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rasharna hylton

on 21 March 2010

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Transcript of obesity

Should obesity be treated on the NHS? Introduction Literature Review Research Review Discussion Conclusion/Evaluation • Obesity; is a medical condition in which access body fat has accumulated the body causing it to encounter health problems.

• NHS; The National Health Service is a publicly funded healthcare system in England. The NHS provides healthcare to anyone, normally resident in the United Kingdom, with mostly free services. The NHS is largely funded from taxation (including a proportion from the National Insurance payments). Most of the expenditure (£98.7 billion in 2008-9) is spent on the NHS
I am currently doing my A-levels and really enjoy learning biology and how the body works. From this interest I thought I would chose a question for my research project something I’m very passionate about. I also thought this would give me an insight into what people think, not just from a biased biological view. It would also give a chance to see whether people make up their own mind on the situation or if they just go with opinions of other from the media. I will find out peoples views on the question by carrying out primary research in the form of a questionnaire. I collected a lot of data from a range of secondary research sources; books, internet sources, newspapers articles, TV documentaries and flyers’. I used all this research to help me discuss reasons for and against this question so I am able to give an unbiased view. This will give the reader a lot of views they may not have considered before. I decided to incorporate obesity into my research question as I feel I have a lot to say on it. Over the past few years it has become a controversial question as more in depth research is carried out on its economical effect on the NHS. This has caused a ripple effect in the media producing documentaries on obese patients and surgery they undergo. There have also been a lot of articles and news on the effect obesity has on NHS. A lot of statistical data was produced showing the cost of obesity on the country, instigating a campaign for healthy eating The major question most people face with obesity is whether a self in flicked illness should be treated for free or should be paid for. Some also face the idea that these patients should not be put on the same scale as patients who have involuntary obtained their illness. The history of obesity
Obesity has been around for years, its reputation varies from appreciation to the opposite in different cultures over a period time. The most famous, perhaps the, earliest evidence of obesity is the Venus figurines, statuettes of an obese female torso that probably had a major role in rituals. In certain cultures and area s where food is limited and poverty is prevalent obesity is viewed as a symbol of wealth and social status. As obesity became more of a problem the government decided to imitate campaigns against it. Obesity began to soar, tripling in just a few short years and worryingly followed by children. This then lead to the introduction Of Body Mass Index (BMI) in 1996.

Changes in society
There are many changes in our life style that has caused an increase in obesity. These changes have lead to people eating more and becoming less active, all which leads to increase in body mass. Society has changed with new technology making food more convenient, to obtain. Technology has meant less activity due to the introduction of video games, internet and television. More people use cars, buses in this society causing them to walk less and have less active jobs. The modern society has allowed obesity be more accessible by increasing portion sizes of food, marketing more fatty foods, making fast food more readily available. Even the modern world of women working alongside men has had an effect on the increase of obesity.
Statistics on obesity
The definition or measurements of obesity have changed over time, from country to country, study to study and overweight to obese. This has made it very difficult to compare modern and old data to draw conclusions.
Excessive weight gain has been brought about by very poor diet and lack of physical exercise. This illness is primarily responsible for instigating over 300,000 deaths of Americans every year. The annual cost of obesity have shoot up to an estimated $ 100 billion. This high amount can’t simply be just ignored.
In 2006, 24% of adults( aged 16 and over) in England were classified as obese, with 41% of women more likely to be morbidly obese compared to 32% of men. It shows an overall increase in obesity over the years from only 15% of obese adults in 1993
In 2006, 16% of children aged 2 to 15 were classed as obese. This represents an overall increase from 11 per cent in 1995.
Overweight and obesity increase with age. About 28% of men and 27% of women aged 16-24 are overweight or obese but 76% of men and 68% of women aged 55-64 are overweight or obese.
The cost of obesity
It is estimated that the cost of obesity to the NHS in England in 2007 was £4.2 billion and would rise to £6.3 billion in 2015.
It has been estimates that in 2001 the cost of obesity was £2 billion on the NHS and £7 billion (3.5 times greater) on the United Kingdom economy.
It has been predicted that in 2050 obesity will increase significantly costing a huge amount. It has foreseen to be estimated at £6.5 billion on the NHS and £45 billion (7 times greater) on the United Kingdom economy.
The cost of treatment is estimated at:
*Gastric banding is in the region of £8,000 to £10,000
*Gastric bypass surgery is in the region of £10,000 to £12,000
*An intra-gastric balloon is in the region of £3,500 to £4,500.

