Analyzing Obesity: Individual Choices and Social Determinants

This essay examines the multifaceted issue of obesity, exploring whether it is primarily driven by individual lifestyle choices or broader social determinants. It begins by defining obesity using the Body Mass Index (BMI) and highlighting its global prevalence, noting its rise in both developed and developing countries. The essay then delves into the determinants of obesity, categorizing them into individual, behavioral, and social-environmental factors. Individual factors include genetic predispositions, while behavioral factors encompass dietary habits, physical activity levels, and sedentary behaviors. The essay emphasizes the growing recognition of social-environmental determinants such as socio-economic status, education levels, and the impact of nutrition transitions. It further discusses the role of healthcare systems and governments in obesity prevention, advocating for interventions that promote healthy lifestyles and address social inequalities. The essay concludes by underscoring the need for a comprehensive approach that considers both individual responsibility and societal influences in tackling the obesity epidemic.

Running head: obesity
Obesity
Author Name(s)
Institutional Affiliation(s)
Author Note

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Abstract
Medical proof has established firm grounds on the relationship between obesity
and overweight. Besides, this association has been found to translate to other health
problems such as hypertension, diabetes mellitus, cardiovascular diseases, and
hyperlipidemias among others. Healthy lifestyle practices have been also established as
one way of preventing obesity. These practices are physical exercises, avoidance of
fatty foods, eating vegetables and fruits and staying hydrated. It is believed that physical
exercises help the body to burn extra calories. Therefore, minimizing consumption of
calories and physical exercises can be major approaches to avoiding obesity. This
paper will be looking at the determinants of obesity, and the approaches that can be
taken to prevent it.
Keywords: Obesity, Calories, Physical Exercises, BMI

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Obesity
Obesity has now been categorized as a global health epidemic. Health
professionals associate this disease with extreme health risks in addition to that it
comes with other diseases such as diabetes, cardiovascular disease (2), and various
kinds of cancers. An understanding of the key determinants and causes of obesity can
be a crucial step towards eliminating it. Government, health organization, as well as
individuals, should develop plans that efficiently deal with this menace. Among other
this, this paper will be taking an in-depth look at how the society can deal with the
obesity epidemic.
What is Obesity
The health definitions for obesity define it as an abnormal or excess
accumulation of fat to the extent of impairing the normal functioning of the body.
According to (Nuttall, 2015), health professionals commonly use body mass index (BMI)
for classifying obesity and overweight in patients. The calculation of BMI involves the
division of the patient's weight(Kg) by the height which should be meters squared.
According to (World Health Organization [WHO], 2016), the report states that an
individual would be classified as overweight if that person’s BMI has a value that is
equal to or greater than 25. For an obese, the report further states that a person would
be obese if his/her BMI totals the same or goes higher than 30. For the sake of children
under five years, WHO states that they would be termed as overweight by finding
whether their weight for height goes past the two standard deviations stated above.
Similarly, a child would be obese if the weight for height goes higher than three for the
standard deviations stated above.

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Global Prevalence of Obesity
The obesity epidemic has been puzzling the global health from 1975 to the
current. For instance, the report of (WHO, 2016) demonstrates that more than 1.9 billion
adults from the age of 18 years are overweight. Among these, 650 million were obese.
To restate, about 39% people aged 18 years above were overweight while 13% were
obese. This study also estimates that 41 million children below 5 years old could be
overweight while 340 million between 5 to 19 years-old could either be overweight or
obese. The report also enlightened that the issue of obesity and overweight in the
population aged between 5 and 19 years old has heightened from 4% to 18% between
1975 and 2016.
Worldwide, both obesity and overweight are categorized as epidemics due to
their high rates of fatality. According to (Jelassi, Miled, Saoud, & Demongeot, 2015),
obesity was once regarded as a health problem in developed countries. This study
reports that states that the number of adults reported being obese in 2007/2008 in the
US were more than 75%. Besides, the who 2016 report of has warned that now rising
in the poor and the developing countries, particularly in urban areas. Obesity poses a
huge dilemma for Australian citizens and the global as well. According to (Australian
Institute of Health and Welfare [AIHW], 2017)obesity ranks second after tobacco when
analyzing the factors that are contributing to huge burden of diseases in Australia apart
from tobacco smoking.
In Australia, the study reports have termed obesity as a significant public health
concern. For example, (AIHW, 2018) recent report has shown obesity as ranking
second from tobacco smoking as the most endangering factors to the lives of Australian

