What is Overweight and Obesity?
Discuss About The Actions To Encourage Healthy Weight Healthy?
Overweight and obesity is a public health challenge experienced by most developed countries including New Zealand. The number of overweight and obese people is increasing day by day causing greater risk for children and adults. With the rapid increase in figures concerning weight gain in the last decade, it has become an important issue to be considered. The developed countries have developed an obesogenic environment as a result of the promotion and availability of plenty of energy dense foods, decline in manual jobs involved in manufacturing resulting in occupations that are low paid with long working hours and increase in deskbound occupations. This problem analysis report focuses on overweight and obesity as the problem frame using the population served by Population of Counties Manukau.
The term overweight and obesity can be demarcated as excessive or abnormal accumulation of fat that presents a risk to the health of an individual (World Health Organization, 2018). However, the terms ‘fat’ and ‘obese’ are altogether different. The term fat defines excess flash on the body whereas the term obese means abnormally fat which is linked with early death and morbidity. The prevalence of obesity has subsequently increased in almost every country across the world and has become a major problem. New Zealand is the part of this global trend. Overweight and obesity is a result of a variety of factors and causes including individual factors such as behavior and genetics. The term behavior includes inactivity, medication use, dietary patterns, physical activity, and other exposures. Other contributing factors include education and skills, physical activity environment and food, promotion and food marketing (Hebestreit, et. al. 2014). Overweight and obesity has become a serious concern due to its association with poorer mental health outcomes, low quality of life, and foremost causes of death in various developed countries including New Zealand.
The population served by Counties Mankau District Health Board contains some exceptional features in comparison with other District Health Board populations related to age structure, size, socio-economic profile and ethnic mix. The geographic area served by Counties Manukau Health is mostly the part of the territorial authority of Auckland Council. For integration and service planning purposes, the region served by Counties Manukau Health is classified into four localities-Eastern, Franklin, Manukau and Mangere/ Otara.
Out of the 20 District Health Boards in New Zealand, the second largest assessed resident population is with Counties Manukau Health. Therefore, the population served by Counties Manukau Health is multi-ethnic with high proportions and numbers of Asian, Maori and Pacific peoples. In the year 2014, Counties Manukau Health served an assessed resident populace of 509,060 people out of which 16% were estimated to be Maori, 23% as Asian, 21% as Pacific people and 40% as NZ Other/ European groups.
The ethnicity mix of Counties Manukau population differs in terms of age. The younger groups have larger proportions of Asian, Maori and Pacific peoples in comparison with the population aged 65 years and above where approximately two-third of the population consist of NZ Other/ European Groups. In comparison with the population of entire New Zealand, higher proportion of children is with Counties Manukau. In the year 2014, twenty-four percent of the estimated resident population of Counties Manukau Health was aged 14 or under. The Pacific and Maori populations have high percentage of population under 15 years of age as compared to other ethnic groups (Counties Manukau Health, 2015).
Causes of Overweight and Obesity
The adults of Counties Manukau suffer from much higher levels of obesity as compared to other Auckland metro District Health Boards Pacific. On the other hand, Counties Manukau suffer from lower prevalence of overweight presumably due to the reason that majority of its population have moved from overweight into obesity. However, approximately one out of every four Pacific peoples were found to be morbidly obese in the sample of Counties Manukau with Body Mass Index (BMI) 40 or more (23.6% standardized, 22.7% crude prevalence) (Counties Manukau Health, 2014)
Overweight and obesity affects children, adults and older adults.The obesity prevalence in Counties Manakau Health population according to the NZ Health Survey 2011-13 combined cohort by age group and gender has been depicted by the following graph.
The graph clearly represents that both men and women are affected by obesity in various age groups from 15 years to 65+ years. The prevalence of obesity among the population group of15- 4 years was found to be 25% in men and 34.9% in women. Similarly, among the population group of 25-44 years, it was 42.8% and 50.8% and in population group of 45-64 years it was estimated to be 43.7% and 41.9%. However, among the population group consisting of people aged 65 years and above, it is subsequently reduced to 28.7% in men and 36.6% in women.
The obesity among children of Counties Manukau between the ages of 2-14 years was found to be 18.6% with 29.9% in Pacific People, 24.5% in Maori and 10.2% in Asian children. Among adults, the total obesity in Counties Manukau was estimated to be 40.5% with 54.35 in Maori, 72.9% in Pacific and 20.7% obesity in Asian people.
