The twenty-first century has come with challenging aspects in health care. Weight management is one challenge that has faced the American citizens and the global population as a whole. Public health concerns on the obesity epidemic and its relation to other chronic diseases are clear. As a result, a multidisciplinary approach is required in weight management since obesity is multi-factorial. Besides, the approach is efficient in that it integrates weight, health, behavioral changes, nutrition, and body exercises to primarily achieve the best health results. Individually, such treatment is essential since different people have different needs to be met to accomplish lifestyle changes in the entire population. This research paper addresses obesity in the United States from various perspectives. It begins by identifying obesity as an epidemic, its prevalence, causes, consequences, and recommendations for implementation of its management strategies.
Research indicates that obesity rates are rising rapidly in the United States over the past decade. The medical practitioners assert that the sedentary western lifestyle marked by technological advancements is implicated with the rising rates of obesity. It is hard to notice people walking or taking a flight of stairs but instead, many people spend most of their time watching television, on the computers, and playing video games. Moreover, excess food is stored in the body as fat, and when it often occurs, great amounts of weight are gained and obesity results. This causes an energy imbalance as excess calories are not combusted due to.inadequate physical exercise. Therefore obesity results from amassing of surplus body fats and is taken as a chronic illness just like diabetes, and hypertension.
Obesity qualifies to be called a chronic disease since it persists for many years, it is progressive and to crown it all, it is deteriorating. Moreover obesity.needs, health care attention and it is characterized by boycotting working hours. Through its effects on ‘metabolism, morbidity and mortality’ it leads to multiple health concerns. Being chronic, obesity can be likened to hypertension, coronary heart disease (CHD), as well as type 2 diabetes. The therapeutic measures are taken to manage the stated chronic conditions such as enhancing morbidity and curbing mortality should also be applied in the management of obesity. Appreciating obesity as a chronic condition allows impetus to strategise its treatment through multidisciplinary coordination to allow professional therapeutic actions (Foreyt 2003).
The foods that individuals consume add up to their well-being by offering proper nutritional values for healthy living. Excess food is stored in the body as fat and when it happens often, great amounts of weight are gained and obesity results. This causes an energy imbalance as excess calories are not combusted due to inadequate physical exercise. Therefore obesity results from amassing of surplus body fats and is taken as a chronic illness just like diabetes and hypertension. It is dangerous to an individual’s health and is considered the second basis of preventable fatalities in the U.S after tobacco. Obesity has become a global epidemic with nations such as the United States unable to manage the issue. In the U.S Obesity has risen from the past decade where currently, two-thirds of American citizens are obese. The United States has the leading obese population followed by Mexico and the United Kingdom (Burniat, 2002). Medical expenditures arising from managing obesity and related problems amounts to hundreds of billion dollars and other losses are incurred in the workforce, which reduces productivity as a result of boycotting work due to obesity health problems (Burniat, 2002).
Obesity is a condition where an individual has acquired a Body mass index (BMI) ranging from thirty and beyond. To calculate BMI, an individual’s weight (kg) is taken relative to height (M2) to evaluate if a person is underweighted, normal or overweight as in the case of obesity. BMI unit is standard and clinically affordable in researching high population. The units are however limited since it does not differentiate between lean mass and fat mass. BMI may neither portray the accurate body fat, such as those with muscles and heavy bone structures, nor the academic & postural conditions. Moreover, BMI does not show the distribution of body fat, essential in assessing dangers related to metabolic illnesses. All the same, BMI is an essential tool in determining adiposity and is practically used to evaluate clinical conditions in relation to weight (Foreyt, 2003). It is predicted that the number of obese citizens in the United States will increase significantly in the future which will not only result in more financial expenditures but also to rise in obese related health issues.
Definition of Terms
- BMI- Body Mass Index
- CDC- Centers for Disease Control and Prevention
- CHD- Coronary Heart Disease
- IBW- Ideal Body Weight
- NCHS- National Centre for Health Statistics
- NIH- National Institutes of Health
- NOPERN- The Nutrition and Obesity Policy Education Research Network
- NPAO- Division of Nutrition, Physical Activity, and Obesity
- Obesity- It is a medical condition where an individual has acquired a BMI ranging from thirty and beyond.
