood to make its way through the heart, leading to either angina or a heart attack.|
|Sleep Apnea||Those with sleep apnea experience pauses in their breathing or shallow inhalations while sleeping. This typically occurs in individuals with abdominal obesity or extra fat around their neck. As fat takes up more space around the neck, the airway is narrowed, making it difficult to breathe properly.|
|Musculoskeletal Disorders||Extra weight means joints and bones are under increased stress and pressure Joint pain and osteoarthritis commonly occur in the knees, hips, or lower back when connective tissue between joints wears thin.|
|Cancer||Overweight or obese individuals have higher risks for certain types of cancer, including colon, breast, endometrial, and gallbladder cancer|
|Gallstones||These stony masses form in the gallbladder and cause stomach or back pain. Obese individuals are at higher risk to develop gallstones.|
Insulin is a hormone that allows glucose to enter cells where it is used as energy. Diabetes occurs when the body either cannot produce insulin or the body is resistant, or non-responsive, to the insulin produced by the pancreas. Lack of insulin response results in increased blood sugar or glucose, the hallmark of diabetes. Type I diabetes requires insulin and typically develops in early childhood. Type II diabetes is often called non-insulin dependent diabetes and is frequently associated with obesity and sedentary lifestyle.
According to Stanford Medicine, obesity is one of the most common risk factors for developing pre-diabetes, a condition of high blood sugar that is not high enough to be classified as diabetic. Pre-diabetics who remain sedentary and overweight may develop Type 2 diabetes. Approximately 80 percent of those who develop Type 2 diabetes are overweight or obese. Other contributing factors to diabetes that are also commonly associated with excess weight include:
Reports suggest that individuals should engage in physical activity three times a week. Those who don't are at greater risk for diabetes.
High Blood Pressure
If an individual has a blood pressure of 140/90mm Hg or higher, their likelihood of developing pre-diabetes is greater than normal.
Cholesterol and Triglyceride Levels
Those with low levels of HDL cholesterol or high levels of triglycerides are at increased risk for diabetes.
Other factors that may be associated with the development of obesity related diabetes are family history, race, and a history of gestational diabetes.
All symptoms result from elevated levels of blood sugar and may include constant thirst, frequent urination, blurred vision, exhaustion, dry skin, unintentional weight loss, infections and wounds that take longer to heal than usual.
Diabetes is diagnosed based on the clinical signs listed above and blood sugar or glucose test results; there are two types of blood glucose tests. If asked to fast for 8 hours prior to the blood draw, the fasting plasma glucose level will be tested. If the result is higher than 126 mg/dl, this may indicate diabetes. Similarly, if the casual plasma glucose (non-fasting) level is above 200 mg/dl, diabetes may be suspected. These tests may be drawn multiple times over a series of days to ensure an accurate reading and to confirm diagnosis of diabetes.
While Type 2 diabetes is typically viewed as incurable, there are a variety of treatments available, including changes in lifestyle and medication.
|Nutrition||While everyone with diabetes should consult with a medical professional to develop a personalized meal plan, common rules tend to include eating high fiber foods, limiting added fats, sugar, and salt, and limiting carbohydrates to 40 to 50 percent of overall calories.|
|Exercise||Physicians and diabetes consultants can help develop a plan for incorporating more exercise, even if this means starting with a few minutes of walking each day.|
|Medications||Several options exist for controlling diabetes. Oral medications are widely used for individuals with Type 2 diabetes, while those with Type 1 use insulin injections or a pump.|
10 Tips for Prevention & Treatment
There are many different prevention techniques for avoiding obesity. According to experts at the Mayo Clinic, Centers for Disease Control and Prevention, and Harvard's School of Public Health, some of the top recommendations include:
Experts recommend at least 150 minutes of moderate activity per week, including activities like swimming or fast walking.
Eating healthy foods
The key is to consume nutrient-dense, calorically low foods, including lots of fruits and vegetables; lean protein, and whole grains. Consuming small, frequent meals throughout the day is recommended to keep blood sugar in check and to reduce food cravings.
Studies have shown that lack of sleep can slow the metabolism, resulting in added pounds. Adults should aim for 7-8 hours of sleep each night.
Limit screen time
Sitting in front of televisions, computers, or other devices for extended periods of time can slow blood flow. Individuals should try and limit television to one hour per day, while those who work in offices should get up from their desks each hour and move around.
Unneeded stress has been shown to activate ghrelin, also known as the “hunger hormone.” Cortisol, a stress hormone, fuels the appetite for fatty and sugary foods; in addition it encourages fat to be deposited in the abdomen. Activities such as meditation, yoga, and deep breathing can help decrease stress levels.
Limit tempting foods
Everyone has a food that triggers excessive consumption. By keeping these out of your home or office, they become less of a temptation. Practice portion control.
Often, weight gain is gradual, creeping up in small, unnoticeable increments. Monthly weigh ins can help determine if the pounds are water weight or weight due to overeating. But keep in mind, muscle weighs more than fat; so if pumping iron, the scale might not budge but clothes will fit better.