Treatment for obesity
Dieting consists of low-calorie, low-fat and low- carbohydrate intake. It is mainly about taking in reasonable amount of calories a day such as 200-800 kcal, producing average weight loss of 1.5-2.5 kg per week.
Exercise is important in making sure you are healthy and increases muscle percentage in the body. It is recommended that you do 30 minutes of moderate exercise e.g. brisk walking, for about 5 days. The exercise should increase heart rate and you should break out in a light sweat to show weight loss.
Medication: There are two anti-obesity medications; Orlistat (xenical) which reduces intestinal fat absorption by inhibiting pancreatic lipase. The other is Sibutramine (meridia) it inhibits appetite neurotransmitters from the brain. Weights lose medication helps obese patients lose a modest amount of weight and reduce incidence of diabetics. The long term side effects these medications have on obesity is not documented but the short term side effect include: high blood pressure, anxiety, high cholesterol and increase risk of heart attack.
Surgery is only available to a proportion of obese patients with a BMI of >40 or are suffering from cardio pulmonary problems due to their weight. For surgical treatment to be considered other forms of weight loss must be tried and failed. Bariatric surgery (weight loss surgery) relies on reducing the volume of the stomach. There are two forms adjustable gastric banding and gastric bypass surgery. There are a few less common forms of surgery used, such as liposuction and intra-gastric balloon their effects on obesity is still being monitored.
Diagnosis of obesity
Obesity can be diagnosed by calculating a person’s Body Mass Index (BMI).It is currently used as the most accurate and reliable way of measuring ideal body mass for each individual, your BMI is calculated by:
1. Measure your height (metres) and multiply the number by itself
2. Measure your weight (kilograms)
3. Divide your weight by the answer you got in step 1 (your height squared),
4. The number you are left with is your BMI which should fit in one of the categories below
•Underweight = <18.5
•Normal weight = 18.5-24.9
•Overweight = 25-29.9
•Obesity = BMI of 30 or greater
Symptoms of obesity
The short term symptoms of obesity include:
•sweating a lot,
•difficulty sleeping,
•inability to cope with sudden physical activity,
•fatigue and
•Back and joint pains.
In the longer term, obesity greatly increases your risk of:
•high blood pressure,
•heart disease and stroke,
•high cholesterol levels (fatty deposits blocking up your arteries),
•breast cancer in women,
•gall bladder disease,
•gastro-oesophageal reflux disease (when acid from the stomach flows up into the gullet) and associated problems,
•polycystic ovarian syndrome ( multiple cysts within the ovaries), and
•Reducing life expectancy.
Obesity does not only effect you short term and long term it’s a new way of life that may sometimes be an emotional rollercoaster, obesity has additional psychological side effect which is the hardest to get rid of, these include:
•having low self-esteem ,
•having low confidence levels,
•feeling isolated in society, or
•Reduced mobility leading towards a poor quality of life.

