Childhood Obesity

obesity

obesity, condition resulting from excessive storage of fat in the body. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index (BMI). It has been estimated that 30% to 35% of Americans are overweight or obese.

Health and Social Implications

Obesity is a major public health concern because it predisposes the individual to many disorders, such as noninsulin-dependent diabetes, hypertension, stroke, and coronary artery disease, and has been associated with an increased incidence of certain cancers, notably cancers of the colon, rectum, prostate, breast, uterus, and cervix. In contemporary American society, obesity also carries with it a sometimes devastating social stigma. Obese people are often ostracized, and discrimination against them, especially in hiring and promotion, is common.

Causes of Obesity

Obesity research has yielded a complicated picture of the underlying causes of the condition. The simple cause is ingestion of more calories than are required for energy, the excess being stored in the body as fat. Inactivity and insufficient exercise can be contributing factors; the less active the person, the fewer calories are needed to maintain normal body weight. Overeating may result from unhealthful patterns of eating established by the family and cultural environment, perhaps exacerbated by psychological distress, an emotional dependence on food, or the omnipresence of high-calorie foods.

In some cases, obesity can come from an eating disorder. It has been shown, for example, that binging for some people releases natural opiates in the brain, providing a sense of well-being and physical pleasure. Other studies have found a strong relationship between obesity in women and childhood sexual abuse.

Some weight-loss experts see obesity as based upon genetics and physiology rather than as a behavioral or psychological problem. For example, rat studies have shown that fat cells secrete a hormone that helps the rat's brain assess the amount of body fat present. The brain tries to keep the amount of that hormone (which also appears to act on the brain area that regulates appetite and metabolic rate) at a set level, resulting in the so-called set point—a weight that the body comes back to, even after resolute dieting. The gene that encodes this hormone, called the obese or ob gene, has been isolated in both rats and humans. In addition, a gene that influences obesity and the onset of diabetes has been identified. It has been estimated that from 8 to 30 different genes may influence obesity.

Treatment

Radical treatments for weight loss have included wiring shut the jaw, operations that reduce the size of the stomach, and intestinal bypass operations circumventing a large area of the small intestine, limiting the area where food is absorbed. The "diet pills" of the 1960s, essentially amphetamines such as Dexedrine, are now seldom prescribed for weight loss. Fenfluramine and dexfenfluramine, drugs formerly used to achieve short-term weight loss, were withdrawn from the market following concerns that they could cause heart valve damage. Drugs to treat obesity now include orlistat (Xenical), which acts to block absorption of dietary fat in the intestine. In 2007 an over-the-counter version of orlistat was approved by the Food and Drug Administration.

Although the study of obesity is yielding many possibilities for treatment, the main focus remains diet (especially a diet limiting fat calories) and exercise, often coupled with emotional and behavioral support. The long-term weight-loss success of most attempts at dieting, however, is notoriously low. Groups such as Overeaters Anonymous, modeled after Alcoholics Anonymous, give support to people with weight problems and eating disorders.

The Columbia Encyclopedia, 6th ed. Copyright© 2013, The Columbia University Press.

Selected full-text books and articles on this topic

Understanding Childhood Obesity
J. Clinton Smith.
University Press of Mississippi, 1999
Our Overweight Children: What Parents, Schools, and Communities Can Do to Control the Fatness Epidemic
Sharron Dalton.
University of California Press, 2004
The Consequences of Childhood Overweight and Obesity
Daniels, Stephen R.
The Future of Children, Vol. 16, No. 1, Spring 2006
The Child-Fat Problem
Eberstadt, Mary.
Policy Review, February-March 2003
The Role of Parents in Preventing Childhood Obesity
Lindsay, Ana C.; Sussner, Katarina M.; Kim, Juhee; Gortmaker, Steven.
The Future of Children, Vol. 16, No. 1, Spring 2006
Weight Bias: Nature, Consequences, and Remedies
Kelly D. Brownell; Rebecca M. Puhl; Marlene B. Schwartz; Leslie Rudd.
Guilford Press, 2005
Librarian’s tip: Chap. 4 "Weight Bias in a Child's World" and Chap. 5 "Weight Bias in a Teen's World"
Overweight Teenagers: Don't Bear the Burden Alone
Michael D. Lebow.
Insight Books, 1995
Eating Disorders and Obesity: A Comprehensive Handbook
Christopher G. Fairburn; Kelly D. Brownell.
Guilford Press, 2005 (2nd edition)
Librarian’s tip: Chap. 77 "Epidemiology and Causes of Obesity in Children" and Chap. 85 "Medical Consequences of Obesity in Children and Adolescents"
Childhood Obesity: Trends and Potential Causes
Anderson, Patricia M.; Butcher, Kristin F.
The Future of Children, Vol. 16, No. 1, Spring 2006
Childhood Lost: How American Culture Is Failing Our Kids
Sharna Olfman.
Praeger, 2005
Librarian’s tip: Chap. 6 "Big Food, Big Money, Big Children"
Handbook of Psychological Treatment Protocols for Children and Adolescents
Vincent B. Van Hasselt; Michel Hersen.
Lawrence Erlbaum Associates, 1998
Librarian’s tip: Chap. 7 "Childhood Obesity"
Type 2 Diabetes in Childhood and Adolescence: A Global Perspective
Martin Silink; Kaichi Kida; Arlan L Rosenbloom.
Martin Dunitz, 2003
Librarian’s tip: Chap. 5 "Childhood and Adolescent Obesity"
Economic Perspectives on Childhood Obesity
Anderson, Patricia M.; Butcher, Kristin F.; Levine, Phillip B.
Economic Perspectives, Vol. 27, No. 3, Fall 2003
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