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Many Voices, One Freedom: United in the 1st Amendment

March 28, 2024

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Obesity is a medical condition in which excess body fat is accumulated to an extent that it is considered to have clear negative impacts on human health. We use a now well-accepted, though not always meaningful, numerical technique to define obesity called the Body Mass Index or BMI. This is a measurement obtained by combining a person’s height and weight in a simple equation. You divide your weight in kilograms by the square of your height in meters. The equation looks like this:

Weight in kilograms_________ = BMI
Height in meters X Height in meters

To convert your weight from pounds to kilograms, simply divide the pounds by 2.2. To convert your height in inches to meters, multiply the inches times 0.025. There are many online calculators that will instantly calculate your BMI when you put in your stats. Here is a good one that works in either Imperial units (lbs and feet) or Metric units (kilograms and centimeters), for example. Here’s what your BMI calculation means:

  • Less than 18.5 = underweight
  • 18.5 to 24.9 = normal weight
  • 25 to 29.9 = overweight
  • 30 or higher = obese

 

The BMI term is misleading in some cases, however, as most fit athletes in the National Football League have BMIs above 30 and most are surely not “obese.” Some 300-plus pound linemen would qualify as obese but most would not be because the equation does not differentiate between weight that is muscle versus weight that is fat.

“Obesity” is, in fact, a bit like “pornography” which has no solid definition but you know it when you see it.

Obesity is correlated with various diseases and conditions such as cardiovascular disease, Type 2 diabetes, osteoarthritis, sleep apnea and even certain types of cancer. In the paper “Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships,” (New England Journal of Medicine, August 26, 2020) it is concluded: 

“Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for individuals with obesity.”

There also now appears to be an increased risk of clinical depression if one is obese and the reverse as well. That is to say, obesity can lead to depression and depression, in turn, can lead to obesity, thereby thrusting a patient into a downward health spiral. It is a very complex subject. There appear to be links between obesity and socioeconomics, automation, genetic susceptibility, medication and mental disorders.

A majority of obese people at any given time are attempting to lose weight but research shows that the ability to maintain weight loss is rare. Obesity prevention requires a complex approach including interventions at community, family and individual levels. Changes to diet and exercise are the main treatments for obesity.

Low-income populations are more likely to live in areas where nutritious groceries are less available and food sources tend to be high in calories and low in fiber and important vitamins and minerals. This occurs in all countries in the world. As seen in the below map, obesity is especially prevalent in the U.S. Presently obesity is looked down upon in most of the world but it was a symbol of wealth at other times in history.

Obesity and life expectancy are invariably related, with little question that it lowers most lifespans. The higher BMIs correlate with higher mortality risk. A 2014 study by the National Institutes of Health found extreme obesity may shorten life expectancy by as much as 14 years. This was calculated after analyzing 20 studies from the United States, Sweden and Australia. They excluded individuals who had ever smoked or had a history of certain diseases. In total, they studied 9,500 individuals who were categorized as extremely obese versus 304,000 of normal weight. Excess deaths were mostly due to heart disease, diabetes, and cancer.

The World Health Organization (WHO) believes that we are in the grip of a global obesity epidemic which could one day be the greatest cause of premature death. The below graph shows that obesity is already the fifth leading cause of death in the world. Professor Philip James, chairman of WHO’s International Obesity Task Force, estimated that at least 300 million adults worldwide are extremely obese, while over one billion are overweight (BMI between 25 and 30).

Obesity rates have risen at least 10-fold since 1980 in some areas of North America, the United Kingdom, Eastern Europe, the Middle East, the Pacific Islands and China. In many developed countries, obesity co-exists with malnutrition. Of particular concern, is the rising rate among children.

Professor James said:

“We now know that the biggest global health burden for the world is dietary in origin and is compounded by association with low physical activity levels. This is going to plague us for the next 30 years.”

The outlook for America is especially bleak in this regard. According to “Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity,” (December 19, 2019, New England Journal of Medicine):

“The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2).”

Obviously, obesity results from changes in diet and physical activity. It has been called a nutrition transition. It appears to be a bigger problem in urban areas where there is a greater range of foods and less demanding physical work than in rural areas.

On our radio show, this coming weekend is Dr. Charles Dinerstein of the American Council of Science and Health, on The Other Side of the Story this Saturday, Oct 9th, and Sunday, Oct 10th at 11 AM ET, with an encore at 8 PM. Listen on iHeart Radio, our world-class media player, or our free apps on AppleAndroid, or Alexa. Each episode goes to major podcast networks early in the week and can be heard on-demand anywhere in the world.

we will discuss the question of whether the nation and individuals would be better off if obesity were to be categorized as a disease that would get funding from insurance companies and the government. Dr. Dinerstein’s guest editorial appears this week on the America Out Loud website as well.

MANY VOICES, ONE FREEDOM: UNITED IN THE 1ST AMENDMENT

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