What Causes Obesity?
Your genes can mean you are more susceptible of becoming obese but it doesn’t mean that you cannot reach normal weight through weight loss techniques.
Diet contributes greatly to obesity. Obese patient take in more calories than recommended daily, these extra calories do not get used up due to lack of exercise, so stores on the body.
Exercise gets rid of excess body fat from high calorie foods. Without exercise these fats build up because they are not getting used up; doing activities that increase heart rate, sweating and build up of muscle. Even small amounts of exercise will help as it will stop you putting on weight even though it may not cause large amounts to come off quickly.
The modern society has increased intensive farming so that fast foods are readily available at cheaper prices. In this society due to television, internet, cars and video games, makes it impossible to walk for up to 30 minutes daily. There has also been a huge increase in food portion sizes ,an increase in advertising of unhealthy sugary food and improves on technology, therefore less labour work is available.
There is a lot of psychological issues faced with obesity, as eating is seen as celebration or solace. Food is not seen as fat gain or high calories intake but as an emotional comfort. Food is fuelled by emotion which can cause addiction to emotional eating.
Gender and age has a small connection with obesity as men burn more calories than women and can more easily gain muscle. As your age rises your metabolism slows down as the amount of muscle in your body decline.
Obesity can also be triggered from other infirmity such as metabolic disorder, low thyroid function. It can also be triggered with certain medicines e.g. steroids and anti-depressant which enhance weight gain. Contraceptive and quitting smoking can amplify your appetite.
Who obesity effects
One of the concerning problems with obesity is that it doesn’t just affect adults it also effects children .childhood obesity has reached worrying figures effecting our children increasingly more each year. Figures show that obese children are more likely to grow up and be obese adults causing huge problems to their life style and bodies. This is very worrying to parents and the government who have been trying to cut down on obesity over the past years but instead seen no changes other then it’s effect more children than before. This problem has made these children more prone to symptoms that come with obesity at a very young age. Treatment used for children are primarily lifestyle changes such as increased activity and food monitoring techniques. Medication for children has not yet been approved by FDA because the side effects to children have not been investigated. In some drastic cases some children have had surgery to lose weight.
Obesity is a global matter affecting all countries differently. Most of the developed countries have the highest percentage of obese people because food is readily available at cheaper prices .Undeveloped countries have lower percentage of obese people as labour is still used, transport is restricted and modern technology is not as widely available
How obesity is related to anorexia
Anorexia is an illness in which includes self- starvation People with this disorder eat very little amounts of food causing them to be very thin. They have intensive and overpowering fear of body fat and weight gain. Both obesity and anorexia are related as they link to eating disorders. This type of disorder relates to troublesome eating behaviours, such as restricted dieting, bingeing or purging, which occur less frequently or are less severe than those required to meet the full criteria for diagnosis of an eating disorder. Eating disorders are very serious they have been linked with such risk taking behaviours such as drug, alcohol tobacco consumption and even suicide attempts. Most people who have these disorders are linked to depression. People who are depresses are two times more likely to become obese at a year follow up compared to people who don’t have depression. Therefore a mental health professional may need to be involved treating a person with an eating disorder as it may be a cry for help.
Aim: To research the public view on obesity:
*To find how much is known about BMI diagnoses of obesity.
*To find what the pubic believe obesity is linked to.
*Explain their view on obesity treatment on the NHS.
*The participants are not very aware of BMI.
*The public know a lot of information about obesity.
*The majority of the views were; that they should be treated on the NHS.
Results obtained from graph.
80% of participants knew that weight and height is needed to calculate BMI
100% of participant knew that BMI stands for Body mass index
44% gave the correct answer for type to obesity, 50% a vast majority of the participants with wrong answer thought it was 30-34.9
83% said obesity is a serious problem in the UK
Half the population said yes and the other said no to whether obesity is a serious illnesses in the UK
70% said that both obesity and anorexia are both as serious as each other
40% said heart failure with 38% saying increased blood pressure for the causes obesity has on your body which are correct. Only 22% giving the wrong problems it has on the body.
Exercise, diet and surgery where the most popular treatments for obesity with about 88% of the answers.
26% think obese patients should be allows surgery to correct their problem for free, with 74% don’t think they should
Only a little less than half the participants think that obesity can be genetically inherited.
48% said eating too much and 44% said not moving around is the causes of obesity.
76% of participants would consider obesity to be self inflicted, 24% said it was inherited illness.
For question 13 which is a worded answer question most of the answer were similar and thought that it could be converted into a pie chart showing what the most common range of answers were whether they said it should or shouldn’t be treated on the NHS. Some answers where completely different so I left as other and will discuss them more when I analyse the results Results obtained from question 13 with participants answering yes for it to be treated.
43% said it should be treated on the NHS to support obesity and the problems gained.
43% believe it should be treated on the NHS but not through surgery
14% said that surgery is very common in the modern times, so should be treated with surgery.
The result obtained from question 13 with the answer NO obesity should be treated on the NHS:
15% wrote that there are more serious illnesses then obesity that should be treated
54% wrote that obesity is self inflicted
31% wrote it’s a waste of tax payers money


