Considering Obesity A Disease: The Spreading Condition

What is Obesity?

Obesity is a medical condition in both children and adults that occurs when someone is extremely overweight which can give rise to medical conditions such as heart disease and high blood pressure. It is measured using a BMI scale which takes sex, age and height into consideration, where a BMI over 29.9 is classified as obese and a BMI over 39.9 is severly obese. The UK obesity levels are relatively high as it has been stated that it affects 1 in 4 adults and is on the rise.

Causes of Obesity

There are many causes of obesity; but it is primarily caused by taking in more calories than one can burn off by exercising, especially foods high in fat and sugar. The excess calories are stored as fat in various places around the body, in the lower region in women and particularly in the abdomen in men. Obesity is as there is a rise of eating too much cheap high-calorie fast food, increasing desk jobs, and increased reliance on cars. Genetics can be a factor triggering obesity, this is because one is more likely to be obese if there family members are. This may partly be due to learning bad eating habits from one's parents or some people inherit a tendency in their genes that makes them prone to overeat.

Despite inheriting this tendency it is still very possible to control it but are likely to struggle more than others to lose weight therefore this isn’t a definitive cause. Obesity can also be caused by some diseases which contribute to weight gain, such as an underactive thyroid gland, which inhibits the hormone which controls metabolism however medicines have been developed which manages this successfully, therefore this isn’t a large obesity trigger. Socioeconomic status has also been linked to obesity which has been determined by a systematic review and meta-analysis study which summarised the information published about these two factors. It highlighted a need for public health policies that have the best chance of reducing obesity and developing healthier habits earlier on in life, especially in the lower and working classes which were shown to be the most vulnerable to obesity due to easy access to cheap and unhealthy foods.

Health Risks of Obesity

There are an abundance of health risks associated with obesity which may be directly caused by being overweight such as type 2 diabetes and heart disease or indirectly caused such as pregnancy issues. Type 2 diabetes occurs when ones blood sugar is higher than normal which can lead to other health issues, like heart disease where fatty deposits accumulate in the major arteries that supply the heart with blood. This can lead to hypertension is associated with obesity as blood vessels will need to circulate more blood to the extra fat tissue putting extra pressure on the walls of one's arteries causing high blood pressure. Another health risk that can be developed due to obesity is gallstones which occurs when there is a build up of bile, which is prevalent in obese people which have increased cholesterol in there bile which can lead to a dysfunctional gall bladder. Futhermore, people who are obese may suffer from sleep apnea which is a disorder where one may momentarily stop breathing during their sleep due to excess neck fat making the airway shrink. This increase in likihood of developing high blood sugar, and high blood pressure can be dangerous in pregnant women as it can increase the risk of complications during pregnancy and delivery, including but not limited to: needing a cesarean delivery, premature birth, miscarriage and big babies. Moreover, obese womenn are a higher risk of developing gynaecological and obstetric problems which can include menstrual irregularities to amenorrhoea which are due to the abnormality of sex hormone metabolism which are displayed in obese women. There are still many health risks being linked to obesity such as cancer, however more research is needed to develop a definitive link.

Costs to the NHS

The cost of obesity to the NHS is substantial and it is a serious strain on the NHS. It has been estimated that the cost of obesity related illness to the NHS is approximately £6.1 billion between 2014 to 2015”. This is relatively high compared to the amount spent on other civil services as it is more than the total spent on the police, the fire service and the judicial system. Overall, obesity has had a much larger effect on economic development costing £27 billion to the wider society for example on disability benefits. It has been predicted that by 2050 the costs to the NHS due to obesity will reach £9.7 billion and the costs to society will reach £49.9 billion per year. The costs to the NHS have been emphasised by the graph below where a person with a BMI of 40 and over costs the NHS 86% more than a person with a healthy weight BMI.

It has been estimated that there has been 35,820 due to diseases related to being overweight and obese in England and Wales in 2014. It was found that the UK government in fact saved £3.6 billion every year in health, welfare and benefit payments. It is said that the burden on the taxpayer has been exaggerated as past researchers have completely omitted the fact that reducing body weight entails its own costs, because the extra life years gained lead to extra pension, healthcare and benefit spending by the government. There have been estimates of the burden of BMI-associated illnesses on the NHS and welfare bill can be set against the £3.6 billion saved to generate the netcost of overweight and obesity. This paper estimated a net cost of £2.47 billion in 2016 prices. The overall cost of overweight and obesity is still substantial, though it is smaller than the initial proposed figure.

