Dec 01, · The Pediatric Growth and Nutrition Branch (PGNB) also supports a wide range of childhood obesity research, including studies on psychosocial risks of obesity, the natural history and clinical pathophysiology of body composition, metabolic syndrome and diabetes, environmental and policy research in relation to obesity, and preventive and therapeutic interventions for childhood obesity This has important, but uncharted, consequences for research about obesity, particularly, research involving face-to-face interaction in data collection. In this paper, we report on a literature review of qualitative studies in which the study participants were adults categorized as obese and the data collection involved face-to-face methods. blogger.com by: 9 obesity epidemic in the United States and provides an overview of the associ-ated economic and health costs. The paper summarizes existing federal pro-grams and policies that address obesity and examines new and emerging policy strategies to battle the bulging American silhouette. Topics explored includeCited by: 11
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Obesity has increasingly been identified as a critical global public health research papers on obesity. This focus on obesity as a health priority raises complex bioethical issues.
Research papers on obesity critical examination of how obesity is defined as a medical problem suggests that ethical approaches could be more productive if obesity were addressed as a social problem with medical consequences, rather than emphasizing it as a medical problem with social consequences.
Obesity is seen as a major public health concern because it is widely recognized as a precipitating factor in the parallel emergence of chronic diseases as a primary cause of death in many countries. Obesity is often reported as a major drain on medical systems, and the growing obesity rates in developing countries are often cited as especially worrying in this regard.
From a bioethics perspective, the focus on obesity as a research papers on obesity priority raises complex issues. Obesity is most simply defined as an excess of adipose fat tissue, usually with negative health effects.
However, this definition is problematic. Medically, as discussed below, the science of obesity is increasingly suggesting that many people can be both obese and healthy. The growing assumption that obesity is defined as a negative characteristic is historically and culturally particular, in marked contrast to cross-cultural records that describe plump bodies as powerful, sexy, social, abundant, fertile, and certainly healthy Brewis a.
The Categorization of Obesity. The most widely employed means to classify people as obese, and then assess variation in population levels of obesity, is through use of body mass index BMI. BMI does not directly measure body fat; rather, it is a proxy measure using the ratio of mass weight relative to height.
These standard categories are arbitrarily defined through cutoff points related to morbidity and mortality rates found in large-scale epidemiological studies, with obesity normally set at a BMI of 30 or higher. While BMI as a measure of obesity is sometimes useful, particularly in clinical studies, because of both individual and population variation, research papers on obesity, this mapping of weight to health risk is not precise or even especially predictive.
For example, there is growing evidence that many people clinically defined as obese prove to be metabolically healthy even as they are advised by doctors they need to lose weight, and that the level of obesity at which conditions like diabetes and heart disease become more prevalent differs across populations.
Moreover, BMI does not discriminate between muscle mass, bone, connective tissue, and amount types of adipose tissue, obscuring accurate measurement of total body fat. As a result, people with highly-developed musculature are labeled obese by the measure, even when they have low levels of actual body fat, research papers on obesity.
Further, some populations have greater bone density on average or shorter leg bone length resulting in falsely high BMI scores Hruschka et al. For example, for decades there has been a public health concern focused on very high obesity risk in Pacific Island populations, but more recent studies have shown that the disease correlates of obesity emerge at higher levels of adiposity in comparison to other groups. Hence, the common standard for categorizing obesity probably misassigns a significant number of people and accordingly implies health risks where none may exist and vice versa.
Additionally, women have a higher percentage of body fat than men, and weight tends to increase in both genders as individuals age. Attempts to address the weaknesses in BMI classifications have resulted in alternative methods that more accurately measure the amount and distribution of body fat, but these use technologies or expertise that are difficult to implement in real-world settings. Defining Obesity as a Disease. Defining obesity against a set standard of what is a normal or healthy level of body fat leads to an emphasis on prevention and cure, and underscores obesity as 1 a problem, with 2 an identifiable cause diagnosisand that 3 requires evaluation, intervention, management, and control.
The central bioethical issue is this: regardless of how people are classified into an obese category, once so categorized it is generally assumed that labeling a person as unhealthy is warranted and medical or other intervention is necessary.
Certainly, obesity has become increasingly identified as a major factor and index of ill-health over the last two decades. This culminated in the formal recognition of obesity as a disease by the American Medical Association ineven in the absence of other risk factors or clinical symptoms. The growing medicalization of obesity as a condition explains why highly invasive and often risky medical treatments for obesity, such as bariatric surgery, are on the rise.
