Obesity in America by jforkus

OBESITY IN AMERICA

Jason Dotson, Janelle Forkus, Ryan Glauser & Angela Shuetz

CONTENTS

02 Scope

04 Solution 1 Â

Solution 3

15 Meet the Team

18 Tasks

38 Reflections

01 03

Background

Ramifications

Solution 2

Appendix

Why Obesity?

Strategic Research

BACKGROUND In the United States, there is an obesity epidemic. This detrimental issue has no regard for race, gender or age. If you are a living human being, you are at risk of obesity if nothing is done to prevent future issues. There are many factors that contribute to obesity in the United States. These include increases in fast food joints, fast food consumption, lack of exercise, differing demographics such as race, gender, age and socioeconomic status. This issue has been in the making for quite some time. Spanning over a half century, obesity has had a place in society. From insignificant decisions such as opening another restaurant to the dangers we face today, obesity has literally grown from a tiny seed to a thriving Sequoia. The following examples, statistics and quotes tell a story of the rise of obesity. The first fast-food restaurant chain, White Castle, opened its doors in 1921 in Wichita, Kansas. Today, more than 160,000 fast-food restaurants feed more than 50 million United States citizens each day, generating sales of more than $110 billion dollars annually. Another fast food company, McDonalds, decided to franchise and by 1960 there were over 100 operating franchises in the United States. In the United States alone there are an estimated 250,000 fast food restaurants. Fast-food consumption has risen from 2% to 10% in a 20year period. Over the last quarter century obesity rates have spiked from 6% to more than 19%. With this rate the conservative numbers for medical costs for obesity reach upwards of $150 billion in the United States. Obesity is a big issue in the United States. Obesity places a giant burden on the health care system. Approximately $150 billion per year in the United States is connected with heart disease, diabetes, cardiovascular disease and cancer. Childhood obesity has risen from 6% to 19% in just 25 years. Ultimately this egregious epidemic is something that needs to be attacked. What is to be done? 1

SCOPE The scope of obesity is grand, according to numerous studies, experts, and statistics. Most notably, the World Health Organization has labeled the issue as a “global epidemic”, reporting that more than 1.5 billion adults were overweight in the year 2008. Those affected by obesity include men, women and children. The World Health Organization reports over 200 million men and nearly 300 million women were obese and 22 million children under the age of five are obese worldwide. Statistics on the subject reveal the following: The percentage of obese adolescents aged twelve to nineteen has more than doubled since the 1970’s. The prevalence of obesity among children aged six to eleven has nearly tripled. Evidence of obesity in ancient civilizations/ages gives an inquirer a sense of the scope of the issue. Obesity spans across multiple ages and civilizations. According to a “biography” of the issue: · “Obesity appears as a medical category of diagnosis in the most ancient medical texts available”. · “In the eighteenth century, obesity was understood as a problem of the affluent; today the affluent are more likely to have a personal trainer and a healthy diet, and it is the poorer classes in the “First World” who are more likely to be overweight as it is argued that they live in urban areas remote from sources of “healthy food”. · “In ancient Greece, fat as a pathological category appears in texts ascribed to Hippocrates (c. 440370 BCE)” · “Early Roman medicine, following the lead of classical Greek medicine, saw obesity as a sign of illness. This was best articulated in the works of Aulus Cornelius Celsus (c. 25 BCE-c. 50 CE) the Roman encyclopedist know for his extant medical work, De Medicina.” · Italian Renaissance author Alvise Cornaro wrote about his negative experience with gluttony, and wrote a book entitled the Temperate Life. Overall, obesity is prevalent, potent and a subject of concern for experts in nutrition and dieting. Methods for control and prevention are constantly being explored in order to address the issue.

RAMIFICATIONS · Health Issues o A poor diet and lack of exercise creates the possibility of insulin resistance and even type 2 diabetes, and because of rising rates of obesity, the rate of diabetes has also risen by nearly 70% since 1995. o Obesity is the leading risk factor to cardiovascular disease, which is the leading cause of death in the US. In fact, in 2007, nearly a quarter of all the countries deaths were due to cardiovascular disease. o Cancer closely trails cardiovascular disease as the leading cause of death in the US. Weight gain and obesity are considered a contributing factor in 20% of new cancer diagnoses. o Studies have demonstrated a correlation between depression and obesity, especially with kids. o Obesity dramatically increases the likelihood for miscarriages in pregnant women, and reduces fertility in both men and women o Asthma, sleep apnea, and hypoventilation are all significantly more common among obese individuals. o Neurologists have come to discover a correlation between declining thinking skills/ short-term memory loss, and obesity. o Obesity leads to arthritic pain, muscle atrophy, deteriorating joints and other musculoskeletal injuries. · Financial Issues o Studies from Harvard’s School of Public Health suggest that obesity could be responsible for $190 billion in government healthcare annually, roughly 21% of all U.S. healthcare costs. o Obesity regularly leads to taking a leave of absence from work, higher transportation costs, and higher insurance rates. o The average U.S. firm with 1,000 or more employees loses $285,000 per year from such costs associated with obesity. o Bogus weight loss industries, known for specifically targeting overweight individuals with phony weight loss solutions, are valued at over $60 billion.