- WON- Weight of the Nation
Prevalence of Obesity in the US
The CDC National Centre for Health Statistics (NCHS) asserts that sixty-six percent of American adult citizens over twenty years of age are struggling with the issue of overweight and obesity. According to its research, NCHS emphasize that from 1976 to 1980, there had been a gradual rise in obesity but since then the statistics have been rising rapidly. From 1999 to 2000, there have been over twice cases of obesity as those recorded in 1960. Today, three in every ten persons are obese where the statistics indicate that the rise in obesity has affected all people from different socio economic and ethnic backgrounds in all regions ion the nation. However, higher prevalence is noted in Southeastern regions in 2006 such as West Virginia and Mississippi where more than 30% of the population is obese. In 2010, the fattest state was Mississippi for a successive period of five years being on the lead while Colorado was the leanest state in the United States (Stern & Kazaks, 2009).
Over a third of the American adult population i.e., over 72 million individuals and seventeen percent of the American children have been noted to be obese. Since 1980 up to 2008, the rates of obese adults have doubled while that of children has tripled. Remarkably, obese rates are on the rise irrespective of socio-economic, ethnic, and gender differences. Health disparities implicated with obesity in the United States indicates through Behavioral Risk Factor Surveillance System that since 2006-2008 blacks had a higher rate of fifty one percent while Hispanics has a twenty one percent higher chance of being obese as compared to other citizens. According to research conducted in 2009 by the Pediatric Nutrition Surveillance System, it is notable that 14.6% of children between two to four years of age from families with low earnings are obese (CDC, 2010).
In recent years, obesity is a chief health concern that has faced the American population. Obesity is silently creeping to become a global epidemic although it is notable in industrialized nations. 2007 research shows that approximately 74.1% of the American population is overweight where Obese adults have become more obese since nineteen ninety seven, two thousand and four and two thousand and seven with the rates of 19.4%, 24.5% and 26.6 % respectively (CDC, 2010). Historically, obesity was implicated with adults although this has been different in today’s world. In the previous two decades, childhood obesity is on the rise, which is transmitted into adulthood and related health complications arise. However, when newborns are overweight, this could be a diabetic condition other than obesity. The elderly on the other hand have lower rates of obesity, which may be due to social economic differences (Wadden & Stankard, 2004).
Obesity is a national health concern that has persisted since the previous decades. For instance, in 1943, a significant number was beyond the IBW where Metropolitan Life Insurance Company asserted that overweight was becoming widespread such that it comprised a critical national health concern. In addition David Satcher, the previous US Surgeon General termed obesity as a ‘public health epidemic’ saying that “Health problems resulting from overweight and obesity could reverse many of the health gains achieved in the U.S in the recent decades” (Stern & Kazaks, 2009). In a different instance, the Healthy People 2010, which was a promotion program by the US Department of Health and Human Services emphasized that overweight and obesity are the primary pointer of the national health. As a result, the department is geared at declining obesity prevalence to not more than fifteen percent of the American population although little has been done in the U.S to achieve that goal as indicated that the situation is getting out of hand (Stern & Kazaks, 2009).
Health repercussions caused by obesity includes physical, social and psychological concerns. For children, there is a development of obesity related conditions that previously affected adults such as type 2 diabetes. Research indicates that 70% of obese children aged five to seventeen years had not less than a single risk factor (e.g. high cholesterol, BP, insulin levels, and triglycerides ) of being predisposed to cardiovascular illnesses while 39% possessed risk factors of not less than two (CDC, 2010). Since the previous three decades, pediatric obesity has doubled for children two to five years of age as well as adolescents between six to eleven years. Currently, close to 9 million children exceeding six years are obese (Stern & Kazaks, 2009).
Causes of Obesity
Childhood obesity is caused by various social, economic and environmental issues which affect eating habits and the number of physical exercises’ that an individual engages in. Maintaining a healthy weight has proven to be problematic in the U.S due to the following factors. First, urban setups do not promote walking or other activities since there are technologies to make that easier e.g. automobiles and taking elevators and escalators. Second, there has been rising pressure in homes meant to minimize the costs of acquirement and preparation which leads to recurrent eating of available junk high calorific food. Third pediatric obesity can be traced to the unavailability and expensive state of nutritious food such as vegetables, milk and fruits. Forth, there are reduced chances of having physical activities in learning institutions and at homes where children no longer ride bikes or walk but are driven home. Finally, leisure time has been overburdened by passive activities such as watching television, online browsing, playing video games and other sedentary activities other than enthusiastic outdoor recreation.
