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Rising Obesity Rates in the Western World

Group 4 Project
by

Ruth Chau

on 11 January 2013

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Transcript of Rising Obesity Rates in the Western World

- low self esteem
/self conscious Obesity and overweight: Fact sheet. [Internet]. 2012. Geneva (CH): World Health Organization [WHO]; [cited 2013 January 6] Available from: http://www.who.int/mediacentre/factsheets/fs311/en/index.html
Lafsky, Mellisa. "The Economics of Obesity: A Q&A With the Author of The Fattening of America." New York Times 08 Feb 2008: n. pag. Web. 2 Jan 2011. http://freakonomics.blogs.nytimes.com/2008/02/08/the-economics-of-obesity-a-qa-with-the-author-of-the-fattening-of-america/
USA. Overweight and Obesity. , 2009. Web. 1 Jan 2011. http://www.cdc.gov/obesity/causes/economics.html
Goel, Rajeev. "Obesity: An economical and Financial Perspective." Journal of Economics and Finance. 30.3 (2010): Print.
NationMaster - World Statistics, Country Comparisons. Obesity statistics - Countries Compared - NationMaster. http://www.nationmaster.com/graph/hea_obe-health-obesity. Accessed 2013 January 2.
http://www.oecd.org/els/healthpoliciesanddata/49712881.pdf Rising rates in the western world i'm lovin' it Obesity: abnormal or excessive fat accumulation that presents a risk to health. Factors/ Less common causes There is greater food availability, as it has become cheap and portable. It is also possible to have a high energy diet all through the year. Cause of obesity Amount of physical activity on a daily basis Eating excess fat
Fats contain over twice as much energy per unit mass than carbohydrates, thus the problem of storing excess energy is intensified An increased intake of energy-dense foods that are high in fat, salt and sugars but low in vitamins, minerals and other micronutrients Types and quantity of food people eat An energy imbalance between calories consumed and calories expended. Excessive carbohydrate intake
Carbohydrates in the form of sugars and starch are the body’s source of energy. If the energy is not used on a day to day basis, the excess
is stored either as glycogen in the liver and muscles or as fat. The body’s capacity to store glycogen is limited so eating an excess of carbohydrate
means that fat reserves build up and can lead to weight gain and obesity. Psychological factors may lead to overeating as a means to cope with the problem. These include:
Low self-esteem
Guilt
Emotional stress
Trauma
Anxiety
Feeling sad
Not sleeping well -Drinking too much alcohol
-Decreased rates of smoking (smoking suppresses appetite)
-Eating habits affect what we eat, when we eat, and how much we eat.
-Busy lifestyles:
No time to plan and make healthy meals
Less free time means less time to exercise Bibliography Body Mass Index (BMI) Family history/genetics Lifestyle choices Illnesses/ Medication/ Other Medications such as carticosteroids and certain anti-depressants
Medical problems such as low thyroid function and overexcretion of certain hormones by the adrenal glands
Type(s) of adenovirus
Menopause in women Psychological factors The Self-perpetuating Nature of Obesity -Leptin resistance
Leptin is a hormone that circulates in proportion to fat cells, and tells the brain when to inhibit appetite
-Dulled neuron receptors
In the nucleus accumbens, dopamine (a neuron transmitter) conveys the feeling of pleasure. In the case of addiction, there are fewer receptors and less pleasure, making the person want to eat more to satisfy themselves. *Someone with a high muscle mass may have a high BMI but have much less fat than an unfit person whose BMI is lower. There are innaccuraces with BMI -Variations in genes controlling appetite and metabolism predispose to obesity
-Syndromes:
Prader-Willi
Bardet-Biedl
Cohen
Ayazi
MOMO By: Ruth, Ganeesha, Jacqueline, Rachel, Henna, Danyal, Aditya, and Ahraz Problem in the Western World Increased consumption of sweetened drinks has contributed to the raised carbohydrate intake of those in the Western world. There is also the problem that they contain refined sugar and high fructose corn syrup. The dangers of fructose will be explored later in the Prezi. Dietary energy availability (2001-2003) Despite the fact that people are less physically active and do not need as much energy, the availability of energy dense foods have increased! Urbanization & development A decrease in physical activity due to:
increasingly sedentary nature of many forms of work (desk jobs as opposed to more active jobs in the past)
changing modes of transportation
labor saving devices
television viewing in leisure time Availability of Energy Dense Food Additional Problems Rise of the Fast Food Joint Sweetened Drinks & Processed Foods Fast food has gained popularity because it is fast, cheap and palatable. However, it has negative effects on health due to its:
Large portion size
High caloric content
Trans fats Red = high energy availability Yellow = low energy availability Economic Implications Obesity and Health Care -as obesity increases, the health care is negatively affected Government Obese Person 1. pay more for medications
3. die at a younger age, therefore, there endure income loss In USA, an obese person will pay $732 more than a healthy person in medical expenses. 2. must pay for health care of unhealthy individuals' frequent medical needs
4. employment, income, etc. decrease
5. taxes increase In USA, 9% of the expenditures were put toward obesity related illnesses. Income is inversely proportional to obesity levels. The more money made, the more fit the individual is likely to be. WHY? lower income = higher obesity rate VS. 30g
10 calories
more difficult to prepare (open the bag, wash, dry, eat) 30g
160 calories
easy to prepare (open the bag, eat) $4.50 $10.00 Governments often subsidize these crops (like potatoes), which are used to produce unhealthy foods. In USA, many junk food companies have a large influence on the fiscal policies, and drive many of the government's subsidies toward their necessary crops. This allows junk foods to be sold a lower price, encouraging lower income people to purchase such items. less calories cheaper People tend to buy unhealthy foods, as it consists of more quantity at a lower price. Impact on Industries Many industries are heavily impacted by obese people using their services. Some industries are heavily impacted by obese persons using their services. for example, the use of airplanes greater weight and pressure on the aircraft causes: fuel usage and costs larger seats needed The cost of accommodating obese people increases the overall cost of the service. Economic Measures to Lower Obesity 1. governments should stop subsidizing junk food companies
