The Obesity Epidemic

Question 1

What is meant by Globesity?

Answer 1

• obesity that affects a very large percentage of the global population.

Question 2

What is meant by Excess Adiposity?

Answer 2

• high amount of body fat in relation to lean mass.
• obese individuals were found to have medical costs that were approximately 30% greater than their normal weight peers (Withrow & Alter, 2011)
• In 2006-07 overweight and obesity cost NHS £5.1 billion (Scarborough et al., 2011)
• Weight loss appears to be the most effective therapy for obesity and related comorbidity

Question 3

Describe the Obesity Epidemic

Answer 3

• Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries (The GBD 2015 Obesity Collaborators)
• Linked to reductions in physical activity owing to more mechanized and technologically driven lifestyles, and less healthy diets (added sugars, more fat)

Question 4

Why is there a “globesity”?

Answer 4

• because of evolution
• because of the Cost-of-Living Crisis
• because of the Covid-19 pandemic
  (Anyanwu et al., 2022; McBribe et al., 2021)

Question 5

Describe the Role of Medicine (McKeown (1979))

Answer 5

Contemporary illness is caused by “influences…which the individual determines by his own behaviour (smoking, eating, exercise, and the like)” (p.118).

“…it is on modification of personal habits such as smoking and sedentary living that health primarily depends” (p.124)

Most dominant illnesses (e.g. Lung cancer, CHD) are caused by behaviours

Question 6

Briefly outline the article ‘When Inflation Rises, Health Outcomes Fail’ (Sean Duffy) in relation to Globesity

Answer 6

how people set their health priorities is influenced by their ability to pay for medications, doctor visits, gym memberships, and even healthy food.

rising costs for normal day-to-day necessities like transportation and housing mean that for many, there isn’t as much money left over to take care of their health

Question 7

Describe research surrounding the causes of globesity (1)

Answer 7

A substantial proportion of participants reported attempts to change health behaviours in the initial survey phase.

However, the lack of change observed over time indicated that overall motivation to engage in healthy behaviours was sustained among the UK adult population, from a period shortly after the first lockdown toward the end of the second prolonged lockdown.

Question 8

Describe research surrounding the causes of globesity (2)

Question 9

Outline the impacts of the Cost of living crisis

Answer 9

• people are struggling to afford food to eat
• reports on skipping meals , buying cheaper/lower quality food, using processed food that doesn’t require cooking (energy cost)

Question 10

Describe the effects of COVID-19 on eating habits

Answer 10

• Eating more (especially if already overweight)
• Snacking more
• Less fruit and veg
• More unhealthy food (emotional eating)

Question 11

Describe the effects of COVID-19 on Physical Activity and sedentary behaviour

Answer 11

• More prolonged sitting
• 25% report lower PA
• Some report PA maintenance and increase (but still below the recommended levels)

Question 12

What is the function of the Body mass index?

Answer 12

• used to describe healthy weight
• BMI = Weight (kg) divided by height (cm) x height (m)
• underweight = < 18.5
• healthy weight = 18.5 - 24.9
• overweight = 25.0 - 29.9
• obese = > 30

Question 13

What is the prevalence of overweight and obese individuals amongst males and females in the UK (2018) ?

Answer 13

Females:
- overweight: 30%
- Obese: 27%

Males:
- overweight: 40%
- obese: 26%

Question 14

Describe the Concept of Energy Balance

Answer 14

• Energy balance: if calories intake is the same as calories burnt/ out, allows person to maintain a stable body weight
• Positive energy balance: if calories in is more than calories burnt/out, that results in weight gain.

negative energy balance: if the calorie intake is less than the calories burnt/out, that results in weight loss.