The obesity epidemic has involved both genders irrespective of racial, ethnic or age differences. Prevalence of obesity indicates that the obese and non-obese children maintain their state. Obesity poses great health risks to children and more so, psychological conditions due to stigmatization where children develop low self-esteem which may hurt their schooling and social life (Institute of Medicine, 2004).
Weight issue has not manifested overnight rather, it has taken place over a number of decades but it was awarded due attention in the recent past. The U.S population had had a notable increase in weight as well as height from the late nineteenth century. The weight gains were initially important in enhancing the body immunity and thus an increased lifespan. This was noted in 1900 -2000 life expectancy which rose by sixty five percent in females and sixty percent in males. However, more gains in weight have resulted to obesity especially in the previous two decades to extreme levels hence, health problems.
The public has not quite understood physiological explanations of obesity in relation to a healthy diet, change of behavioral patterns and the role of physical fitness. The surge may be reflected in a rise in per capita energy input for nineteen seventy of 2220 Kcal and nineteen ninety seven of 2680 Kcal as derived from the national supplies of food items in the U.S. Energy consumption in the US is due to several factors. In the 1980s for instance, 3300 calories of food were produced by each individual but since then the farm policy shifted where farmers embraced low prices, flexible planting patterns and were more inclined to market forces. As a result, bumper harvest was achieved so much so that every America produces 3900 calories daily. Food prices have decreased and are available in all food joints and restaurants all year. There has also been sophistication in the packaging and processing of ready palatable and affordable food, which is highly commercialized and advertised. This has made preparations easier contributing to the surge due to overindulgence. On the same note, “in 1965, it took a housewife more than two hours per day to shop for, cook, and clean up from meals. By 1995, the time it took to do these tasks was cut in half “(Stern & Kazaks, 2009).
In addition, social learning theory explains that the surge in obesity in adults may be due to social learning, which occurs in the family in early childhood. Therefore, the effort to lose excess weight varies with social strata. Social learning is attributed to weight management procedures in relation to physical activity and dietary patterns. Moreover, Psychological time-bomb theory shows that obese individuals may grow psychological symptoms especially portrayed during weight cutback efforts. This theory explains that these are severe in individuals whose onset is early and have extreme obesity. These people are so sensitive of their state especially adolescents who face prejudice in schools and employment opportunities. Such social factors segregate adolescents into permissive situations in relation to obesity such that their body weights become even more extreme. Affluent sedentary lifestyles are to blame for the rise in obesity in the American population. Most of activities are automated where muscular work is minimal especially in children (Cassell & Gleaves, 2006).
Risks Associated With Obesity
Obesity not only poses a health problem such as type 2 diabetes, cancer and cardiovascular illnesses but also an economic letdown in the U.S. The prevalence in many states is alarming and obesity has become an epidemic not only in the United States but also in other western nations. Over half of the citizens are obese and most importantly, the rise in childhood obesity where one in every seven children in the United States are overweight while a third are obese. This is so since there is plenty of junk food with less physical exercises or complete inactivity. Obesity in the United States may be attributed to unhealthy lifestyles with less physical activities. To combat, obesity then, there has to be modification in eating behaviors and reduction of physical inactivity through policies aimed at combating the vice. A young individual with obesity is highly predisposed to future health risks. Overweight adolescents possess seventy percent chance of being obese adults. As a result, heart illnesses due to elevated cholesterol level and blood pressure results in obese individuals. Hence, there are serious health concerns that the young children in the United States will undergo through debilitating chronic illnesses which will significantly reduce their lifespan (Stern & Kazaks, 2009).
State programs prove helpful in creating public awareness, monitoring the population, evaluating and offering health related conditions, which includes but are not limited to osteoarthritis, hypertension, diabetes, cardiovascular illnesses and related disabilities. Diabetes for instance is the seventh basis of fatalities in the U.S. in 2008, fifty seven million adults had the condition. Obesity as well is implicated with pregnancy complications where the obese women have a thrice chance of death in the first month and twice the probability of stillbirths as those born by normal women. The federal programs of Medicare and Medicaid incur much of obesity related costs, especially pediatric obesity. Obesity is a non-communicable disease that can be managed or prevented by assessing the factors that cause it. A risk factor is “a measurable element in the chain of disease causation and a strong predictor of future risk” (Wadden & Stankard, 2004). Risk factors are essential in predicting statistical relations with a prospect of disease jeopardy including the causative factors. On the other hand, risk indicators possess statistical relations with prospected disease risk without the causative factors.
