North American Obesity, Diet, Culture, and Weight Discrimination in Healthcare.
Definitions. Obesity: According to the CDC: Weight that is higher than what is considered healthy for a given height is described as overweight or obesity. According to Oxford Languages Dictionary The condition of being grossly fat or overweight. Diet: According to Dictionary.com: Food and drink considered in terms of its qualities, composition, and its effects on health. Weight Discrimination: According to MedicalNewsToday : Weight discrimination is when someone receives different treatment than others because of their body weight. People of higher weights are often discriminated against at work, school, healthcare settings, and in interpersonal relationships..
Definition of Culture. A community or population sufficiently large enough to be self-sustaining—that is, large enough to produce new generations of members without relying on outside people. The totality of that group’s thoughts, experiences, and patterns of behavior and its concepts, values, and assumptions about life that guide behavior and how those evolve with contact with other cultures. The process of social transmission of these thoughts and behaviors from birth in the family and schools over the course of generations. Elements of Culture: Symbols, Rituals, Values & Heroes.
Background. Obesity rates in America has stayed the same since 2003, but is has doubled since 1980. 36.2% of U.S adults are obese or... ⅓ U.S adults are obese, and ⅔ U.S adults are overweight or obese. Obesity rates are higher in the Hispanic, Mexican-American, and Black communities within America. Black women have the highest rate of obesity in America at 59% If current trends continue, it is estimated that ½ of the population in America will be Obese by 2030. In Canada, obesity has steadily increased. In 1979, 14% of Canadian adults were obese. By 2021, 29.4% of Canadian adults are obese. 28.9 % of all adults in Mexico are obese..
Percent of obese adults (Body Mass Index of 30+) n -9.9% • 10-14.9% '15-19.9% e 20 - 240% • 25 - 290% WA NM 30 - 34.9% VA NC 35%+.
North American Obesity. Individuals who are obese tend to receive negative bias within North America: In Education, Employment, and in Healthcare Weight bias is usually socially acceptable and usually ignored. Individuals who are obese in North America are at risk for unfair treatment. Examples of weight stigma include: Verbal teasing, physical aggression, & relational victimization. Individuals usually seen as lazy, have no will-power, etc. According to The Washington post “Although societal attitudes toward other stigmatized groups have become less prejudiced in recent decades, there has been little change in weight bias”..
What causes Obesity?. Obesity can be influenced by a multitude of different factors. Although diet and exercise do contribute to your health it is a popular misconception that those are the sole reasons for obesity. In reality there are numerous aspects that directly affect obesity some which you have no control over. We can break down it down to 2 main categories with different contributing factors E xternal and internal External refers to influences from external sources such as environmental and societal factors Internal factors are influenced by genetic composition. In healthcare and as another loving human we must remember there are lots of behaviors conducive to developing obesity that can be influenced by external and internal factors beyond an individual's control it's not all about their diet and exercise regime..
What causes Obesity? -External Factors. Industrialization - Industrialization causes changes in societal structures, such as food production, food abundance, a decrease in energy expenditure because of sedentary lifestyles, access to modern education, and changes in the role of women. For example availability of recreational spaces may influence a person’s ability or choice to engage in physical activity just like the grocery store and restaurants that are accessible to you in your area will influence what you can eat. Socioeconomic - High socioeconomic status is negatively correlated with obesity in developed countries, but positively correlated in developing countries. For example, availability of healthful food at reasonable prices may influence food purchasing behaviors. Cultural influences - Cultural influences affect the intake of energy-dense foods that are high in fat, increase in sedentary lifestyles and attitudes toward body image. Societal changes - Societal changes impact behaviors that contribute to weight gain, such as overeating and reduced physical activity. Pleasure derived from food palatability can be a powerful driver of overconsumption behavior that can result in an energy imbalance favoring weight gain..
What causes Obesity? - Internal Factors. A person’s genetics may determine the extent to which external or environmental factors impact their weight. Studies have shown that 40% to 70% of interindividual differences in BMI are explained by genetic factors. Many different genetic qualities and your family's health history can help influence obesity. For example if diabetes, high cholesterol, or high blood pressure run in your family you at higher risk of developing those conditions which can make maintaining a healthy weight more difficult. There are some genes that can directly cause obesity in specific disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome..
