Obesity in the United States Term Paper

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There is a long list of illnesses associated with obesity, including hypertension; dyslipidemia and respiratory problems such as asthma, sleep apnea and depression. It was only recently discovered that there exists a strong and direct correlation between heart failure and obesity. The following study makes this correlation clear.

In 2002, Kenchaiah et al. examined the relationship between overweight and lesser degrees of obesity on the risk of developing heart failure in 5881 participants in the Framingham Heart Study. Heart failure developed in a total of 496 (8%) subjects (258 women and 238 men). After adjustment for known risk factors, overweight women with a body mass index of (BMI) 25.0-29.9) had a 50% greater risk of heart failure, and obese women (BMI & gt; or =30.0) were twice as likely to develop heart failure compared with normal weight individuals. Overweight men had a 20% increase in heart failure risk, whereas obese men had a 90% higher increased risk. With each increase of 1 unit of BMI, a woman's risk of heart failure increased 7% and a man's risk of heart failure increased 5%. More importantly, obesity alone was estimated to account for 14% of heart failure cases in women and 11% of heart failure cases in men.

This correlation is reiterated in another study entitled: Obesity and Heart Failure, from The Journal of Cardiovascular Nursing.

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Obesity and heart disease are closely associated as obesity is a primary contributor to hypertension, diabetes, and dyslipidemia, all risk factors for the development of coronary artery disease (CAD). Coronary artery disease and hypertension have long been accepted as contributors to heart failure. Hypertension, diabetes, and left ventricular hypertrophy account for up to 90% of the risk for heart failure in the U.S. population.

What is of concern is that obesity is not seen only as a contributing factor to heart failure but as a cause in its own right.

Term Paper on Obesity in the United States Assignment

With recent advances in cellular technology, it is clear that not only is obesity an interwoven thread in the fabric of CAD, but it also stands alone as an independent risk factor of heart failure. Chronic heart failure continues to be a major cause of cardiovascular mortality and morbidity in the United States, currently affecting 4.8-million Americans and reaching another 550,000 people each year.

A further study also serves to corroborate these findings.

Obesity is known to have significant adverse effects on many of the coronary artery disease (CAD) risk factors, including arterial pressure, insulin resistance, plasma lipids (especially increasing triglycerides and decreasing high-density lipoprotein cholesterol), physical activity, inflammation, exercise capacity, and LVH. (19,20) Despite adversely affecting all of these individual risk factors, data from both the Framingham Heart Stud (21) and a large cohort of female U.S. nurses (22) have indicated that obesity is an independent risk factor for major CAD events in men and, particularly, women. Several studies indicate a progressive increase in all-cause mortality associated with overweight and, especially, with frank obesity.

Obesity is therefore seen as an independent risk factor in heart failure. There is also evidence that dyslipidemia and arterial inflammation together play an important role in the development of coronary artery disease, in which obesity is an important factor. "Dyslipidemia and markers for arterial inflammation (cardiac C-reactive protein (CRP), interleukin 6 (IL-6)) rise with diabetes and hypertension. They also rise with obesity. Obesity is characterized by an increased prevalence toward hypertriglyceridemia."

There are many other factors to consider in the relationship of obesity to other health issues and diseases. Suffice to say that this relationship is becoming more pervasive with the increase in obesity as both a contributory and direct factor in the understanding of health and disease.

Research has clearly shown the deleterious impact of obesity in relationship to increased health risks, negative factors associated with psychosocial functioning, increased risks of disability and lost productivity, and rising costs of medical care and weight loss treatment. The overall health of our society is at risk due to the increasing prevalence of obesity.

4. Public Health

The cost of obesity is reflected in its effect on public healthcare figures. While rates may differ from state to state, the cost of obesity is reflected in the percentage amount spent by Healthcare.

Medical expenditures due to obesity range from a high of 7.4% of total healthcare spending in Puerto Rico to a low of 4% in Arizona. The eight states with the largest commitment of their healthcare dollars use, on average, 42% more of their healthcare funds for obesity than the eight states with the lowest commitment.

These figures are expanded upon in the following study.

Obesity is responsible for at least 300,000 deaths per year, and the 2003 direct health cost of obesity has been tagged at $75-billion. That is approximately $350 per year for every American adult. A 2003 report found that 5.3% of annual health costs were medical expenses attributable to obesity. And it has been estimated that if you are an American aged 18 to 36 and obese, you will on average generate 36% more medical expenses per year than if you were not obese.

The extent of the financial cost of the treatment of obesity and related illnesses can be seen in the statistics for the year 2000. During this year, obesity generated health costs of $75-billion, which amounted to 6% of the total health expenditure. Obesity accounted for $18-billion in cost, or 7% of the Medicare budget.

During this period there were also "approximately 80,000 stomach and intestine stapling surgeries in 2002, costing an estimated $2.4-billion."

The cost to the public sector cannot be estimated in pecuniary terms alone. The cost in terms of death and disability as well as the loss of working hours and productivity has to be assimilated into the overall equation. The complicating factor when calculating the cost of obesity to public health is the fact that obesity engenders and is linked to a wide range of other diseases and ailments that also increase the cost, in all sense of the word, to the public sector and healthcare in general.

Consider the fact that obesity is fertile breeding ground for chronic diseases like type-2 diabetes, cardiovascular disease and arthritis; that it is causally connected to cancers including endometrial cancer, some breast cancers, colon and kidney cancer; and that it is also an instigator of sleep apnea, gall bladder disease, back and joint disorders, and depression. Now go through the list again and think about the emergency room visits, hospitalization, surgery and rehabilitation. The paralyzing impact of obesity on the health care budget and the need for true health system reform becomes obvious.

The above statement also means that the treatment and study of obesity is absorbing resources and time that could rather be used to improve the healthcare system in general. An indication of the direct cost and effect of the increasing cases of obesity can be seen when compared to the cost of tobacco smoking to public health. According to a number of reports the medical costs associated with obesity have in fact overtaken the costs associated with smoking.

The nation's obesity epidemic has gotten so bad it has overtaken tobacco as the leading cause of preventable deaths. Health-care costs linked to obesity and resulting conditions such as diabetes and heart disease are greater than those related to smoking and problem drinking.

The cost to the economy and to production is self evident when one considers that Individuals who are obese have a 50 to 100% increased risk of premature death from all causes compared to individuals with a BMI in the range of 20 to 25. This means that the costs associated with obesity have both direct and indirect effects on the overall economy.

Overweight and obesity and their associated health problems have substantial economic consequences for the U.S. health care system. The increasing prevalence of overweight and obesity is associated with both direct and indirect costs. Direct health care costs refer to preventive, diagnostic and treatment-services related to overweight and obesity (for example, physician visits and hospital and nursing home care). Indirect costs refer to the value of wages lost by people unable to work because of illness or disability, as well as the value of future earnings lost by premature death.

These costs can be seen in the escalating amounts attributed to obesity.

In 1995, the total (direct and indirect) costs attributable to obesity amounted to an estimated $99-billion. (27) In 2000, the total cost of obesity was estimated to be $117-billion ($61 billion direct and $56 billion indirect). (28) Most of the cost associated with obesity is due to type 2-diabetes, coronary heart disease and hypertension.

The level of seriousness of obesity can be seen in the recent change in Medicare legislation. Obesity is now classified as an illness, which may be covered by Medicare. Health and Human Services Secretary Tommy G. Thompson announced "...that the Centers for Medicare and Medicaid Services would remove language in Medicare's… [END OF PREVIEW] . . . READ MORE

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