2. governments should drive more subsidies to things leading to positive externalities (like fitness gyms)
3. increase healthy food sales
in school cafeterias
promote healthy eating in grocery stores (especially in junk food aisles) But, this can often lead to problems with employment. For example, Coca-Cola owns many junk food companies consisting of countless employees who would lose their jobs without the same amount of output. Impact on Employment Rates Impact on Employment Rate Obese workers take leave from work due to illnesses/incapability compared to an average employee.
Decrease productivity and output
Increase in costs for employers Short & Long Term Impacts of Obesity Short Term Effects of Obesity People with an extreme amount of additional weight may suffer from the following short term effects due to their size: • Hypercholesterolemia (High cholesterol)
• High blood pressure
• Difficulty standing and walking
• Shortness of breath during routine activities
• Problems with breathing during sleep as well as difficulty sleeping
• Increased joint aches and pains
• Gestational diabetes in pregnant women
• Fatty liver disease (also called nonalcoholic steatohepatitis or NASH)
• Gout
• Gastroesophageal reflux disease (GERD)
• Blood clots during pregnancy
• Muskoskeletal disorders (metabolic strains on bones, muscles, and joints)
• Fertility issues including a reduction in ovulation
• Increase in the need for c-section deliveries Short-term Health Risks Long Term Effects of Obesity Type II diabetes
Cardiovascular disease (Heart attack)
Coronary Artery Disease
Respiratory Disease/Decreased functioning of lungs
Hypertension
Gastrointestinal disease (Liver and Gallbladder disease)
Stroke
Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
Certain cancers, including breast cancer
Sleep apnea
Gynecological problems (abnormal menses, infertility)
Pregnant women with obesity issues have elevated risks for long-term health concerns for their unborn babies.
An increased chance of miscarriages and birth defects including Spina Bifida–the leading cause of childhood paralysis.
Mortality Long-term Health Risks While the initial discomforts and health problems associated with obesity may seem inconvenient and unpleasant for sufferers, the long term risk factors are extremely serious. Over time, obesity sufferers are at high risk for the following health concerns: The Impact of rising rates of Obesity Reasons for Obesity in the Western World - Availability, convenience, and low costs of fatty foods (e.g., fast food restaurants, junk food) Cultural Impact On Obesity - In countries outside of the Western World, obesity is a sign of wealth as opposed to holding a negative connotation Chart from the Organization for Economic Growth and Development Obesity Around The World Diet continued Surgery Medications and herbal remedies Diet OBESITY: BIOCHEMISTRY Top 3 Countries With The
Highest Obesity Rates 1. United States (30.6%) 2. Mexico (24.2%) 3. United Kingdom (23.0%) - Increased Transportation such as driving instead of walking, taking the bus intead of riding a bike - Food is more accessible (i.e., getting it delivered as opposed to hunting for it) People are influenced by those around them. Friends alter their perception of what it means to be obese, about what is an acceptable weight The Social Network Effect Example: West Africa - Obesity is attractive and represent a cultural right in the country of Gambia
- Cultural right = more eligible for marriage
- Also represents wealth, good health, and beauty Obesity Rates in Various Developed Countries The Obesity Epidemic Society and Obesity Negative Media Portrayal Positive Media Portrayal Obesity in the Media Obesity in the Media Social
Implications Obesity is "socially contagious." The Framingham Heart Study shows that an Obese friend increases the chances of you becoming obese by 57% Mutual obese friends increase your chance by 171%. The phenomena extends three degrees: Friends Friends of Friends Friends of Friends of Friends Thus, the weight gain of an individual is influenced by the people in his or her social network. Education Health Care Employment Retail Travel Obesity is a condition of increased adipose tissue mass
the accumulation of triglycerols (fats), a metabolically active tissue, allows for body weight to become excessive
Adipose tissue: Through hyperplasia and hypertrophy, they can vary greatly between individuals (more so than any other tissue)
The adipose tissue is also a storage tissue for fats when energy is taken in by the body (also metabolized as energy or heat biosynthesis) Saturated VS. Unsaturated Fatty Acids Saturated Fats: Society has a negative opinion of obese and overweight individuals. Butter, dairy products, meat
Saturated fats are evenly filled out with hydrogen (remains solid at room temperature
A tightly packed structure, therefore saturated fatty acids increase level of bad cholesterol (LDL) and also clog arteries
The consumption of saturated fats should not be more than 10% of total calories per day
For a healthy diet, one should have less total fat, saturated fat, and cholesterol Vegetable oils
The indication of double bonds in hydrocarbon chain results in formation of unsaturated fatty acids
Fatty acids with single double bond is called a monounsaturated fatty acid- these are good fats because they have low cholesterol content
Multiple double bonds are called polyunsaturated fatty acids. Therefore, they remain liquid at room temperature and need to by hydrogenated to be solidified. Unsaturated fatty acids increase levels of good cholesterol (HDL) by taking the LDL to the liver to be broken down and removed from the body
Unsaturated fats are essential fatty acids that one's body can't manufacture and is therefore provided by one's diet (omega 3 and omega 6)