Other health consequences of obesity are Physical consequences which include glucose intolerance, type 2 diabetes, arthritis orthopedic problems, impaired balance, sleep apnea, metabolic syndrome, impaired balance, Hepatic steatosis, cholelithiasis, cancer, dyslipidemia, cardiovascular illnesses and hypertension. Emotional, health is also affected due to low self esteem, stress & depression and having a low self image. Social health implicated with obesity arises due to stigma, prejudice, personal marginalization, mockery, maltreatment and harmful stereotyping.
Children born in the U.S in the year two thousand are predisposed to type 2 diabetes; 30%, in boys and 40% in girls at some stage in life. The lifetime risk of acquiring type 2 diabetes is great for the ethnic minorities during birth and as they grow up. Type 2 diabetes is predominant in children and young adolescents in that it adds up to 8-45% of emerging pediatric cases in the 1990s as compared to less than 4% before the 1990s. The epidemic contributes to a declining life expectancy which has improved due to curbing infectious diseases since it causes a predisposition to chronic conditions such as type 2 diabetes (Institute of Medicine, 2004).
Genetic factors may also play a vital role in the accumulation of excess body fats in the body. Although the statistics are staggering, there has been a notable pattern where parents with obesity have children with the same condition. Obese parents double the chances of having an obese child. In addition, children from ethnic minorities, low socio-economic levels, and those residing in the Southern region have increased rates of obesity as compared to other American citizens. Notably African Americans, Asian Americans and Hispanics have high rates of obese adolescents. Inclusive of all genders, Hispanics and African Americans children go beyond the 95th percentile. In boys, the highest prevalence is in Hispanics while in girls, African Americans have the highest prevalence (Institute of Medicine, 2004).
Obesity has proven to be very expensive as noted in two thousand and eight where medical expenditures linked to obesity added up to $147 billion. In comparison, the CDC assert that “in 2006, obese people spent $1,400 more in medical care costs than did people at a normal weight…From the periods 1979–1981 to 1997–1999, annual hospital costs related to obesity among children and adolescents increased from $35 million to $127 million, respectively” (CDC, 2010). Estimates from CDC shows that direct and indirect expenditure arising from obesity rated at $51.64 billion & $99.2 billion in nineteen ninety five respectively as compared to $61 billion, $117 billion in two thousand. In two thousand and three, these values went up to $75 billion (CDC, 2010).
Recommendations for Obesity
In two thousand and nine July, the CDC initiated “Recommended Community Strategies and Measurements to Prevent Obesity in the United States.” Comprising twenty four strategies aimed at assisting local governments recognize and implement policies that are attributed to physical exercises and eating habits to encourage health eating patterns and physical fitness. They are grouped into six which include “Strategies to promote the availability of affordable, healthful food and beverages, Strategies to support healthful food and beverage choices, Strategy to increase breastfeeding, Strategies to encourage physical activity or limit sedentary activity among children and youth, Strategies to create safe communities that support physical activity, and Strategy to encourage communities to organize for change” (CDC, 2010). The U.S government and local and international agencies should partner to draft policies as follows.
- Society should advance the accessibility of inexpensive healthier food and beverage options in public places.
- The communities should establish foundations and NGOs to actively fund engage in research and facilitate campaign efforts on the obesity epidemic in the whole of the United States.
- School programs should be created, which encourage healthy dietary patterns, physical activities and behavioral change.
- The U.S government should ensure that there are infrastructural measures such as security, affordability, and accessibility taken into consideration in places where physical activities are possible.
- The communities should be educated through state and local agencies on the benefits of exclusive breastfeeding children up to a certain age.
- The government and local agencies should aim at a multidisciplinary approach in obesity management.
- An obese individual in society should be aided through collaborative efforts from health practitioners to engage in lifestyle adjustment through behavior modification
- Obese individuals should engage in aerobic exercises to facilitate energy expenditure.
Such strategies are important in managing obesity today and in future and are essential for the state and local government agencies and public institutions to implement.
