Obesity: Hypertension and Health Care

I. Abstract As a health care professional it is our position statement that obesity should be considered as a disease. Overweight and obese adults are considered at risk for developing diseases such as type II diabetes, hypertension, high blood cholesterol, coronary heart disease, and certain type of cancers. An average of 300,000 deaths is associated with obesity and the total economic cost of obesity in U. S. was about $ 117 billion in 2000. As health care professionals it is our responsibility to increase public awareness of health consequences of over weight and obesity.

Obesity as a disease: Obesity fits all the definitions of ? disease’, that is, interruption in bodily function. II. Position Statement Obesity is a growing health problem and leading cause of preventable deaths in U. S. As a health care professional it is our position statement that obesity should be considered as a disease. Over weight along with obese are also at risk for many diseases. However, it is our recommendation that expenses related to weight reduction program should only be paid to cure a specific obesity related disease.

Medicare and insurance companies should not make payment for treatment of obesity unrelated to a medical condition such as improving a person’s general appearance and well being. As treatment in this context has not been determined to be reasonable and necessary. Various kinds of programs such as nutrition education and importance of physical activity must be offered to over weight individuals. Also we must adapt a sensitive approach to change our national perspective of obesity and over weight from an issue of appearance to an issue of health concern. III.

Key Points 1. Diseases related to obesity: Overweight and obese adults are considered at risk for developing diseases such as type II diabetes, hypertension, high blood cholesterol, coronary heart disease, and some type of cancers. 2. What is obesity costing U. S. : An average of 300,000 deaths is associated with obesity and the total economic cost of obesity in U. S. was about $ 117 billion in 2000. 3. Obesity as a disease: Obesity fits all the definitions of ? disease’, that is, interruption in bodily function. IV. Supporting Facts 1. Diseases related to obesity.

Obesity has been proven to affect the structure and function of the body and is also associated with onset of specific diseases. The National Institutes of Health Guidelines summarizes that overweight and obese adults with a BMI of 25 are considered at risk for developing diseases such as type II diabetes, hypertension, high blood cholesterol, coronary heart disease, and some type of cancers. Individuals with a BMI of 25 to 29. 9 are considered overweight, while individuals with a BMI ;30 are considered obese [1]. a. Obesity and Type II Diabetes:

A research done by Amy Weinstein et al. states that physical activity and BMI are independent predictors of type II diabetes. It further adds that degree of association of BMI is much more then physical activity. The research was done on forty thousand women with a follow up for seven years [2]. b. Obesity and Cardiovascular Diseases [CVD]: Strong relationship has been observed between obesity and heart related diseases. Researches confirm that weight gain increases blood pressure in obese and overweight hypertensive and nonhypertensive individuals.

Weight gain has shown to increase serum triglycerides, blood cholesterol level, and low-density lipoprotein (LDL) also called bad cholesterol. Weight gain is also related to decreased high-density lipoprotein (HDL) also known as good cholesterol [1]. c. Obesity and Respiratory function: A study from England concluded that abdominal obesity damages respiratory functions in men and women. The relationship between the two was found out by using waist: hip ratio for measuring abdominal obesity and using spirometry to assess respiratory function.

The linear and inverse results of spirometry assessment were related to the increase in waist: hip ratio [3]. d. Obesity and Dementia: Researches have been undergone to find out affect of obesity on dementia and Alzheimer’s disease. Findings from a long term investigation states that middle aged obese are a twice as likely to develop dementia in later life as nonobese. The study also relates CVD, diabetes, and lack of physical activity to dementia [4]. e. Obesity and Psychosocial problems: Over weight and especially obese also suffer from various discriminations in areas of employment, education and disability benefits.

It also prevents them from becoming a contributing member of society thus resulting in lower self esteem issues. A study from American Medical Association claims that morbid obese children and adolescents have lower health-related quality of life than healthy children and adolescents. It states psychosocial issues may cover issues related to self worth and depressive symptoms, lower quality of life is a more comprehensive word that addresses physical, emotional, social, and school performance.

Health care professionals recommend parents and teachers to enhance health related quality of life issues of their children and students respectively [5]. 2. What is obesity costing U. S.? Epidemic of over weight covers more then one billion adults worldwide, as stated by WHO. Among those at least 300 million are obese [6]. a. Health consequences: Obesity is a chronic health problem resulting in maximum number of deaths next to deaths cause by smoking [7]. An investigation of causes of deaths in 1991 states that approximately 324,940 deaths were caused by obesity [8]. And an average of 300,000 deaths is associated with obesity.

As mentioned above obesity is also related to serious health conditions such as CVD, certain types of cancer, type II diabetes, respiratory problems and arthritis etc. b. Economic consequences: Along with severe health consequences, obesity seriously effects U. S. economy. Health care costs related to obesity and over weight involve direct and indirect expenses. Direct expenses include diagnosis, prevention, and treatment services related to obesity and obesity related diseases. Indirect costs include morbidity (income lost from decreased productivity and absenteeism) and mortality (future income lost by premature death) costs.

The total economic cost of obesity in U. S. was about $ 117 billion in 2000. 3. Obesity as a disease: Critics of above statement suggest obesity is more of a personal responsibility rather than a disease. There should be proper balance between consumption of food and physical activity. Lack of exercise results on storage of all the calories thus resulting in gain on weight over the period of time. Whereas anti-obese parties suggest sexually transmitted diseases and certain types of cancer such as skin cancer is also an example of lack of personal responsibility but they are considered diseases and treated according to it.

Obesity fits all the definitions of ? disease’, that is, interruption in bodily function. Thus obesity by all means is a disease. V. Roles and Responsibilities: As health care professionals it is our responsibility to increase public awareness of health consequences of over weight and obesity. We need to introduce variety of programs related to nutrition intervention and physical activity. Investment in research that improves our understanding of causes, treatment, and prevention of obesity and over weight is required on national basis. We also need to encourage healthy eating in our daily lives.

VI. References: 1. Evidence to IRS to Make Obesity Treatment a Medical Deduction [Online]. American Obesity Association. http://www. obesity. org/subs/tax/irs97. shtml [accessed Oct. 4th 2004]. 2. Weinstein R. A. et al (2004) Relationship of Physical Activity vs. Body Mass Index with Type 2 Diabetes in Women. JAMA, Sept. 8, 2004. Vol 292, No. 10 (Reprinted). 3. Canoy D. et al (2004) Abdominal obesity and respiratory function in men and women in EPIC-Norfolk Study, U. K. Amer. J. Epidemiol, 2004;159 (12): 1140-1149. 4. Wysong P. (Aug. 2004) Obese Mid-Lifers at Higher Risk of Dementia.