Obesity

Obesity is a rapidly growing phenomenon in the United States; because it involves health issues, some observers have referred to it as an epidemic. The Centers for Disease Control and Prevention report that in 2010, 36% of adults and 17% of children were obese. Since 1980, obesity rates have doubled for adults and tripled for children. The overall prevalence of obesity in men and women is virtually the same. However, the obesity rate for adolescent boys (19%) is higher than the obesity rate for adolescent girls (15%), and women at least 60 years old have higher rates of obesity (42%) than do their male counterparts (32%). Both African Americans and Mexican Americans have a considerably greater prevalence of obesity than do whites.

For adults, obesity is defined as a body mass index (BMI) greater than or equal to 30 kilograms of body mass per height in meters squared (kg/m2). Nevertheless, much research on obesity includes “overweight” individuals with a BMI range of 25 to 29.9 kg/m2. The terms obesity and overweight are often used interchangeably. Children are considered overweight if their BMI is greater than or equal to the 95th percentile of children, controlling for age and sex.

Being obese is especially problematic because it is linked to several physical health problems, including cardiovascular disease, various cancers, dyslipidemia, stroke, osteoarthritis, reproduction problems, metabolic syndrome, and respiratory problems. In addition, being overweight is linked to mental health problems such as impaired cognitive function, depression, and feelings of stigmatization. In fact, the prevalence of weight discrimination or obesity stigmatization has increased by 66% over the past two decades.

Stigmatization is the result of linking a negative trait to a perceived disposition that disqualifies an individual from certain interactions. Stigmatized individuals are associated with a wide range of imperfections (e.g., lazy, sloppy, unintelligent, and/or unattractive). The sociologist Erving Goffman maintained that individuals might be stigmatized for their physical traits, social identity, or a perceived weakness of character. Obesity is doubly stigmatizing, because it is a physical trait and often attributed to a lack of willpower. The severity of stigmatization may increase if there is a perception that an obese individual could lose weight, but she or he is perceived as not trying to maintain a healthy weight. Weight bias tends to be stronger than other commonly recognized stigmas (e.g., sexual orientation and racial minority status).

Obesity is thought to affect an individual's ability to reason, think logically, or focus. Obesity stigma among children is linked to low self-esteem, self-perceptions of physical appearance, athletic competence, and cognitive ability. Persistent low self-esteem among obese children increases the likelihood of future low self-esteem, as well as other risky behaviors such as smoking and alcohol use. Obese children often develop eating disorders such as anorexia and bulimia. Overweight girls are twice as likely to develop an eating disorder as are normal weight girls. Eating disorders occurring among [Page 474]obese children are often attributed to teasing by other children and parents.