SOLUTION ONE Bringing the community together to fight obesity. Community-based efforts that encourage healthier living. “Community-based’ is implicative of local governments, such as city-counsels, mayors, and county clerks or legislators. Their “efforts” include initiatives that effect either the city or county such as roads, government-run properties, and local commerce. “Efforts that encourage healthier living” are in reference to programs/initiatives that would promote exercise and clean diets. This includes bike-lanes, wellmaintained sidewalks, close access to public parks and recreation centers, the promotion of local produce, and integration of health-sponsoring activities such as marathons. Promoting cycling and walking is a cheap and effective way to promote healthier living in a community. Several articles and editorials in the leading medical and public health journals have explicitly advocated more walking and cycling for daily travel as the most affordable, feasible, and dependable way for people to get the additional exercise they need, with the US surgeon general specifically recommends more walking and cycling for practical, daily travel as an ideal approach to raising physical activity levels. 4

Supporting the local marketsâ&#x20AC;&#x2122; efforts to further promote their produce is healthier for the community while strengthening its economy. Money spent locally stays local. Purchasing locally builds your local economy instead of handing over the earnings to a corporation in another city, state, or country. Also, since the food itself moves through less hands, more of the money you spend will end up in the pockets of those raising and growing those foods. Locally grown produce is proven to be healthier for oneâ&#x20AC;&#x2122;s diet than other, genetically modified foods. Hosting marathons and other such events in oneâ&#x20AC;&#x2122;s community raises public health, morale and spurs economic growth. Parks and recreation centers are essential in combating some of the most complicated challenges our country faces such as poor nutrition, obesity and physical activity. They help reduce obesity and incidences of chronic disease by providing opportunities to increase rigorous activity in a variety of forms. Increasing access to recreation facilities is an essential strategy for preventing childhood obesity. In distressed neighborhoods of Philadelphia, Pennsylvania, where vacant lots were converted into small parks and community green spaces, residents in said neighborhoods reported significantly less stress and more exercise.

STRENGTHS

WEAKNESSES

This would give individuals a greater incentive to travel through exercise-based transportation.

Studies have shown that Americans are far more likely than other countries to have bike/pedestrian walkway accidents (Pucher and Dijkstra).

Supporting local produce.

It will be healthier for local consumers and help bolster the local economy.

Local produce is generally more expensive than GMO foods. This will likely lead to lowered approval ratings among local officials.

Hosting marathons and other physically active events

This leads to increased enthusiasm for physical activity as well as possible streams of revenue to the community through donations and sponsorships.

Depending on the size and general fitness level of the community, this could potentially be a financial loss for a town or county.

Promoting cleaner sidewalks and bike-lanes

Increasing access to public parks and recreation centers.

This has been proven to increase the physical wellness of a community.

Such initiatives would be more expensive than any other proposed solution on this form.

SOLUTION TWO Balance the food "checkbook". A food ‘checkbook’ is a document which records the foods that an individual eats every day. It includes the number of calories the foods contain, the ingredients of processed foods, the serving size that the individual takes in, and other factors. To “balance” the checkbook, an individual must look up the standards for healthy eating based on their BMI, or Body Mass Index recorded in various places online, such as Choosemyplate.gov. Eating more calories than you burn for energy will lead to weight gain. As individuals record their food intake, they will be able to better understand how much food they take in. This will allow them to modify their diet as they deem necessary in order to avoid obesity. -Stanford HealthCare, How to Treat Obesity

Steps to the solution: 1. Access the website Choosemyplate.gov. This can be accomplished on a personal computer at home, or at a local internet café, when access to a personal computer is not possible. The information contained on this website is generally deemed credible, as it is a part of the United States Department of Agriculture. 2. Click on the tab “Find Resources”, and beneath it the tab MyPlate Plan. Here you will be able to enter your information to determine a healthy calorie intake number. A loose definition of “Calories” would be a number representing the energy that your body takes in through food consumption. Ideally, there should be a healthy balance between the energy that you take in and the energy that you expend, in order to prevent obesity. 3. Now click on “Toolkits” under the section that says “Find Resources”. Explore the sections that discuss what a healthy eating pattern is, as well as key recommendations in the path for health. 4. Balance your meals in accordance with the things that you have learned. Every time you eat, record the estimated number of calories of the meal. Consult with your local doctor or healthcare professional when necessary.