Levels of Analyses and Ultimate Causation. Current scientific evidence on the causes of obesity can be analyzed at different levels, often working iteratively and in feedback with each other.
At the genetic level, some individuals have a predisposition toward higher weights, weight gain, and difficulty in weight loss, related to genetic variants in appetite, research papers on obesity, metabolism, and activity.
At the individual level, obesity is the result of excess calorie intake over calories expended through physical activity, but individual-level factors such as income, education level, ethnicity, age, research papers on obesity, and gender also predict differential risks of being obese, as does use of certain medications or comorbidities such as depression.
Institutional factors such as health care access also matter. At the community, neighborhood, or regional level, obesity risk accrues differently based solely on where people live. This correlation is due, in part, to the low cost of high density foods, changes in activity with the move to urban settings and structural and economic barriers to healthier lifestyles Metzl and Hansen The built environment of a particular locale is one example of how the physical expression of social, spatial, and economic factors relates to obesity prevalence: walkability, public transportation, access to fresh foods, safety, research papers on obesity, parks, light and shade, access to healthcare, and density all help shape obesity risk.
For example, research papers on obesity, barriers in transportation and distance may make it difficult for residents to access healthy foods, while the perception by residents that the place they live in is unsafe or of poor quality may limit opportunities to be physically active.
Social and economic factors also influence residential effects, including social exclusion, discrimination, and diminished economic infrastructure. Efforts to address residential effects often evoke stakeholder objections, as these efforts may inhibit personal choice, stigmatize neighborhood residents, or create changes that conflict with personal lifestyles and cultural values ten Have et al. Education and wealth, and most especially poverty, are also implicated in obesity risk. The relationship between income and obesity is complex and varies depending on the economic development of the resident country, research papers on obesity.
Most nations, even the poorest, demonstrate some level of obesity, even in the presence of food shortages and undernutrition. The combination of under and over nutrition increases the likelihood of obesity and has significant implications in terms of health risks and negative health effects. As poorer nations become increasingly urbanized and research papers on obesity, these problems are exacerbated, particularly as low income countries have fewer healthcare resources to meet the challenges posed by chronic conditions associated with obesity.
Evidence suggests that income and obesity also rise together as inexpensive food becomes easily accessible. However, research papers on obesity, this trend reverses at the point where the apparent social costs of obesity outweigh the advantages. In middle to high-income countries, obesity tends to be inversely correlated with socioeconomic status, meaning that the highest obesity rates are found in those populations with the lowest incomes and with the lowest levels of educational achievement Brewis a, research papers on obesity.
At a national level, BMI appears to rise in the early and accelerated phases of economic development due to a complex set of factors including urban migration, a shift from traditional occupations, and increased technology.
At the individual level, poverty is contextual, demonstrating a complex residential pattern, with both rural and urban poverty linked to lower education and research papers on obesity obesity. While there have been some efforts to develop community-level interventions in line with increasing recognition of these upstream causes of obesity risk, medical and public health interventions continue to give the most attention to individual behavior change.
This is despite decades of evidence that most such behavioral change strategies eventually fail to result in weight lost, and often research papers on obesity to promote weight regain Brewis a. Obesity and Social Justice Considerations. The role of proximate and ultimate factors discussed above means that obesity can be framed as a social justice issue, not solely a medical one.
This suggests a very different course, emphasis, and pathway for public health interventions. Policies that seek to restrict behavior passively or actively can disproportionately affect the poor, the rural, and the malnourished. Of critical importance is who designs, implements, and evaluates these efforts.
How do these interventions ethically impact personal physical health while promoting equality and maintaining individual autonomy? If population-level interventions are not necessarily individually research papers on obesity and may in fact have psychosocial and cultural costs with their own negative health consequences, should public health entities intervene at all? These are some of the ethical issues that arise when the focus moves away from considering obesity fundamentally a medical problem to thinking about obesity at the aggregate level.
The challenge is to consider both the ultimate structural as well as the proximate factors nutrition, research papers on obesity, and medical conditions that shape obesity risk when developing obesity policy and interventions.
Identifying the causes of obesity, when coupled with how it is defined, becomes important in the research papers on obesity frame used to intervene. To date, research papers on obesity, there have been multiple framings in approaches to combat the rise of obesity.
