problem with obesity essay

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Obesity: causes, consequences, treatments, and challenges.

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Obesity: causes, consequences, treatments, and challenges, Journal of Molecular Cell Biology , Volume 13, Issue 7, July 2021, Pages 463–465, https://doi.org/10.1093/jmcb/mjab056

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Obesity has become a global epidemic and is one of today’s most public health problems worldwide. Obesity poses a major risk for a variety of serious diseases including diabetes mellitus, non-alcoholic liver disease (NAFLD), cardiovascular disease, hypertension and stroke, and certain forms of cancer ( Bluher, 2019 ).

Obesity is mainly caused by imbalanced energy intake and expenditure due to a sedentary lifestyle coupled with overnutrition. Excess nutrients are stored in adipose tissue (AT) in the form of triglycerides, which will be utilized as nutrients by other tissues through lipolysis under nutrient deficit conditions. There are two major types of AT, white AT (WAT) and brown AT, the latter is a specialized form of fat depot that participates in non-shivering thermogenesis through lipid oxidation-mediated heat generation. While WAT has been historically considered merely an energy reservoir, this fat depot is now well known to function as an endocrine organ that produces and secretes various hormones, cytokines, and metabolites (termed as adipokines) to control systemic energy balance. Studies over the past decade also show that WAT, especially subcutaneous WAT, could undergo ‘beiging’ remodeling in response to environmental or hormonal perturbation. In the first paper of this special issue, Cheong and Xu (2021) systematically review the recent progress on the factors, pathways, and mechanisms that regulate the intercellular and inter-organ crosstalks in the beiging of WAT. A critical but still not fully addressed issue in the adipose research field is the origin of the beige cells. Although beige adipocytes are known to have distinct cellular origins from brown and while adipocytes, it remains unclear on whether the cells are from pre-existing mature white adipocytes through a transdifferentiation process or from de novo differentiation of precursor cells. AT is a heterogeneous tissue composed of not only adipocytes but also nonadipocyte cell populations, including fibroblasts, as well as endothelial, blood, stromal, and adipocyte precursor cells ( Ruan, 2020 ). The authors examined evidence to show that heterogeneity contributes to different browning capacities among fat depots and even within the same depot. The local microenvironment in WAT, which is dynamically and coordinately controlled by inputs from the heterogeneous cell types, plays a critical role in the beige adipogenesis process. The authors also examined key regulators of the AT microenvironment, including vascularization, the sympathetic nerve system, immune cells, peptide hormones, exosomes, and gut microbiota-derived metabolites. Given that increasing beige fat function enhances energy expenditure and consequently reduces body weight gain, identification and characterization of novel regulators and understanding their mechanisms of action in the beiging process has a therapeutic potential to combat obesity and its associated diseases. However, as noticed by the authors, most of the current pre-clinical research on ‘beiging’ are done in rodent models, which may not represent the exact phenomenon in humans ( Cheong and Xu, 2021 ). Thus, further investigations will be needed to translate the findings from bench to clinic.

While both social–environmental factors and genetic preposition have been recognized to play important roles in obesity epidemic, Gao et al. (2021) present evidence showing that epigenetic changes may be a key factor to explain interindividual differences in obesity. The authors examined data on the function of DNA methylation in regulating the expression of key genes involved in metabolism. They also summarize the roles of histone modifications as well as various RNAs such as microRNAs, long noncoding RNAs, and circular RNAs in regulating metabolic gene expression in metabolic organs in response to environmental cues. Lastly, the authors discuss the effect of lifestyle modification and therapeutic agents on epigenetic regulation of energy homeostasis. Understanding the mechanisms by which lifestyles such as diet and exercise modulate the expression and function of epigenetic factors in metabolism should be essential for developing novel strategies for the prevention and treatment of obesity and its associated metabolic diseases.

A major consequence of obesity is type 2 diabetes, a chronic disease that occurs when body cannot use and produce insulin effectively. Diabetes profoundly and adversely affects the vasculature, leading to various cardiovascular-related diseases such as atherosclerosis, arteriosclerotic, and microvascular diseases, which have been recognized as the most common causes of death in people with diabetes ( Cho et al., 2018 ). Love et al. (2021) systematically review the roles and regulation of endothelial insulin resistance in diabetes complications, focusing mainly on vascular dysfunction. The authors review the vasoprotective functions and the mechanisms of action of endothelial insulin and insulin-like growth factor 1 signaling pathways. They also examined the contribution and impart of endothelial insulin resistance to diabetes complications from both biochemical and physiological perspectives and evaluated the beneficial roles of many of the medications currently used for T2D treatment in vascular management, including metformin, thiazolidinediones, glucagon-like receptor agonists, dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter inhibitors, as well as exercise. The authors present evidence to suggest that sex differences and racial/ethnic disparities contribute significantly to vascular dysfunction in the setting of diabetes. Lastly, the authors raise a number of very important questions with regard to the role and connection of endothelial insulin resistance to metabolic dysfunction in other major metabolic organs/tissues and suggest several insightful directions in this area for future investigation.

Following on from the theme of obesity-induced metabolic dysfunction, Xia et al. (2021) review the latest progresses on the role of membrane-type I matrix metalloproteinase (MT1-MMP), a zinc-dependent endopeptidase that proteolytically cleaves extracellular matrix components and non-matrix proteins, in lipid metabolism. The authors examined data on the transcriptional and post-translational modification regulation of MT1-MMP gene expression and function. They also present evidence showing that the functions of MT1-MMP in lipid metabolism are cell specific as it may either promote or suppress inflammation and atherosclerosis depending on its presence in distinct cells. MT1-MMP appears to exert a complex role in obesity for that the molecule delays the progression of early obesity but exacerbates obesity at the advanced stage. Because inhibition of MT1-MMP can potentially lower the circulating low-density lipoprotein cholesterol levels and reduce the risk of cancer metastasis and atherosclerosis, the protein has been viewed as a very promising therapeutic target. However, challenges remain in developing MT1-MMP-based therapies due to the tissue-specific roles of MT1-MMP and the lack of specific inhibitors for this molecule. Further investigations are needed to address these questions and to develop MT1-MMP-based therapeutic interventions.

Lastly, Huang et al. (2021) present new findings on a critical role of puromycin-sensitive aminopeptidase (PSA), an integral non-transmembrane enzyme that catalyzes the cleavage of amino acids near the N-terminus of polypeptides, in NAFLD. NAFLD, ranging from simple nonalcoholic fatty liver to the more aggressive subtype nonalcoholic steatohepatitis, has now become the leading chronic liver disease worldwide ( Loomba et al., 2021 ). At present, no effective drugs are available for NAFLD management in the clinic mainly due to the lack of a complete understanding of the mechanisms underlying the disease progress, reinforcing the urgent need to identify and validate novel targets and to elucidate their mechanisms of action in NAFLD development and pathogenesis. Huang et al. (2021) found that PSA expression levels were greatly reduced in the livers of obese mouse models and that the decreased PSA expression correlated with the progression of NAFLD in humans. They also found that PSA levels were negatively correlated with triglyceride accumulation in cultured hepatocytes and in the liver of ob/ob mice. Moreover, PSA suppresses steatosis by promoting lipogenesis and attenuating fatty acid β-oxidation in hepatocytes and protects oxidative stress and lipid overload in the liver by activating the nuclear factor erythroid 2-related factor 2, the master regulator of antioxidant response. These studies identify PSA as a pivotal regulator of hepatic lipid metabolism and suggest that PSA may be a potential biomarker and therapeutic target for treating NAFLD.

In summary, papers in this issue review our current knowledge on the causes, consequences, and interventions of obesity and its associated diseases such as type 2 diabetes, NAFLD, and cardiovascular disease ( Cheong and Xu, 2021 ; Gao et al., 2021 ; Love et al., 2021 ). Potential targets for the treatment of dyslipidemia and NAFLD are also discussed, as exemplified by MT1-MMP and PSA ( Huang et al., 2021 ; Xia et al., 2021 ). It is noted that despite enormous effect, few pharmacological interventions are currently available in the clinic to effectively treat obesity. In addition, while enhancing energy expenditure by browning/beiging of WAT has been demonstrated as a promising alternative approach to alleviate obesity in rodent models, it remains to be determined on whether such WAT reprogramming is effective in combating obesity in humans ( Cheong and Xu, 2021 ). Better understanding the mechanisms by which obesity induces various medical consequences and identification and characterization of novel anti-obesity secreted factors/soluble molecules would be helpful for developing effective therapeutic treatments for obesity and its associated medical complications.

Bluher M. ( 2019 ). Obesity: global epidemiology and pathogenesis . Nat. Rev. Endocrinol . 15 , 288 – 298 .

Google Scholar

Cheong L.Y. , Xu A. ( 2021 ). Intercellular and inter-organ crosstalk in browning of white adipose tissue: molecular mechanism and therapeutic complications . J. Mol. Cell Biol . 13 , 466 – 479 .

Cho N.H. , Shaw J.E. , Karuranga S. , et al.  ( 2018 ). IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045 . Diabetes Res. Clin. Pract . 138 , 271 – 281 .

Gao W. , Liu J.-L. , Lu X. , et al.  ( 2021 ). Epigenetic regulation of energy metabolism in obesity . J. Mol. Cell Biol . 13 , 480 – 499 .

Huang B. , Xiong X. , Zhang L. , et al.  ( 2021 ). PSA controls hepatic lipid metabolism by regulating the NRF2 signaling pathway . J. Mol. Cell Biol . 13 , 527 – 539 .

Loomba R. , Friedman S.L. , Shulman G.I. ( 2021 ). Mechanisms and disease consequences of nonalcoholic fatty liver disease . Cell 184 , 2537 – 2564 .

Love K.M. , Barrett E.J. , Malin S.K. , et al.  ( 2021 ). Diabetes pathogenesis and management: the endothelium comes of age . J. Mol. Cell Biol . 13 , 500 – 512 .

Ruan H.-B. ( 2020 ). Developmental and functional heterogeneity of thermogenic adipose tissue . J. Mol. Cell Biol . 12 , 775 – 784 .

Xia X.-D. , Alabi A. , Wang M. , et al.  ( 2021 ). Membrane-type I matrix metalloproteinase (MT1-MMP), lipid metabolism, and therapeutic implications . J. Mol. Cell Biol . 13 , 513 – 526 .

Author notes

Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China E-mail: [email protected]

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Obesity Essay

Last updated on: Feb 9, 2023

Obesity Essay: A Complete Guide and Topics

By: Nova A.

11 min read

Reviewed By: Jacklyn H.

Published on: Aug 31, 2021

Are you assigned to write an essay about obesity? The first step is to define obesity.

The obesity epidemic is a major issue facing our country right now. It's complicated- it could be genetic or due to your environment, but either way, there are ways that you can fix it!

Learn all about what causes weight gain and get tips on how you can get healthy again.

On this Page

What is Obesity

What is obesity? Obesity and BMI (body mass index) are both tools of measurement that are used by doctors to assess body fat according to the height, age, and gender of a person. If the BMI is between 25 to 29.9, that means the person has excess weight and body fat.

If the BMI exceeds 30, that means the person is obese. Obesity is a condition that increases the risk of developing cardiovascular diseases, high blood pressure, and other medical conditions like metabolic syndrome, arthritis, and even some types of cancer.

Obesity Definition

Obesity is defined by the World Health Organization as an accumulation of abnormal and excess body fat that comes with several risk factors. It is measured by the body mass index BMI, body weight (in kilograms) divided by the square of a person’s height (in meters).

Obesity in America

Obesity is on the verge of becoming an epidemic as 1 in every 3 Americans can be categorized as overweight and obese. Currently, America is an obese country, and it continues to get worse.

Paper Due? Why Suffer? That's our Job!

Causes of obesity

Do you see any obese or overweight people around you?

You likely do.

This is because fast-food chains are becoming more and more common, people are less active, and fruits and vegetables are more expensive than processed foods, thus making them less available to the majority of society. These are the primary causes of obesity.

Obesity is a disease that affects all age groups, including children and elderly people.

Now that you are familiar with the topic of obesity, writing an essay won’t be that difficult for you.

How to Write an Obesity Essay

The format of an obesity essay is similar to writing any other essay. If you need help regarding how to write an obesity essay, it is the same as writing any other essay.

Obesity Essay Introduction

The trick is to start your essay with an interesting and catchy sentence. This will help attract the reader's attention and motivate them to read further. You don’t want to lose the reader’s interest in the beginning and leave a bad impression, especially if the reader is your teacher.

A hook sentence is usually used to open the introductory paragraph of an essay in order to make it interesting. When writing an essay on obesity, the hook sentence can be in the form of an interesting fact or statistic.

Head on to this detailed article on hook examples to get a better idea.

Once you have hooked the reader, the next step is to provide them with relevant background information about the topic. Don’t give away too much at this stage or bombard them with excess information that the reader ends up getting bored with. Only share information that is necessary for the reader to understand your topic.

Next, write a strong thesis statement at the end of your essay, be sure that your thesis identifies the purpose of your essay in a clear and concise manner. Also, keep in mind that the thesis statement should be easy to justify as the body of your essay will revolve around it.

Body Paragraphs

The details related to your topic are to be included in the body paragraphs of your essay. You can use statistics, facts, and figures related to obesity to reinforce your thesis throughout your essay.

If you are writing a cause-and-effect obesity essay, you can mention different causes of obesity and how it can affect a person’s overall health. The number of body paragraphs can increase depending on the parameters of the assignment as set forth by your instructor.