STRENGTHS

WEAKNESSES

By monitoring the calorie intake on a daily basis, one can be on the road to maintaining a healthy balance of the calories consumed and expended, thus effectively working to prevent obesity. As each individual engages in this practice, those around them will likely be inspired to do the same.

Some may find it difficult to â&#x20AC;&#x153;balance the caloric checkbookâ&#x20AC;? due to limited food options in their community. Those with a low budget may find it difficult as well. Those that suffer from certain disabilities may find it difficult to record their caloric intake.

SOLUTION THREE Focus on ending obesity. Maintaining the media can help promote healthy living. Controlling how much television that is watched would not only help the children get off the couch, but it would lower their exposure to all the things on TV that are cause obesity such as fast food. Research says that “…children who watched cartoons with food commercials ate 45 percent more snack food while viewing than children who watched cartoons with non-food advertising.” As children snack with low exercise they tend to not be going in the direction of healthier living. The key here is to help these individuals find balance and something other to do than to just revert to watching television. Physical fitness, being outside with friends, socializing are ways that children and adults are able to be more active. Constructing more grocery stores can lead to healthier lifestyles. The construction of more grocery stores in a closer area would help all individuals and group be more focused on losing weight. Grocery stores sell more wholesome foods allowing for a better option for children and adults who are trying to fight obesity. It is already a hard fight and by bringing grocery stores into the neighborhoods, it would make it easier for them. A study at Harvard University showed how more supermarkets would help drop the obesity rates. The found that, “…that living in a food desert is associated in some studies with a higher risk of obesity.” There needs to be something done about this.

Schools can have a big impact on youth. Children spend the majority of each day where? At their schools. If something was done to allow for a stronger diet and fitness plan to be done here it would drop the rising rates of obesity. “Kids consume up to 50 percent of their daily calories at school: More than 30 million students eat school lunches, and 14 million eat school breakfasts.” With numbers like this it is safe to say that something should happen. Providing more options of fruits and vegetables would start getting the ball rolling combined with a stronger focus on physical fitness. This is a time when individuals are being molded and formed into what they become in the future. Likewise, promoting healthy choices at work can impact adults. Just like students, adults spend the majority of their day at work. Many are working the typical office job where much of the day you are sitting down. It is important that even at work there is a focus on better diet and a better physical well-being. If companies were to “Offer incentives to promote healthy behaviors, such as participation in physical activity. Types of incentives include: Financial, Days off, Employee recognition, Medical plan enhancements, such as coverage for weight loss programs and lower co-pays and premiums” obesity coming from individuals who are sitting and working would drop. Imagine this, a shorter lunch where a worker could quicker go across the street to the newly opened grocery store and purchase food that is fresher and healthier. This combined with a renovated fitness center in the office would cause for happier employees.

Maintaining the media to help promote healthy living. Construct more grocery stores.

Promote at schools, healthier eating and better fitness. Promote at work, healthier eating and better fitness.

STRENGTHS

WEAKNESSES

This would help individuals old and young have less fast food exposure and more healthier options in front of them.

You are limiting something that people truly enjoy. This also negatively affects fast food chains.

This allows for a healthy option. There is an opportunity to eat the healthy foods sold in the store.

Not all grocery store may be able to afford placing stores here. Is it worth the risk?

This helps set the standard for children early on in life of how to stay healthy.

Budgeting for a project this big is very pricy.

This is an opportunity to help come together as a team. It also helps find ways to recognize coworkers.

Some coworker might become offended by their not being recognized. Could possibly foster isolation.

FOR MORE INFORMATION More information on obesity and what we can do can be found on the following websites: https://www.cdc.gov/obesity/index.html https://www.nhlbi.nih.gov/health-topics/overweight-and-obesity https://www.obesity.org/ https://www.choosemyplate.gov/ https://www.publichealth.org/public-awareness/obesity/ https://kidshealth.org/en/parents/overweight-obesity.html

APPENDIX

MEET THE TEAM

Jason Dotson I currently live in Rexburg, Idaho with my wife. We’ve been married for six months and are loving every minute of it. Despite currently finding myself in Idaho, I’ve lived in Texas with my family for most of my life with my parents and five siblings. I’m a communication major with an emphasis in public relations and I’m hoping to go into social media marketing analysis upon graduation.