The consumption should be 30% per day Unsaturated Fats Leptin Protein that is the key regulator of body weight homeostasis Structure: 4 helical bundles (167 amino acids)
Adipokine: hormone secreted by adipose tissue (leptin is an adipokine)
Leptin is secreted from adipocytes into circulation, trans versing into the Central Nervous System and further binding to leptin receptors in the hypothalamic arcuate nucleus Hypothalamic-Leptin Axis In MORE Detail... Is a feedback system
Tells the brain (arcuate nucleus) to prevent seeking more food when too much fat is present (signals a DECREASE in adipose buildup)
It allows the brain to adjust the metabolic rate to control energy use
POMC (Pro-opiomelanocortin) is produced through secretion
There are 2 products of secretion
1. Alpha-MSH (alpha melanocyte)
2. ACTH (Adrenocorticotropin)
Alpha-MSH binds to receptors in hypothalamic paraventricular nucleus, which causes a decrease in food intake Leptin receptors have JAK STAT pathway for signaling
Leptin binds to leptin receptor of anorexigenic (satiety signals) neurons and the receptors dimerize
Then, JAK autophosphorylates itself
JAK phosphorylates leptin receptor
STAT binds phosphotyrosine of leptin receptor
JAK phosphorylates STAT
Phosphorylated STAT leaves the leptin receptor
Soluable phosphorylated STAT dimerizes (enters nucleus and binds to promoter)
STAT signals expression of:
1. POMC: Pre-hormone, precursor for 3 different MSH'S (melanocyte-stimulating hormone)
2. SOCS (suppressor of cytokine signaling): Stops phosphorylation of JAK, leptin domains, and STAT When excess fat builds up in the fat cell, leptin is produced and enters the bloodstream
Leptin receptors triggered in hypothalamus (which shifts hypothalamus to "Speed Energy" mode)
Leptin changes slowly (may take days to weeks)
Orexigenic: Hunger signals
Anorexigenic: Satiety Signals Appetite reduction (doesn't go looking for food)
Increase in sympathetic tone to skeletal muscle, incease in ATP and mitochondrial proteins (muscles prepared to function optimally)
Increase in TSH to increase thyroid output and increase in baseline energy
Beta- adrenergic increases lypolysis (break out stored energy for immediate use) Appetite increases (seeks more food)
Decrease in sympathetic and increase in vagal tone to slow down muscle function
Incease in fat absorption
Vagus increases peristalsis and insulin production (for food and processing)
Vagus nerve also slows heart rate and myocardial oxygen consumption Undernourished= Ghrelin (which stimulates orexigenic neurons to release neuropeptides and proteins) signals the hypothalamus to issue eating signals
Over nourished= anorexigenic peptides signal hypothalamus that one is full Hypothalamus is tricked into thinking that there is no leptin being released from fat cells
It then sends orexin-A all over one's brain, making them think that they're starving
Hypothalamus stuck in "Conserve Evergy" mode, therefore there is an increased appetite, slowing down the metabolic rate, and increasing fat storage
One's brain is constantly "starving", even if fat cells increase Small peptide hormone released by hypothalamus to act on the rest of the brain
Signals hunger, after the hypothalamus is stimulated by ghrelin from the stomach
It also signals wakefulness, so no one's brain stays awake long enough to seek more food and not hibernate (reason that some obese children don't sleep well) Obese people face stigma, prejudice and discrimination in areas of: The Result Leptin deficiency (homo zygote)- Body is continuously hungry
Brain damage to leptin receptor area: hypothalamic obesity syndrome
Excess insulin blocks receptors (fructose ultimately responsible because it leads to the excess)
Insulin receptors in brain share the same substrate as leptin receptors
Excess insulin hogs the substrate, leaving none for leptin to use (leptin attaches to the receptor, but nothing happens) Obese children may be bullied for their weight Even high levels of leptin have no effect on hypothalamus (known as leptin resistance)
Occurs in increased % of obese children and adults
Causes of hyperinsulin state: high fat diet, low fiber diet, sleep deprivation, and increased fructose diet Fructose A MAJOR Cause of Hyperinsulinemia Fructose is absorbed from the intestine and enters the liver without insulin regulation, and it doesn't suppress ghrelin (hunger hormone)
Then, it is converted into acetyl-CoA, which floods the Kreb Cycle, forcing excess production of free fatty acids, triglycerides, and VLDL lipoproteins
This excess production of fat leads to a fatty liver, causing hepatic inflammation and more insulin resistance
Faculty feedback to the liver results in massive insulin production, leptin resistance, and obesity. Fructose becomes free fatty acids (building blocks of all lipids)
It becomes VLDL lipoproteins and triglycerides (lipids associated with cardiovascular disease)
It becomes uric acid (oxidative stres, vascular inflammation) First introduced in 1970's as 42% + 55% to stimulate sucrose taste
Higher levels up to 90% to make it sweeter and addictive
The addiction is caused by leptin resistance, leading to constant hunger and craving of more sweet foods cereal, packaged foods, hot dogs, ketchup, ice cream
Junk food, candy sweets
Table sugar (sucrose)- 50% fructose
Sports drinks, energy drinks Difficulty fitting into seats on planes, requiring double seats when travelling Difficulty buying clothes
Requiring tailor-made clothes
Prejudice or ridicule from store staff or other shoppers while in the mall Difficulty getting or keeping a job
Reduced pay and promotion prospects
Prejudice and discrimination from co-workers Adds bulk to food (stomach can then turn off ghrelin sooner)
Fiber slows absorption of sugar in the gut
Fiber binds to bile acids, reducing fat absorption from the gut
Fruits + vegetables are a good source
Foods are "processed" to remove fiber (removes part that spoils)
HFCS (fructose) is often added to retard spoiling (poisons bacteria)
Shelf life greatly increases, nutritional value greatly decreases Physicians are also biased against obese people.
A survey in the United States including a nationally representative sample of primary care physicians revealed that:
>1/2 respondents viewed obese people as awkward and unattractive
>50% believed they would not be compliant with treatment
1/3 thought of them as "weak-willed" and "lazy"

