How much does genetics influence obesity?
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(CNN Spanish) --
The United States is currently the country with the most obese people in the world, according to data from the World Health Organization (WHO).
Pre-pandemic information from the Centers for Disease Control and Prevention (CDC) indicated that the prevalence of obesity in US adults was 41.9%.
A person is considered obese when they have a BMI (body mass index) of 30 or more, and overweight when their BMI is between 25 and 29.9.
Obesity can increase the risk of several types of diseases, such as diabetes, heart disease, stroke, and cancer.
More than 1 million children and adolescents suffer from obesity in the US. Know the guidelines of pediatricians to stop it
"In the United States alone, there were four million deaths from obesity in 2015, with more than two-thirds of those deaths caused by cardiovascular disease," Kyla Lara-Breitinger, a preventive cardiology physician at the Mayo Clinic in Rochester, told CNN. , in Minnesota.
In addition, she adds, the degree of obesity and the length of time a person is obese significantly influence cardiovascular disease.
A woman walks past a sign for sugary drinks in Brooklyn, New York, in 2013. (Credit: Spencer Platt/Getty Images)
"It is incredibly important to address obesity, as many of the symptoms of excess weight, including breathing problems and reduced exercise tolerance, can mask underlying cardiovascular disease," Breitinger says.
The groups most affected by obesity in the US are non-Hispanic black adults (49.9%), Hispanic adults (45.6%), and non-Hispanic white adults (41.4%).
In the year 2020, no state had an obesity rate below 20%.
In Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia, 35% or more of adults are obese.
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What are the reasons behind the obesity rates in the US?
The causes of obesity are varied, and medical experts recommend considering it as a multifactorial disease.
Some of the various factors that contribute to the development of obesity, as Jaime Ponce, former president of the American Society for Metabolic and Bariatric Surgery (ASMBS), explains to CNN, are the following:
eating patterns
Malfunction of hormones that indicate hunger and satiety.
Genetics and environmental epigenetics, transmitted by parents suffering from obesity to their children.
Social and environmental factors including a sedentary lifestyle, stress, lack of adequate sleep, access to high-calorie foods and beverages.
Pre-existing medical conditions and medications that cause weight gain and hunger.
"Since the 1970s, we've seen the United States exacerbate all of that. Consumption of less healthy fast foods in larger portions increased; corn production increased while at the same time new sweeteners high in corn syrup were developed, more cheap and long-lasting stored than sugar; a lifestyle was imposed that predisposes people to eat more outside the home; and school systems with unhealthy eating practices for children became general due to contracts with beverage and fast food companies that are financially attractive for schools," says Ponce, who is also medical director of Bariatric Surgery and Obesity Medicine at CHI Memorial Hospital in Chattanooga.
Americans weigh more this decade, but fewer adults want to lose weight
According to him, these bad eating habits were combined with the expansion of television, which quickly became the favorite hobby of families, and of computers and video games.
"Sedentary jobs; long distances to work that mean using public transportation instead of walking; fewer areas for pedestrians; more insecurity for outdoor activities in certain cities, limiting exercise options—all part of of this phenomenon," he says in conversation with CNN.
"It has been the 'perfect storm' for a country as rich as the United States," according to Jaime Ponce.
Dr. Moises Roizental, dedicated to obesity medicine and medical director of Unique Interventional Radiology, in Miami, spoke with CNN and added that, for years, in the United States the indications -including from scientific societies- suggested the consumption of carbohydrates as basis of the daily diet.
This is: cereals, bread and pasta.
"This coincided with the development and government sponsorship of very cheap processed and fast food, which added to a sedentary lifestyle, and the advertising of sugary soft drinks and food with a high flour and sugar content, which are also addictive," says Roizental. .
Thus, the American began to eat more quantity and consume poor quality calories and ultra-processed foods, more times per day, and in all areas, from school to hospitals, passing through the workplace.
"Little awareness and little culture and education about healthy eating are responsible for the fact that the US is one of the countries with the most obesity in the world," he says.
Some tips to combat the obesity epidemic in the US.
According to a 2019 report in The New England Journal of Medicine, if healthier eating habits are not collectively adopted, the situation in the country will worsen.
More than half of the US will be obese in 10 years, and one in four Americans will be "severely obese," with a body mass index of more than 35, meaning they will be over 100 pounds (45 kilograms). overweight.
Therefore, the question of how to combat overweight and obesity becomes more pressing than ever.
In this regard, there is a consensus among specialists in relation to both diet and physical activity.
In relation to food, however, it is not about eating less.
Ponce explains that more nutritional education is needed at different levels: "Changing food policies in schools, modifying economic instruments such as taxes and nutritional labeling and, finally, developing new foods that help maintain the proper caloric balance."
Regarding physical activity, the aim is not for people to start doing physical activity individually, but for an environment and policies that encourage them to do so.
"Developing interventions designed to change the environment to increase physical activity (such as better and safer places to walk), providing guidance for policy makers, and selecting strategies to increase physical activity are some initiatives to consider." says Ponce.
In terms of programs that can help people with this disease in a timely manner, the options are varied.
"Our program seeks to destigmatize obesity and includes education on how obesity affects cardiovascular health; dietary assessments by registered dietitians; participation in small group behavioral weight management program; and assessment on weight loss medications such as GLP-1Ras and bariatric surgery would help patients,” says Kyla Lara-Breitinger of the Mayo Clinic.
Ponce develops something similar, explaining that "the best results are obtained in multidisciplinary centers with access to nutritionists, psychologists, and with support in physical exercise and in management with evidence-based drugs for obesity."
And he concludes: "We live in exceptional times with many very effective and very safe therapies that could benefit a large part of the population of the United States if we all had access to the different forms of prevention and management of the disease. Even today, there are many health insurance companies that do not offer coverage for all of the evidence-based strategies that are available."
With information from Carolina Melo.
Obesity in the United States