Janelle Forkus Janelle Forkus is a student at BYU-Idaho and is two weeks away from graduating. She will be receiving her degree in communication. She grew up in Brentwood, California and with her parents and her two older sisters and her younger brother. She loves cooking, yoga and sunshine. She recently adopted a six-month old silver lab named Maverick.

MEET THE TEAM

Ryan Glauser Ryan Glauser is a communications major currently enrolled at Brigham Young University – Idaho. He studies the influence of communication amongst a variety of backgrounds, primarily focusing on interpersonal theory. Ryan worked with others in Louisiana for a span of two years, then taking his natural abilities to Phoenix, Arizona; Anaheim, California and Long Island, New York. His canny abilities of influence and persuasion have earned him top leadership in the company with whom he now works. In his free time, Ryan spends time with his family, in church worship and spending time with his girlfriend Brianna. He loves sports and if you ask him which one, he’ll say basketball and football, but he also enjoys baseball. Ryan strives for continuous personal growth. With his love for people and his desire to constantly learn, Ryan is excited to share some of what has helped him.

Angela Schuetz Angela Schuetz, 24, Student at Brigham Young University-Idaho studying Marriage and Family Studies emphasis Advocacy and Policy.

WHY OBESITY?

Our team selected the topic of obesity because we consider it to be an issue of concern among all types of people. We wanted to choose an issue that effects people everywhere. We felt it was necessary to add our research findings to those already explored. Despite its popularity in the cultural zeitgeist, obesity rates continue to rise. Dr. C. Everett Koop said, "Except for smoking, obesity is now the number one preventable cause of death in this country. 300,000 people die of obesity every year." Since obesity is preventable, there are solutions out there. My group decided to explore this issue and possible solutions.

TASKS

Jason Dotson- As a writer for this project, I was tasked with coming up with one of the proposed solutions for combating obesity. Mine was based around community efforts to emphasize healthy living and exercise. There were several methods that a community could do that would put emphasis on a healthier lifestyle, and I highlighted several of these in my portion of the paper. These highlighted methods included constructing bike lanes, thoroughly maintaining sidewalks, promoting local produce, hosting physical public events, and constructing more parks and recreation centers. Janelle Forkus- I volunteered to be the editor for my group. I have been in charge of designing the book, collecting all the assignments and providing feedback to the other members of my group. The most difficult, but also the most fun, part of my job was designing the book. I love design and I think it plays a big part in the presentation of information. You could have a book full or really exciting and interesting information, but if it is presented well, no one will want to read it. Ryan Glauser- I researched the background of the obesity problem in the United States. I was able to find so many intriguing statistics regarding the deadly issue going on here in the United States. Obesity rates touch all races, genders and ages. The most time I spent on this issue book was gathering information from all the resources I used. As I did the research necessary to find viable information, things were found that I hadnâ&#x20AC;&#x2122;t thought of. This issue book has really helped open my eyes to the issue at play here in the United States. Angela Schuetz- I completed the task of writer #2, responsible for constructing research on the scope of the issue, a proposed solution, an interview and websites/organizations that provide information on the topic. 18

STRATEGIC RESEARCH Source 1 Hurt, Ryan T, et al. “The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists.” Gastroenterology & Hepatology, Millennium Medical Publishing, Dec. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3033553/. Obesity is close to being the number one leading cause for preventable death in the United States. Obesity levels vary greatly regarding gender and race. 1. Obesity is associated with a higher incidence of a number of diseases, including diabetes, cardiovascular disease, and cancer. 2. Over the past 25 years, this rate has risen from 6% to 19%. 3. A conservative estimate would place the healthcare burden for obesity at approximately $150 billion per year in the United States 4. There are key stats indicating that gender and race have many differences obesity levels. 5. The United States now has approximately 250,000 fast food restaurants, and total fast food consumption has risen from 2% to 10% of total energy intake per person over a 20year period.

Source 2 “An Epidemic of Obesity: U.S. Obesity Trends.” The Nutrition Source, 12 Apr. 2016, www.hsph.harvard.edu/nutritionsource/an-epidemic-of-obesity/. A massive amount of people in the United States are obese. These rates keep increasing over the past 30 years. 1. In 1990, obese adults made up less than 15 percent of the population in most U.S. states. 2. By 2010, 36 states had obesity rates of 25 percent or higher, and 12 of those had obesity rates of 30 percent or higher. 3. Roughly two out of three U.S. adults are overweight or obese (69 percent) and one out of three is obese (36 percent) 4. One out of six children and adolescents ages 2 to 19 are obese and one out of three are overweight or obese 5. In the U.S., the nationwide SEARCH for Diabetes in Youth Study found that type 2 diabetes accounted for only 6 percent of new diabetes cases in non-Hispanic white children ages 10 to 19 years, but anywhere from 22 to 76 percent of new cases in other ethnic groups. (10)