Another study found that as the patient's weight increased, the physicians:
Had less patience
Had less confidence in the patient's ability to comply with treatment
Felt less desire to help them "Speed Energy" Mode "Conserve Energy" Mode How the Hypothalamic-Leptin Axis Works: Society's Point of View They are often thought to be:
undisciplined
dishonest
sloppy
ugly socially unattractive
unintelligent
sexually unskilled
less likely to do productive work Negative stereotypes are attached to obese individuals. Psychological Effects There are many psychological effects on individuals suffering from obesity, and some can be very negative. The most common psychological effects on a person dealing with obesity include: - depression - anxiety Weight stigma is especially prevalent in North American society as it is perceived that obese individuals are responsible for their condition. (Photo Credit: Christi Nielson@Flickr) These are some of the many harmful adjectives used to describe obese or overweight people. Obesity has spread to the point that people have developed even a fear of obesity: obesophobia. The cycle continues... -social discrimination Medias Effect on Individuals / Boys vs. Girls Girls The media uses tools such as photoshop to edit pictures in magazines in order to promote the idea that skinny models are beautiful. The majority of actors presented on television are at or below normal weight. The prejudice and discrimination towards obese or overweight individuals in society is reflected in the media. The media plays a key role in everyones daily lives in todays society. People are constantly being exposed to media in the forms of newspapers, magazines, and television, and for this reason, it has a huge influence on the choices individuals make. For this reason, the media can have large psychological effects on many women. As the magazines display women that are extremely thin, even those women who may be slighty obese in comparison to models would want to look like the women portrayed in magazines, although they are completely healthy themselves. Greenberg et al. analyzed 5 episodes of the top 10 prime time American television shows comparing television actors’ BMI to that of the American public.