MARCH 2010 I wanted my questionnaire to able to be generalised so, I made sure I gave it to 15 females and 15 males. I made sure that I gave out my questionnaire to a variety of people, with different waste sizes, different ages and ethnicity. I also thought an opportunity sample would be the best way to carry out the questionnaire as it would make sure that I gave it to a wider range of public and would also eliminated researcher bias;-choosing people who I believe would give me the result I would like to obtain. To make sure my questionnaire was not biased I stood at the school gate and gave it to anyone who was available. This meant that a range of ages in the school from 12(year 7s) to 60(teachers). For my discussion I broke down the key question into smaller questions so I can build up to my final question. I have used questions from my questionnaire to answer because I have got result, I can discuss and draw conclusions from and they all relate to and lead up to the final question. What does BMI calculate?
I chose the participants to answer this question so I could determine whether they were fully aware of the way to measure obesity. The results were pleasing showing that 80% knew that you require weight and height to calculate BMI. This knowledge is very important to know in the public as it is one of the main international ways to calculate your BMI, to determine whether you are a normal weight for your height.
What does BMI mean?
Seeing the word BMI and knowing what it stands for is important for the modern society to be able to cut down on obesity. They need to be aware of ways to prevent their weight from getting out of control by constant checking if worried so it can be corrected in time before it has to be treated with medical attention.
What BMI indicates class 2 obesity?
A lot people are aware of using the BMI but are not sure what the numbers mean and the different stages of obesity. I wasn’t even aware of the classes till I looked it up, so I thought this would be the question to see if it was my ignorance to looking at groups I don’t fit into or that the population where actually uniformed of the classes that obesity have. The results were very interesting showing that only 43% knew that class 2 obesity is between 35.0 and 39.9 where that 50% thought it was between 30 and 34.9. It showing my predictions that not many people are oblivious of the different classes of obesity and believe it just fits into one category; obese.
Is obesity a serious problem in the UK?
This question has mixed reviews on this question as a majority of people don’t know that obesity is big problem in the UK and has been for many years. Obesity is not campaigned enough showing the statistic and how serious it is in the UK let alone the world, it is a world epidemic showing it is a big issue. The fact that it has not been decrease over time but instead done the opposite is worrying to the future of children who may grow up thinking obesity is not a problem and the easy solution is surgery without being ware of the risks it causes to their heath and the risk surgery cause over all.
Do you consider obesity as serious as other illnesses?
A bundle of people are naive when it comes to obesity, believing that it the persons fault because if they want to lose weigh they could just stop eating. It’s not that easy when your obese there are so many other side of it that are involved such as the mental attraction to large intakes of food. It is not just about losing weight it’s about becoming healthy and feeling better about you. When you reach class 3 obesity it is really hard to lose weight especially, as they are unable to move around easily. About 9,000 people a year die from being obese; this problem has been around for years. The result I obtained from this question showed what I expected which is that people are oblivious to the seriousness of obesity with 43% saying it not serious and only 57% saying it is serious.
Which is more serious? Obesity, anorexia or both?
This question is very important in determining how people perceive obesity as well as eating disorder. Most people are unaware that behind eating disorders is someone looking for help. A lot of eating disorders are brought by depression and the fact that people judge them means that means it causes a lot more problem. My prediction was that people might see anorexia to be more serious as it is always in the media to lose weight and has a big effect on all ages. Most people lose weight so they can get what they see and what their told is the perfect body, this becomes an obsession which turns into an addiction where losing weight is never enough. For obesity it’s the opposite where they are unable to lose the weight so gain it instead. 70% of the participants answered both for being as serious as each other.
What problems will obesity cause on the body?
To my surprise there was 23% who gave wrong answers of slow metabolism and sleep problems which have nothing to do with obesity. The causes that it has on your body are very hazardous on your organs putting pressure on them this causes them to not function properly. The main reason why people die of obesity it is not the large amounts of fat on your body it’s the effect it has on your body and vital organs such as the heart. Due to the heavy amounts fat it is also very difficult for the problems to be corrected as their body is very fragile and any slight change such as surgery or high intake of certain medication could cause the organs to malfunction.
What treatment is there for obesity?