Source 3 Do Fast Food Restaurants Contribute to Obesity?, National Bureau of Economic Research, www.nber.org/aginghealth/2009no1/w14721.html. How close we are to fast food may or may not affect the obesity rates. Numbers say it’s more likely to have obesity when you’re closer. 1. The authors find that proximity to a fast food restaurant significantly increases the risk of obesity. For children, having a fast food restaurant within 0.10 miles of school increases the probability of obesity by 1.7 percentage points, or 5.2 percent. 2. For pregnant women, having a restaurant within 0.10 miles increases the probability of gaining over 20 kilos during pregnancy by 0.2 percentage points 3. One possible explanation is that proximity to fast food reduces the costs of fast food, principally travel costs. 4. A second explanation is that easier access to fast food tempts consumers who have selfcontrol problems. 5. The effects are largest for African American mothers and mothers with a high school education or less.

Source 4 Pirello, C. (2019). How Fast Food Has Changed Our Nation. [online] One Green Planet. Available at: https://www.onegreenplanet.org/natural-health/vegan-health/how-fast-foodhas-changed-our-nation/ [Accessed 16 Mar. 2019]. The growth of the fast food industry has allowed for a massive spike in obesity levels. With the building of more and more fast food restaurants there is a correlation with medical costs due to obesity spike. This information is nuts. 1. The first fast-food restaurant chain, White Castle, opened its doors in 1921 in Wichita, Kansas 2. The decision to franchise their idea along with a distinctive architectural design (the Golden Arches) put McDonald’s on the map. By 1960, there were 100 franchises operating across the country. 3. Today, more than 160,000 fast- food restaurants feed more than 50 million Americans each and every day, generating sales of more than $110 billion dollars annually. 4. U.S. government surveys from 1977–1978, 1989–1991, and 1994–1996 reveal an alarming trend: More and more Americans ate their daily foods in the form of snack foods and fast food with each subsequent survey. 5. With fast- food restaurants everywhere, from airports to hospital lobbies, Americans are spending more on these foods than they do on higher education, computers, or new cars combined 6. The fast- food industry is the largest employer of minimum-wage workers in the country 7. By 1975, (about the time McDonald’s introduced the drive-through window), the obesity rate in America had climbed to 15%. Since then, the overweight population has ballooned, with obesity rates topping 32%. 22

Source 5 Adult Obesity Causes & Consequences | Overweight & Obesity | CDC. (n.d.). Retrieved from https://www.cdc.gov/obesity/adult/causes.html# It is very interesting just how much the obesity issue has an effect on our society ranging from military to health to genetics and more. Weight is affecting all these departments significantly. 1. Obesity results from a combination of causes and contributing factors, including individual factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. 2. The leading causes of death in the U.S. and worldwide, including diabetes, heart disease, stroke, and some types of cancer. 3. Medical costs associated with overweight and obesity may involve direct and indirect costs 4. Direct medical costs may include preventive, diagnostic, and treatment services related to obesity. Indirect costs relate to morbidity and mortality costs including productivity. 5. In 2007-2008, 5.7 million men and 16.5 million women who were eligible for military service exceeded the Army’s enlistment standards for weight and body fat.

Source 6 Herrera, B. M., & Lindgren, C. M. (2010, December). The genetics of obesity. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955913/ There are more things that cause obesity that just physical things that we think about like eating and not exercising. There are many emotional and mental aspects that play a key role. NOTE: Based on Australian notes but they are still very applicable to the United States. 1. Eating more kilojoules than you use 2. Modern living 3. Socioeconomic factors 4. Changes in the food supply 5. Inactivity 6. Genes 7. Birth factors

Source 7 The role of physical activity and exercise in obesity and weight management: Time for critical appraisal. (2016, April 08). Retrieved from https://www.sciencedirect.com/science/article/pii/S2095254616300060 If we have higher energy intakes than our energy outputs, over a longer period of times then we will see a weight gain. 1. Public health actions to reduce obesity have mostly focused on individuals, encouraging them to eat healthier and to exercise more. 2. A recent study showed that in the US, daily energy expenditure due to work related PA has decreased by more than 100 kcal during last 50 years in both men and women, and this reduction is associated with the increase in mean body weight during this time frame 3. It was recently estimated that in women, daily housework-related energy expenditure has decreased by 360 kcal in the US since the 1960s 4. Many studies have implicated sedentary behavior, including passive transportation, with weight gain 5. There is also a wealth of evidence from controlled trials that exercise (or PA) carried out over long periods of time can generate energy deficit and thereby induce weight loss

