Weight of the Nation

Part I: Consequences
Part I of The Weight of the Nation discussed the effects of the obesity epidemic in America. It immediately grabbed my attention when they stated that more than 18% of American children are obese. Two-thirds of America (or 68.8%) is overweight or obese. There is a strong connection between a high BMI and diabetes mellitus and hypertension, especially when accompanied by a high percentage of abdominal fat. I found it interesting, and important, that the first woman who shared her story pointed out the psychosocial effects of her obesity. She expressed that her self-esteem is affected by how her husband expresses his view of her weight. She later stated, “You get tired of that feeling of failure," regarding her failed efforts at losing weight.
Part one also focused on The Bogalusa Heart Study. This includes a biannual physical exam of school children. These children, about 16,000 currently, have been followed by the study into adulthood. Results of this study indicate that heart disease begins in childhood. It was shocking to hear that “20% of autopsied children, who died a non-cardiac death, had plaques in their coronary arteries."
Other shocking facts in this section were that 77% of obese children were obese as adults. Meanwhile, only 7% of healthy weight children became obese in adulthood. We often hear, “I don’t have money to eat healthy” but research also indicates that poverty no longer has a linear relationship with obesity, and that obesity now affects people of economic statuses.
Obesity is the driving force for insulin resistance. It can also lead to a fatty liver, which in turn increases cardiovascular risk factors. This can further lead to non-alcoholic fatty liver disease. This disease is expected to be the number one reason for liver transplants in the next ten years.
An increase in weight can substantially increase diabetes risk, even if you are not overweight. However, it is not all bad news... a 10% weight loss can have significant positive effects metabolically.
Part II: Choices
Part II further discusses the reason for failed weight loss efforts and suggests tips for successful weight loss. It emphasizes the negative effects of sweetened beverages, including juice! It is interesting to learn that the thirst and hunger mechanisms are completely different. Fad diets are also discussed. Most fad diets advise to eliminate one of the macronutrients, but in reality you need to equally reduce all three macronutrients and eat a balanced meal to maintain weight loss.
The Set Point phenomena regarding how two people with the same current weight may have different caloric and metabolic needs is discussed.
A gastric bypass surgery is then detailed.
Later, the importance of exercise is emphasized! While exercise is not the number one intervention to achieve weight loss, it is essential for maintaining weight loss from dietary changes and for reducing the risk of hypertension, diabetes, osteoporosis, and arthritis.
Part III: Children in CrisisPart III focuses on the obesity epidemic in children which is considered a "public health emergency." High insulin levels and cardiovascular risks are seen in obese children.
There is an increased likelihood of obesity in children who watch a lot of television. Therefore, the importance of physical activity is detailed. Children who participate in physical programs show an increase in lean body mass and decreased triglyceride and cholesterol levels.
Most of this section discusses the legislature changes necessary for school lunch changes and advertising. It's shocking that "94% of schools failed to meet USDA standards for healthy school meals" in 2012. The impact of sugar-sweetened beverages and energy drinks is stressed. Our culture needs to reevaluate what we advertise and serve to our children.
Part IV: Challenges
Part IV introduces patients with medical effects secondary to obesity such as: Neuropathy, sleep apnea, liver issues, high cholesterol, and diabetes. Obesity is a significant factor to rising medical costs!
The agricultural side is discussed in this section. In America, there is an increase in corn and soy products rather than fruits and vegetables. Our current industrial food system calls for cheap and fast meals which poorly effects our nutritional intake. There is an emphasis on the need to grow local food movement.
Community health efforts are on the rise which could have a positive impact. Some work forces, such as the fire department and construction companies shown, are promoting healthy changes for their employees. Activities in a low-income community are helping members learn and maintain a healthy lifestyle.