With obesity finally being designated a disease and recent recognition that it is a very complicated disease, one might assume that people are more comfortable with the diagnosis and actively seeking treatment. According to research published on March 7, 2017, based on data from 1998 to 2014, fewer Americans were losing weight. Seems counterintuitive, doesn’t it? Are we becoming more comfortable with being larger?
The trajectory of obesity rates has been on an upswing over the last three decades. Researchers from Georgia Southern University used data sets from the National Health and Nutrition Examination Survey (NHANES), which clearly showed the escalation of obesity trends during the last three decades. The NHANES is a valued data set (that is ongoing) because the sampling approaches, interviews with subjects, and physical examinations were and continue to be standardized, and have been used in extensive research. In this case, the researchers focused on three samplings during the decades and assessed the percentage of subjects (adults) who were identified as overweight or living with obesity, in addition to their efforts to lose weight.
Over the last three decades, the number of adults identified as overweight or obese has increased from 53 percent to 66 percent, according to the Journal of the Medical Association (JAMA) March 2017 report. Ask anyone who has tried to lose weight, and they will likely tell you how hard it is to take it off and keep it off.
Question obesity specialists who treat these patients and they will more than likely tell you how, despite the growing arsenal of treatment options, obesity perpetuates as a chronic disease with a high rate of recidivism. The study’s author Jian Zhang, M.D., acknowledged how prevalent cyclical dieting is because losing weight is a lifelong commitment with enormous challenges. He asserts that the multiple weight loss failures that many people experience may result in them giving up and accepting their health condition.
There is however a pervasive, unkind attitude toward people who are large and discrimination and stigmatization can start from age 3. Given the unpleasant treatment that many individuals with obesity receive, how does the study explain the possibility that fat self-acceptance is the reason for lower rates of weight loss?
One theory is that there are so many more individuals struggling with excess weight that it is becoming a new norm. In addition to less social pressure to lose weight, more patients with obesity are surviving well into their senior years, thanks to the many treatments available for co-morbid conditions like diabetes, heart disease, and even cancer.
In this study, the most notable finding was the decline in weight loss efforts among subjects who were identified as overweight (not yet obese). African American women showed the steepest weight loss declines over the last three decades. The researchers noted that in the 1980’s and 1990’s, 66 percent of overweight and obese African American women said they had tried to lose weight in the last 12 months. In the last decade that number had dropped to 55 percent.
Obesity also escalated more in the African American female community, compared to white women in the last three decades. The last data set in the study showed that 79 percent of African American women were overweight or obese, compared to 59 percent of white women. Experts agree that there are limitations to the NHANES data sets, because questionnaires have an element of subjectivity.
We also need to ask if just diet or diet and exercise or handing someone a pedometer is “enough” to guide weight loss, long-term. Research shows that obesity specialist and primary care physicians need to do a better job treating the whole person, and that includes addressing the mental health part of obesity. Obesity is also a chronic disease, which means that people need ongoing and possibly lifetime support.
If fat acceptance means a decline in the negative stereotyping associated with obesity, then that’s a good thing. However, obesity is associated with a number of health risks. Developing diabetes may mean lifelong use of medications and injections, and an increased risk of associated heart disease and circulatory issues. Excess abdominal fat has a strong link to several cancers.
The quality-of-life and health care costs associated with obesity cannot be ignored. Pediatricians need to do a better job intercepting childhood obesity early in life and helping parents and children with reasonable and accessible interventions. Once obesity entrenches, the current success rate of treatment is still quite low. Of course, we mostly need to remain focused on finding new and effective ways to prevent and to treat obesity.
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