Obesity and mental health

Obesity has a stigma attached to it and this can lead to mental health issues such as low self-esteem, binge eating, starvation, which can affect the quality of life of the person and their friends and family. This increase in mental disorders, increasing the cost burden on the NHS due to the increasing need for psychiatric help. Furthermore, many people who are obese cannot actually identify why they are gaining weight and may be in denial or just unaware, this leads to a feeling of hopelessness where obese poeple feel as if they are eating healthy and not getting any effects, leading to low moods which can also effect other family members moods. Obesity in both men and women can increase the risk of poor sexual health due low self esteem about their body image, leading to a lack of sexual activity.

A case study determined that depression was more common in those who are obese however there was a lack of evidence to fully assess whether this is causative or just correlative. This is because depression is very complex and caused by many factors such as genetics, chemical imbalance and obesity may have just been the trigger. The push of risk of obesity may run the risk of pushing it the other way, increasing the risk of eating disorders which are highly prevalent among adolescents and have serious long-term consequences. Binging has been associated with obesity where people cannot control how much they eat and dieting do not show results leading to an increase in eating disorders. The increase in Bulimia and purging affect social relationships, school functioning, and perhaps most importantly in young patients, family relationships. Suicide is one of the leading causes of death in adult eating disordera. People with the binge eating/purging are more prone to suicidality than those with the restricting subtype. A change in attitudes is clearly needed where obesity is viewed as an eating disorder rather being stigmatised and shamed which has been shown to give rise to other mental health issues such as bulimia, anxiety and depression.

Treatments of obesity?

The most well known and used diet to lose weight is by limiting how much calories one consumes. This is achieved through either a low or very low calorie diets, where weight loss from very low calorie diets is achieved primarily through a loss of total body fat. However, the long-term benefits of a very low calorie diets are limited due to a high rebound weight gain. Another way people tend to lose weight is through meal replacement which is either done fully or partially. This is when meals are replaced with other low calorie foods, which leads to a lower total daily calorie intake. Partial meal replacement has been demonstrated to lead to an increased long term weight loss. These effects were similarly shown by a subsequent systematic review, where it was shown that partial meal replacement yielded a greater weight loss benefit over low and very low calorie diets at 1 year.

It has been suggested that obesity is an addiction that needs to be treated like a drug addiction. It was proposed that hunger was a learned behavior and with time the behavior becomes organized and food cues, such as the sight and smell of food, become conditioned and develop the ability to induce craving, approach and consumption, much as drug-associated cues do. In drug abuse research, a focus on the behavioral expressions of compulsive drug use has helped achieve a better understanding of the neurobiology of the addiction process. There have been investigations into how reward, stress, and cognitive functions intersect and are disrupted to ultimately drive compulsive behavior have begun to lay the framework for novel diagnosis, treatment, and prevention of addiction disorders. It is described that conceptual framework of compulsive eating is similar to the effects of drugs of abuse. By focusing on the interactions between obesity and potential causative factors we can start to identify how these factors influence each other, for example, how the relationship between low emotional states on habit learning and decision-making processes may affect the potential for one to become obese. Perhaps, if attitudes and the approach to compulsive eating is changed better solutions would be established that can better diagnosis, prevention, and treatment of disorders of pathological eating may be reached.

Is there really a risk?

A newspaper article highlighted the fact that the NHS falsifying news. They claimed that many of the 16 to 24 year olds were falsely classified as obese when they were at school and most of the 11 to 15 year olds who were classified as obese in 2016 will stop being obese the day they are medically classifed as an adult. They further state that ‘The true rate of childhood obesity cannot be derived from the NHS data but it is clearly much lower than the government claims…’.

Furthermore, the emphasis on achieving a ‘perfect body’ has developed a new risk as this pressure has led to an increased number of people turning to surgical alternatives as the prospect of dieting seems too difficult, which will increase the number of people exposed to surgical complications. It was published that more women are seeking liposuction, possibly to get a body that looks good and, according to a leading cosmetic surgeon and latest UK data shows procedures have gone up 12% in a year, from 2,039 in 2017 to 2,286 in 2018. Perhaps a more viable and preferable option is to emphasise healthy eating rather than losing weight and losing weight is achieved as a by product of this.

Conclusion

In conclusion, there are an abundance of real risks of obesity both physically e.g. diseases, mentally e.g body confidence issues and socially e.g NHS costs. It seems that the current approach of dieting and exercise has not been effective, however the real risk maybe that a new approach is needed as obesity may just be a side effect of a wider problem, it may just be a coping mechanism for stress or anxiety and perhaps treating the root of the problem may be a more efficient and effective approach.

However, NHS costs for obesity may be substituted for cost of increasing eating disorders therefore more emphasis on healthy eating with losing weight as a side effect rather than losing weight bring the goal as may promote eating disorders.