Child obesity.m4a. Obesity in Children. Obesity in children is a serious problem in the United States, putting many children at risk for poor health and developing more serious conditions such as diabetes. The prevalence of obesity was 19.3% and affected about 14.4 million children and adolescents. Obesity prevalence was 13.4% among 2- to 5-year-olds, 20.3% among 6- to 11-year-olds. Obesity prevalence was 25.6% among Hispanic children, 24.2% among non-Hispanic Black children, 16.1% among non-Hispanic White children, and 8.7% among non-Hispanic Asian children..
Teen obesity.m4a. Obesity in Teenagers. 21.2% of teenagers are obese in America. Teen obesity can be caused and linked to genes, socioeconomic issue, metabolism, insomnia, and lifestyle choices. Genes. Obesity may be passed down through families. Having even one obese parent may raise a child’s risk for it. Metabolism is the way your body produces food into energy. Each person’s body uses energy differently. Metabolism and hormones don’t affect everyone the same way therefore can play a role in weight gain in teens. Socioeconomic factors plays a role in teen obesity due to the limited resources readily available for some in lower-income areas. Obesity is more common among low-income communities and households due to limited access to affordable healthy foods. Or they may not have a safe place to exercise. Lifestyle choices such as overeating and an inactive lifestyle both contribute to obesity. A diet full of sugary, high-fat, and refined foods can lead to weight gain. Also a lack of regular exercise. Children who watch TV and sit at a computer tend to be more obese due to limited physical activity..
Adult obesity.m4a. Obesity in Adults. The main cause of obesity in adults is energy imbalance. Over time, if people eat and drink more than the body needs and uses in day-to-day activities, this extra energy will be stored as fat. Obesity-related conditions include hypertension, stroke, type 2 diabetes and certain types of cancer. These are among the leading causes of preventable, premature death. Non-Hispanic Black adults (49.6%) had the highest age-adjusted prevalence of obesity, followed by Hispanic adults (44.8%), non-Hispanic White adults (42.2%) and non-Hispanic Asian adults (17.4%). The obesity prevalence in adults aged 20 to 39 years is 40.0%.
Obesity in Elders. Obesity can affect the elderly in a multitude of ways here some examples of health risks it can cause from Ojin.nursingworld.org. Obesity in older adults impacts not only morbidity and mortality, but importantly impacts quality of life and the risk of institutionalization Epidemic obesity is not only a problem in childhood and adulthood but it also extends into older ages. The prevalence of obesity in older people has dramatically increased in recent years: in the United States, more than 30% of men and women aged 60 years and over are obese. 29.3 % of 65+ older adults are obese. "An important determinant of body-fat mass is the relationship between energy intake and expenditure. Weight gain occurs when the balance is tipped and we take in more calories than we burn. Most studies indicate that how much we eat does not decline with advancing age ( Gary, Hunt, VanderJagt, & Vellas, 1992 )". Therefore, it is likely that a decrease in energy expenditure, particularly in the 50- to 65-year-old age group, contributes to the increase in body fat as we age. In those 65 years of age and older, hormonal changes that occur during aging may cause the accumulation of fat. Aging is associated with a decrease in growth hormone secretions, reduced responsiveness to thyroid hormone, decline in serum testosterone, and resistance to leptin. In obese patients, lungs decrease in size. Both the increased weight on the chest wall of obese patients and the difficulty they experience in lifting the heavy chest wall may contribute to difficulty in breathing. In the obese elderly, these changes are accentuated by changes in the lung structure and function associated with normal aging. These changes in the lungs include decreased alveolar surface available for gas exchange, increased chest wall stiffness, and stiffening of the elastin and the collagen tissue supporting the lungs "Arthritis is the leading cause of disability in older adults. A high body mass index (BMI) is an associated risk factor for knee osteoarthritis (OA) in older persons ( Villareal et al., 2005 )". By 65 years of age the prevalence of osteoarthritis is 68% in women and 58% in men. This age-related increase in the prevalence of OA may reflect bodily changes as a result of a lifetime of being overweight which results in strain on weight-bearing joints ( Villareal et al. ). Obesity, or even being overweight, increases the load placed on joints, especially the knee and hip joints. Breakdown in cartilage, resulting from the increased weight on joints, may result in pain and further functional disability ( Lorig & Fries, 2006 )..