The health and well-being of an individual is adversely affected due to overweight and obesity. Potential problem include depression, chronic musculoskeletal problems, respiratory difficulties, infertility and relationship problems. The life-threatening problems are classified into four categories: gallbladder disease, cardiovascular disease problems, certain types of cancers specifically large hormonally related bowel cancers, insulin resistance linked conditions such as type 2 diabetes (CDC, 2018). The risk of developing life threatening problems and type 2 diabetes is increases with the increase in body fatness.
Overweight and obesity also has various economic and societal consequences on the health care system of New Zealand. Both direct and indirect medical costs are involved in the medical costs associated with overweight and obesity (Utter, Denny, Teevale, Peiris-John & Dyson, 2015). Diagnostic, preventive and treatment services are included in the direct medical costs related to obesity. Indirect medical costs are associated with mortality and morbidity costs including productivity. The measurement of productivity is undertaken on the basis of absenteeism (the cost incurred due to non- presence of employees at work as a result of obesity-related health reasons) and presenteeism ( reduced productivity of employees while being present at work) along with premature disability and mortality.
A Childhood obesity plan was initiated in Counties Manukau which aimed at preventing and managing obesity in children and youth up to 18 years of age. It was launched in the year 2015 and focused on three areas made up of 22 initiatives:
- Interventions were targeted for obese people
- Support increased for people who are at risk of becoming obese
- Healthier choices made easier for people in New Zealand through the adoption of broad approaches (Swinburn & Vandevijvere, 2016).
Population Served by Counties Manukau Health
The key focus of the plan is on the environment, food, and being active during all the stages of life, starting from pregnancy and early childhood (Ministry of Health, 2018).
The guidelines related to Healthy Weight Gain in Pregnancy have been released by Ministry of Health which raises awareness in pregnant women regarding healthy nutrition. Counties Manukau Health has contracted directly with Ministry of Health for the purpose of improving infant nutrition. Two interdependent work streams are involved i.e. health services development and community action.
A national level policy has been implemented as the ‘Actions to Encourage Healthy Weight and Healthy Lifestyles’. This encouraged the families to live healthy lives by way of making good choices in food, sustaining a healthy weight, being physically active, not indulging in practices like smoking and drink alcohol (The Hub by Superu, 2018).
The risk of suffering from various health problems increases due to overweight and obesity (Hutchison, Matto, Harrigan, Charlesworth & Viggiani, 2007). Such health problems include diabetes, heart disease and certain cancers. Overweight and obesity in pregnant woman may lead to health problems for the woman and her child. Not dealing with overweight and obesity on time can result in various consequences including sleep apnea, heart disease, type 2 diabetes, strokes, certain types of cancer, high blood pressure, kidney disease, fatty liver disease, osteoarthritis, and pregnancy problems such as increased risk of cesarean delivery, high blood sugar during pregnancy, etc. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018).
With the increase in BMI, the risk of non-communicable diseases also increases. The chances of obesity, disability and premature deaths are increased in adulthood in cases where an individual faces obesity in its childhood. Along with the future risks, obese children also experience complications in breathing, hypertension, insulin resistance, increased risk of fractures, cardiovascular diseases and psychological effects (Williams, Mesidor, Winters, Dubbert & Wyatt, 2015).
The major cause of overweight and obesity is an imbalance in energy between calories consumed and calories expended (Rossen & Rossen, 2011). Worldwide, there has been:
- An increase in the intake of energy-dense foods. These include foods that are high in fat.
- Increasing urbanization, deskbound nature of various types of jobs and changing transportation modes leading to rise in physical inactivity.
- The patterns of physical activity and diets have also been changed as a result of societal and environmental changes linked with the lack of supportive policies and development in sectors such as agriculture, health, urban planning, transport, distribution, food processing, education and marketing.
An important role is played by the cultural and familial patterns of food intake along with the accessibility and intake of high fat diets, highly palatable foods, high energy and increasing portion sizes. Calorific intake is increased due to sugar sweetened soft drinks and fast food outlets (Wolin & Petrelli, 2009). Physical activity has been reduced due to current lifestyles in which greater reliance is on the use of technology as a labor saving device (Burns et. al., 2009)
The determinants lead to the actual problem of overweight and obesity when no steps are taken to prevent the occurrence of the problem. Overweight and obesity is initiated when an individual eats too much and moves too little. When the consumption of high amounts of energy is made, specifically sugars and fat and the energy is not burned by way of physical activity and exercise then the surplus energy is stored by the body in the form of fat which slowly results into obesity. Obesity does not happen overnight but is a result of poor lifestyle choices and diet over time such as eating and drinking alcohol in large quantities, consuming too much sugary drinks and fast foods. Nowadays, people are least involved in physical activities as their jobs require them to sit at a desk for the entire day. Instead of preferring walking or cycling, they rely on their cars. Also, they never get time for exercise and tend to watch TV, play computer games and browse the internet for relaxation. The causes of overweight and obesity is undertaken by almost everyone these days but obesity is actually caused to those who take no steps for its prevention.