Start each body paragraph with a topic sentence that is the crux of its content. It is necessary to write an engaging topic sentence as it helps grab the reader’s interest. Check out this detailed blog on writing a topic sentence to further understand it.

End your essay with a conclusion by restating your research and tying it to your thesis statement. You can also propose possible solutions to control obesity in your conclusion. Make sure that your conclusion is short yet powerful.

Obesity Essay Examples

Essay about Obesity (PDF)

Childhood Obesity Essay (PDF)

Obesity in America Essay (PDF)

Essay about Obesity Cause and Effects (PDF)

Satire Essay on Obesity (PDF) 

Obesity Argumentative Essay (PDF)

Obesity Essay Topics

Choosing a topic might seem an overwhelming task as you may have many ideas for your assignment. Brainstorm different ideas and narrow them down to one, quality topic.

If you need some examples to help you with your essay topic related to obesity, dive into this article and choose from the list of obesity essay topics.

Childhood Obesity

As mentioned earlier, obesity can affect any age group, including children. Obesity can cause several future health problems as children age.

Here are a few topics you can choose from and discuss for your childhood obesity essay:

• What are the causes of increasing obesity in children?
• Obese parents may be at risk for having children with obesity.
• What is the ratio of obesity between adults and children?
• What are the possible treatments for obese children?
• Are there any social programs that can help children with combating obesity?
• Has technology boosted the rate of obesity in children?
• Are children spending more time on gadgets instead of playing outside?
• Schools should encourage regular exercises and sports for children.
• How can sports and other physical activities protect children from becoming obese?
• Can childhood abuse be a cause of obesity among children?
• What is the relationship between neglect in childhood and obesity in adulthood?
• Does obesity have any effect on the psychological condition and well-being of a child?
• Are electronic medical records effective in diagnosing obesity among children?
• Obesity can affect the academic performance of your child.
• Do you believe that children who are raised by a single parent can be vulnerable to obesity?
• You can promote interesting exercises to encourage children.
• What is the main cause of obesity, and why is it increasing with every passing day?
• Schools and colleges should work harder to develop methodologies to decrease childhood obesity.
• The government should not allow schools and colleges to include sweet or fatty snacks as a part of their lunch.
• If a mother is obese, can it affect the health of the child?
• Children who gain weight frequently can develop chronic diseases.

Obesity Argumentative Essay Topics

Do you want to write an argumentative essay on the topic of obesity?

The following list can help you with that!

Here are some examples you can choose from for your argumentative essay about obesity:

• Can vegetables and fruits decrease the chances of obesity?
• Should you go for surgery to overcome obesity?
• Are there any harmful side effects?
• Can obesity be related to the mental condition of an individual?
• Are parents responsible for controlling obesity in childhood?
• What are the most effective measures to prevent the increase in the obesity rate?
• Why is the obesity rate increasing in the United States?
• Can the lifestyle of a person be a cause of obesity?
• Does the economic situation of a country affect the obesity rate?
• How is obesity considered an international health issue?
• Can technology and gadgets affect obesity rates?
• What can be the possible reasons for obesity in a school?
• How can we address the issue of obesity?
• Is obesity a chronic disease?
• Is obesity a major cause of heart attacks?
• Are the junk food chains causing an increase in obesity?
• Do nutritional programs help in reducing the obesity rate?
• How can the right type of diet help with obesity?
• Why should we encourage sports activities in schools and colleges?
• Can obesity affect a person’s behavior?

Health Related Topics for Research Paper

If you are writing a research paper, you can explain the cause and effect of obesity.

Here are a few topics that link to the cause and effects of obesity.Review the literature of previous articles related to obesity. Describe the ideas presented in the previous papers.

• Can family history cause obesity in future generations?
• Can we predict obesity through genetic testing?
• What is the cause of the increasing obesity rate?
• Do you think the increase in fast-food restaurants is a cause of the rising obesity rate?
• Is the ratio of obese women greater than obese men?
• Why are women more prone to be obese as compared to men?
• Stress can be a cause of obesity. Mention the reasons how mental health can be related to physical health.
• Is urban life a cause of the increasing obesity rate?
• People from cities are prone to be obese as compared to people from the countryside.
• How obesity affects the life expectancy of people? What are possible solutions to decrease the obesity rate?
• Do family eating habits affect or trigger obesity?
• How do eating habits affect the health of an individual?
• How can obesity affect the future of a child?
• Obese children are more prone to get bullied in high school and college.
• Why should schools encourage more sports and exercise for children?

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Topics for Essay on Obesity as a Problem

Do you think a rise in obesity rate can affect the economy of a country?

Here are some topics for your assistance regarding your economics related obesity essay.

• Does socioeconomic status affect the possibility of obesity in an individual?
• Analyze the film and write a review on “Fed Up” – an obesity epidemic.
• Share your reviews on the movie “The Weight of The Nation.”
• Should we increase the prices of fast food and decrease the prices of fruits and vegetables to decrease obesity?
• Do you think healthy food prices can be a cause of obesity?
• Describe what measures other countries have taken in order to control obesity?
• The government should play an important role in controlling obesity. What precautions should they take?
• Do you think obesity can be one of the reasons children get bullied?
• Do obese people experience any sort of discrimination or inappropriate behavior due to their weight?
• Are there any legal protections for people who suffer from discrimination due to their weight?
• Which communities have a higher percentage of obesity in the United States?
• Discuss the side effects of the fast-food industry and their advertisements on children.
• Describe how the increasing obesity rate has affected the economic condition of the United States.
• What is the current percentage of obesity all over the world? Is the obesity rate increasing with every passing day?
• Why is the obesity rate higher in the United States as compared to other countries?
• Do Asians have a greater percentage of obese people as compared to Europe?
• Does the cultural difference affect the eating habits of an individual?
• Obesity and body shaming.
• Why is a skinny body considered to be ideal? Is it an effective way to reduce the obesity rate?

Obesity Solution Essay Topics

With all the developments in medicine and technology, we still don’t have exact measures to treat obesity.

Here are some insights you can discuss in your essay:

• How do obese people suffer from metabolic complications?
• Describe the fat distribution in obese people.
• Is type 2 diabetes related to obesity?
• Are obese people more prone to suffer from diabetes in the future?
• How are cardiac diseases related to obesity?
• Can obesity affect a woman’s childbearing time phase?
• Describe the digestive diseases related to obesity.
• Obesity may be genetic.
• Obesity can cause a higher risk of suffering a heart attack.
• What are the causes of obesity? What health problems can be caused if an individual suffers from obesity?
• What are the side effects of surgery to overcome obesity?
• Which drugs are effective when it comes to the treatment of obesity?
• Is there a difference between being obese and overweight?
• Can obesity affect the sociological perspective of an individual?
• Explain how an obesity treatment works.
• How can the government help people to lose weight and improve public health?

Writing an essay is a challenging yet rewarding task. All you need is to be organized and clear when it comes to academic writing.

• Choose a topic you would like to write on.
• Organize your thoughts.
• Pen down your ideas.
• Compose a perfect essay that will help you ace your subject.
• Proofread and revise your paper.

Were the topics useful for you? We hope so!

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Marketing, Thesis

As a Digital Content Strategist, Nova Allison has eight years of experience in writing both technical and scientific content. With a focus on developing online content plans that engage audiences, Nova strives to write pieces that are not only informative but captivating as well.

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Prevention, prevention, prevention.

Losing weight is hard to do.

In the U.S., only one in six adults who have dropped excess pounds actually keep off at least 10 percent of their original body weight. The reason: a mismatch between biology and environment. Our bodies are evolutionarily programmed to put on fat to ride out famine and preserve the excess by slowing metabolism and, more important, provoking hunger. People who have slimmed down and then regain their weight don’t lack willpower—their bodies are fighting them every inch of the way.

This inborn predisposition to hold on to added weight reverberates down the life course. Few children are born obese, but once they become heavy, they are usually destined to be heavy adolescents and heavy adults. According to a 2016 study in the New England Journal of Medicine , approximately 90 percent of children with severe obesity will become obese adults with a BMI of 35 or higher. Heavy young adults are generally heavy in middle and old age. Obesity also jumps across generations; having a mother who is obese is one of the strongest predictors of obesity in children.

All of which means that preventing child obesity is key to stopping the epidemic. By the time weight piles up in adulthood, it is usually too late. Luckily, preventing obesity in children is easier than in adults, partly because the excess calories they absorb are minimal and can be adjusted by small changes in diet—substituting water, for example, for sugary fruit juices or soda.

Still, the bulk of the obesity problem—literally—is in adults. According to Frank Hu, chair of the Harvard Chan Department of Nutrition, “Most people gain weight during young and middle adulthood. The weight-gain trajectory is less than 1 pound per year, but it creeps up steadily from age 18 to age 55. During this time, people gain fat mass, not muscle mass. When they reach age 55 or so, they begin to lose their existing muscle mass and gain even more fat mass. That’s when all the metabolic problems appear: insulin resistance, high cholesterol, high blood pressure.”

Adds Walter Willett, Frederick John Stare Professor of Epidemiology and Nutrition at Harvard Chan, “The first 5 pounds of weight gain at age 25—that’s the time to be taking action. Because someone is on a trajectory to end up being 30 pounds overweight by the time they’re age 50.”

The most realistic near-term public health goal, therefore, is not to reverse but rather to slow down the trend—and even this will require strong commitment from government at many levels. In May 2017, the Trump administration rolled back recently-enacted standards for school meals, delaying a rule to lower sodium and allowing waivers for regulations requiring cafeterias to serve foods rich in whole grains. If recent expansions in food entitlements and school meals are undermined, “It would be a ‘disaster,’ to use the president’s word,” says Marlene Schwartz, director of the Rudd Center for Obesity & Food Policy at the University of Connecticut. “The federal food programs are incredibly important, not just because of the food and money they provide families, but because supporting better nutrition in child care, schools, and the WIC [Women, Infants, and Children] program has created new social norms. We absolutely cannot undo the progress that we’ve made in helping this generation transition to a healthier diet.”

Get the science right.

It is impossible to prescribe solutions to obesity without reminding ourselves that nutrition scientists botched things decades ago and probably sent the epidemic into overdrive. Beginning in the 1970s, the U.S. government and major professional groups recommended for the first time that people eat a low-fat/high-carbohydrate diet. The advice was codified in 1977 with the first edition of The Dietary Goals for the United States , which aimed to cut diet-related conditions such as heart disease and diabetes. What ensued amounted to arguably the biggest public health experiment in U.S. history, and it backfired.

At the time, saturated fat and dietary cholesterol were believed to be the main factors responsible for cardiovascular disease—an oversimplified theory that ignored the fact that not all fats are created equal. Soon, the public health blitz against saturated fat became a war on all fat. In the American diet, fat calories plummeted and carb calories shot up.

“We can’t blame industry for this. It was a bandwagon effect in the scientific community, despite the lack of evidence—even with evidence to the contrary,” says Willett. “Farmers have known for thousands of years that if you put animals in a pen, don’t let them run around, and load them up with grains, they get fat. That’s basically what has been happening to people: We created the great American feedlot. And we added in sugar, coloring, and seductive promotion for low-fat junk food.”

Scientists now know that whole fruits and vegetables (other than potatoes), whole grains, high-quality proteins (such as from fish, chicken, beans, and nuts), and healthy plant oils (such as olive, peanut, or canola oil) are the foundations of a healthy diet.

But there is also a lot scientists don’t yet know. One unanswered question is why some people with obesity are spared the medical complications of excess weight. Another concerns the major mechanisms by which obesity ushers in disease. Although surplus body weight can itself directly cause problems—such as arthritis due to added load on joints, or breast cancer caused by hormones secreted by fat cells—in general, obesity triggers myriad biological processes. Many of the resulting conditions—such as atherosclerosis, diabetes, and even Alzheimer’s disease—are mediated by inflammation, in which the body’s immune response becomes damagingly self-perpetuating. In this sense, today’s food system is as inflammagenic as it is obesigenic.

Scientists also need to ferret out the nuanced effects of particular foods. For example, do fermented products—such as yogurt, tempeh, or sauerkraut—have beneficial properties? Some studies have found that yogurt protects against weight gain and diabetes, and suggest that healthy live bacteria (known as probiotics) may play a role. Other reports point to fruits being more protective than vegetables in weight control and diabetes prevention, although the types of fruits and vegetables make a difference.

A 2017 article in the American Journal of Clinical Nutrition showed that substituting whole grains for refined grains led to a loss of nearly 100 calories a day—by speeding up metabolism, cutting the number of calories that the body hangs on to, and, more surprisingly, by changing the digestibility of other foods on the plate. That extra energy lost daily—by substituting, say, brown rice for white rice or barley for pita bread—was equivalent to a brisk 30-minute walk. One hundred calories a day, sustained over years, and multiplied by the population is one mathematical equivalent of the obesity epidemic.

A companion study found that adults who ate a whole-grain-rich diet developed healthier gut bacteria and improved immune responses. That particular foods alter the gut microbiome—the dense and vital community of bacteria and other microorganisms that work symbiotically with the body’s own digestive system—is another critical insight. The microbiome helps determine weight by controlling how our bodies extract calories and store fat in the liver, and the microbiomes of obese individuals are startlingly efficient at harvesting calories from food. [To learn more about Harvard Chan research on the gut microbiome, read “ Bugs in the System .”] The hormonal effects of sleep deprivation and stress—two epidemics concurrent and intertwined with the obesity trend—are other promising avenues of research.