Where is Responsibility Assigned for Obesity?. People Held Responsible: - Family members - Affected individual Outsiders are seen as enablers. Biological and genetic factors are ignored. Individuals viewed as Lazy, unintelligent, and unmotivated..
Obesity Stereotypes within North America. All obese people are lazy. Al obese people have unhealthy eating habits Individuals lack motivation. Individuals are have poor hygiene. Individuals are worthless. Statistics Around 53% of women with obesity report hearing inappropriate comments about their weight from healthcare professionals. Approximately 79% of people with excess weight or obesity report eating more to cope with weight discrimination. About 52% of women say that their weight has been a barrier to receiving appropriate healthcare. Concerns about weight are also associated with delaying or avoiding preventative care. Roughly 40% of healthcare professionals admit to having negative reactions to patients with obesity..
New Recording 3.m4a. Forms of Weight Discrimination.
Healthcare Values. Views on obesity in healthcare have had a negative connotation behind them for years. Healthcare professionals tend to have an overall bias towards obese patients, often blaming their health conditions on their weight. Furthermore it is typical that nurses want to avoid caring for overweight patients because they find the responsibilities involved less appetizing such as giving sponge baths or changing diapers. Research has consistently shown that healthcare professionals are biased against people deemed as having overweight or obesity. This causes them to behave in discriminatory ways, such as blaming serious health issues on weight and, therefore, inadvertently ignoring other possible causes. Many healthcare professionals’ attitudes about obesity have little scientific backing. Although research does show a correlation between having obesity and certain health risk factors, not everyone with obesity is unhealthy. In fact, one 2015 study suggested that many adults with obesity are healthy and that 2–50% are “metabolically normal,” indicating a low risk of cardiovascular and other conditions. Prioritizing weight above all other health issues can damage the mental and physical health of people deemed to have obesity. It may even contribute to rising rates of obesity. One 2015 paper suggested that healthcare professionals report viewing people with overweight or obesity as lazy, as weak-willed, or as lacking self-control. Rather than treating obesity as a health condition, they may treat it as a personality trait, judging a person as less compliant and more unhygienic based on their weight. Doctors may also overestimate the extent to which a person can control their weight, choosing to attribute weight to a lack of discipline rather than a complex interaction between genes, the environment, stress, overall health, and personal choices. Weight bias is becoming more common in healthcare. One 2016 paper suggested that weight bias increased by 66% during the previous decade. Healthcare values towards obese patients in recent decades have more often than not presented a judgmental bias to the correlation between their weight and health..
Weight Discrimination in Healthcare. Healthcare professionals apply societal weight bias views to patients ex. laziness, poor hygiene, dishonesty Professionals may overestimate the extent to which a person can control their weight There are many factors that can affect a person’s weight, and their control over those is not always strong Practices integrated into healthcare that have weight bias ex. BMI scale, insurance policies, ill-equipped to treat overweight patients.
Consequences of Weight Stigma in Healthcare. Patients avoid getting health care; reports of obese patients cancelling appointments due to anxiety. Patients feel inadequate, fear judgment from professionals Lots of patients refuse to go to healthcare professionals in fear of what they might tell them about their health Doctor shopping results in missed health conditions and inadequate care Patients let their health decline for fear of judgment ex. avoiding preventative care Not enough education about how to treat overweight patients Incorrectly assume diagnoses that state unhealthy condition is due to weight alone Eating disorders are becoming more common among Americans.
How Can We Reduce Weight Bias in Healthcare?. Healthcare professionals must first be willing to change things Teach more about how to treat such patients Teach that weight is a complex interaction of many factors, ex. Genes, overall health, personal choices, environment, stress Teach unlearning bias of weight Change systems that are inherently biased Social and cultural changes in bias? How do we achieve that?.
References. https://www.cdc.gov/obesity/adult/defining.html https://www.dictionary.com/browse/health https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends/obesity-rates-worldwide/ https://worldpopulationreview.com/country-rankings/most-obese-countries https://www.obesityaction.org/resources/weight-discrimination-a-socially-acceptable-injustice/ https://acpinternist.org/archives/2017/02/weight.htm www.rethinkobesity.com https://ojin.nursingworld.org/ https://www.medicalnewstoday.com/articles/obesity-discrimination-in-healthcare#statistics https://www.cdc.gov/obesity/data/childhood.html https://www.stanfordchildrens.org/en/topic/default?id=obesity-in-adolescents-90-P01627.