The Effect of Obesity on State Health Care Expenditures: An Empirical Analysis

The purpose of this study is to examine the effects of obesity rates on per capita state health care expenditures. A two-stage least square regression model is used. In the first stage of the estimation, factors influencing obesity rates are determined. The determinants of obesity rates are outlined throughout the research process. In the second stage, the impact of obesity rates on per capita health expenditures across states is evaluated. The empirical results indicate that obesity rates do indeed have a direct effect on state health care expenditures. After reviewing the project’s results, various solutions are proposed as possible methods to slow and perhaps reverse growing obesity rates with the objective of reducing health care expenditures. The solutions offered may possibly decrease the prevalence of obesity across the nation and in turn lower per capita health care spending

Should strategies to tackle childhood obesity also focus on mental health?

Childhood obesity continues to be a concern in the UK as in many other countries. Although there has been a ‘levelling off’ of BMI recorded through the National Childhood Measurement Programme in recent years the upward trend continues in older and more deprived children. Childhood obesity has been linked to poor mental health but whether psychological and social problems are a consequence or a contributor to obesity is unknown. Childhood obesity programmes that recognise and address psychosocial problems are proving useful in addressing obesity problems but there continued support is subject to continued funding. School Nurses, by measuring children’s height and weight, can identify children at risk of obesity but this is ineffective on its own and more support and advice is needed for School Nurses on how to tackle the complex conditions surrounding childhood obesity

Defining Obesity: An Argument for the Social Environment Perspective

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, are largely ignored. The traditional, medicalized narrative is the dominant narrative in U.S. society today. As a result, policy initiatives aimed at reducing the prevalence of obesity focus on changing individuals’ behaviors. One such initiative is to tax sugar-sweetened beverages (SSBs). The idea is to deter individuals from buying sugary drinks and steer them towards healthier options. In this paper, I use an SSB tax policy in order to examine how obesity is defined, measured, and viewed by different groups in American society. Furthermore, I argue that the traditional narrative of obesity is flawed and contributes to unnecessary negative stigma of the obese. In contrast, I will show that social factors play the most important role in the growing trend towards larger and heavier bodies. Therefore, policy initiatives aimed at reducing obesity should focus on reducing social disparities in society

Fuzzy logic as a decision-making support system for the indication of bariatric surgery based on an index (OBESINDEX) generated by the association between body fat and body mass index

Background: A Fuzzy Obesity Index (OBESINDEX) for use as an alternative in bariatric surgery indication (BSI) is presented. The search for a more accurate method to evaluate obesity and to indicate a better treatment is important in the world health context. BMI (body mass index) is considered the main criteria for obesity treatment and BSI. Nevertheless, the fat excess related to the percentage of Body Fat (%BF) is actually the principal harmful factor in obesity disease that is usually neglected. This paper presents a new fuzzy mechanism for evaluating obesity by associating BMI with %BF that yields a fuzzy obesity index for obesity evaluation and treatment and allows building up a Fuzzy Decision Support System (FDSS) for BSI.

Methods: Seventy-two patients were evaluated for both BMI and %BF. These data are modified and treated as fuzzy sets. Afterwards, the BMI and %BF classes are aggregated yielding a new index (OBESINDEX) for input linguistic variable are considered the BMI and %BF, and as output linguistic variable is employed the OBESINDEX, an obesity classification with entirely new classes of obesity in the fuzzy context as well is used for BSI.

Results: There is a gradual, smooth obesity classification and BSI when using the proposed fuzzy obesity index when compared with other traditional methods for dealing with obesity.

Conclusion: The BMI is not adequate for surgical indication in all the conditions and fuzzy logic becomes an alternative for decision making in bariatric surgery indication based on the OBESINDEX

Childhood Maltreatment and BMI Trajectories to Mid-Adult Life: Follow-Up to Age 50y in a British Birth Cohort.

Childhood maltreatment including abuse and neglect has been associated with adult obesity, but evidence on life-course development of obesity or BMI gain is unclear. We aim to establish whether childhood maltreatments are related to obesity or BMI at different life-stages 7y-50y and to identify possible explanations for associations

Pediatric Obesity: Influence on Drug Dosing and Therapeutics

Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of US children and adolescents. Severe obesity (³120% of the 95th percentile of BMI-for-age, or a BMI of ³35 kg/m2) is the fastest growing subgroup and now approaches 6% of all US youth. Health consequences (e.g., type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Since therapeutic interventions are less effective in severe obesity, prevention is a high priority. Treatment plans involving combinations of behavioral therapy, nutrition and exercise achieve limited success. Only one drug, orlistat, is FDA-approved for long-term obesity management in adolescents 12 years and older. As part of comprehensive medication management, clinicians should consider the propensity for a given drug to aggravate weight gain and to consider alternatives that minimize weight impact. Medication management must take into account developmental changes as well as pathophysiology of obesity and comorbidities. Despite expanding insight into obesity pathophysiology, there are gaps in its translation to therapeutic application. The historical construct of obesity as simply a fat storage disorder is fundamentally inaccurate. The approach to adjusting doses based solely on body size and extrapolating from therapeutic knowledge of adult obesity may be based on assumptions that are not fully substantiated. Classes of drugs commonly prescribed for comorbidities associated with obesity should be prioritized for clinical research evaluations aimed at optimizing dosing regimens in pediatric obesity

Does Presenting Patients’ BMI Increase Documentation of Obesity?