And then there are the mystery factors. One recent hypothesis is that an agent known as adenovirus 36 partly accounts for our collective heft. A 2010 article in The Royal Society described a study in which researchers examined samples of more than 20,000 animals from eight species living with or around humans in industrialized nations, a menagerie that included macaques, chimpanzees, vervets, marmosets, lab mice and rats, feral rats, and domestic dogs and cats. Like their Homo sapiens counterparts, all of the study populations had gained weight over the past several decades—wild, domestic, and lab animals alike. The chance that this is a coincidence is, according to the scientists’ estimate, 1 in 10 million. The stumped authors surmise that viruses, gene expression changes, or “as-of-yet unidentified and/or poorly understood factors” are to blame.

Master the art of persuasion.

A 2015 paper in the American Journal of Public Health revealed the philosophical chasm that hampers America’s progress on obesity prevention. It found that 72 to 98 percent of obesity-related media reports emphasize personal responsibility for weight, compared with 40 percent of scientific papers.

A recent study by Drexel University researchers also quantified the political polarization around public health measures. From 1998 through 2013, Democrats voted in line with recommendations from the American Public Health Association 88.3 percent of the time, on average, while Republicans voted for the proposals just 21.3 percent of the time.

Clearly, we can’t count on bipartisan goodwill to stem the obesity crisis. But we can ask what kinds of messages appeal to politically divergent audiences. A stealth strategy may be to avoid even uttering the word “obesity.” On January 1 of this year, Philadelphia’s 1.5-cents-per-ounce excise tax on sugar-sweetened and diet beverages took effect. When Philadelphia Mayor Jim Kenney lobbied voters to approve the tax, his bid centered not on improving health—the unsuccessful pitch of his predecessor—but on raising $91 million annually for prekindergarten programs.

“That’s something lots of people care about and can get behind—it’s a feel-good policy, and it makes sense,” says psychologist Christina Roberto, assistant professor of medical ethics and health policy at the University of Pennsylvania, and a former assistant professor of social and behavioral sciences and nutrition at Harvard Chan. The provision for taxing diet beverages was also shrewd, she adds, because it spread the tax’s pain; since wealthier people are more likely than less-affluent individuals to buy diet drinks, the tax could not be slapped with the label “regressive.”

But Roberto sees a larger lesson in the Philadelphia story. Public health messaging that appeals to values that transcend the individual is less fraught, less stigmatizing, and perhaps more effective. As she puts it, “It’s very different to hear the message, ‘Eat less red meat, help the planet’ versus ‘Eat less red meat, help yourself avoid saturated fat and cardiovascular disease.’”

Supermarket makeovers

Supermarket aisles are other places where public health can shuffle a deck stacked against healthy consumer choices.

With slim profit margins and 50,000-plus products on their shelves, grocery stores depend heavily on food manufacturers’ promotional incentives to make their bottom lines. “Manufacturers pay slotting fees to get their products on the shelf, and they pay promotion allowances: We’ll give you this much off a carton of Coke if you put it on sale for a certain price or if you put it on an end-of-aisle display,” says José Alvarez, former president and chief executive officer of Stop & Shop/Giant-Landover, now senior lecturer of business administration at Harvard Business School. Such promotional payments, Alvarez adds, often exceed retailers’ net profits.

Healthy new products—like flash-frozen dinners prepared with heaps of vegetables and whole grains, and relatively little salt—can’t compete for prized shelf space against boxed mac and cheese or cloying breakfast cereals. One solution, says Alvarez, is for established consumer packaged goods companies to buy out what he calls the “hippie in the basement” firms that have whipped up more nutritious items. The behemoths could apply their production, marketing, and distribution prowess to the new offerings—and indeed, this has started to happen over the last five years.

Another approach is to make nutritious foods more convenient to eat. “We have all of these cooking shows and upscale food magazines, but most people don’t have the time or inclination—or the skills, quite frankly—to cook,” says Alvarez. “Instead, we should focus on creating high-quality, healthy, affordable prepared foods.”

An additional model is suggested by Jeff Dunn, a 20-year veteran of the soft drink industry and former president of Coca-Cola North America, who went on to become an advocate for fresh, healthy food. Dunn served as president and chief executive officer of Bolthouse Farms from 2008 to 2015, where he dramatically increased sales of baby carrots by using marketing techniques common in the junk food business. “We operated on the principles of the three 3 A’s: accessibility, availability, and affordability,” says Dunn. “That, by the way, is Coke’s more-than-70-year-old formula for success.”

Show them the money.

Obesity kills budgets. According to the Campaign to End Obesity, a collaboration of leaders from industry, academia, public health, and policymakers, annual U.S. health costs related to obesity approach $200 billion. In 2010, the nonpartisan Congressional Budget Office reported that nearly 20 percent of the rise in health care spending from 1987 to 2007 was linked to obesity. And the U.S. Centers for Disease Control and Prevention (CDC) found that full-time workers in the U.S. who are overweight or obese and have other chronic health conditions miss an estimated 450 million more days of work each year than do healthy employees—upward of $153 billion in lost productivity annually.

But making the money case for obesity prevention isn’t straightforward. For interventions targeting children and youth, only a small fraction of savings is captured in the first decade, since most serious health complications don’t emerge for many years. Long-term obesity prevention, in other words, doesn’t fit into political timetables for elected officials.

Yet lawmakers are keen to know how “best for the money” obesity-prevention programs can help them in the short run. Over the past two years, Harvard Chan’s Steve Gortmaker and his colleagues have been working with state health departments in Alaska, Mississippi, New Hampshire, Oklahoma, Washington, and West Virginia and with the city of Philadelphia and other locales, building cost-effectiveness models using local data for a wide variety of interventions—from improved early child care to healthy school environments to communitywide campaigns. “We collaborate with health departments and community stakeholders, provide them with the evidence base, help assess how much different options cost, model the results over a decade, and they pick what they want to work on. One constant that we’ve seen—and these are very different political environments—is a strong interest in cost-effectiveness,” he says.

In a 2015 study in Health Affairs , Gortmaker and colleagues outlined three interventions that would more than pay for themselves: an excise tax on sugar-sweetened beverages implemented at the state level; elimination of the tax subsidy for advertising unhealthy food to children; and strong nutrition standards for food and drinks sold in schools outside of school meals. Implemented nationally, these interventions would prevent 576,000, 129,100, and 345,000 cases of childhood obesity, respectively, by 2025. The projected net savings to society in obesity-related health care costs for each dollar invested: $31, $33, and $4.60, respectively.

Gortmaker is one of the leaders of a collaborative modeling effort known as CHOICES—for Childhood Obesity Intervention Cost-Effectiveness Study—an acronym that seems a pointed rebuttal to the reflexive conservative argument that government regulation tramples individual choice. Having grown up not far from Des Plaines, Illinois, site of the first McDonald’s franchise in the country, he emphasizes to policymakers that at this late date, America cannot treat its way out of obesity, given current medical know-how. Only a thoroughgoing investment in prevention will turn the tide. “Clinical interventions produce too small an effect, with too small a population, and at high cost,” Gortmaker says. “The good news is that there are many cost-effective options to choose from.”

While Gortmaker underscores the importance of improving both food choices and options for physical activity, he has shown that upgrading the food environment offers much more benefit for the buck. This is in line with the gathering scientific consensus that what we eat plays a greater role in obesity than does sedentary lifestyle (although exercise protects against many of the metabolic consequences of excess weight). “The easiest way to explain it,” Gortmaker says, “is to talk about a sugary beverage—140 calories. You could quickly change a kid’s risk of excess energy balance by 140 calories a day just by switching from a sugary drink a day to water or sparkling water. But for a 10-year-old boy to burn an extra 140 calories, he’d have to replace an hour-and-a-half of sitting with an hour-and-a-half of walking.”

Small tweaks in adults’ diets can likewise make a big difference in short order. “With adults, health care costs rise rapidly with excess weight gain,” Gortmaker says. “If you can slow the onset of obesity, you slow the onset of diabetes, and potentially not only save health care costs but also boost people’s productivity in the workforce.”

One of Gortmaker’s most intriguing calculations spins off of the food industry’s estimated $633 million spent on television marketing aimed at kids. Currently, federal tax treatment of advertising as an ordinary business expense means that the government, in effect, subsidizes hawking of junk food to children. Gortmaker modeled a national intervention that would eliminate this subsidy of TV ads for nutritionally empty foods and beverages aimed at 2- to 19-year-olds. Drawing on well-delineated relationships between exposure to these advertisements and subsequent weight gain, he found that the intervention would save $260 million in downstream health care costs. Although the effect would probably be small at the individual level, it would be significant at the population level.

Level the playing field through taxes and regulation.

When public health took on cigarette smoking, starting in the 1960s, it did so with robust policies banning television ads and other marketing, raising taxes to increase prices, making public places smoke-free, and offering people treatment such as the nicotine patch. In 1965, the smoking rate for U.S. adults was 42.2 percent; today, it is 16.8 percent.

Similarly, America reduced the rate of deaths caused by motor vehicle accidents—a 90 percent decrease over the 20th century, according to the CDC—with mandatory seat belt laws, safer car designs, stop signs, speed limits, rumble strips, and the stigmatization of drunk driving.

Change the product. Change the environment. Change the culture. That is also the policy recipe for stopping obesity.

Laws that make healthy behaviors easier are often followed by positive changes in those behaviors. And people who are trying to adopt healthy behaviors tend to support policies that make their personal aspirations achievable, which in turn nudges lawmakers to back the proposals.

One debate today revolves around whether recipients of federal Supplemental Nutrition Assistance Program (SNAP) benefits (formerly known as food stamps) should be restricted from buying sodas or junk food. The largest component of the USDA budget, SNAP feeds one in seven Americans. A USDA report, issued last November, found that the number-one purchase by SNAP households was sweetened beverages, a category that included soft drinks, fruit juices, energy drinks, and sweetened teas, accounting for nearly 10 percent of SNAP money spent on food. Is the USDA therefore underwriting the soda industry and planting the seeds for chronic disease that the government will pay to treat years down the line?

Eric Rimm, a professor in the Departments of Epidemiology and Nutrition at the Harvard Chan School, frames the issue differently. In a 2017 study in the American Journal of Preventive Medicine , he and his colleagues asked SNAP participants whether they would prefer the standard benefits package or a “SNAP-plus” that prohibited the purchase of sugary beverages but offered 50 percent more money for buying fruits and vegetables. Sixty-eight percent of the participants chose the healthy SNAP-plus option.

“A lot of work around SNAP policy is done by academics and politicians, without reaching out to the beneficiaries,” says Rimm. “We haven’t asked participants, ‘What’s your say in this? How can we make this program better for you?’” To be sure, SNAP is riddled with nutritional contradictions. Under current rules, for example, participants can use benefits to buy a 12-pack of Pepsi or a Snickers bar or a giant bag of Lay’s potato chips but not real food that happens to be heated, such as a package of rotisserie chicken. “This is the most vulnerable population in the country,” says Rimm. “We’re not listening well enough to our constituency.”

Other innovative fiscal levers to alter behavior could also drive down obesity. In 2014, a trio of strong voices on food industry practices—Dariush Mozaffarian, DrPH ’06, dean of Tufts University’s Friedman School of Nutrition Science and Policy and former associate professor of epidemiology at the Harvard Chan School; Kenneth Rogoff, professor of economics at Harvard; and David Ludwig, professor in the Department of Nutrition at Harvard Chan and a physician at Boston Children’s Hospital—broached the idea of a “meaningful” tax on nearly all packaged retail foods and many chain restaurants, with the proceeds used to pay for minimally processed foods and healthier meals for school kids. In essence, the tax externalizes the social costs of harmful individual behavior.

“We made a straightforward proposal to tax all processed foods and then use the income to subsidize whole foods in a short-term, revenue-neutral way,” explains Ludwig. “The power of this idea is that, since there is so much processed food consumption, even a modest tax—in the 10 to 15 percent range—is not going to greatly inflate the cost of these foods. Their price would increase moderately, but the proceeds would not disappear into government coffers. Instead, the revenue would make healthy foods affordable for virtually the entire population, and the benefits would be immediately evident. Yes, people will pay moderately more for their Coke or for their cinnamon bear claw but a lot less for nourishing, whole foods.”

Another suggestion comes from Sandro Galea, dean of the Boston University School of Public Health, and Abdulrahman M. El-Sayed, a public health physician and epidemiologist. In a 2015 issue of the American Journal of Public Health , they called for “calorie offsets,” similar to the carbon offsets used to mitigate environmental harm caused by the gas and oil industries. A “calorie offset” scheme could hand the food and beverage industries a chance at redemption by inviting them to invest in such undertakings as city farms, cooking classes for parents, healthy school cafeterias, and urban green spaces.

These ambitious proposals face almost impossibly high hurdles. Political battle lines typically pit public health against corporations, with Big Food casting doubt on solid nutrition science, deeming government regulation a threat to free choice, and making self-policing pledges that it has never kept. On the website for the Americans for Food and Beverage Choice, a group spearheaded by the American Beverage Association, is the admonition: “[W]hether it’s at a restaurant or in a grocery store, it’s never the government’s job to decide what you choose to eat and drink.”

Yet surprisingly, many public health professionals are convinced that the only way to stop obesity is to make common cause with the food industry. “This isn’t like tobacco, where it’s a fight to the death. We need the food industry to make healthier food and to make a profit,” says Mozaffarian. “The food industry is much more diverse and heterogeneous than tobacco or even cars. As long as we can help them—through carrots and sticks, tax incentives and disincentives—to move towards healthier products, then they are part of the solution. But we have to be vigilant, because they use a lot of the same tactics that tobacco did.”

