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Social Determinants Of Obesity: Physical Activity

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Question:

Discuss about the Social Determinants of Obesity for Physical Activity.

 

Answer:

Introduction

Obesity has become a public health issue that has created moral panic worldwide leading to obesity crisis. The prevalence of obesity has increased to two folds among the children, adolescents and adults over the past decades worldwide. This condition has contributed to the burden of disease in many countries and high healthcare costs that are attributable to the obesity. Instead of identifying the appropriate effective approaches to thwart the global pandemic of obesity, it is important to know the underlying causes of obesity (Witten, 2016). This highlights the argument that is obesity caused by the individual lifestyle choices or due to broader social determinants of health. It also raises questions that whether obesity is a result of the biology that is making obesity a matter of societal concern. The following essay deals with the determinants of obesity and the relationship between the social determinants and individual lifestyle choices. It will also deal with the risk factors and implications for addressing the obesity.

The nature and scale of obesity is multifactorial. There is no single cause for obesity. There are endless debates about the nature and causes of obesity. It is defined as a medical condition where there is excess fat accumulation that has an adverse effect on the health. It is linked to reduction of life expectancy or related health problems. Individuals are considered obese based on the body mass index (BMI) that determines the obese condition when it exceeds 30kg/m2. It is calculated by dividing the weight of a person (in kg) by square of the height. It is the most useful measure at the population level to assess the levels of obesity in all age groups (Rahman & Harding, 2013). The nature of obesity is determined by BMI that estimate the body fat. Obesity is classified into three classes. The range of BMI describes the risk level of obesity. BMI between the ranges of 25 to 29 shows overweight and not an obesity condition. The class 1 is called the low-risk obesity where the BMI is between 30 and 34.9. Moderate-risk obesity is defined as the class 2 obesity where the obesity is between 35 and 39. High risk obesity occurs when the BMI is equal or greater than 40.

According to World Health Organization (WHO) the scale of obesity issue has shown an increased trend. During the year 2014, there were 1.9 billion adults and over 600 people were obese (World Health Organization, 2014). Most of the world’s population is suffering from obesity and is greatly contributing to the burden of disease. WHO has described the obesity issue as a global epidemic and classified as chronic disease. Obesity crisis is one of the issue that skyrocketing in countries like Australia. A study conducted by the University of Sydney showed that by 2025, the obesity rate will increase to 35 percent from 28 per cent among the Australian adults. The nature of obesity in Australia depicts that young people are gaining more weight than the middle age people. This shows that individual lifestyle factors are the cause of obesity among the young Australian people.

There are several causes of obesity. The balance between the intake of calories and energy expenditure determines the weight of an individual. The common causes of obesity are lack of physical exercise and overeating. Therefore, weight gain is a result of genetics, behavior, metabolism, environment and culture. Leptin deficiency is one of the genetic causes that is involved in the fat regulation. Overeating is another cause of weight gain where high diet in carbohydrates and highly saturated fatty consumption leads to obesity. Frequency of eating has a relationship with weight gain where small frequent meals results in stable insulin levels and large meals cause insulin level spikes. Sedentary lifestyle leads to burning of few calories and strongly correlated to weight gain. Endocrine disorders also cause obesity like hypothyroidism or Cushing syndrome (Malik, Willett & Hu, 2013).

Among the causes, risk factors results in obesity. According to WHO, unhealthy lifestyle habits like lack of physical activity, unhealthy diet, lack of sleep and stress increases the risk for obesity. Eating of Trans and saturated fats and high added sugars are the main risk factors that increase the risk for development of obesity. Apart from the individual lifestyle choices and genetics, socio-economic factors also increase the chances of risk for obesity. An unhealthy social environment and low socio-economic status contribute to the risk factors for obesity (Suglia et al., 2013).

 

On a broader aspect, the social determinants of health are the major causes of developing obesity. Understanding of the determinants of obesity helps to develop effective prevention interventions and policies that address the obesity issue. The determinants of obesity encompasses the gender, age, education status, ethnicity, employment status, socio-economic factors and behavioral factors like lack of exercise, alcohol consumption, smoking, low level income level. Among all the determinants of obesity, social determinants have a potential; relation to obesity. The individuals belonging to low socio-economic status (SES) are prone to obesity and related risk. The low level of education among the low SES groups is more likely to become obese along with poor housing are obese (Bhurosy & Jeewon, 2014). However, in high-income countries, people with high SES adopt healthy living with regular exercise and healthy eating. In addition, on a contrary, the problems of malnutrition are replaced by the overconsumption and this greatly affects the SES level among the high and low income countries. People belonging to high SES participate in activities like watching television, shopping and unhealthy eating like junk foods that contribute to high BMI and sedentary lifestyle (Popkin & Slining, 2013).

