Running Head: OBESITY
Prevalence of Obesity in USA
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Prevalence of Obesity in USA
Obesity has emerged as the most pressing nutritional problem facing the developed world. This trend has occurred over a relatively short period of time; in the United States, it appears to have begun in the last quarter of the 20th century. The epidemic in children followed shortly thereafter. The most recent data (1999–2000) from national surveys in the United States suggest that almost two thirds of the adult population is overweight, and almost one third is obese (Flegal et.al, 2002, pp. 1724). In children, current estimates (1999–2000) ...view middle of the document...
Consensus definitions of overweight and obesity have been set at 25 (overweight) and 30 (obesity), with severity classes of obesity defined as follows: overweight, 25.0 to 29.9; Class I obesity, 30.0 to 34.9; Class II obesity, 35.0 to 39.9; and Class III obesity, 40.0+. The WHO (2000) terminology differs slightly, but the cutoff points are the same.
In growing children, in whom weight and height are both changing (and at different rates), the definition of obesity is inherently more complicated. Although no universally agreed on standard exists for assessing overweight and obesity in children and adolescents, there is a growing consensus that BMI should be adopted as an indirect measure of adiposity for children and adolescents, as well (Barlow & Dietz, 1998, pp. 223). Because BMI varies substantially by age and gender during childhood and adolescence, the specific BMI cutoffs used to classify obesity must be gender- and age-specific and must be referenced against a standard. In the United States, the standard used is the CDC Revised Growth Reference (Barlow & Dietz, 1998, pp. 228). Internationally, several standards (Cole et.al, 1995, pp. 27; Ogden et al., 2002, pp. 1728), including one based on a pooled international sample (Cole et.al, 2000, pp. 1241), are also in use.
Several periods in development have been proposed as critical periods in the development of persistent obesity and its comorbid consequences. These include the prenatal period (when intrauterine exposures may influence adiposity), early childhood, and adolescence. Some evidence suggests that breast-feeding may protect against later obesity. Likelihood of persistence in adulthood of obesity from childhood is related both to age at onset and severity.
Childhood obesity has a number of immediate, intermediate, and long-term health consequences (Must & Strauss, 1999, pp. S3). These include classic cardiovascular risk factors, such as high blood pressure, abnormal blood lipid levels, and impaired glucose tolerance. Respiratory conditions include sleep-disordered breathing. In addition, early menarche and menstrual abnormalities are linked to overweight. Of particular concern is the emergence of type 2 diabetes, once considered an adult-onset disease, as a disease of childhood. The psychological impact may represent one of the most damaging effects of obesity given that stigmatization and social isolation may result in lower self-esteem and depression. In a recently replicated classic study, children were asked to rank order a series of drawings of children with various handicaps (crutches, wheelchair, missing a hand, facial disfigurement, obesity) based on which child they would “like best” (Latnerm & Stunkard, 2003, pp. 456). The obese child was ranked last irrespective of the ranking child's sex, race, socioeconomic status, living environment, and own disability. In another study, ratings of quality of life for children with obesity were similar to...