Sow what we want to reap.

Americans overeat what our farmers overproduce.

“The U.S. food system is egregiously terrible for human and planetary health,” says Walter Willett. It’s so terrible, Willett made a pie chart of American grain production consumed domestically. It shows that most of the country’s agricultural land goes to the two giant commodity crops: corn and soy. Most of those crops, in turn, go to animal fodder and ethanol, and are also heavily used in processed snack foods. Today, only about 10 percent of grain grown in the U.S. for domestic use is eaten directly by human beings. According to a 2013 report from the Union of Concerned Scientists, only 2 percent of U.S. farmland is used to grow fruits and vegetables, while 59 percent is devoted to commodity crops.

Historically, those skewed proportions made sense. Federal food policies, drafted with the goal of alleviating hunger, preferentially subsidize corn and soy production. And whereas corn or soybeans could be shipped for days on a train, fruits and vegetables had to be grown closer to cities by truck farmers so the produce wouldn’t spoil. But those long-ago constraints don’t explain today’s upside-down agricultural priorities.

In a now-classic 2016 Politico article titled “The farm bill drove me insane,” Marion Nestle illustrated the irrational gap between what the government recommends we eat and what it subsidizes: “If you were to create a MyPlate meal that matched where the government historically aimed its subsidies, you’d get a lecture from your doctor. More than three-quarters of your plate would be taken up by a massive corn fritter (80 percent of benefits go to corn, grains and soy oil). You’d have a Dixie cup of milk (dairy gets 3 percent), a hamburger the size of a half dollar (livestock: 2 percent), two peas (fruits and vegetables: 0.45 percent) and an after-dinner cigarette (tobacco: 2 percent). Oh, and a really big linen napkin (cotton: 13 percent) to dab your lips.”

In this sense, the USDA marginalizes human health. Many of the foods that nutritionists agree are best for us—notably, fruits, vegetables, and tree nuts—fall under the bureaucratic rubric “specialty crops,” a category that also includes “dried fruits, horticulture, and nursery crops (including floriculture).” Farm bills, which get passed every five years or so, fortify the status quo. The 2014 Farm Bill, for example, provided $73 million for the Specialty Crop Block Grant Program in 2017, out of a total of about $25 billion for the USDA’s discretionary budget. (The next Farm Bill, now under debate, will be coming out in 2018.)

By contrast, a truly anti-obesigenic agricultural system would stimulate USDA support for crop diversity—through technical assistance, research, agricultural training programs, and financial aid for farmers who are newly planting or transitioning their land into produce. It would also enable farmers, most of whom survive on razor-thin profit margins, to make a decent living.

In the early 1970s, Finland’s death rate from coronary heart disease was the highest in the world, and in the eastern region of North Karelia—a pristine, sparsely populated frontier landscape of forest and lakes—the rate was 40 percent worse than the national average. Every family saw physically active men, loggers and farmers who were strong and lean, dying in their prime.

Thus was born the North Karelia Project, which became a model worldwide for saving lives by transforming lifestyles. The project was launched in 1972 and officially ended 25 years later. While its initial goal was to reduce smoking and saturated fat in the diet, it later resolved to increase fruit and vegetable consumption.

The North Karelia Project fulfilled all of these ambitions. When it started, for example, 86 percent of men and 82 percent of women smeared butter on their bread; by the early 2000s, only 10 percent of men and 4 percent of women so indulged. Use of vegetable oil for cooking jumped from virtually zero in 1970 to 50 percent in 2009. Fruit and vegetables, once rare visitors to the dinner plate, became regulars. Over the project’s official quarter-century existence, coronary heart disease deaths in working-age North Karelian men fell 82 percent, and life expectancy rose seven years.

The secret of North Karelia’s success was an all-out philosophy. Team members spent innumerable hours meeting with residents and assuring them that they had the power to improve their own health. The volunteers enlisted the assistance of an influential women’s group, farmers’ unions, homemakers’ organizations, hunting clubs, and church congregations. They redesigned food labels and upgraded health services. Towns competed in cholesterol-cutting contests. The national government passed sweeping legislation (including a total ban on tobacco advertising). Dairy subsidies were thrown out. Farmers were given strong incentives to produce low-fat milk, or to get paid for meat and dairy products based not on high-fat but on high-protein content. And the newly established East Finland Berry and Vegetable Project helped locals switch from dairy farming—which had made up more than two-thirds of agriculture in the region—to cultivation of cold-hardy currants, gooseberries, and strawberries, as well as rapeseed for heart-healthy canola oil.

“A mass epidemic calls for mass action,” says the project’s director, Pekka Puska, “and the changing of lifestyles can only succeed through community action. In this case, the people pulled the government—the government didn’t pull the people.”

Could the United States in 2017 learn from North Karelia’s 1970s grand experiment?

“Americans didn’t become an obese nation overnight. It took a long time—several decades, the same timeline as in individuals,” notes Frank Hu. “What were we doing over the past 20 years or 30 years, before we crossed this threshold? We haven’t asked these questions. We haven’t done this kind of soul-searching, as individuals or society as a whole.”

Today, Americans may finally be willing to take a hard look at how food figures in their lives. In a July 2015 Gallup phone poll of Americans 18 and older, 61 percent said they actively try to avoid regular soda (the figure was 41 percent in 2002); 50 percent try to avoid sugar; and 93 percent try to eat vegetables (but only 57.7 percent in 2013 reported they ate five or more servings of fruits and vegetables at least four days of the previous week).

Individual resolve, of course, counts for little in problems as big as the obesity epidemic. Most successes in public health bank on collective action to support personal responsibility while fighting discrimination against an epidemic’s victims. [To learn more about the perils of stigma against people with obesity, read “ The Scarlet F .”]

Yet many of public health’s legendary successes also took what seems like an agonizingly long time to work. Do we have that luxury?

“Right now, healthy eating in America is like swimming upstream. If you are a strong swimmer and in good shape, you can swim for a little while, but eventually you’re going to get tired and start floating back down,” says Margo Wootan, SD ’93, director of nutrition policy for the Center for Science in the Public Interest. “If you’re distracted for a second—your kid tugs on your pant leg, you had a bad day, you’re tired, you’re worried about paying your bills—the default options push you toward eating too much of the wrong kinds of food.”

But Wootan has not lowered her sights. “What we need is mobilization,” she says. “Mobilize the public to address nutrition and obesity as societal problems—recognizing that each of us makes individual choices throughout the day, but that right now the environment is stacked against us. If we don’t change that, stopping obesity will be impossible.”

The passing of power to younger generations may aid the cause. Millennials are more inclined to view food not merely as nutrition but also as narrative—a trend that leaves Duke University’s Kelly Brownell optimistic. “Younger people have been raised to care about the story of their food. Their interest is in where it came from, who grew it, whether it contributes to sustainable agriculture, its carbon footprint, and other factors. The previous generation paid attention to narrower issues, such as hunger or obesity. The Millennials are attuned to the concept of food systems.”

We are at a public health inflection point. Forty years from now, when we gaze at the high-resolution digital color photos from our own era, what will we think? Will we realize that we failed to address the obesity epidemic, or will we know that we acted wisely?

The question brings us back to the 1970s, and to Pekka Puska, the physician who directed the North Karelia Project during its quarter-century existence. Puska, now 71, was all of 27 and burning with big ideas when he signed up to lead the audacious effort. He knows the promise and the perils of idealism. “Changing the world may have been utopic,” he says, “but changing public health was possible.”

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Essay on Obesity

List of essays on obesity, essay on obesity – short essay (essay 1 – 150 words), essay on obesity (essay 2 – 250 words), essay on obesity – written in english (essay 3 – 300 words), essay on obesity – for school students (class 5, 6, 7, 8, 9, 10, 11 and 12 standard) (essay 4 – 400 words), essay on obesity – for college students (essay 5 – 500 words), essay on obesity – with causes and treatment (essay 6 – 600 words), essay on obesity – for science students (essay 7 – 750 words), essay on obesity – long essay for medical students (essay 8 – 1000 words).

Obesity is a chronic health condition in which the body fat reaches abnormal level. Obesity occurs when we consume much more amount of food than our body really needs on a daily basis. In other words, when the intake of calories is greater than the calories we burn out, it gives rise to obesity.

Audience: The below given essays are exclusively written for school students (Class 5, 6, 7, 8, 9, 10, 11 and 12 Standard), college, science and medical students.

Introduction:

Obesity means being excessively fat. A person would be said to be obese if his or her body mass index is beyond 30. Such a person has a body fat rate that is disproportionate to his body mass.

Obesity and the Body Mass Index:

The body mass index is calculated considering the weight and height of a person. Thus, it is a scientific way of determining the appropriate weight of any person. When the body mass index of a person indicates that he or she is obese, it exposes the person to make health risk.

Stopping Obesity:

There are two major ways to get the body mass index of a person to a moderate rate. The first is to maintain a strict diet. The second is to engage in regular physical exercise. These two approaches are aimed at reducing the amount of fat in the body.

Conclusion:

Obesity can lead to sudden death, heart attack, diabetes and may unwanted illnesses. Stop it by making healthy choices.

Obesity has become a big concern for the youth of today’s generation. Obesity is defined as a medical condition in which an individual gains excessive body fat. When the Body Mass Index (BMI) of a person is over 30, he/ she is termed as obese.

Obesity can be a genetic problem or a disorder that is caused due to unhealthy lifestyle habits of a person. Physical inactivity and the environment in which an individual lives, are also the factors that leads to obesity. It is also seen that when some individuals are in stress or depression, they start cultivating unhealthy eating habits which eventually leads to obesity. Medications like steroids is yet another reason for obesity.

Obesity has several serious health issues associated with it. Some of the impacts of obesity are diabetes, increase of cholesterol level, high blood pressure, etc. Social impacts of obesity includes loss of confidence in an individual, lowering of self-esteem, etc.

The risks of obesity needs to be prevented. This can be done by adopting healthy eating habits, doing some physical exercise regularly, avoiding stress, etc. Individuals should work on weight reduction in order to avoid obesity.

Obesity is indeed a health concern and needs to be prioritized. The management of obesity revolves around healthy eating habits and physical activity. Obesity, if not controlled in its initial stage can cause many severe health issues. So it is wiser to exercise daily and maintain a healthy lifestyle rather than being the victim of obesity.

Obesity can be defined as the clinical condition where accumulation of excessive fat takes place in the adipose tissue leading to worsening of health condition. Usually, the fat is deposited around the trunk and also the waist of the body or even around the periphery.

Obesity is actually a disease that has been spreading far and wide. It is preventable and certain measures are to be taken to curb it to a greater extend. Both in the developing and developed countries, obesity has been growing far and wide affecting the young and the old equally.

The alarming increase in obesity has resulted in stimulated death rate and health issues among the people. There are several methods adopted to lose weight and they include different diet types, physical activity and certain changes in the current lifestyle. Many of the companies are into minting money with the concept of inviting people to fight obesity.

In patients associated with increased risk factor related to obesity, there are certain drug therapies and other procedures adopted to lose weight. There are certain cost effective ways introduced by several companies to enable clinic-based weight loss programs.

Obesity can lead to premature death and even cause Type 2 Diabetes Mellitus. Cardiovascular diseases have also become the part and parcel of obese people. It includes stroke, hypertension, gall bladder disease, coronary heart disease and even cancers like breast cancer, prostate cancer, endometrial cancer and colon cancer. Other less severe arising due to obesity includes osteoarthritis, gastro-esophageal reflux disease and even infertility.

Hence, serious measures are to be taken to fight against this dreadful phenomenon that is spreading its wings far and wide. Giving proper education on benefits of staying fit and mindful eating is as important as curbing this issue. Utmost importance must be given to healthy eating habits right from the small age so that they follow the same until the end of their life.

Obesity is majorly a lifestyle disease attributed to the extra accumulation of fat in the body leading to negative health effects on a person. Ironically, although prevalent at a large scale in many countries, including India, it is one of the most neglect health problems. It is more often ignored even if told by the doctor that the person is obese. Only when people start acquiring other health issues such as heart disease, blood pressure or diabetes, they start taking the problem of obesity seriously.

Obesity Statistics in India:

As per a report, India happens to figure as the third country in the world with the most obese people. This should be a troubling fact for India. However, we are yet to see concrete measures being adopted by the people to remain fit.

Causes of Obesity:

Sedentary lifestyle, alcohol, junk food, medications and some diseases such as hypothyroidism are considered as the factors which lead to obesity. Even children seem to be glued to televisions, laptops and video games which have taken away the urge for physical activities from them. Adding to this, the consumption of junk food has further aggravated the growing problem of obesity in children.

In the case of adults, most of the professions of today make use of computers which again makes people sit for long hours in one place. Also, the hectic lifestyle of today makes it difficult for people to spare time for physical activities and people usually remain stressed most of the times. All this has contributed significantly to the rise of obesity in India.

Obesity and BMI:

Body Mass Index (BMI) is the measure which allows a person to calculate how to fit he or she is. In other words, the BMI tells you if you are obese or not. BMI is calculated by dividing the weight of a person in kg with the square of his / her height in metres. The number thus obtained is called the BMI. A BMI of less than 25 is considered optimal. However, if a person has a BMI over 30 he/she is termed as obese.

