Page 576 - Encyclopedia of Nursing Research

WeIGhT MAnAGeMenT n 543

paying for organized services to assist indi- were obese—a 1 in 6 incidence. Overweight
viduals with weight reduction, such as health and obesity have a greater effect on minori-
center-based and commercial programs. ties; Blacks had 51% and hispanics had 21% W–Z
Informal weight management includes per- higher obesity prevalence compared with
sonal weight-loss methods without pro- Whites. national study of costs attributed to
fessional assistance. Weight management overweight and obesity revealed that medi-
usually is targeted at reducing weight (ver- cal expenses accounted for over 9% of total
sus gaining) because of societal pressures to u.S. medical expenditures in 1998 or approx-
be thin and growing epidemic incidences of imately $78.5 billion (Finkelstein, Fiebelkorn,
overweight, obesity, and comorbidities. For & Wang, 2003). In 2002, expenses rose to $92.6
adults 20 years or older, overweight is defined billion, half of which were paid by Medicaid
as having a body mass index (BMI) of 25 to and Medicare.
29.9 kg/m and Class 1 obesity is defined as Overweight and obesity are multifacto-
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having a BMI of 30 to 34.9 kg/m (national rial conditions. etiological influences include
2
heart, Lung, and Blood Institute [nhLBI], bio-psycho-sociocultural factors and toxic,
1998). Class 2 obesity is defined as having a obesogenic environmental factors (Apovian,
BMI of 35 to 39.9 kg/m , and Class 3 is hav- 2010; Blackburn et al., 2010). experts agree
2
ing a BMI of greater than 40 kg/m (World that obesogenic environmental factors, more
2
health Organization expert Committee on than biological reasons, explain the obesity
Physical Status, 1995). epidemic over the past four decades. Four
Overweight and obesity are a grave conditions account for the environmental
health care epidemic despite efforts and stimulus–response nature of the rise in obe-
national initiatives to abate this growing sity in the united States: (1) a fast-paced eat-
dilemma. Progress in the past 10 years toward ing style consisting of fatty, glycemic “fast
healthy People 2010 objectives for overweight foods” and super sizing; (2) excessive calorie
and obesity was of little consequence, thus intake; (3) reduced physical activity and tech-
requiring retention and revision for the new nological dependency; and (4) heightened
healthy People 2020 objectives for healthy responsiveness to food as a stimulant (hill,
weight and obesity (Sondik, haung, Klein, Wyatt, Reed, & Peters, 2003).
& Satcher, 2010). According to the national unfortunately, failure rates for weight
health and nutrition examination Survey loss treatments in the united States, once
(nhAneS) u.S. data from 2007 to 2008, over- estimated to be as high as 90% to 95%, have
all prevalence of overweight and obesity for not improved. Long-term habits of overeat-
adults was 68% (approximately 72% among ing without hunger and with minimal reg-
men and 64% among women; Flegal, Carroll, ular physical exercise in a fast-paced society
Ogden, & Curtin, 2010). Overall, obesity have been described as chronic and refrac-
prevalence was 35.5% for women and 32.2% tory with high recidivism for treatment
for men. Class 3 obesity was reported to have (Wadden, Brownell, & Foster, 2002). Most
increased at greater rates than any other class weight-loss treatments in the united States
of obesity in the united States (Blackburn, have not helped reduce weight over the long
Wollner, & haymsfield, 2010). term and have even contributed to the over-
Over the past three decades, childhood weight problem (hill & Wyatt, 2005). As
obesity has more than doubled among chil- obesity increased, so did many associated
dren ages 2 to 5 years, has tripled among comorbid conditions, including hyperten-
youth ages 6 to 11 years, and has more sion, dyslipidemia, type 2 diabetes, coronary
than tripled among adolescents ages 12 to heart disease, stroke, gallbladder disease,
19 years (Flegal et al., 2010). Approximately osteoarthritis, sleep apnea and respiratory
17% of American children ages 2 to 19 years problems, and endometrial, breast, prostate,