These ethical frames are not mutually exclusive and often coexist within a particular approach. Understanding the ethical platform from which programs spring will enable better understanding of the consequences intentional or unintentionalsuccesses, and failures.
Identifying obesity as a health problem is more than defining disease, biomedical risk, and treatment; assigning responsibility — individual or otherwise — becomes part of the equation. The increasing prevalence of obesity on a global scale is accompanied by concerns that society is harmed in some way.
This sense of harm in turn is linked to the notion of blame. How responsibility and blame are assigned varies with different ethical frames.
Emphasis on Individual Responsibility. The notion of individual responsibility has dominated the discourse surrounding the obesity crisis and efforts to contain the problem. Individual responsibility is rooted in notions of individual autonomy based within a moralistic theory of personal determination.
Morality frames emphasize the threat to social values and economic stability by focusing on personal choice and the impact these choices have on society Boero A morality frame advances notions of normal, ideal, virtue, right, and wrong. In this frame, obesity is related to personal failings — a lack of self-discipline, restraint, rationality, and moral failings attributed to poor life choices gluttony, sloth, and a lack of adherence to personal improvement.
Obesity, therefore, is self-induced and harm is self-inflicted. Because the individual is responsible for their health and body, blame is personal and can take the form of value imperatives about who is obese or overweight and who is responsible. Interventions and public health campaigns using this frame focus on problem awareness, promote better individual health behaviors, and encourage personal responsibility.
This type of framing, when used in conjunction with a medical definition of obesity, places the focus of the intervention on achieving a physical ideal body weight and ignores the psychosocial dimensions of health, even as it places responsibility upon the individual as psychologically weak or morally lax.
Stigmatization, discrimination, and negative self-image are the result, which have their own negative health consequences Sagay ; Puhl and Heuer Biomedical and Public Health Frames. The biomedical frame uses the language of risk to intervene and regulate the body in order to promote health or, more usually, decrease illness or disease.
Obesity in this frame is seen as pathologic — a biological condition to be monitored, treated, and cured. The body is understood to be the recipient of treatment, a somewhat passive vessel that needs management by healthcare professionals Sagay De-emphasizing personal responsibility can be helpful in decreasing stigma, but medicalization also promotes research papers on obesity by labeling obese bodies as sick.
Framing obesity in terms of mortality and morbidity imparts urgency and authority to the issue. The locus research papers on obesity intervention is on proximate factors and responsibility remains with the individual-aspatient, though the medical system is a crucial partner in terms of defining the problem and determining and managing treatment, research papers on obesity. However, the biomedical frame informs larger policy issues resulting in industry and governmental regulations generally rooted in economic analyses, such as differential insurance rates for individuals based upon weight, corporate programs to incentivize weight reduction or dietary choice, bans or taxes on sugar-sweetened beverages, and regulation of nutritional information on food products.
A public health frame assigns responsibility to the government local, research papers on obesity, state, and federal. Public health entities are most often located within governments and are charged with setting standards, regulating and research papers on obesity public safety and promoting health, and minimizing or preventing public harm while at the same time ensuring individual liberty, privacy, and public access to needed resources.
This equation differs internationally as notions of individual and public health are culturally constituted. In general, obesity is seen as a threat to public health and the approach taken is to reduce the threat, generally combining individual and systemic approaches to address the issue.
Ethical approaches in this frame deal with the differential distribution of obesity across groups and subpopulations as prevalence and risk manifest variably within cultural groups, gender, socioeconomic status, etc.
Obesity, diet and health research - Professor Susan Jebb OBE FMedSci
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Recent studies have indicated that obesity is associated with hypertension, sodium retention, and increased sympathetic nervous system activity. The purpose of this study was to determine the role of renal nerves in mediating the sodium more by Salah Eldin Kassab 0 Views Dec 01, · The Pediatric Growth and Nutrition Branch (PGNB) also supports a wide range of childhood obesity research, including studies on psychosocial risks of obesity, the natural history and clinical pathophysiology of body composition, metabolic syndrome and diabetes, environmental and policy research in relation to obesity, and preventive and therapeutic interventions for childhood obesity Jun 18, · This paper focuses on obesity as the main cause of health problems in the modern world. Overview. Obesity is regarded as one of the leading causes of death across the world. Many studies have revealed that prevalence of overweight and obesity is higher in developed countries than in developing blogger.comted Reading Time: 9 mins
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