High consumption of fast foods, large portion sizes, lack of physical exercise and high beverage consumption among the high SES groups have a strong influence on the obesity and energy expenditure. This shows that obesity is caused by individual lifestyle choices. People staying in close proximity to the fast food restaurants have a high rate of obesity. Moreover, studies have shown that obesity has gradually become a natural extension of the advancing economy. The easy accessible foods available at a low cost are making people eat more fast foods and less exercise because of the labor-saving devices are making obesity a lifestyle choice due to adoption of sedentary lifestyle. Smoking, alcohol consumption and high expenditure on the fast foods also make them prone to overweight and obesity. Less energy expenditure and high food consumption are the lifestyle and behavioral factors that affect obesity (Egger & Dixon, 2014).

Environmental factors like the community characteristics where access to unhealthy food items like in rural or urban areas also contributes to burden of obesity. Individual factors are also the determinants of obesity like individual characteristics of depression. The people belonging to low SES groups have low or intermediate levels of education are increasingly exposed to obesogenic ambience. Education is the key determinant of obesity that needs to be addressed. Age is also a determining factor for obesity where it is more prevalent among the women than men. During episodes of depression, a person is addicted to binge eating where they consume foods in an uncontrollable manner (Roberto et al., 2015).  

These determinants encompassing the social, economic, cultural and individual factors including the behavior factors have serious implications (De Garine, 2013). It is important to address these determinants that would aid in the development and implementation of health promotion, obesity prevention and reduction among the individuals and at the societal level. These determinants are related to each other that contribute to obesity as a whole. The individual and societal factors influence the lifestyle or behavior of an individual that contribute to high BMI or obese condition. The environmental factors also influence the behavior of an individual towards high food consumption and less energy expenditure that also leads to overweight and obesity. The individual determinants also influence the obesogenic condition directly like genetic factors, socio-economic factors and individual factors like depression. The above link between the different determinants of obesity illustrates that they all contribute to obesity where the lifestyle or behavioral factors are the key determinants of obesity (Newman et al., 2015). This shows that obesity is an individual lifestyle choice on a large extent as compared to the broader determinants of health.

As the individual lifestyle factors influence the overweight or obese conditions to a great extent, it is the responsibility to address the obesity on an individual level. The implications of the unhealthy lifestyle choices have a detrimental effect on their quality of life and vulnerability to related risk factors of obesity. It is important to address the unhealthy lifestyle choices in order to curb the burden of obesity and high cost of healthcare. Although it is not explicitly stated, it is evident that it is the responsibility at the individual and societal level to address the unhealthy behavioral factors.  Behavioral modification and implementation of stringent policies is the responsibility of the individuals and the society to address the obesity issue (Teixeira et al., 2015). Behavior change via the implications of dietary management is important to address the obesity as an individual lifestyle choice. Due to the obese state, individuals suffer from psychological problems like depression, anxiety and poor-self esteem. Behavior modification programs for the young and the adults are important and responsibility to reduce the burden of morbidity and mortality among the individuals (Dalle Grave et al., 2013). It helps to change the problematic eating patterns via self-management that is related to food consumption and weight loss management. However, there is a group of people who encourages fat acceptance that advocates glorification of obesity where people love their obese condition (Robinson & Christiansen, 2014). This also has implications where they feel encouraged to adopt affirming and forgiving attitude towards their bodies. The determinants of obesity like individual or behavior factors have a detrimental effect on the burden of disease and are a major public health issue.

Obesity is a major public health issue that is contributing to the burden of disease. The social and individual factors are the key determinants that are considered to be the main causes of obesity among the population. The BMI is a way to measure the class of obesity and the obese condition. It has key risk factors like consumption of fast foods, lack of physical exercise and sedentary lifestyle contribute to obesity. Modification to lifestyle and behavioral changes are required to address the problem of obesity. The implications of the individual or behavioral factors need to be addressed so that it would help to mitigate the problem of obesity.