The results were mixed but over all showing that a majority of people answered exercise (30%) and diet (30%)and surgery(22%). These results don’t surprise me because exercise and diet are the most media driven ways of losing weight. New diet are being designed regularly all with the campaign of weight lose in short amounts of time with the biggest effect. Exercising has only recently been introduced in to the obesity campaign publicising that 30 minutes a day for at least 3 days a week will help you maintain an normal body weight and as well as keeping you healthy. Medication had a very low 18% put it as a way of treatment. Medication is not very published as methods of weight lose because with it bring a lot of side effect and is only a short term supply. This shows that that people are very oblivious to other forms of treatment not even mentioning social support as an answer because people don’t relate obesity with psychological issues and need for support to overcome this before they can try to treat obesity fully.
Do you think obese patients should be allowed surgery to correct their problem for free?
This question is talked about a lot but when it comes down to it obese patient need help as they has an illness. When I say for free in this question I am referring to the NHS as it provides treatment free of cost to British citizens under the health service. A lot of people have to bear in mind that surgery is not cheap; the cost goes to the government. There is also cost of care and support from health professionals that need to be paid for. All these costs add up to thousands per patients, which each year costs billions to the economy and the governmet.26% answered that it should be treated for free probably because they see it as an addiction rather than self-inflicted. Obesity is just the same as any form of bodily harm such as drug abuse, alcoholism and other problems which other may class as an illness. 74% said it should not be treated for free.
Can obesity be genetically inherited?
This question is very controversial, 43% of participants believe that it can be genetically inherited with 57% saying can’t be. Obesity can be inherited as we know but it doesn’t determine your future, many people are judgemental to obesity as they feel it’s brought on their selves but the is a very oblivious perception to obesity as it can be passed down from your parents. Statistics show that if both parents are obesity there is a 80% chance that your child is obese, It doesn’t necessarily mean though that you can’t prevented. If they know the gene for it they may be able to find a suppressant to suppress the gene and stop it from occurring in the gene pool. Parents should be more informed about the statistics of obesity being pasted on, so parents can see that if they live a healthy life style their children might not as well.
What is the cause of obesity?
The results were as expected that more participants about 47% in total would give the answer that eating too much is the main cause of obesity because this is what is advertised and we are told is the main cause of obesity. The intake of more calories than your recommended daily guidance which makes you put on weight in the form of fat deposites.44% said it was caused by not moving around which means not be able to meet the demands if your environment. A very small 9 % gave the answer not working which I didn’t expect. To try to explain their answer they were probably think that as you put on weight you are unable to work as you can’t carry out task sufficiently without having to stop for a breath. If they were working then at least they would able to be active at work.
What kind of illness would you consider obesity to be?
This question has so many opinions that it has a combination of answers ranging from self inflicted, involuntary to inherit.76% answer that it is self-inflicted showing they only see obesity as eating too much. They are not informed of what lies underneath weight such as person who may need support rather than judgement. Only 24% said it’s inherited which is understandable as a majority that gave this answer chose yes that obesity can be genetically inherited
Should obesity be treated on NHS?
The results were similar with a little more than half saying it should be treated on the NHS not for surgery though but for other forms of treatment. The rest said obesity should not be treated on the NHS as they feel it too expensive to be paying for everyone’s treatment and that it’s their fault so they should have to pay for it.

In conclusion I really enjoyed working on this project as it opened my eye to a different side of obesity that I was not aware of. It gave me a real in depth detail of obesity, looking at all the different accepts of it that not many people are oblivious to.

My fist hypothesis about assuming people knew about BMI gave mixed answers as a lot of people knew what it stands for but didn’t know how to calculate it or what the number give means in each of the categories. My second hypothesis was again mixed review of answers with some knowing a lot about obesity and the causes and problems you obtain from it. My last hypothesis was approved as a bulk of people said that it should be helped on the NHS. I predicted they would give this answer as it could happen to anyone to gain an addiction and if you need help the only way to get help is from the NHS. Obesity is classed as a disability when it gets to the stage where they can’t carry out everyday tasks without getting out of breath. There were a few problems throughout the project such as on the questionnaire. I forgot to label each answer with a letter before I gave out the questionnaire, this was important as I used the letters to help collect my results. I over came this problem by labelling the empty questionnaire (attached to the back) with these letters so I knew what each letter, each answer would fall under. The hardest part of the whole project was collecting the background information as there were so many sources about obesity. I had to always bear in mind that they are not always valid and might not talk honestly about what they are publishing for. Hopefully from this project you are able to draw your own conclusion on the research question.
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