What is a matter of concern is that with growing urbanisation there has been a rapid increase of obese people in India? It is of utmost importance to consider this health issue a serious threat to the future of our country as a healthy body is important for a healthy soul. We should all be mindful of what we eat and what effect it has on our body. It is our utmost duty to educate not just ourselves but others as well about this serious health hazard.

Obesity can be defined as a condition (medical) that is the accumulation of body fat to an extent that the excess fat begins to have a lot of negative effects on the health of the individual. Obesity is determined by examining the body mass index (BMI) of the person. The BMI is gotten by dividing the weight of the person in kilogram by the height of the person squared.

When the BMI of a person is more than 30, the person is classified as being obese, when the BMI falls between 25 and 30, the person is said to be overweight. In a few countries in East Asia, lower values for the BMI are used. Obesity has been proven to influence the likelihood and risk of many conditions and disease, most especially diabetes of type 2, cardiovascular diseases, sleeplessness that is obstructive, depression, osteoarthritis and some cancer types.

In most cases, obesity is caused through a combination of genetic susceptibility, a lack of or inadequate physical activity, excessive intake of food. Some cases of obesity are primarily caused by mental disorder, medications, endocrine disorders or genes. There is no medical data to support the fact that people suffering from obesity eat very little but gain a lot of weight because of slower metabolism. It has been discovered that an obese person usually expends much more energy than other people as a result of the required energy that is needed to maintain a body mass that is increased.

It is very possible to prevent obesity with a combination of personal choices and social changes. The major treatments are exercising and a change in diet. We can improve the quality of our diet by reducing our consumption of foods that are energy-dense like those that are high in sugars or fat and by trying to increase our dietary fibre intake.

We can also accompany the appropriate diet with the use of medications to help in reducing appetite and decreasing the absorption of fat. If medication, exercise and diet are not yielding any positive results, surgery or gastric balloon can also be carried out to decrease the volume of the stomach and also reduce the intestines’ length which leads to the feel of the person get full early or a reduction in the ability to get and absorb different nutrients from a food.

Obesity is the leading cause of ill-health and death all over the world that is preventable. The rate of obesity in children and adults has drastically increased. In 2015, a whopping 12 percent of adults which is about 600 million and about 100 million children all around the world were found to be obese.

It has also been discovered that women are more obese than men. A lot of government and private institutions and bodies have stated that obesity is top of the list of the most difficult and serious problems of public health that we have in the world today. In the world we live today, there is a lot of stigmatisation of obese people.

We all know how troubling the problem of obesity truly is. It is mainly a form of a medical condition wherein the body tends to accumulate excessive fat which in turn has negative repercussions on the health of an individual.

Given the current lifestyle and dietary style, it has become more common than ever. More and more people are being diagnosed with obesity. Such is its prevalence that it has been termed as an epidemic in the USA. Those who suffer from obesity are at a much higher risk of diabetes, heart diseases and even cancer.

In order to gain a deeper understanding of obesity, it is important to learn what the key causes of obesity are. In a layman term, if your calorie consumption exceeds what you burn because of daily activities and exercises, it is likely to lead to obesity. It is caused over a prolonged period of time when your calorie intake keeps exceeding the calories burned.

Here are some of the key causes which are known to be the driving factors for obesity.

If your diet tends to be rich in fat and contains massive calorie intake, you are all set to suffer from obesity.

Sedentary Lifestyle:

With most people sticking to their desk jobs and living a sedentary lifestyle, the body tends to get obese easily.

Of course, the genetic framework has a lot to do with obesity. If your parents are obese, the chance of you being obese is quite high.

The weight which women gain during their pregnancy can be very hard to shed and this is often one of the top causes of obesity.

Sleep Cycle:

If you are not getting an adequate amount of sleep, it can have an impact on the hormones which might trigger hunger signals. Overall, these linked events tend to make you obese.

Hormonal Disorder:

There are several hormonal changes which are known to be direct causes of obesity. The imbalance of the thyroid stimulating hormone, for instance, is one of the key factors when it comes to obesity.

Now that we know the key causes, let us look at the possible ways by which you can handle it.

Treatment for Obesity:

As strange as it may sound, the treatment for obesity is really simple. All you need to do is follow the right diet and back it with an adequate amount of exercise. If you can succeed in doing so, it will give you the perfect head-start into your journey of getting in shape and bidding goodbye to obesity.

There are a lot of different kinds and styles of diet plans for obesity which are available. You can choose the one which you deem fit. We recommend not opting for crash dieting as it is known to have several repercussions and can make your body terribly weak.

The key here is to stick to a balanced diet which can help you retain the essential nutrients, minerals, and, vitamins and shed the unwanted fat and carbs.

Just like the diet, there are several workout plans for obesity which are available. It is upon you to find out which of the workout plan seems to be apt for you. Choose cardio exercises and dance routines like Zumba to shed the unwanted body weight. Yoga is yet another method to get rid of obesity.

So, follow a blend of these and you will be able to deal with the trouble of obesity in no time. We believe that following these tips will help you get rid of obesity and stay in shape.

Obesity and overweight is a top health concern in the world due to the impact it has on the lives of individuals. Obesity is defined as a condition in which an individual has excessive body fat and is measured using the body mass index (BMI) such that, when an individual’s BMI is above 30, he or she is termed obese. The BMI is calculated using body weight and height and it is different for all individuals.

Obesity has been determined as a risk factor for many diseases. It results from dietary habits, genetics, and lifestyle habits including physical inactivity. Obesity can be prevented so that individuals do not end up having serious complications and health problems. Chronic illnesses like diabetes, heart diseases and relate to obesity in terms of causes and complications.

Factors Influencing Obesity:

Obesity is not only as a result of lifestyle habits as most people put it. There are other important factors that influence obesity. Genetics is one of those factors. A person could be born with genes that predispose them to obesity and they will also have difficulty in losing weight because it is an inborn factor.

The environment also influences obesity because the diet is similar in certain environs. In certain environments, like school, the food available is fast foods and the chances of getting healthy foods is very low, leading to obesity. Also, physical inactivity is an environmental factor for obesity because some places have no fields or tracks where people can jog or maybe the place is very unsafe and people rarely go out to exercise.

Mental health affects the eating habits of individuals. There is a habit of stress eating when a person is depressed and it could result in overweight or obesity if the person remains unhealthy for long period of time.

The overall health of individuals also matter. If a person is unwell and is prescribed with steroids, they may end up being obese. Steroidal medications enable weight gain as a side effect.

Complications of Obesity:

Obesity is a health concern because its complications are severe. Significant social and health problems are experienced by obese people. Socially, they will be bullied and their self-esteem will be low as they will perceive themselves as unworthy.

Chronic illnesses like diabetes results from obesity. Diabetes type 2 has been directly linked to obesity. This condition involves the increased blood sugars in the body and body cells are not responding to insulin as they should. The insulin in the body could also be inadequate due to decreased production. High blood sugar concentrations result in symptoms like frequent hunger, thirst and urination. The symptoms of complicated stages of diabetes type 2 include loss of vision, renal failure and heart failure and eventually death. The importance of having a normal BMI is the ability of the body to control blood sugars.

Another complication is the heightened blood pressures. Obesity has been defined as excessive body fat. The body fat accumulates in blood vessels making them narrow. Narrow blood vessels cause the blood pressures to rise. Increased blood pressure causes the heart to start failing in its physiological functions. Heart failure is the end result in this condition of increased blood pressures.

There is a significant increase in cholesterol in blood of people who are obese. High blood cholesterol levels causes the deposition of fats in various parts of the body and organs. Deposition of fats in the heart and blood vessels result in heart diseases. There are other conditions that result from hypercholesterolemia.

Other chronic illnesses like cancer can also arise from obesity because inflammation of body cells and tissues occurs in order to store fats in obese people. This could result in abnormal growths and alteration of cell morphology. The abnormal growths could be cancerous.

Management of Obesity:

For the people at risk of developing obesity, prevention methods can be implemented. Prevention included a healthy diet and physical activity. The diet and physical activity patterns should be regular and realizable to avoid strains that could result in complications.

Some risk factors for obesity are non-modifiable for example genetics. When a person in genetically predisposed, the lifestyle modifications may be have help.

For the individuals who are already obese, they can work on weight reduction through healthy diets and physical exercises.

In conclusion, obesity is indeed a major health concern because the health complications are very serious. Factors influencing obesity are both modifiable and non-modifiable. The management of obesity revolves around diet and physical activity and so it is important to remain fit.

In olden days, obesity used to affect only adults. However, in the present time, obesity has become a worldwide problem that hits the kids as well. Let’s find out the most prevalent causes of obesity.

Factors Causing Obesity:

Obesity can be due to genetic factors. If a person’s family has a history of obesity, chances are high that he/ she would also be affected by obesity, sooner or later in life.

The second reason is having a poor lifestyle. Now, there are a variety of factors that fall under the category of poor lifestyle. An excessive diet, i.e., eating more than you need is a definite way to attain the stage of obesity. Needless to say, the extra calories are changed into fat and cause obesity.

Junk foods, fried foods, refined foods with high fats and sugar are also responsible for causing obesity in both adults and kids. Lack of physical activity prevents the burning of extra calories, again, leading us all to the path of obesity.

But sometimes, there may also be some indirect causes of obesity. The secondary reasons could be related to our mental and psychological health. Depression, anxiety, stress, and emotional troubles are well-known factors of obesity.

Physical ailments such as hypothyroidism, ovarian cysts, and diabetes often complicate the physical condition and play a massive role in abnormal weight gain.

Moreover, certain medications, such as steroids, antidepressants, and contraceptive pills, have been seen interfering with the metabolic activities of the body. As a result, the long-term use of such drugs can cause obesity. Adding to that, regular consumption of alcohol and smoking are also connected to the condition of obesity.

Harmful Effects of Obesity:

On the surface, obesity may look like a single problem. But, in reality, it is the mother of several major health issues. Obesity simply means excessive fat depositing into our body including the arteries. The drastic consequence of such high cholesterol levels shows up in the form of heart attacks and other life-threatening cardiac troubles.

The fat deposition also hampers the elasticity of the arteries. That means obesity can cause havoc in our body by altering the blood pressure to an abnormal range. And this is just the tip of the iceberg. Obesity is known to create an endless list of problems.

In extreme cases, this disorder gives birth to acute diseases like diabetes and cancer. The weight gain due to obesity puts a lot of pressure on the bones of the body, especially of the legs. This, in turn, makes our bones weak and disturbs their smooth movement. A person suffering from obesity also has higher chances of developing infertility issues and sleep troubles.

Many obese people are seen to be struggling with breathing problems too. In the chronic form, the condition can grow into asthma. The psychological effects of obesity are another serious topic. You can say that obesity and depression form a loop. The more a person is obese, the worse is his/ her depression stage.

How to Control and Treat Obesity:

The simplest and most effective way, to begin with, is changing our diet. There are two factors to consider in the diet plan. First is what and what not to eat. Second is how much to eat.

If you really want to get rid of obesity, include more and more green vegetables in your diet. Spinach, beans, kale, broccoli, cauliflower, asparagus, etc., have enough vitamins and minerals and quite low calories. Other healthier options are mushrooms, pumpkin, beetroots, and sweet potatoes, etc.

Opt for fresh fruits, especially citrus fruits, and berries. Oranges, grapes, pomegranate, pineapple, cherries, strawberries, lime, and cranberries are good for the body. They have low sugar content and are also helpful in strengthening our immune system. Eating the whole fruits is a more preferable way in comparison to gulping the fruit juices. Fruits, when eaten whole, have more fibers and less sugar.

Consuming a big bowl of salad is also great for dealing with the obesity problem. A salad that includes fibrous foods such as carrots, radish, lettuce, tomatoes, works better at satiating the hunger pangs without the risk of weight gain.

A high protein diet of eggs, fish, lean meats, etc., is an excellent choice to get rid of obesity. Take enough of omega fatty acids. Remember to drink plenty of water. Keeping yourself hydrated is a smart way to avoid overeating. Water also helps in removing the toxins and excess fat from the body.

As much as possible, avoid fats, sugars, refined flours, and oily foods to keep the weight in control. Control your portion size. Replace the three heavy meals with small and frequent meals during the day. Snacking on sugarless smoothies, dry fruits, etc., is much recommended.

Regular exercise plays an indispensable role in tackling the obesity problem. Whenever possible, walk to the market, take stairs instead of a lift. Physical activity can be in any other form. It could be a favorite hobby like swimming, cycling, lawn tennis, or light jogging.

Meditation and yoga are quite powerful practices to drive away the stress, depression and thus, obesity. But in more serious cases, meeting a physician is the most appropriate strategy. Sometimes, the right medicines and surgical procedures are necessary to control the health condition.

Obesity is spreading like an epidemic, haunting both the adults and the kids. Although genetic factors and other physical ailments play a role, the problem is mostly caused by a reckless lifestyle.

By changing our way of living, we can surely take control of our health. In other words, it would be possible to eliminate the condition of obesity from our lives completely by leading a healthy lifestyle.

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7.5: Obesity Epidemic - Causes and Solutions

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• Alice Callahan, Heather Leonard, & Tamberly Powell
• Lane Community College via OpenOregon

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Since the 1980s, the prevalence of obesity in the United States has increased dramatically. Data collected by the Centers for Disease Control and Prevention show rising obesity across the nation, state-by-state. 1

The methods used by the CDC to collect the data changed in 2011, so we can’t make direct comparisons between the periods before and after that change, but the trend has continued. Every year, more and more people in the U.S. are obese.