Source 8 Arroyo-Johnson, C., & Mincey, K. D. (2016, December). Obesity Epidemiology Worldwide. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599163/ Gender and race have a big impact on how obesity is measured. Many things go into how this is determined. We can look at the socioeconomic statuses of the people and make a proper assessment from there. 1. Obesity prevalence in the US varies by gender (Figure 1), race/ethnicity (Figure 2), and socioeconomic status. 2. Among children, the prevalence of obesity in the US was 17% in 2011–2014 and similar to adults prevalence also varies by gender, age (Figure 4) and race/ethnicity (Figure 5). 3. Asian Americans have the lowest percentage of obese people in the United States among African-Americans, Whites and Hispanics. 4. African-American blacks have the highest percentage of obese individuals in the United States. 5. In the US, the prevalence of obesity among adults over the age of 20 is approximately 36%.

Source 9 Bevans, Katherine B., et al. "Children's Eating Behavior: The Importance of Nutrition Standards for Foods in Schools." Journal of School Health81.7 (2011): 4249. MEDLINE. Web. What children eat in school effect their eating habits and appetites outside of school. The healthier their school lunches are, the more likely children are to develop healthy eating habits on their own. 1. The nutritional value of school lunches effects the eating habits of children 2. These effects can be long term 3. They occur both in and outside of school 4. Less nutritional lunch offering effect children negatively 5. More nutritional offerings effect children positively

Source 10 Blair, Melissa. "New Report Finds Adult Obesity Rates Decreased in Four States." Obesity, Fitness & Wellness Week (2016): 308. Web. It is possible to lower obesity on a widespread level without negatively on an unobtrusive level. Four states, Minnesota, Montana, New York and Ohio, have decreased their population’s rate of obesity through the use of various programs. 1. Obesity rates in the US as a whole are steadily rising. 2. Despite this, Minnesota, Montana, New York and Ohio decreased their states’ obesity rate between 2014 to 2015. 3. Focusing on early childhood health policies was a key factor in these states’ success. 4. Ensuring clean walk-ways and safe bike-lanes is another way to incentivize public health. 5. The threats that are most common among obese Americans have changed in the past 30 years and governments need to adapt to ensure continued health.

Source 11 Green, Lawrence W., Leslie J. Sim, and Heather Breiner. "Evaluating obesity prevention efforts." 2013. Web. The success of obesity prevention in a community is largely dependent upon how relevant said community deemed it to be. Because of this, the largest key to success in communal obesity prevention was to first incite obesity awareness. 1. Community-wide obesity prevention is most effect when obesity prevention is a high priority in said community. 2. Obesity prevention became a high priority when a community could clearly answer these three questions: 3. “Why is obesity prevention important to me?” 4. “What works to prevent obesity?” 5. “How are we doing in preventing obesity?”

Source 12 Mitchell, Nia S., MD, MPH|Catenacci, Victoria A., MD|Wyatt, Holly R., MD|Hill, James O., PhD. "Obesity: Overview of an Epidemic." Psychiatric Clinics of North America 34.4 (2011): 717-32. MEDLINE. Web. Obesity is a huge health risk for US citizens and despite increased awareness on the issue, obesity rate continue to climb. 1. Approximately 34% of adults and 15–20% of children and adolescents in the U.S. are obese. 2. Obesity increases the risk of many chronic diseases in children and adults. 3. The epidemic of obesity arose gradually over time 4. Substantial public health efforts are being directed toward addressing obesity, but there is not yet clear evidence of success 5. Because of the complexity of obesity, it is likely to be one of the most difficult public health issues our society has faced.

Source 13 Mohn, Emily S., et al. "Obesity: Prevention and Treatment." American Journal of Epidemiology 181.12 (2015): 1018. Web. Counseling should begin in infancy and focus on healthy feeding, activity, and family lifestyle behaviors to ensure healthier living in adolescence and adulthood. 1. For children with overweight or obesity, the American Academy of Pediatrics outlines 4 stages of treatment: 2. Primary care providers should offer "prevention plus," the use of motivational interviewing to achieve healthy lifestyle modifications in family behaviors or environments 3. Children requiring the next level of obesity treatment, structured weight management, need additional support beyond the primary care provider (such as a dietitian, physical therapist, or mental health counselor) and more structured goal setting with the team, including providers adept at weight management counseling 4. Children with severe obesity and motivated families may benefit from referral to a comprehensive multidisciplinary intervention, such as an obesity treatment clinic 5. Tertiary care interventions are provided in a multidisciplinary pediatric obesity treatment clinic with standard clinical protocols for evaluation of interventions, including medications and surgery