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citizens. According to (Moodie, et al., 2008), Australia had more than 63% adults who
were overweight and obese. The report also stated that 27% of children between 5-17-
year-old were overweight and obese. In Australia, the obesity distribution has been
mostly inequitable across the country. The prevalence of both issues has escalated in
the last 30 years. However, government and health sector operations against it has
been slow.
What are the determinants/causes of obesity?
Like as mentioned above, obesity comes when the body is unable to deal with
the excess fat that deters the normal body function. In a general sense, excess fats
arise from consumption of foods with high calories and the failure of the body to expend
the extra calories creating an energy imbalance (WHO, 2016). In increase in calorie
intake with less physical activities to burn the calories would lead to accumulation of
fats. Similarly, lack of public awareness and policies for health, transport, agriculture,
urban planning, food processing, environment, distribution, education, and marketing
also contribute to the populations', and education has been one of the two main reasons
for the dietary and physical activity approaches (Black, Moon, & Baird, 2014) Thus,
factors and determinants for obesity can be individual, behavioral, psychosocial, or even
environmental. Furthermore, these determinants can vary due to factors like age or sex.
One point of contradiction is that the past studies have been solely emphasizing on
individual risk factors as the key determinants for obesity. However, recent studies on
obesity have greatly divulged from this view, and they have now focused on other
determinant seeing them as heightened than individual factors. These are the
environmental factors and social factors.

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Individual determinants
Studies that look at individual factors focus mainly on genetic make up and gene
interaction. The studies behind this hypothesis offer their explanations that the genes
that cause resemblances and adoptees could also cause variation in weights (Huang &
Hu, 2015). Other studies have also compared obese people and non-obese people and
have found genetic variation. These studies have demonstrated that variance in these
genes can also cause variation in metabolism of fats. With this, it has been found that
some forms of obesity demonstrate strong hereditary components (Qi & Cho, 2008).
Behavioral/Individual Role
Current studies are focusing on behavioral and social factors as the main
determinants of obesity. The behavioral factors include a lot of habits that sometimes
are predetermined by social factors. Some of these habits are like caloric intake,
physical activities, eating styles, meal frequencies, sedentary behaviors, sleep duration,
alcoholism, and smoking among others (Affenito, Franko, Striegel-Moore, & Thompson,
2012). According to (Moodie, et al., 2008), individuals have the responsibilities of
maintaining their health and a healthy society. This report means that it is people who
make choices about the life they would want to live through their behaviors.
In one situation that show how own contribution can lead to obesity was
explained by (Traversy & Chaput, 2015). This study explains that recreational or social
activities where participants consume alcohol with energy levels (7 kcal/g) are at higher
risk of obesity. Further, a study conducted by (Dancause, et al., 2013) has shown that
there is increased consumption of animal products which much it is protein. The authors
term this as a risky behavioral contributor to obesity. The authors also link this behavior

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to the economic development which has led to the evolving of a new global culture of
higher dependence on processed foods. In countering such behaviors, the work of
(Haskell, et al., 2007) recommends minimizing sugar and fatty food an instead
substitute them with fruits, vegetables, legumes and whole grains. The work also
recommends regular physical exercises for at least one hour per day for children and
about one and half hours per week for adults. On the contrary (Moodie, et al., 2008)
state that these decisions largely come as inspirations from social, physical outcomes,
opportunities in life and the environment, and WHO2016 advises people to find access
to health services. Moreover, (Moodie, et al., 2008) advocates for societal guidance
from health sectors to help people make the best choices regarding the management of
their health.
Social-Environmental Determinants
The study of (Stein, Weinberger-Litman, & Latzer, 2014) raises the issue of
socio-economic status (SES). This study found a consistent relationship between
obesity and SES. The study states that the there is a clear relationship between low
industrialized countries, low SES, and higher rates of obesity. This study also talks
about the level of education. Places where there is low level of education are seen to
have higher prevalence of obesity.
Another issue regarding social determinants is brought forward by the study of
(Duncan, et al., 2011). According to transition in life is also becoming a major cause of
obesity. These authors undertook a study to explain how nutrition transition experienced
in Brazil has led contributed to the increased cases of obesity. This study noted that
Brazilians have left the traditional diets and they are now taking foods with high levels of