While the temptation to indulge on the weekends or during vacations can be high, it's best to try and maintain a healthy eating plan as much as possible, or return to healthy eating as soon as possible thereafter.
Pack up leftovers
In addition to commercially prepared food being calorically denser than food prepared at home, portion sizes in American restaurants are larger than those in other countries. Ask for half your meal to be packed up for later.
Eat at the table
Studies have shown that those who eat in front of their televisions or computers mindlessly consumer more calories than those who focus solely on their meal. Try and sit at the table and concentrate on eating rather than multitasking.
While prevention is always the best strategy, there are also steps to treat obesity and lose weight healthfully. Some of the most effective include:
Practice a healthy diet
Though fad diets come and go, research has proven time and again that the key is to consume fewer calories than are being burned on a daily basis. Dietitians can help create a meal plan suited to individual needs. The goal is to eat well most of the time.
Whether maintaining or seeking to return to a healthy weight, exercise is key. In addition to burning calories, exercise also builds lean muscle, which helps burns calories more effectively.
Set realistic goals
People don't become obese overnight; in the same way, it takes time to lose weight. For adults, experts recommend trying to lose between five and 10 percent of their current weight over six months at a rate of one to two pounds per week.
Practice healthy lifestyle habits
For those who normally head straight for the television after work, encourage them to go for a walk instead. Rather than heading to the break room vending machine for an afternoon snack, pack fruit each morning.
Keep track of your diet and exercise
Keeping a record of foods consumed and exercise patterns will not only motivate individuals to stay on track, it can also help them to understand problem times or areas for improvement.
Make small changes that add up
Extra calories can be burned by taking the stairs rather than the elevator, parking at the far end of the lot, or getting off one stop early if using public transportation. All of these small changes will add up.
Get regular check ups
Often after six months of weight management, weight loss will occur at a slower pace. It's important to consult with medical professionals to ensure weight is being lost in a healthful manner and to seek professional advice on how to accelerate weight loss.
Seek counseling or support
For some, there may be underlying emotional or behavioral issues related to eating and weight gain. Counseling can help in understanding the root causes, while support groups can help people stay on track.
Ask your doctor about medication
There are a number of prescriptions that, alongside healthy eating and exercise, can help individuals that are struggling to lose weight.
Ask your doctor about bariatric surgery
While surgery should not be one's first option unless recommended by a medical professional, there are surgical procedures that limit the amount of food an individual is able to consume. Some of the most common include gastric bypass, gastric sleeves, and laparoscopic gastric banding.
Public Health Degrees, Specialties, and Careers
Students interested in assisting obese populations often pursue a degree in public health. These versatile programs, offered at the bachelor's, master's and doctoral levels, provide students an opportunity to train for public health careers specializing in obesity and weight management. Some of the most common areas of study include:
This track prepares students to recognize risk factors associated with overweight or obesity; examining environmental, behavioral, social and psychological factors contributing to the condition. In some cases, students in this specialty may focus on specific populations or regions of the world.
Charged with identifying how obesity affects the public, those in this role often have advanced degrees and work to develop preventative measures, such as programs or initiatives focused on healthy living.Research Scientist:
Most positions in this field given the intricate research needs require at least a master's level degree. The position involves designing and developing research plans and methodologies to address specific needs within the obesity research spectrum.
Within this specialty, students learn how to effectively communicate and influence public health education initiatives, on a local and/or global level. The end goal is always kept at the forefront, with students being asked to think about the outcomes in how public healthcare is delivered. It will also help students understand how to best communicate health information to a variety of different audiences.Outcomes Research
With a focus on the end goal, these professionals measure existing programs against statistical data to understand how effective they are. They may also conduct independent research to back up their findings.Obesity Communications Specialist
Often works closely with the public and media outlets to provide relevant and recent information about the latest obesity statistics and healthy lifestyle initiatives. These professionals also sometimes work within advocacy or education initiatives to ensure all populations understand how to properly care for themselves.Obesity & Chronic Disease
Throughout this specialty, students will learn about obesity through a spectrum of perspectives, incorporating epidemiological, sociological, economic, and policy-related theories. Students will also undertake both basic and applied research, understanding how obesity contributes to other diseases such as diabetes, high blood pressure, and high cholesterol. At risk populations are given special consideration.Obesity Prevention Coordinator
This position frequently supports increased awareness of healthy eating and physical activities among populations most at risk for obesity, including low-income areas or neighborhoods with limited access to healthy foods or safe areas to exercise. Activities may include educating, working one-on-one with individuals, or leading workshops.Bariatrician
Working directly with bariatric surgeons, individuals in this role assist in surgical weight loss procedures by performing pre-op medical screenings, post-op follow-up services, and other non-surgical tasks.Diet & Nutrition
This area of study prepares students to educate communities about dietary choices. The most innovative programs will draw from the latest research on the obesity epidemic and equip students with the skills to communicate the connections between food and health.Nutritionist or Registered Dietitian
With an in-depth understanding of the dietary needs of varied demographics, nutritionists and registered dietitians may work one-on-one to create individualized healthy meal plans or work in the public to advocate and educate about balanced diets.
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