Source 14 "Obesity: Can we Stop the Epidemic?" Harvard Public Health (2017)Web. The hyper increase of fast food, sugary drinks and other processed foods have gradually increased the obesity levels in the US to an epidemic. 1. It can be more profitable to food manufacturers to put less sugar and more vitamins into their foods. 2. Obesity and the ways one’s body processes the food it consumes isn’t something that was fully realized until the past 40 years, largely attributing to the massive rise in unhealthy foods in the mid-1900s 3. The best way to prevent obesity is to instill healthy habits in children at a young age 4. Other countries have been able to slow the consumption of unhealthy foods by taxing food manufacturers for fat, calories, and sugars their foods contain 5. Part of the reason why healthy foods, such as fruits and vegetables are so expensive is because less than 5% of the US’s crop acreage is used to produce it, thus creating scarcity.

Source 15 Ohri-Vachaspati, Punam, et al. "Strategies Proposed by Healthy Kids, Healthy Communities Partnerships to Prevent Childhood Obesity." Preventing chronic disease 9 (2012): E11. MEDLINE. Web. There are a variety of relevant solutions toward preventing childhood obesity. These are relatively affordable and can benefit communities greatly. 1. Providing incentives to retailers to locate and serve healthier foods in underserved areas showed successful results toward lowering obesity in communities 2. Improving mechanisms for purchasing food from farms showed successful results toward lowering obesity in communities 3. Enhancing infrastructure that supports walking and cycling showed successful results toward lowering obesity in showed successful results toward lowering obesity in communities 4. Improving access to outdoor recreational facilities showed successful results toward lowering obesity in communities.

Source 16 Steven Allender, et al. "A Community Based Systems Diagram of Obesity Causes." PLoS One 10.7 (2015): e0129683. Virology and AIDS Abstracts. Web. According to the article’s findings, there are four main causes of obesity in the public’s perception. Identifying these causes can lead to positive discussions in addressing them. The four causes were: 1. Social influences 2. Fast food and junk food 3. Minimal sport participation 4. General physical inactivity

Source 17 Arulkumaran, S., & Mahmood, T. (2013). Obesity. [electronic resource] : a ticking time bomb for reproductive health. Amsterdam : Elsevier, 2013. Retrieved from https://byui.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx? direct=true&db=cat03146a&AN=BYUID.4207656&site=eds-live The problem of obesity spans across multiple nations and those of different ages, even children. 1. “According to the estimates by the World Health Organization (WHO) in 2008, more than 1.5 billion adults were overweight” 2. “Of those, over 200 million men and nearly 300 million women were obese” 3. “The prevalence of obesity in adults in the United States is 33.9%, compared to 23.1% in Canada, 22.7% in the United Kingdom, 16.9% in France and 16.4% in Australia” 4. “Approximately, 22 million children under 5 years of age are estimated to be overweight worldwide” 5. “In the United States, the prevalence of excess weight is increasing rapidly across the country”

Source 18 Dillon, E. (2007). Obesity. [electronic resource]. Detroit, Mich. : Greenhaven Press, c2007. Retrieved from https://byui.idm.oclc.org/login? url=https://search.ebscohost.com/login.aspx? direct=true&db=cat03146a&AN=BYUID.3708564&site=eds-live Changes in rates of obesity have fluctuated recently, according to researchers. 1. “An estimated 15% of children and adults from ages six to nineteen are seriously overweight” 2. The percentage of obese adolescents aged twelve to nineteen has more than doubled since the 1970’s 3. The prevalence of obesity among children aged six to eleven has nearly tripled. 4. More than 10 percent of preschool children between ages two and five are overweight. 5. ”Researchers at the Centers for Disease Control and Prevention have found that young people who consider themselves extremely overweight are more than twice as likely as their normal-weight classmates to consider or attempt suicide”

Source 19 Blades, M. (2005). Obesity. [electronic resource]. Bradford, England : Emerald Group Publishing, c2005. Retrieved from https://byui.idm.oclc.org/login? url=https://search.ebscohost.com/login.aspx? direct=true&db=cat03146a&AN=BYUID.2511250&site=eds-live Evidence is limited in knowing how to effectively treat obesity, yet remains a concern of the World Health Organization. 1. “In the UK one in five adults is obese” 2. “Obesity is considered by the World Health Organization to constitute a world-wide epidemic” 3. “becoming obese was considered to be a far greater fear than nuclear war” 4. There is a lack of evidence of the efficacy of treatment programs for overweight and obese children.