Question 15

Describe the genetic explanation to explaining why we eat unhealthily (BIO)

Answer 15

a set of SNPs in the first intron of the FTO (fat mass and obesity associated) gene on chromosome 16q12.2 is consistently strongly associated with early-onset and severe obesity in both adults and children of European ancestry (Dina et al., 2007)

But also, genetic variants in 127 biologic candidate genes have been reported to be associated with obesity-related phenotypes (Yang et al., 2007)

Question 16

Explain how the interaction between our genes and the environment plays a role in unhealthy eating

Answer 16

• rather complex interplay between predisposing genes and environmental stimuli (e.g., consumption of fried-food interacts with genetic background in relation to obesity: Qi et al., 2014)
• BMI according to frequency of fried food consumption and thirds of genetic risk score; higher score=higher risk

Question 17

Describe how stress (psychological aspect) can explain unhealthy eating

Answer 17

linked to consumption of “comfort” food
Induced stress led to increase of high-fat food option (M&Ms) vs. low-fat option (grapes)

This change in food choice particularly significant for dieters and women (Zellner et al., 2006)

Question 18

Describe how mood (psychological aspect) can explain unhealthy eating

Answer 18

Reward and gratification associated with food consumption leads to dopamine (DA) production

This in turn activates reward and pleasure centres in the brain (Singh, 2014).

Highly palatable foods activate the same brain regions of reward and pleasure that are active in drug addiction (Volkow et al., 2012)

Question 19

Describe how social factors can explain unhealthy eating

Answer 19

• linked to food consumption (e.g., “Lots of women I know eat healthy food/fast food when they are out”) (Ball et al., 2010)
• Obesogenic environment
  Promoting positive energy balance (adverts of energy-dense food and drinks; “takeaway culture”, convenience food, fast food; increased meal size)
• Media
  (More TV viewing linked to obesity)

Sedentary lifestyle instead of PA

Promotion of unhealthy consumption (e.g., TV snacking, indulgent food ads)

Question 20

Outline theories that explain why we eat unhealthily

Answer 20

• Developmental approach
  Exposure
  Social learning (modelling)
  Associative learning

Cognitive approach
Cognitions as predictors of behaviour
Theory of planned behaviour (Ajzen, 1985)

Psychophysiological approach
Role of hunger and satiety (inter-meal period: inhibits intake after termination of a meal)

Sensory attributes of food affect consumption

Smoking, drugs, stress affect hunger and consumption

Question 21

Identify the barriers to healthy eating

Answer 21

(Pinho et al., 2018):
Lack of willpower
Time constraints
Taste preferences
(Amongst adult europeans)

Student sample (Hilger et al., 2017)
Lack of time due to studies
Lack of healthy meals at the university canteen
High prices of healthy foods

Question 22

Describe why the cost of healthy food is a barrier to healthy eating

Answer 22

research has shown that eating healthy is more costly (healthier diets cost $1.48/day more; Rao et al., 2013)

Healthy food prices go up
quicker than for less healthy
options (based on nutrition
value)

The mean 2012 price/1000kcal
was £2.50 for less healthy
items and £7.49 for more
healthy items (UK; Jones et al., 2014)

Question 23

Outline Barriers to Physical Activity

Answer 23

As seen by Nursing & Medical students:
Lack of time
Facilities with inconvenient schedules
Exercise difficult to fit around study/placements (Blake, Stanulewicz & Mcgill, 2017)

General adult sample:
Lack of time
Lack of motivation (Chinn et al., 1999)

Older adults:
Poor health
Lack of company
Lack of interest (Moschny et al., 2011)

Question 24

Describe Social Predictors of Physical Activity

Answer 24

Enjoyable
Non-joggers vs. Joggers (Riddle, 1980)
Non-joggers – Exercise required too much discipline, too much time, & had no +ve effects

Social contact & Social support (Molloy et al., 2010)

Exercise in older adults (52-87 years) (Hardy & Grogan, 2009) – Social support as motivation to keep going

Sense of purpose & challenge (Beck et al., 2010)

Question 25

Outline Demographic predictors of lower physical activity

Answer 25

Age (younger), educated, lower body weight, access to facilities, being male, having money (Dishman, 1982; King et al., 1992)

Ethnic Differences – Black ethnic group less active, with Black women particularly less active (differences persist when income & education controlled; Shea et al., 1992)

Question 26

Identify predictors of Physical Activity

Answer 26

Social benefits
Affect
Costs of exercise
Benefits of exercise
Exercise self-efficacy
Planning
Past behaviour (habit)
Demographics