These trends are unmistakable, and they’re not just occurring in adults. Childhood obesity has seen similar increases over the last few decades—perhaps an even greater concern as the metabolic and health effects of carrying too much weight can be compounded over a person’s entire lifetime.

While obesity is a problem across the United States, it affects some groups of people more than others. Based on 2015-2016 data, obesity rates are higher among Hispanic (47 percent) and Black adults (47 percent) compared with white adults (38 percent). Non-Hispanic Asians have the lowest obesity rate (13 percent). And overall, people who are college-educated and have a higher income are less likely to be obese. 2  These health disparities point to the importance of looking at social context when examining causes and solutions. Not everyone has the same opportunity for good health, or an equal ability to make changes to their circumstances, because of factors like poverty and longstanding inequities in how resources are invested in communities. These factors are called “ social determinants of health. ” 3

The obesity epidemic is also not unique to the United States. Obesity is rising around the globe, and in 2015, it was estimated to affect 2 billion people worldwide, making it one of the largest factors affecting poor health in most countries . 4 Globally, among children aged 5 to 19 years old, the rate of overweight increased from 10.3 percent in 2000 to 18.4 percent in 2018. Previously, overweight and obesity mainly affected high-income countries, but some of the most dramatic increases in childhood overweight over the last decade have been in low income countries, such as those in Africa and South Asia, corresponding to a greater availability of inexpensive, processed foods. 5

Despite the gravity of the problem, no country has yet been able to implement policies that have reversed the trend and brought about a decrease in obesity. This represents “one of the biggest population health failures of our time,” wrote an international group of researchers in the journal The Lancet in 2019. 6  The World Health Organization has set a target of stopping the rise of obesity by 2025. Doing so requires understanding what is causing the obesity epidemic; it is only when these causes are addressed that change can start to occur.

Causes of the Obesity Epidemic

If obesity was an infectious disease sweeping the globe, affecting billions of people’s health, longevity, and productivity, we surely would have addressed it by now. Researchers and pharmaceutical companies would have worked furiously to develop vaccines and medicines to prevent and cure this disease. But the causes of obesity are much more complex than a single bacteria or virus, and solving this problem means recognizing and addressing a multitude of factors that lead to weight gain in a population.

At its core, rising obesity is caused by a chronic shift towards positive energy balance—consuming more energy or calories than one expends each day, leading to an often gradual but persistent increase in body weight. People often assume that this is an individual problem, that those who weigh more simply need to change their behavior to eat less and exercise more, and if this doesn’t work, it must be because of a personal failing, such as a lack of self-control or motivation. While behavior patterns such as diet and exercise can certainly impact a person’s risk of developing obesity (as we’ll cover later in this chapter), the environments where we live also have a big impact on our behavior and can make it much harder to maintain energy balance.

Environment

Many of us live in what researchers and public health experts call “ obesogenic environments. ” That is, the ways in which our neighborhoods are built and our lives are structured influence our physical activity and food intake to encourage weight gain. 7 Human physiology and metabolism evolved in a world where obtaining enough food for survival required significant energy investment in hunting or gathering—very different from today’s world where more people earn their living in sedentary occupations. From household chores, to workplace productivity, to daily transportation, getting things done requires fewer calories than it did in past generations.

Our jobs have become more and more sedentary, with fewer opportunities for non-exercise thermogenesis (NEAT) throughout the day. There’s less time in the school day for recess and physical activity, and fears about neighborhood safety limit kids’ ability to get out and play after the school day is over. Our towns and cities are built more for cars than for walking or biking. We can’t turn back the clock on human progress, and finding a way to stay healthy in obesogenic environments is a significant challenge.

Our environments can also impact our food choices. We’re surrounded by vending machines, fast food restaurants, coffeeshops, and convenience stores that offer quick and inexpensive access to calories. These foods are also heavily advertised, and especially when people are stretched thin by working long hours or multiple jobs, they can be a welcome convenience. However, they tend to be calorie-dense (and less nutrient-dense) and more heavily processed, with amounts of sugar, fat, and salt optimized to make us want to eat more, compared with home-cooked food. In addition, portion sizes at restaurants, especially fast food chains, have increased over the decades, and people are eating at restaurants more and cooking at home less.

Poverty and Food Insecurity

Living in poverty usually means living in a more obesogenic environment. Consider the fact that some of the poorest neighborhoods in the United States—with some of the highest rates of obesity—are often not safe or pleasant places to walk, play, or exercise. They may have busy traffic and polluted air, and they may lack sidewalks, green spaces, and playgrounds. A person living in this type of neighborhood will find it much more challenging to get adequate physical activity compared with someone living in a neighborhood where it’s safe to walk to school or work, play at a park, ride a bike, or go for a run.

In addition, poor neighborhoods often lack a grocery store where people can purchase fresh fruits and vegetables and basic ingredients necessary for cooking at home. Such areas are called “ food deserts ”—where healthy foods simply aren’t available or easily accessible.

Another concept useful in discussions of obesity risk is “food insecurity.”  Food security  means “access by all people at all times to enough food for an active, healthy life.” 8  Food insecurity  means an inability to consistently obtain adequate food. It may seem counter-intuitive, but in the United States, food insecurity is linked to obesity. That is, people who have difficulty obtaining enough food are more likely to become obese and to suffer from diabetes and hypertension. This is likely related to the fact that inexpensive foods tend to be high in calories but low in nutrients, and when these foods form the foundation of a person’s diet, they can cause both obesity and nutrient deficiencies. It’s estimated that 12 percent of U.S. households are food insecure, and food insecurity is higher among Black (22 percent) and Latino (18 percent) households. 3

What about genetics? While it’s true that our genes can influence our susceptibility to becoming obese, researchers say they can’t be a cause of the obesity epidemic. Genes take many generations to evolve, and the obesity epidemic has occurred over just the last 40 to 50 years—only a few generations. When our grandparents were children, they were much less likely to become obese than our own children. That’s not because their genes were different, but rather because they grew up in a different environment. However, it is true that a person’s genes can influence their susceptibility to becoming obese in this obesogenic environment, and obesity is more prevalent in some families. A person’s genetic make-up can make it more difficult to maintain energy balance in an obesogenic environment, because certain genes may make you feel more hungry or slow your energy expenditure. 2

Solutions to the Obesity Epidemic

Given the multiple causes of obesity, solving this problem will also require many solutions at different levels. Because obesity affects people over the lifespan and is difficult to reverse, the focus of many of these efforts is prevention, starting as early as the first years of life. We’ll discuss individual weight management strategies later in this chapter. Here, we’ll review some strategies happening in schools, communities, and at the state and federal levels.

Support Healthy Dietary Patterns

Interventions that support healthy dietary patterns, especially among people more vulnerable because of food insecurity or poverty, may reduce obesity. In some cases, studies have shown that they have an impact, and in other cases, it’s too soon to know. Here are some examples:

• Implement and support better nutrition standards for childcare, schools, hospitals, and worksites. 9
• Limit marketing of processed foods, especially ads targeted towards children.
• Provide incentives for supermarkets or farmers markets to establish businesses in underserved areas. 9

Figure 9.21. Farmers markets can expand healthy food options for neighborhoods and build connections between consumers and local farmers.

• Place nutrition and calorie content on restaurant and fast food menus to raise awareness of food choices. 9 Beginning in 2018, as part of the Affordable Care Act, chain restaurants with more than 20 locations were required to add calorie information to their menus, and some had already done so voluntarily. There isn’t yet enough research to say whether having this information improves customers’ choices; some studies show an effect and others don’t. 10 Many factors influence people’s decisions, and the type of restaurant, customer needs, and menu presentation all likely matter. For example, some studies show that health-conscious consumers choose lower calorie menu items when presented with nutrition information, but people with food insecurity may understandably choose higher calorie items to get more “bang for their buck”. 11 Research has also shown that adding interpretative images—like a stoplight image labeling menu choices as green or red as shorthand for high or low nutrient density—can help. And a 2018 study found that when calorie counts are on the left side of English-language menus, people order lower-calorie menu items. Putting calorie counts on the right side of the menu (as is more common) doesn’t have this effect, likely because the English language is read from left to right. 12 Some studies have also found that restaurants that implement menu labeling offer lower-calorie and more nutrient-dense options, indicating that menu labeling may push restaurants to look more closely at the food they serve. 10,13

• Increase access to food assistance programs and align them with nutrition recommendations. For example, in 2009, the U.S. Department of Agriculture revised the food packages for the Women, Infants, and Children (WIC) program to better align with the Dietary Guidelines for Americans. The new packages emphasized more fruits, vegetables, whole grains, and low-fat dairy and decreased the availability of juice. After this change, there was a decrease in the obesity rate of children in the WIC program. Similar progress may be made by increasing access to the Supplemental Nutrition Assistance Program (SNAP) in order to reduce food insecurity. Many farmers’ markets now accept SNAP benefits for the purchase of fresh fruit and vegetables. 3
• Tax sugary drinks, such as soda and sports drinks, which contribute significant empty calories to the U.S. diet and are associated with childhood obesity. Local taxes on soda and other sugary drinks are often controversial, and soda companies lobby to prevent them from passing. However, early research in U.S. cities with soda taxes show that they do work to decrease soda consumption. 3 In the U.S., soda has only been taxed at the local level, and the tax has been paid by consumers. The United Kingdom has taken a different approach: They started taxing soft drink manufacturers for the sugar content of the products they sell. Between 2015 and 2018, the average sugar content of soda sold in the U.K. dropped by 29 percent. 14

Support Greater Physical Activity

Increasing physical activity increases the energy expended during the day. This can help maintain energy balance, thus preventing weight gain. It may also help to shift a person into negative energy balance and facilitate weight loss if needed. But simply adding an exercise session—a run or a trip to the gym, say—often doesn’t shift energy balance (though it’s certainly good for health). Why? Exercise can increase hunger, and there’s only so many calories a person can burn in 30 or 60 minutes. That’s why it’s also important to look for opportunities for non-exercise activity thermogenesis (NEAT); that is, find ways to increase movement throughout the day.

• P rioritize physical education and recess time in schools. In addition to helping kids stay healthy, movement also helps them learn.  
• Make neighborhoods safer and more accessible for walking, cycling, and playing.
• When safe, encourage kids to walk or bike to school.
• Build family and community activities around physical activity, such as trips to the park, walks together, and community walking and exercise groups.
• Facilitate more movement in the workday by encouraging walking meetings, movement breaks, and treadmill desks.
• Find ways to move that are enjoyable to you and fit your life. Yard work, walking your dog, playing tag with your kids, and going out dancing all count!

VIDEO: “ James Levine: ‘I Came Alive as a Person’ “ by NOVA’s Secret Life of Scientists and Engineers, YouTube (April 24, 2014), 3:04 minutes. This short video explains some of the research on NEAT and efforts to increase it in our lives

VIDEO: “ The Weight of the Nation: Poverty and Obesity” by HBO Docs, YouTube (May 14, 2012), 24:05 minutes.

VIDEO: “ The Weight of the Nation: Healthy Foods and Obesity Prevention” by HBO Docs, YouTube (May 14, 2012), 31:11 minutes. These segments from the HBO documentary series, “The Weight of the Nation,” explore some of the causes and potential solutions for obesity.

References:

• 1 CDC. (2019, September 12). New Adult Obesity Maps. Retrieved October 30, 2019, from Centers for Disease Control and Prevention website: https://www.cdc.gov/obesity/data/prevalence-maps.html
• 2 CDC. (2019, January 31). Adult Obesity Facts | Overweight & Obesity | CDC. Retrieved October 30, 2019, from https://www.cdc.gov/obesity/data/adult.html
• 3 Trust for America’s Health. (2019). The State of Obesity: Better Policies for a Healthier America . Retrieved from https://www.tfah.org/report-details/stateofobesity2019/
• 4 Swinburn, B. A., Kraak, V. I., Allender, S., Atkins, V. J., Baker, P. I., Bogard, J. R., … Dietz, W. H. (2019). The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. The Lancet , 393 (10173), 791–846. https://doi.org/10.1016/S0140-6736(18)32822-8
• 5 UNICEF. (2019). The State of the World’s Children 2019. Children, Food and Nutrition: Growing well in a changing world . New York.
• 6 Jaacks, L. M., Vandevijvere, S., Pan, A., McGowan, C. J., Wallace, C., Imamura, F., … Ezzati, M. (2019). The obesity transition: Stages of the global epidemic. The Lancet Diabetes & Endocrinology , 7 (3), 231–240. https://doi.org/10.1016/S2213-8587(19)30026-9
• 7 Townshend, T., & Lake, A. (2017). Obesogenic environments: Current evidence of the built and food environments. Perspectives in Public Health , 137 (1), 38–44. https://doi.org/10.1177/1757913916679860
• 8 Pan, L., Sherry, B., Njai, R., & Blanck, H. M. (2012). Food Insecurity Is Associated with Obesity among US Adults in 12 States. Journal of the Academy of Nutrition and Dietetics , 112 (9), 1403–1409. https://doi.org/10.1016/j.jand.2012.06.011
• 9 CDC. (2019, June 18). Community Efforts | Overweight & Obesity | CDC. Retrieved October 30, 2019, from https://www.cdc.gov/obesity/strategies/community.html
• 10 Bleich, S. N., Economos, C. D., Spiker, M. L., Vercammen, K. A., VanEpps, E. M., Block, J. P., … Roberto, C. A. (2017). A Systematic Review of Calorie Labeling and Modified Calorie Labeling Interventions: Impact on Consumer and Restaurant Behavior. Obesity (Silver Spring, Md.) , 25 (12), 2018–2044. https://doi.org/10.1002/oby.21940
• 11 Berry, C., Burton, S., Howlett, E., & Newman, C. L. (2019). Understanding the Calorie Labeling Paradox in Chain Restaurants: Why Menu Calorie Labeling Alone May Not Affect Average Calories Ordered. Journal of Public Policy & Marketing , 38 (2), 192–213. https://doi.org/10.1177/0743915619827013
• 12 Dallas, S. K., Liu, P. J., & Ubel, P. A. (2019). Don’t Count Calorie Labeling Out: Calorie Counts on the Left Side of Menu Items Lead to Lower Calorie Food Choices. Journal of Consumer Psychology, 29(1), 60–69. https://doi.org/10.1002/jcpy.1053
• 13 Theis, D. R. Z., & Adams, J. (2019). Differences in energy and nutritional content of menu items served by popular UK chain restaurants with versus without voluntary menu labelling: A cross-sectional study. PLOS ONE , 14 (10), e0222773. https://doi.org/10.1371/journal.pone.0222773
• 14 Public Health England. (2019). Sugar reduction: Report on progress between 2015 and 2018 . Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832182/Sugar_reduction__Yr2_progress_report.pdf