 

References

Bhurosy, T., & Jeewon, R. (2014). Overweight and obesity epidemic in developing countries: a problem with diet, physical activity, or socioeconomic status?. The Scientific World Journal, 2014.

https://www.hindawi.com/journals/tswj/2014/964236/abs/

Dalle Grave, R., Centis, E., Marzocchi, R., El Ghoch, M., & Marchesini, G. (2013). Major factors for facilitating change in behavioral strategies to reduce obesity. Psychol Res Behav Manag, 6, 101-10.

https://www.researchgate.net/profile/Riccardo_Dalle_Grave/publication/257757050_Major_factors_for_facilitating_change_in_behavioral_strategies_to_reduce_obesity/links/0c9605310838fd1565000000.pdf

De Garine, I. (2013). Social aspects of obesity (Vol. 1). Routledge.

https://books.google.co.in/books?hl=en&lr=&id=6UDbAAAAQBAJ&oi=fnd&pg=PP1&dq=De+Garine,+I.+(2013).+Social+aspects+of+obesity+(Vol.+1).+Routledge.&ots=l6AjweUM-Y&sig=C-VuQcD2m1962eWbjGn3ibf0TH0#v=onepage&q&f=false

Egger, G., & Dixon, J. (2014). Beyond obesity and lifestyle: a review of 21st century chronic disease determinants. BioMed research international, 2014.

https://www.hindawi.com/journals/bmri/2014/731685/abs/

Malik, V. S., Willett, W. C., & Hu, F. B. (2013). Global obesity: trends, risk factors and policy implications. Nature Reviews Endocrinology, 9(1), 13-27.

https://www.nature.com/nrendo/journal/v9/n1/abs/nrendo.2012.199.html

Newman, L., Baum, F., Javanparast, S., O'Rourke, K., & Carlon, L. (2015). Addressing social determinants of health inequities through settings: a rapid review. Health promotion international, 30(suppl 2), ii126-ii143.

https://academic.oup.com/heapro/article/30/suppl_2/ii126/644696/Addressing-social-determinants-of-health

Popkin, B. M., & Slining, M. M. (2013). New dynamics in global obesity facing low?and middle?income countries. Obesity Reviews, 14(S2), 11-20.

https://onlinelibrary.wiley.com/doi/10.1111/obr.12102/full

Rahman, A., & Harding, A. (2013). Prevalence of overweight and obesity epidemic in Australia: some causes and consequences. JP Journal of Biostatistics, 10(1), 31.

https://search.proquest.com/openview/83c4e06e520973d6bd8ac2a3fff46085/1?pq-origsite=gscholar&cbl=1816344

Roberto, C. A., Swinburn, B., Hawkes, C., Huang, T. T., Costa, S. A., Ashe, M., ... & Brownell, K. D. (2015). Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet, 385(9985), 2400-2409.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61744-X/fulltext?cc=y=

Robinson, E., & Christiansen, P. (2014). The changing face of obesity: exposure to and acceptance of obesity. Obesity, 22(5), 1380-1386.

https://onlinelibrary.wiley.com/doi/10.1002/oby.20699/full

Suglia, S. F., Duarte, C. S., Chambers, E. C., & Boynton-Jarrett, R. (2013). Social and behavioral risk factors for obesity in early childhood. Journal of developmental and behavioral pediatrics: JDBP, 34(8), 549.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3960979/

Teixeira, P. J., Carraça, E. V., Marques, M. M., Rutter, H., Oppert, J. M., De Bourdeaudhuij, I., ... & Brug, J. (2015). Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC medicine, 13(1), 84.

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0323-6

Witten, K. (2016). Geographies of obesity: environmental understandings of the obesity epidemic. Routledge.

https://books.google.co.in/books?hl=en&lr=&id=0O4GDAAAQBAJ&oi=fnd&pg=PP1&dq=Witten,+K.+(2016).+Geographies+of+obesity:+environmental+understandings+of+the+obesity+epidemic.+Routledge.&ots=D74S98H0Kk&sig=lbR5EhHqKnjw4Mn_1_DWlO2-png#v=onepage&q&f=false

World Health Organization. (2014). Global status report on noncommunicable diseases 2014. World Health Organization.

https://books.google.co.in/books?hl=en&lr=&id=HbQXDAAAQBAJ&oi=fnd&pg=PR2&dq=World+Health+Organization.+(2014).+Global+status+report+on+noncommunicable+diseases+2014.+World+Health+Organization.&ots=PawzIgT3zC&sig=Yb6ogC2n40ZOFpE3fLwiqPx0qT0#v=onepage&q=World%20Health%20Organization.%20(2014).%20Global%20status%20report%20on%20noncommunicable%20diseases%202014.%20World%20Health%20Organization.&f=false

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