They found that:
only 25% of men on television were obese or overweight vs. 60% of American men
~90% of women on television were at or below normal weight vs. ~50% of American women Boys The media tends to show images of very buff male models that spend majority of their time working out in order to look the way they do. This is an inaccurate representation of majority of the male population as most people do not have the time to work out for several hours a day. To obese males, these pictures can cause a desire to work out, or go to the gym regularly. However most people do not have the time to work out regularly, and if one begins working out without knowing the correct methods it can easily lead to injuries at the gym. Popular television shows that include obese characters present them as comedic, lonely individuals, or freaks. They are portrayed as:
static minor characters
no romantic relationships
few positive interactions
unsuccessful
shown eating fast food or being lazy
often made the butt end of jokes Obese stereotypes are being reinforced by popular media, adding to the social stigma against obesity. Obese individuals are usually photographed in the worst possible light. - Overall, it is easy to argue that obesity is more common in the Western world where access to food is easier and cost is not as substantial to an individual's income
- Obesity is less common in developing countries, which explains why the site of an obese person would come across as a sign of wealth and being fed well as opposed to an unhealthy lifestyle For example:
dehumanized - only showing their bodies with their heads cut off

biased - at the least flattering angle to their size, partically undressed to emphasize their weight Examples of Dehumanizing Pictures:
"The Headless Stomach" (Photo Credit: Jeff Haynes/AFP/Getty Images) Caricatures and cartoons mock people who are obese or overweight. Although the majority of media is negative, positive portrayals of obesity have the potential to promote health and discourage obesity. A study from the Rudd Center for Food Policy & Obesity at Yale shows that portraying obese people in a more respectful manner can significantly reduce the public's negative prejudice and stereotypes. However, the satire used in these protrayals is meant to highlight the problem in order to work towards a solution. Obesity in the Media Neutral Media Portryal Some media present obesity in a negative manner for the purpose of drawing attention to the problem. Social Efforts to Combat Obesity The Canadian Obesity Network The Childhood Obesity Foundation Canada’s official representative in the IASO
Focuses on:
addressing obesity's social stigma
changing the way health proffessionals and policy makers view obesity
improving access to prevention and treatment resources The creation of organizations to bring people together to actively find a solution to obesity.

For example: International Association for the Study of Obesity (IASO) A global umbrella organization for 53 national obesity associations representing 56 countries
Founded in the 1980s
Have helped to spread awareness about obesity and improve the quality of obesity education
helped to initiate a global action program to prevent obesity and its related chronic diseases Canada's leading authority on childhood obesity
Founded in 2004
Has initiated several programs to raise awareness and prevent childhood obesity These programs include...