Purpose: Despite the associated health consequences, obesity is infrequently documented as a problem in medical charts. The purpose of this study is to determine whether a simple intervention (routine listing of the BMI on the medical chart) will increase physician documentation of obesity in the medical record. Methods: Participants were resident physicians in a family medicine residency program. Participants were randomly assigned to either an experimental group or a control group. For experimental group physicians, the Body Mass Index was listed alongside other vital signs of patients seen in an ambulatory setting. Physician documentation of patient obesity was assessed by chart review after patient visits. Documentation was defined as inclusion of obesity on the problem list or in the progress note. Results: The intervention did not significantly increase the rate of documentation of obesity in the medical chart. Several reasons for the lack of change are explored, including the difficulty of treating obesity successfully

Childhood obesity and educational attainment : A systematic review

Background This report describes the findings and methods of a systematic review of research which explores the relationship between obesity and educational attainment. It has been conducted at a time of great concern about levels of obesity in the UK, and the negative physical, psychological and social impacts of obesity. Current research suggests that there may be a relationship between obesity and poor educational attainment. It is likely that obesity and poor school performance are elements of a broader picture of inequalities in health and education, whereby disadvantaged socio-economic groups tend to have poorer health and lower levels of education. However, it is possible that other factors influence obesity and attainment, such as gender, discrimination and poor mental and emotional well-being. This systematic review was therefore commissioned to address the question: What do we know about the relationship between childhood obesity and educational attainment, from the research literature? In order that our review might be informed by those closest to observing any interaction between obesity and attainment, we sought the perspectives of teachers and young people to identify the causal pathways that seemed most pertinent to them. Findings Is there a statistical association between obesity and educational attainment? While often conflicting, an overall pattern emerges from the research evidence suggesting that there is a weak negative association between obesity and educational attainment in children and young people; i.e. that higher weight is associated with lower educational attainment. Obesity is also associated with other variables, such as socio-economic status, and when these other variables are taken into consideration, the association between obesity and attainment becomes still weaker, and often loses statistical significance. To what extent does the research evidence explore the influence of the broader determinants of health, and in particular socio-economic position, in explaining any link between obesity and attainment? Place of residence, ethnicity, occupation, gender, religion, education, socio-economic status (SES) and social capital were all explored as potential moderating variables in the included research. Twenty-three of 29 studies used a measure of socio-economic status as a moderating variable. Various factors appear to contribute to low educational attainment to some extent, although given the variation in definitions, analyses and quality of data, it is impossible to point to any causative or definite risk factors. Authors of the included studies have posited theories suggesting that the link between obesity and educational attainment is moderated by individual and societal factors. Does the research evidence support or refute these? Most studies explored the influence of obesity upon attainment. Only two studies examined the influence of attainment upon obesity. Many authors suggested multiple causal pathways, many of which remained untested in their studies. The moderating variables used in statistical analyses of the relationship between obesity and attainment were not consistent with the causal pathways proposed, which is probably a reflection of the constraints imposed upon authors conducting secondary analyses of pre-existing datasets (i.e. they made use of existing variables, rather than collecting their own, tailored data). The most frequently cited factors resulting from obesity and impacting upon educational attainment were poor mental health, stigmatisation and discrimination, disordered sleep, decreased time spent in physical activity and socialising, and absenteeism. Different perspectives on obesity and attainment Few young people initially thought that obesity and educational attainment were associated. However, they considered obesity and educational attainment to be of importance to young people. Young people considered parental influence and circumstances, including family income and poverty, and bullying and emotional health to be the most important factors which might explain an association between obesity and educational attainment. Most teachers said that there was an association between obesity and educational attainment. Bullying, low self-esteem and emotional well-being, poverty and poor diet, and physical activity were commonly cited by teachers as being the most important and credible mediating variables in this association. Teachers also considered gender, ethnicity and parental influence to be important factors. While researchers, teachers and young people identified causal pathways whereby low academic attainment resulted from poor mental and emotional health among obese children and young people, only four studies adjusted for mental and emotional health variables. This may represent a significant divergence in the perspectives of researchers and stakeholders. Alternatively, it may be that in the 23 studies which conducted a secondary analysis of an existing dataset, such data were not available to the authors. Another divergence concerns the impact of reduced participation in sports and social activities. While teachers and young people located this within a broader framework of isolation and lower socialisation suffered by obese children – and thus felt reduced sports participation would result in lower attainment – three studies in the included research proposed a causal pathway in which reduced participation in sports and social activities might lead to increased time spent studying and hence higher attainment