Obesity in Counties Manakau Health Population
This suggests that the intervention actions and strategies that are implemented by the government needs to be focused on creating awareness that how poor lifestyle choices and behaviors can lead to overweight and obesity over time. The awareness programs should also include the steps to be taken for the prevention of such problem such as increasing physical activity by walking, cycling and exercises, less intake of energy dense foods, etc. The focus should be on the prevention of obesity before the birth of the child along with taking steps right after the birth. The promotion of healthy food habits should be made along with increasing awareness regarding the harmful effects of fast foods and energy dense foods in the people residing in New Zealand.
Conclusion
The focus of this problem analysis report was on the problem of overweight and obesity faced by estimated resident population of Counties Manukau Health. From children to older adults, overweight and obesity is the problem that is experienced by everyone these days due to the adoption of poor lifestyles and behaviors. Therefore, it can be concluded that for preventing overweight and obesity, physical activity should be included in the daily routine in the form of regular exercises, cycling, walking, etc. Moreover, the intake of energy dense foods, fast foods, alcohol in large quantities should be avoided and the intake of healthy food should be increased.
References
Burns, D., Costello, J., Haggart, M., Kerr, J., Longshaw, K., & Thornton, E. (2009). The public health challenge of obesity: is it the new smoking?. Journal of Community Nursing, 23(11), 4-9.
CDC. (2018). The Health Effects of Overweight and Obesity. Retrieved March 13, 2018 from https://www.cdc.gov/healthyweight/effects/index.html
Counties Manukau Health. (2014). Counties Manukau District Health Board. Retrieved March 13, 2018 from https://www.countiesmanukau.health.nz/assets/Blog/teamcounties/obesity-way-forward-a-paper-presented-to-elt-august-2014.pdf
Counties Manukau Health. (2015). Demographic Profile: 2013 Census Population of Counties Manukau. Retrieved March 13, 2018 from https://www.countiesmanukau.health.nz/assets/About-CMH/Demographics-and-populations/Census-2013-profile-for-residents-of-Counties-Manukau.pdf
Hebestreit, A., Börnhorst, C., Pala, V., Barba, G., Eiben, G., Veidebaum, T., … & Pigeot, I. (2014). Dietary energy density in young children across Europe. International Journal of Obesity, 38(S2), S124.
Hutchison, E. D., Matto, H. C., Harrigan, M. P., Charlesworth, L. W. & Viggiani, P. A.(2007). Challenges of Living: A Multidimensional Working Model for Social Workers. SAGE Publications.
Ministry of Health. (2018). Childhood obesity plan. Retrieved March 13, 2018 from https://www.health.govt.nz/our-work/diseases-and-conditions/obesity/childhood-obesity-plan
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Health Risks of Being Overweight. Retrieved March 13, 2018 from https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight
Rossen, L. & Rossen, E. (2011). Obesity 101. Springer Publishing Company.
Swinburn, B., & Vandevijvere, S. (2016). WHO report on ending childhood obesity echoes earlier recommendations. Public health nutrition, 19(1), 1.
The Hub by Superu. (2018). Actions to Encourage Healthy Weight and Healthy Lifestyles. Retrieved March 13, 2018 from https://thehub.superu.govt.nz/project/actions-encourage-healthy-weight-and-healthy-lifestyles
Utter, J., Denny, S., Teevale, T., Peiris-John, R., & Dyson, B. (2015). Prevalence and recent trends in overweight, obesity, and severe obesity among New Zealand adolescents. Childhood Obesity, 11(5), 585-589.
Williams, E. P., Mesidor, M., Winters, K., Dubbert, P. M., & Wyatt, S. B. (2015). Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current obesity reports, 4(3), 363-370.
Wolin, K. Y. & Petrelli, J. M. (2009). Obesity. ABC-CLIO.
World Health Organization. (2018). Obesity and overweight. Retrieved March 13, 2018 from https://www.who.int/mediacentre/factsheets/fs311/en/
Yofee, L. (2009). How to Avoid the Obesity Epidemic. Retrieved March 13, 2018 from https://www.everydayhealth.com/healthy-living/obesity-prevention.aspx
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