Living Green, Healthy, and Thrifty (LiGHT):
a web-based intervention and prevention program that promotes healthy food and an active lifestyle

Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE):
a program that engaged various members of the community to find ways to prevent childhood obesity Leptin Feedback BLOCKED Orexin-A (hypocretin-1) Leptin Blocked In the Hyperinsulin State... In One's Liver... High Fructose Corn Syrup (HFCS) Fructose in EVERYTHING Glucose Eating simple sugars and carbohydrates (pure glucose), blood sugar levels increase, which increases the strength of the insulin signal from the pancreas and contributes to increased fat storage Consuming carbohydrates with fiber (whole grain) reduces the rate at which one absorbs glucose
This decreases the strength of the insulin signal and reduces the extent to which one stores excess glucose as fat A nutrient molecule that your cells can use to provide energy
Brain depends on a steady supply of it to remain functional
Too much of it = Excess energy in the body
The cells respond by storing excess in the form of fat (leading to obesity)
Consistently consuming glucose that one needs to meet their cellular needs it usually stored in body fat form FIBER Another Factor... Anderson L. 2009 Nov 17. The Trend in Obesity: The Elect of Social Norms on Perceived Weight and Weight Goal [Internet]. [cited 2012 Dec 22] . Available from: http://www2.binghamton.edu/economics/graduate/documents/prospectus-by-l-anderson.pdf
Childhood Obesity Foundation . Our Story [Internet]. Vancouver(BC):Childhood Obesity Foundation; [cited 2012 Dec 30] . Available from: http://www.childhoodobesityfoundation.ca/ourStory
Greenberg B, Eastin M. 2003 Aug. Portrayals of Overweight and Obese Individuals on Commercial Television [Internet].National Center for Biotechnology Information & U.S. National Library of Medicine; [2003 Aug, cited 2012 Dec 22] . Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447967/
Kiderra I. 2007 Jul 25. Obesity Is "Socially Contagious," Study Finds [Internet]. [cited 2012 Dec 22] . Available from: http://ucsdnews.ucsd.edu/newsrel/soc/07-07ObesityIK-.asp
Lim M. Obesity [Internet]. Tangient LLC; [2013, cited 2013 Jan 6] . Available from: http://appsychtextbk.wikispaces.com/Obesity
Picard A. Shaming the obese - with photos like these - isn't working [Internet]. The Globe and Mail Inc.; [2012 Sept 10, cited 2012 Dec 22] . Available from: http://m.theglobeandmail.com/life/health-and-fitness/health/conditions/shaming-the-obese---with-photos-like-these---isnt-working/article623275/?service=mobile
Ross C. 2012 Mar 02. Stigmatizing Obesity [Internet]. Psychology Today; [cited 2012 Dec 27] . Available from: http://www.psychologytoday.com/blog/real-healing/201203/stigmatizing-obesity
Sharma A. 2012 Nov 27. The scourge of the obesity epidemic [Internet]. Edmonton(AB):Troy Media; [cited 2013 Jan 4] . Available from: http://www.troymedia.com/2012/11/27/the-scourge-of-the-obesity-epidemic/
The Canadian Obesity Network . About CON-RCO [Internet]. Edmonton(AB):The Canadian Obesity Network; [cited 2012 Dec 31] . Available from: http://www.obesitynetwork.ca/about
The International Association for the Study of Obesity . IASO Home [Internet]. London(UK):The International Association for the Study of Obesity; [cited 2013 Jan 6] . Available from: http://www.iaso.org/
UK Department for Work and Pensions. 2008 Apr. Effects of Obesity [Internet]. [cited 2012 Dec 22] . Available from: http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/obesity/effects-obesity.shtml
Whyte J. 2010 Apr. Media Portrayal of People Who are Obese [Internet]. American Medical Association; [cited 2012 Dec 27] . Available from: http://virtualmentor.ama-assn.org/2010/04/msoc1-1004.html
Wilson A. 2012 Feb 20. Positive media portrayals of obese individuals reduce weight stigma [Internet].New Haven(CT):Yale University; [cited 2013 Jan 4] . Available from: http://news.yale.edu/2012/02/20/positive-media-portrayals-obese-individuals-reduce-weight-stigma National Heart, Lung, and Blood Institute, National Institutes of Health (2000). The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (NIH Publication No. 00-4084). Available online: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.
Purnell JQ (2008). Obesity. In DC Dale, DD Federman, eds., ACP Medicine, section 3, chap. 10. Hamilton, ON: BC Decker.
American Gastroenterological Association (2002, reapproved 2008). AGA technical review on obesity. Gastroenterology, 123(3): 882-932. [Erratum in Gastroenterology, 123(5): 1752.]
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg et al., eds., Williams Textbook of Endocrinology, 11th ed, pp. 1563-1587. Philadelphia: Saunders.
American Society for Metabolic and Bariatric Surgery (2009). Updated position statement on sleeve gastrectomy as a bariatric procedure. Available online: http://www.asmbs.org/Newsite07/resources/Updated_Position_Statement_on_Sleeve_Gastrectomy.pdf
Brethauer SA, et al. (2009). Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surgery for Obesity and Related Diseases, 5: 469-475.
Flier JS, Maratos-Flier E (2008). Biology of obesity. In AS Fauci et al., eds., Harrison's Principles of Internal Medicine, 17th ed., vol. 1, pp. 462-468. New York: McGraw-Hill. •One solution to reducing obesity is cardio exercise
•For example, regular jogging can help reduce chances of obesity in an individual
•Obesity is generally more common in societies where passive entertainment (TV, gaming, etc.) is more prevalent
oRather than active entertainment such as soccer, swimming, jogging and similar activities
•Having an awareness of this fact is an important step in working towards lowering obesity rates
•An example of an effective solution can be found in Ontario, where every family is given $500 of credit to bed used towards paying to enroll their children in physical activities
•Such government programs encourage more citizens to get their kids to be physically active, resulting in a lower risk of obesity as they grow up Excercise Solutions Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. A committed diet is necessary.
Weight-loss surgeries include:
Laparoscopic gastric banding
Gastric bypass surgery
Sleeve gastrectomy (less common)