Image Credits

• Figure 9.17. “Obesity Trends Among U.S. Adults, BRFSS, 1990-2010” by Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention is in the Public Domain
• Figure 9.18. “Prevalence of self-reported obesity among U.S. adults in 2011 and 2018” by Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention is in the Public Domain
• Figure 9.19. “Trends in obesity prevalence” by National Center for Health Statistics is in the Public Domain
• Figure 9.20. Elements of obesogenic environment: “wocintech” by WOCinTech Cha is licensed under CC BY 2.0 ; “Perfect timing” by Tamara Menzi , Unsplash is in the Public Domain, CC0 ; “Vending machines” by Purchase College Library is licensed under CC BY-NC 2.0
• Figure 9.21. Farmers markets. “group of people standing near vegetables” by Megan Markham is in the Public Domain, CC0 ; “Veggies at Corvallis Farmers Market” by Friends of Family Farmers is licensed under CC BY-ND 2.0
• Figure 9.22. Menu labeling. “Ballpark Calorie Counting” by Kevin Harber is licensed under CC BY-NC-ND 2.0
• Figure 9.23. Increasing physical activity. “Early bird” by Jorge Vasconez is in the Public Domain, CC0 ; “boy running to the future” by Rafaela Biazi is in the Public Domain, CC0 ; “people riding bicycles inside bicycle lane beside skyscraper” by Steinar Engeland is in the Public Domain, CC0

Obesity in children is rising dramatically, and it comes with major – and sometimes lifelong – health consequences

2023 California Health Equity Fellow, University of Southern California

Disclosure statement

Christine Nguyen does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Southern California provides funding as a member of The Conversation US.

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In the past two decades, children have become more obese and have developed obesity at a younger age. A 2020 report found that 14.7 million children and adolescents in the U.S. live with obesity.

Because obesity is a known risk factor for serious health problems , its rapid increase during the COVID-19 pandemic raised alarms.

Without intervention, many obese adolescents will remain obese as adults. Even before adulthood, some children will have serious health problems beginning in their preteen years.

To address these issues, in early 2023, the American Academy of Pediatrics released its first new obesity management guidelines in 15 years.

I am a pediatric gastroenterologist who sees children in the largest public hospital in California, and I have witnessed a clear trend over the last two decades. Early in my practice, I only occasionally saw a child with a complication of obesity; now I see multiple referrals each month. Some of these children have severe obesity and several health complications that require multiple specialists.

These observations prompted my reporting for the California Health Equity Fellowship at the University of Southern California.

It’s important to note that not all children who carry extra weight are unhealthy. But evidence supports that obesity, especially severe obesity, requires further assessment.

How obesity is measured

The World Health Organization defines obesity as “abnormal or excessive fat accumulation that presents a risk to health.”

Measuring fat composition requires specialized equipment that is not available in a regular doctor’s office. Therefore most clinicians use body measurements to screen for obesity.

One method is body mass index, or BMI, a calculation based on a child’s height and weight compared to age- and sex-matched peers. BMI doesn’t measure body fat, but when BMI is high , it correlates with total body fat.

According to the American Academy of Pediatrics , a child qualifies as overweight at a BMI between the 85th and 95th percentile . Obese is defined as a BMI above the 95th percentile . Other screens for obesity include waist circumference and skin-fold thickness , but these methods are less common.

Because many children exceeded the limits of existing growth charts, in 2022 the Centers for Disease Control and Prevention introduced extended growth charts for severe obesity. Severe obesity occurs when a child reaches the 120th percentile or has a BMI over 35. For instance, a 6-year-old boy who is 48 inches tall and is 110 pounds would meet criteria for severe obesity because his BMI is 139th percentile.

Severe obesity carries a heightened risk of liver disease, cardiovascular disease and metabolic problems such as diabetes. As of 2016, almost 8% of children ages 2 to 19 had severe obesity .

Other health problems associated with severe obesity include obstructive sleep apnea , bone and joint problems that can cause early arthritis, high blood pressure and kidney disease . Many of these problems occur together.

How obesity affects the liver

The liver disease associated with obesity is called nonalcoholic fatty liver disease . To store excess dietary fat and sugar, the liver’s cells fill with fat. Excess carbohydrates in particular get processed into substances similar to the breakdown products of alcohols . Under the microscope, a pediatric fatty liver looks similar to a liver with alcohol damage.

Occasionally children with fatty liver are not obese; however, the greatest risk factor for fatty liver is obesity. At the same BMI, Hispanic and Asian children are more susceptible to fatty liver disease than Black and white children. Weight reduction or reducing the consumption of fructose, a naturally occurring sugar and common food additive – even without significant weight loss – improves fatty liver.

Fatty liver is the most common chronic liver disease in children and adults. In Southern California, pediatric fatty liver doubled from 2009 to 2018. The disease can progress rapidly in children, and some will have liver scarring after only a few years.

Although few children currently require liver transplants for fatty liver, it is the most rapidly increasing reason for transplantation in young adults . Fatty liver is the second-most common reason for liver transplantation in the U.S., and it will be the leading cause in the future .

Links between obesity and diabetes

Fatty liver is implicated in metabolic syndrome , a group of conditions that cluster together and increase the risk of cardiovascular disease and diabetes.

In a telephone interview, Dr. Barry Reiner, a pediatric endocrinologist, voiced his concerns to me about obesity and diabetes.

“When I started my practice, I had never heard of type 2 diabetes in children,” says Reiner. “Now, depending on which part of the U.S., between a quarter and a third of new cases of diabetes are type 2.”

Type 1 diabetes is an autoimmune disease previously called juvenile-onset diabetes. Conversely, type 2 diabetes was historically considered an adult disease.

However, type 2 diabetes is increasing in children, and obesity is the major risk factor . While both types of diabetes have genetic and lifestyle influences, type 2 is more modifiable through diet and exercise.

By 2060, the number of people under 20 with type 2 diabetes will increase by 700% . Black, Latino, Asian, Pacific Islander and Native American/Alaska Native children will have more type 2 diabetes diagnoses than white children.

“The seriousness of type 2 diabetes in children is underestimated,” says Reiner. He added that many people express a misconception that type 2 diabetes is a mild, slow-moving disease.

Reiner pointed to an important study showing that type 2 diabetes acquired in childhood can rapidly progress . As early as 10 to 12 years after their childhood diagnosis, patients developed nerve damage, kidney problems and vision damage. By 15 years after diagnosis, at an average age of 27, almost 70% of the patients had high blood pressure .

Most patients had more than one complication. Although rare, a few patients experienced heart attacks and strokes. When people with childhood onset diabetes became pregnant, 24% delivered premature infants, over double the rate in the general population .

Heart health

Cardiovascular changes associated with obesity and severe obesity can also increase a child’s lifetime chance of heart attacks and strokes. Carrying extra weight at 6 to 7 years old can result in higher blood pressure, cholesterol and artery stiffness by 11 to 12 years of age . Obesity changes the structure of the heart , making the muscle thicken and expand.

Although still uncommon, more people in their 20s, 30s and 40s are having strokes and heart attacks than a few decades ago. Although many factors may contribute to heart attack and stroke, obesity adds to that risk.

Talk about being healthy, not focusing on weight

Venus Kalami, a registered dietitian, spoke with me about the environmental and societal influences on childhood obesity.

“Food, diet, lifestyle and weight are often a proxy for something greater going on in someone’s life,” says Kalami.

Factors beyond a child’s control, including depression , access to healthy food and walkable neighborhoods , contribute to obesity.

Parents may wonder how to help children without introducing shame or blame. First, conversations about weight and food should be age appropriate.

“A 6-year-old does not need to be thinking about their weight,” says Kalami. She adds that even preteens and teenagers should not be focusing on their weight, though they likely already are.

Even “good-natured” teasing is harmful. Avoid diet talk, and instead discuss health. Kalami recommends that adults explain how healthy habits can improve mood, focus or kids’ performance in a favorite activity.

“A 12-year-old isn’t always going to know what is healthy,” Kalami said. “Help them pick what’s available and make the best choice, which may not be the perfect choice.”

Any weight talk, either criticism or compliments for weight loss, may backfire, she adds. Praising a child for their weight loss can reinforce a negative cycle of disordered eating. Instead, cheer the child’s better health and good choices.

Dr. Muneeza Mirza, a pediatrician, recommends that parents model healthful behavior.

“Changes should be made for the whole family,” says Mirza. “It shouldn’t be considered a punishment for that kid.”

• Cardiovascular disease
• Kidney disease
• Cardiovascular health
• Obesity epidemic
• High blood pressure
• World Health Organization (WHO)
• American Academy of Pediatrics
• Centers for Disease Control and Prevention (CDC)
• Body mass index
• Weight stigma

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The critical role of gut microbiota in obesity

Affiliation.

• 1 Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• PMID: 36339448
• PMCID: PMC9630587
• DOI: 10.3389/fendo.2022.1025706

Obesity is a global epidemic characterized by energy disequilibrium, metabolic disorder, fat mass development, and chronic low-grade inflammation, which significantly affects the health state of individuals of all ages and strains the socioeconomic system. The prevalence of obesity is rising at alarming rates and its etiology involves complicated interplay of diet, genetic, and environmental factors. The gut microbiota, as an important constituent of environmental factors, has been confirmed to correlate with the onset and progression of obesity. However, the specific relationship between obesity and the gut microbiota, and its associated mechanisms, have not been fully elucidated. In this review, we have summarized that the microbial diversity was significantly decreased and the Firmicutes/Bacteroidetes ratio was significantly increased in obesity. The altered gut microbiota and associated metabolites contributed to the progression of the disease by disrupting energy homeostasis, promoting lipid synthesis and storage, modulating central appetite and feeding behavior, as well as triggering chronic inflammation, and that the intentional manipulation of gut microbiota held promise as novel therapies for obesity, including probiotics, prebiotics, and fecal microbiota transplantation.

Keywords: SCFAs; bile acids; energy homeostasis; gut microbiota; obesity.

Copyright © 2022 Cheng, Zhang, Yang and Chu.

Publication types

• Research Support, Non-U.S. Gov't
• Fecal Microbiota Transplantation / adverse effects
• Gastrointestinal Microbiome*
• Inflammation / complications
• Obesity / metabolism

Harnessing the Power of Critical Thinking in Daily Life

This essay about critical thinking outlines its importance and practical applications in everyday life. It defines critical thinking as the art of analyzing and evaluating information to form reasoned conclusions, emphasizing the importance of questioning information, structuring thoughts, and self-reflection. The essay discusses how critical thinking encourages creativity and systematic problem-solving, which are valuable in both professional and personal settings. Challenges such as information overload and the necessity for constant skepticism are also addressed. Furthermore, the essay explores the role of critical thinking in education, advocating for a learning environment that promotes independent thought and exploration. Overall, it presents critical thinking as a vital skill that enhances decision-making and fosters a more informed, discerning society.

How it works

Critical thinking isn’t merely a buzzword or a skill reserved for the confines of academia; it’s a robust, everyday tool that can dramatically enhance our decision-making and problem-solving capabilities. So, what exactly is critical thinking? Simply put, it’s the art of analyzing and evaluating information to reach well-reasoned conclusions. It’s about being actively engaged in your thought processes, challenging conventional wisdom, and not taking things at face value.

Critical thinking starts with questioning. Whenever you encounter new information, whether through a conversation, reading, or media, it involves pausing and asking yourself: What is the evidence? Who benefits from this information? Could there be a bias? Consider a scenario where you read a headline that feels emotionally charged; a critical thinker would step back and assess the source, check for other evidence, and not let initial emotions drive immediate reactions.

Structuring your thoughts is another cornerstone of critical thinking. It’s not just about what you think but how you organize those thoughts. This could mean prioritizing what’s most important or structuring your day to optimize for peak mental performance. For example, in planning a project, critical thinking helps lay out clear, manageable steps, ensuring that each phase builds on the previous one for coherent results.

Self-reflection is a significant, albeit challenging, aspect of critical thinking. It requires us to examine our own beliefs and motivations critically, asking ourselves why we hold certain views and being open to adjusting those views in light of new evidence. This self-examination extends to recognizing personal biases—everyone has them, and they can color our perceptions and decisions in subtle, sometimes profound ways.