The US government, agencies and public institutions should undertake the following steps in state and local levels;
- Accessibility: Increase accessibility of healthy dietary norms in public areas through formulating programs that aims at supplying affordable vegetables, fruits and nutritious food at workplaces. Incentives should be awarded to distributors and procure of food in farms without having the food processed. The nation should advance the geographical accessibility of supermarkets and food joints in marginalized areas. The Division of Nutrition, Physical Activity, and Obesity (NPAO) in CDC is geared at lowering the rates of obesity hence managing related health problems by initiating and funding state programs. NPAO is at present working and funding twenty five states through coordinating and partnering with other agencies to manage obesity. NPAO utilize policy and environmental strategies to decline television watching and unhealthy eating habits by promoting sugar-free and less calorific food with physical exercises. They have initiated eating fruits, milk and vegetables and advocated for exclusive breastfeeding for a stipulated duration. The program is aimed at declining health disparities through the Division of Nutrition, Physical Activity, and Obesity and the execution of a comprehensive state plan. CDC grants technical support to every state to come up with comprehensive state plans, community involvement and leadership capability to tackle obesity (CDC, 2010). These have seen banning junk food and high-calorie beverages in learning institutions. California for instance banned snacks in elementary institutions in two thousand and three. The creation of public awareness through education, programs is essential for people to embrace the need to change their eating habits and unhealthy lifestyles which is the main goal of the ‘Let’s Move’ initiative by Mitchell Obama.
- Monitoring and Partnership Efforts: CDC examines the trends of obesity through research to manage and control it through The Nutrition and Obesity Policy Education Research Network (NOPERN). NOPERN was initiated in 2009 to evaluate the consequence of policy adjustments on eating patterns and health results. Moreover, the CDC’s motive to curb obesity in the United States is by innovative partnerships with agencies such as Macro International Inc, Robert Wood Johnson Foundation, Let’s Move! Initiative, National Institutes of Health among others.
- School policies: these are aimed at improving the dietary patterns of school children. Food choice should be regulated during schooling e.g. from cafeterias and vending machines, dietary patterns can be modified. On the same note, the parents should be made aware of the effect of enticing children with food as gifts. Besides, the already obese children need to fit in the social setups such as schools and within the families without being segregated from the rest. Therefore, there is a need for children to become aware guided by rules and education that obese children are just normal and should not be marginalized since this affects their psychological health. The government should aim at regulating advertisements of high calorific food and beverages such as chocolates and ice creams. Some of these commercials are not only misleading but are also contributing factors to the rise of junk consumption especially for adolescents and young adults. Sugar free food and beverages should instead be promoted by the U.S Food Standard agencies in public places (Burns, 2010). In addition, the government should foresee the production of wholemeal cereal products such as bread, biscuits, among others. This could be accomplished through formulating training programs especially in schools where the children are educated on physical education and allow time for extracurricular activities. In addition, there is a need to educate children and young adolescents on the consequences of spending much time on passive activities such as watching television and playing video and computer games. Instead, active outdoor recreational activities such as walking, bicycle riding, and swimming are advocated for physical and mental well being.
- Safety and Green-spaces: in the US there have been many vehicle accidents where pedestrians face injuries and deaths as they engage in physical exercises. Therefore, the government should create an initiative meant to reduce such fatalities by establishing infrastructural changes where paths are designated for walking. The communities should be sensitized on such issues by encouraging them to walk to shopping malls, schools, work and other places rather than boarding a vehicle. The urban setups should be designed in such a manner that they encourage physical activities such as ensuring ample spaces in between buildings and also avoiding the use of escalators on particular days in a week (Burns, 2010).
- Maternity care: breastfeeding exclusively is essential for the healthy development of a child. Weaning at an early age not only exposes a child to the risk of infections but also helps to expose him or her to a chance of gaining excess weight at an early age. For instance, their government should consider a community such as Navajo which introduces weaning at a tender age and do not stick to exclusive breastfeeding habits. Therefore such a program would be essential to assist such a community to become sustainable economically by decreasing medical expenses resulting from illnesses and medication of the infant. In addition, mothers don’t have to boycott working to care for the ill child as well as having to incur costs such as buying baby formula. NPAO has initiated eating of fruits, milk and vegetables and advocated for exclusive breastfeeding for a stipulated duration.
- Multidisciplinary approach in obesity management: the modality involves the integration of approaches targeting at controlling the energy intake, encouraging more physical exercise as well as achieving behavioral shifts. This allows the room for shedding excess weight, weight preservation and most importantly, enhances the value of life. Health care practitioners in these fields allow both patients and physicians to achieve positive results in the management of obesity. The multiple health practitioners pulling their expertise together to manage obesity ensure combined efforts in drafting strategies than a lone person.