REFLECTIONS Jason Dotson This project hit so close to home because both of my parents are considered obese and two of my siblings are starting to get larger than the average person of their weight. That was why doing my portion of the project was so easy; because I’ve seen and have heard every excuse in the book firsthand. For example, when I was younger both of my parents used to work and take care of 6 children all under one roof. It was easier to just grab a family sized pizza from Papa Murphy’s eat food, sit down and do more work, and then go to bed and do it all over again the next day. In my life there was no clear reason for biking to work or stopping by the local farmer’s market to grab some fresh fruit and vegetables. Everything was always so busy and on a time crunch that we always just went the route of what was fast, easy, and most cost efficient. Sadly, this doesn’t always mean the healthiest way. The reason this project was so beneficial to me is because I could finally take the time to learn more about the ways to make healthy living an easy step in your life. I had to work hard to stay fit and active, to eat healthy, and to not go by the examples of my parents; but after this project I learned that your entire family can live this way so easily! I personally took the time to talk to my family about this as well to see their input. I discussed my project with my mom because she is the one that does most of the grocery shopping and all the eating out for dinner ideas. Her input was that healthy food can take longer to prepare, eating out can be less hassle, and that you don’t want to venture out to buy something new or healthy and waste your money because your family doesn’t like it, and no one will eat it. When I talked to my dad, he mentioned that he has a lot of stress from work, spends a lot of time at work, and then when he isn’t doing anything work related, he just wants to relax. I completely understand where both of my parents are coming from and it was great to talk to them about their side of the story. 38

Talking to my parents about their issues really opened my eyes. I think that the solutions I researched and came up with for my project would really help my family! Let’s start with my dad, his problem is that his life has a lot of work involved and then he wants to relax and spend time with his family and working out seems like a hard thing to add into his life. Well, he doesn’t have to work out, staying active is just as beneficial in your life! This is where having family recreation centers or parks would help because us as a family could go down and play frisbee or even just walk around the sidewalk together or heck, even swing! Then with my mom, if we had local farmer’s markets that were close enough to make it convenient to go and contained price efficient fruits and veggies, my mom would be set! Then she can just the time to Pinterest a super easy recipe and try it out and it wouldn’t be a complete waste of money! The reason I share these points is to show how I learned a lot from this project. I personally think that you didn’t truly learn unless you can take the lesson and apply it into your real life. Anyone can finish a project or complete an exam and then walk away forgetting everything, but I’ve really taken to this project because it was so important to me. I basically want you to understand that my overall experience was fantastic! Sure, deadlines are stressful and putting trust in others to do their part can be hard to do. I one hundred percent admit that a map at times felt way more enticing than working on this project. However, I got it all done and I not only feel very accomplished, but well educated on an important topic. I also really liked the group that I worked with. I’m an extreme introvert when it comes to working in school-based groups, but my group was awesome to work with and we had a great time! I appreciate all of their hard work and I am glad to say that I have turned in an assignment that I am proud to put my name on!

Janelle Forkus When we were first introduced to our final assignment, I immediately started thinking about what topic my group should focus on. At the time, I didn't know who my group was and all of the ideas I had were for big, controversial topics, like abortion. Once I learned more about the project and volunteered to be an editor, I thought less and less about the topic since I wouldn't be doing most of the research. My group decided to tackle the topic of obesity and it was not what I was expecting at all. In my head, obesity isn't controversial or big at all. However, I learned more from this project than I expected. I was shocked to learn that 3.4 million deaths per year are caused by obesity. This issue is bigger than just the United States, it is effecting the whole world. It effects everyone: young people, old people, people of any race, people of all incomes. It is a devastating issue that could be prevented. I think the best cure to almost any issue is education and obesity is no different. This book educates people and when people are educated they can make good choices. I think education is such a strong power and even when we are no longer going to school I hope we continue to educate ourselves.

Ryan Glauser While doing this and putting it all together it was interesting to see the number of things that I could learn from researching something I thought I had previously known a lot about. You can see different perspectives and ways of going about solving the issue. Different studies show different ideas or ways of going about things. When working alongside your group in putting things together you are held accountable by the deadlines that you supposed to meet. One of the best feelings in regard to group work is when there is open communication with ideas and information being shared. Obesity is a tough issue to solve, however, I feel as though there are some things here, that can help turn the issue we are seeing as a country, around

Angela Schuetz The completion of this assignment has opened my eyes to the various organizations and resources available to those that struggle with obesity. I have come to understand that the need for communities to be aware of these resources is a task worth undertaking. I was left in awe at the depth of information and assistance available to individuals just at the click of a mouse. I felt a sense of personal responsibility to take advantage of the ChooseMyPlate website in an effort to monitor my own nutrition practices as well as an act intended to encourage others to monitor their nutritional health. I think that as individuals are empowered to seek out solutions to their medical problems, they will be surprised to discover an army of responsible, concerned citizens that are ready to help.