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sodium, saturated fat, and cholesterol. Besides, the study also stated that people are
now living in sedentary lifestyles. The results of this study found three highest
contributors to children obesity. These modifiable factors were increased use of
transportation means to school. That is, children are using buses that drop them to their
homes and pick them for school. Another factor found was the increased use of
computers to automatize manual tasks, and uptake of heavy breakfast. Also, the report
(Butland, et al., 2007) raises the same issue of engineering and mechanization of tasks.
This report states that unlike before, vehicles have replaced the normal walking that can
help people burn extra calories.
There are unexplained connections between the physical environment and
obesity. However, few studies have tried to explain this concept in terms of geographic
clustering in various ethnic groups. For example, in the study of (Katzmarzyk, 2008), the
author explains that raises the issue of increased cases of obesity in Aboriginal
Canadian while comparing them with the rest of the people. However, looking at a
different direction, this issue falls more on matters of race and ethnicity hence becoming
an issue of SES. One case that can fall in this scenario was the study of (Squalli, 2017)
that examined whether there is any relationship between obesity and greenhouse
emissions while considering the development in transportation output in relation to
crops and animal farming. Indeed, this study was able to establish that there is rise in
cases of obesity with the increases emissions of CO2 and N2O.
Disease prevention
The WHO in (Moodie, et al., 2008) defines prevention as ‘strategies and actions
are taken that are aimed at diminishing chances of potential infection, interruptions or

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slow progression of the disorders or defeating disabilities. In this case, preventing
obesity requires appropriate interventions that aim at encouraging people to practice
healthy behaviors. According to (WHO & Commissions for Social Determinants of
Health, 2009) these interventions should be aimed at enlightening the society on the
dangers of the mentioned determinants of obesity and how people can avoid them.
Role of healthcare systems
There is a great need for healthcare sectors to emphasize encouraging people to
practice a healthy lifestyle. The use of the 5As (ask, assess, advise/agree, assist and
arrange) should be implemented as one method of analyzing the actions taken for the
prevention of obesity in the populations (Sturgiss & Weel, 2017). People should be
encouraged to invest in disease prevention, early detection and taking appropriate
measures of maintaining optimum health. Health systems should ensure that there is
complete care provided to the patients diagnosed with obesity, and actions are taken for
monitoring their behaviors as they proceed through medication.
Role of governments
According to (Swinburn & Wood, 2013), the government has a major role to play
in the prevention of obesity. The author mentions roles like prevention of unhealthy
foods from public consumption, prevention of marketing of unhealthy food, and control
of labeling and packaging of foods among others. In this support, (Brownell, et al., 2010)
states that government can also take regulatory actions like nutrition improvements in
schools, and revising food taxes placed on healthier food.

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Social determinants of health
Regarding social determinants, healthcare systems are the ones closest to the
communities hence offering the best channels for a change. With this, these systems'
should be structured in a way they would serve all people by ensuring equitable,
comprehensive coverage with access to satisfactory human resources. These systems
must be able to penetrate into social health determinants with established primary care.
Potential initiatives
People should understand that they are the key determinants of their health.
Even though the government has control on trades and practices, it may not be able to
intervene with people's choices as the laws regarding their rights allows the citizens to
choose what they want with their lives. Individuals should take care of their behaviors
and refrain from those that put their health at risk. Preventing obesity requires a change
of behaviors, and personal monitoring of food and life that someone is living.
Conclusion
Obesity has been recognized as one of the chronic diseases. However, unlike
most of the chronic diseases, the highest determinant of risks to obesity depends on
people's choices. Individuals should focus on reshaping their behaviors and living in an
environment that has nutritional abundance. Foods with lots of fats and alcohol should
be avoided or reduced as one approach to healthy living. This paper aimed at
discussing the issue of obesity. In this objective, the paper has covered the key
determinants of obesity, and the various interventions that people can take to avoid it.
Ultimately, this paper has observed that social determinants are the key contributors
and their avoidance can minimize the risks to obesity.

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