Referring to the algorithm ascertained by NIH, it takes six months for the first motive of achieving 10% drops in body weight. During the time span plans should incorporate regulations on dietary energy intake, more physical activities and changes in behavior patterns. When the six months are over, maintaining that weight is essential where some people may initiate further reductions in weight but through supervision. This plan is tailored to incorporate the personal needs, aims and situations of an individual patient. The model of the multidisciplinary approach offers progressive treatment as a long-term executive strategy. Such a model must include medical evaluation of the patient incorporating nutritionists, physiotherapists and behavioral counselors where the patient is integral in these different disciplines. The strategy may vary with the resource available, patient and physician as well as the scenario in which the setup is conducted. There is a need for record-keeping and enhanced communication (Foreyt 2003).
- Lifestyle Adjustment
This comprises the patient being supervised to make necessary adjustments in his or her day to day engagements. This treatment program aims at achieving changes such as dietary patterns, attitudes, behavior and physical fitness. Its main aim is not to decline the weights but attitude modification under observation to accomplish positive change. The patient is able to manage his lifestyle which ultimately causes his wellbeing. In this case, the healthcare team makes a follow-up of the patient’s chances for necessary therapy measures to be undertaken to educate as well as motivate the patient (Foreyt 2003).
In treating obesity, there is a need to monitor the patient which allows the health practitioner to determine the severity as well as implications of the condition. This helps in creating a statistical basis where change is made or evaluated. Baseline assessment involves the health professional calculating the patient’s BMI before and after implementing the management strategies. In addition, waist measurements could be taken to evaluate the adults’ visceral adipose which is not detected by BMI or weight measurements. Fortunately, such accumulations respond well to therapy in shedding weight (Foreyt 2003).
- Aerobic Exercises
Energy expenditure is mostly achieved through physical exercises which should be moderated to avoid increased intake of calories as a result of vigorous physical activity. Taking food immediately or afterwards after having a period of physical activity is not recommended since one replenishes the calorific expenditure. Sedentary individuals consume as much as the active ones thus leading to the accumulation of excess body fats. Through various studies, it is clear that increased activities affect the calorific expenditure but it is unclear on its effect on calorific input. However, various studies point out that there is no accelerated intake of energy after physical activity (Foreyt 2003).
Patient’s assessment, studies indicates that regular physical activity does not increase calorific consumption of individuals since the dietary preference is in most cases is dictated by psychological and environmental factors (Foreyt 2003). Therefore in managing obesity physical activity is of paramount importance although many people are usually unable to retain the schedule and ends up failing. Physical inactivity leads to the accumulation of body fats which causes a gain in weight as indicated in the case where obese individuals are inactive and only 22% of Americans are often active (Foreyt 2003).
Justification and Discussion
To manage obesity, urgent health concerns have to be considered to take a preventive approach. Preventing pediatric and adult obesity involves a collective role of the person, family, society, government and economic contributions. This will enhance the implementation of policies regarding obesity in multiple approaches while collaborative efforts are invested in various sectors (Institute of Medicine, 2004). A priority for the management of obesity is to consider the mass populations and design preventive measures. Preventive measures have taken into consideration the causes of obesity and therefore ensure the public health of people of all ages. Simultaneously, the measures have to consider not only reducing excess body weight but also curbing any further increase in weight among populations. Besides, the medical interventions chiefly are geared at handling the risk factors associated with diabetes such as type 2 diabetes and cardiovascular illnesses. Community Strategies are necessary, for instance, during the opening conference by the CDC, Weight of the Nation (WON), there were recommendation plans were drafted to assist the society to manage the obesity epidemic by environmental modifications geared at encouraging healthy eating and physical exercises
Based on eating habits, concerning physical activity, obesity arises from consuming more calories than the body utilizes in normal day to day activities. Weight gain arises when energy intake overwhelms energy expenditure in a given duration. Therefore, striking an energy balance is crucial for ordinary growth and development and curbing storage of excess energy. To reverse the obesity figures in the United States, equilibrium has to be achieved for input and output of energy in persons. The cause of obesity in the United States is diverse and complicated concerning socio-economic, personal and environmental aspects. The surroundings are conducive for boycotting physical exercises while on the other hand accelerating unhealthy eating habits. Public health has to be considered especially in schools, workplaces and hospitals to establish programs that sensitize the public on the epidemic. To manage obesity in the United States, there have to be initiatives on creating policies and having an environmental approach to ensuring that health options are not only affordable but are also undemanding and inexpensive to manage obesity.
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