There are supplements and herbal remedies that claim they have weight loss effects. Many of these claims are not true, and this is an ethical concern as businesses are only trying to make money off other people's desperation. Some of these supplements can have serious side effects.
• The other major solution to obesity lies in eating habits
• Higher consumption of refined carbohydrates, found in processed foods, inevitably reads to higher obesity rates
• Avoiding these kinds of foods is difficult in countries such as the United States because fast food restaurants are practically integrated into their culture, and the food served by these eateries contain large amounts of refined carbohydrates
• One of the most effective steps being taken to reduce obesity is the promotion of healthy eating culture
• The Subway restaurant in a manifestation of this healthy culture, as a significant portion of its success can be attributed to individuals trying to make healthier food choices
• For example, nearly every restaurant today offers a healthy, low fat alternative to their main courses, something that would not have been common a decade or two ago
• This is a result of the general population being educated to the risks of an unhealthy diet, forcing food vendors to adjust their businesses to their consumers
• In addition, popular fast food restaurants are now openly displaying the nutrition facts of their meal items so that consumers are aware which selections have the most carbohydrates
• The healthy eating culture combined with awareness leads to people thinking twice before eating unhealthy foods regularly, or at least choosing a less carbohydrate loaded item from the menu •The best way to improve society’s diet as a whole is to mentally condition at a young age to like healthy foods
•For example, schools in the Peel Region recently underwent a dietary transformation in which all soft drinks and high fat foods in cafeterias, like poutine, were replaced with healthier alternatives such as chocolate milk, fruit juice, and mashed potatoes
•This results in a society with young adults who are aware of the risks of high-carb foods and at the same time have acquired a taste for the healthier alternatives
•This also creates a market for healthier foods which would have a large impact on the popularity on unhealthy fast foods
•One of the main reasons fast food is popular despite the risks to health it comes with is that it is extremely cheap
•On the other hand, healthier choices and organic foods and much more expensive, partly because there isn’t as much demand for them so they are more exclusive products
•If a larger market for healthy food was created, it would be more affordable to eat healthy and a significant step would be taken in fighting obesity

•Therefore, people should continue to be educated on the risks of eating unhealthy and be offered healthy meal alternatives • Yoga can be an effective approach for an individual to decreasing the risk of obesity
• The practicing of Yoga shouldn’t be taken as a obesity prevention measure completely on its own, but it is a great complimentary activity
• Certain branches of Yoga, namely “free wind” and “pranayama” help reduce fats in certain parts of the body
• There are yoga cleansing techniques that can be used to expel toxins and excess fat
• Yoga also promotes a healthy diet, urging practitioners to eat more raw fruits and vegetables and avoid the over-consumption of meat to balance food intake Lifestyle
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