Critical thinking also dovetails with creativity. It pushes us to question existing approaches and brainstorm innovative solutions. This creative problem-solving becomes invaluable in workplaces that value adaptability and forward-thinking, where the usual solutions don’t always resolve new or complex problems.

However, developing and maintaining strong critical thinking skills is not without its challenges. It demands a consistent, deliberate effort and the mental flexibility to consider multiple viewpoints and outcomes. In today’s fast-paced world, where information overload is common, it can be particularly daunting to sift through vast amounts of data to find what’s relevant and true.

Moreover, instilling critical thinking in educational environments can be tricky. It requires creating a space where questioning is encouraged, and students aren’t penalized for thinking outside the box or challenging the status quo. Educators must strike a balance between guiding students and giving them the freedom to explore ideas independently.

In the real world, critical thinking is more than an academic exercise; it’s a practical skill that affects every decision we make. From discerning which job offer to accept to navigating personal relationships, the ability to analyze facts dispassionately, understand logical connections, and make informed judgments is invaluable. It helps us avoid manipulation and make decisions that align with our values and goals.

In essence, critical thinking is about cultivating a mindset that questions, analyzes, and innovates. It empowers us to tackle complex challenges, reduces our susceptibility to misinformation, and enhances our ability to communicate effectively. By fostering this skill, we can improve not only our own lives but also contribute to a more rational, informed society.

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Does Medicare Cover Wegovy?

Photo Illustration by Amelia Manley for Verywell Health; Getty Images

Key Takeaways

• Medicare now covers the injectable anti-obesity drug Wegovy for reducing cardiovascular risks in patients with heart disease and obesity, following its FDA approval for this specific use.
• Despite the broader availability of Wegovy, Medicare’s coverage for anti-obesity medications remains limited to those with additional medically accepted indications, due to longstanding legislative restrictions.
• The high cost of anti-obesity drugs and the uncertain impact on overall healthcare spending are major barriers to expanding Medicare coverage for these medications.

By law, Medicare doesn’t cover any weight loss or anti-obesity drugs. But one Food and Drug Administration (FDA) indication at a time, that could start to change.

In March, the FDA approved Wegovy to reduce the risk of heart attack, stroke, and other cardiovascular problems in adults with heart disease who have obesity or overweight. The injectable medication, part of a class of drugs called glucagon-like peptide (GLP-1) receptor agonists, was previously approved just for weight management.

The heart disease indication means Medicare Part D plans can cover the drug.

“CMS is clarifying that anti-obesity medications that receive FDA approval for an additional medically accepted indication…can be considered a Part D drug for that specific use,” said a memo issued by the Center for Medicare and Medicaid Services (CMS). “Unless provided as a supplemental benefit, Part D coverage is still not available for anti-obesity medications when used for chronic weight management in patients who do not have the additional medically accepted indication.”

Now, pharmaceutical companies are researching other conditions that obesity medications can treat in order to earn more FDA indications, potentially expanding insurance coverage. In April, for instance, Eli Lilly announced study results demonstrating Zepbound significantly improved symptoms of obstructive sleep apnea .

Why Doesn’t Medicare Cover Obesity Medication?

While some other insurers will cover anti-obesity drugs without an additional “medically accepted condition,” the Medicare Modernization Act of 2003 still prohibits it. Medicare Part D and Medigap plans are also unlikely to cover them.

“That decision is decades old and based on concerns over the safety of weight loss drugs like Belviq and Redux, which turned out to have side effects and were pulled from the market by the FDA,” David Farber, JD , a law partner focusing on healthcare in the Washington, D.C., office of law firm King & Spalding, told Verywell.

It’s not just the injectable anti-obesity drugs that Medicare doesn’t cover; plans also don’t cover older oral weight management drugs such as Xenical. These medications don’t help people lose weight quite as quickly as GLP-1s like Wegovy or Zepbound, but they’re still very effective, Dina Griauzde, MD , an obesity specialist at Michigan Medicine, told Verywell.

Lawmakers have introduced legislation to allow Medicare to cover anti-obesity drugs several times, including the Treat and Reduce Obesity Act last year. The Obesity Action Coalition is lobbying Congress about the legislation. The chair of the organization’s Board of Directors, Kristal Hartman, says she expects it to take three to five years before the legislation passes.

The real reason for the coverage delay, experts say, is concern over how much it will cost the healthcare system.

“Authorizing Medicare coverage of anti-obesity drugs seems unlikely at this point,” Juliette Cubanski, PhD, MPP, MPH , deputy director of the Program on Medicare Policy at the Kaiser Family Foundation, told Verywell. “While the cost of this legislation is unknown, it’s likely to be a barrier to implementation.”

An October 2023 blog post from the Congressional Budget Office (CBO) confirms that the agency is looking into the issue: “CBO has not yet produced a cost estimate for legislation that would expand access to AOMs [anti-obesity medications] for beneficiaries of government programs such as Medicare, but the agency is monitoring trends in the use of AOMs, along with their prices, effects on health, and coverage by insurance plans.”

CBO pegged the monthly out-of-pocket cost of semaglutide (the active ingredient in Ozempic, Wegovy, and Rybelsus) at $1,349 per month, which would be over $16,000 a year for a consumer.

“Medicare’s coverage of AOMs at their current prices…would increase overall federal spending,” CBO said. That could result in higher premiums—the monthly amount Medicare recipients pay for their plans.

While the Congressional Budget Office said it will continue to examine how much anti-obesity medications will cost or save Medicare in the long run, it is not currently aware of research that suggests the drugs will improve health outcomes enough to decrease healthcare spending for related conditions.

Other Ways to Access GLP-1 Drugs

While Medicare can’t cover obesity medication, it can cover similar drugs used to treat type 2 diabetes. Both Ozempic and Mounjaro are eligible for Medicare coverage, and both work in part by controlling insulin release and delaying gastric emptying to modulate blood sugar. A byproduct of those mechanisms of action is weight loss.

If you don’t have a diabetes diagnosis but you and your primary care doctor believe you are a good candidate for a GLP-1 medication, consider taking an A1C blood test, an American Diabetes Association spokesperson told Verywell. Almost three million Americans are living with undiagnosed diabetes, half of whom have overweight. If the test confirms you have diabetes, you’ll have a better chance of getting coverage for medication—which might also help manage your weight. 

What This Means For You

If you have obesity or overweight and heart disease, the new Medicare coverage for Wegovy might offer you a valuable treatment option. It’s important to discuss with your healthcare provider whether this medication could be suitable for you. More indications for GLP-1 drugs are on the horizon, which means more insurance coverage may be, too.

Santilli M, Manciocchi E, D'Addazio G, et al.  Prevalence of obstructive sleep apnea syndrome: a single-center retrospective study .  Int J Environ Res Public Health . 2021;18(19):10277. doi:10.3390/ijerph181910277

UpToDate. Glucagon-like peptide 1 receptor agonists for the treatment of type 2 diabetes mellitus .

By Fran Kritz Kritz is a healthcare reporter with a focus on health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.

Watch CBS News

Teens come up with trigonometry proof for Pythagorean Theorem, a problem that stumped math world for centuries

By Bill Whitaker

May 5, 2024 / 7:00 PM EDT / CBS News

As the school year ends, many students will be only too happy to see math classes in their rearview mirrors. It may seem to some of us non-mathematicians that geometry and trigonometry were created by the Greeks as a form of torture, so imagine our amazement when we heard two high school seniors had proved a mathematical puzzle that was thought to be impossible for 2,000 years. 

We met Calcea Johnson and Ne'Kiya Jackson at their all-girls Catholic high school in New Orleans. We expected to find two mathematical prodigies.

Instead, we found at St. Mary's Academy , all students are told their possibilities are boundless.

Come Mardi Gras season, New Orleans is alive with colorful parades, replete with floats, and beads, and high school marching bands.

In a city where uniqueness is celebrated, St. Mary's stands out – with young African American women playing trombones and tubas, twirling batons and dancing - doing it all, which defines St. Mary's, students told us.

Junior Christina Blazio says the school instills in them they have the ability to accomplish anything. 

Christina Blazio: That is kinda a standard here. So we aim very high - like, our aim is excellence for all students. 

The private Catholic elementary and high school sits behind the Sisters of the Holy Family Convent in New Orleans East. The academy was started by an African American nun for young Black women just after the Civil War. The church still supports the school with the help of alumni.

In December 2022, seniors Ne'Kiya Jackson and Calcea Johnson were working on a school-wide math contest that came with a cash prize.

Ne'Kiya Jackson: I was motivated because there was a monetary incentive.

Calcea Johnson: 'Cause I was like, "$500 is a lot of money. So I-- I would like to at least try."

Both were staring down the thorny bonus question.

Bill Whitaker: So tell me, what was this bonus question?

Calcea Johnson: It was to create a new proof of the Pythagorean Theorem. And it kind of gave you a few guidelines on how would you start a proof.

The seniors were familiar with the Pythagorean Theorem, a fundamental principle of geometry. You may remember it from high school: a² + b² = c². In plain English, when you know the length of two sides of a right triangle, you can figure out the length of the third.

Both had studied geometry and some trigonometry, and both told us math was not easy. What no one told  them  was there had been more than 300 documented proofs of the Pythagorean Theorem using algebra and geometry, but for 2,000 years a proof using trigonometry was thought to be impossible, … and that was the bonus question facing them.

Bill Whitaker: When you looked at the question did you think, "Boy, this is hard"?

Ne'Kiya Jackson: Yeah. 

Bill Whitaker: What motivated you to say, "Well, I'm going to try this"?

Calcea Johnson: I think I was like, "I started something. I need to finish it." 

Bill Whitaker: So you just kept on going.

Calcea Johnson: Yeah.

For two months that winter, they spent almost all their free time working on the proof.

CeCe Johnson: She was like, "Mom, this is a little bit too much."

CeCe and Cal Johnson are Calcea's parents.

CeCe Johnson:   So then I started looking at what she really was doing. And it was pages and pages and pages of, like, over 20 or 30 pages for this one problem.

Cal Johnson: Yeah, the garbage can was full of papers, which she would, you know, work out the problems and-- if that didn't work she would ball it up, throw it in the trash. 

Bill Whitaker: Did you look at the problem? 

Neliska Jackson is Ne'Kiya's mother.

Neliska Jackson: Personally I did not. 'Cause most of the time I don't understand what she's doing (laughter).

Michelle Blouin Williams: What if we did this, what if I write this? Does this help? ax² plus ….

Their math teacher, Michelle Blouin Williams, initiated the math contest.

Bill Whitaker: And did you think anyone would solve it?

Michelle Blouin Williams: Well, I wasn't necessarily looking for a solve. So, no, I didn't—

Bill Whitaker: What were you looking for?

Michelle Blouin Williams: I was just looking for some ingenuity, you know—

Calcea and Ne'Kiya delivered on that! They tried to explain their groundbreaking work to 60 Minutes. Calcea's proof is appropriately titled the Waffle Cone.

Calcea Johnson: So to start the proof, we start with just a regular right triangle where the angle in the corner is 90°. And the two angles are alpha and beta.

Bill Whitaker: Uh-huh

Calcea Johnson: So then what we do next is we draw a second congruent, which means they're equal in size. But then we start creating similar but smaller right triangles going in a pattern like this. And then it continues for infinity. And eventually it creates this larger waffle cone shape.

Calcea Johnson: Am I going a little too—

Bill Whitaker: You've been beyond me since the beginning. (laughter) 

Bill Whitaker: So how did you figure out the proof?

Ne'Kiya Jackson: Okay. So you have a right triangle, 90° angle, alpha and beta.

Bill Whitaker: Then what did you do?

Ne'Kiya Jackson: Okay, I have a right triangle inside of the circle. And I have a perpendicular bisector at OP to divide the triangle to make that small right triangle. And that's basically what I used for the proof. That's the proof.

Bill Whitaker: That's what I call amazing.

Ne'Kiya Jackson: Well, thank you.

There had been one other documented proof of the theorem using trigonometry by mathematician Jason Zimba in 2009 – one in 2,000 years. Now it seems Ne'Kiya and Calcea have joined perhaps the most exclusive club in mathematics. 

Bill Whitaker: So you both independently came up with proof that only used trigonometry.

Ne'Kiya Jackson: Yes.

Bill Whitaker: So are you math geniuses?

Calcea Johnson: I think that's a stretch. 

Bill Whitaker: If not genius, you're really smart at math.

Ne'Kiya Jackson: Not at all. (laugh) 

To document Calcea and Ne'Kiya's work, math teachers at St. Mary's submitted their proofs to an American Mathematical Society conference in Atlanta in March 2023.

Ne'Kiya Jackson: Well, our teacher approached us and was like, "Hey, you might be able to actually present this," I was like, "Are you joking?" But she wasn't. So we went. I got up there. We presented and it went well, and it blew up.

Bill Whitaker: It blew up.

Calcea Johnson: Yeah. 

Ne'Kiya Jackson: It blew up.

Bill Whitaker: Yeah. What was the blowup like?

Calcea Johnson: Insane, unexpected, crazy, honestly.

It took millenia to prove, but just a minute for word of their accomplishment to go around the world. They got a write-up in South Korea and a shout-out from former first lady Michelle Obama, a commendation from the governor and keys to the city of New Orleans. 

Bill Whitaker: Why do you think so many people found what you did to be so impressive?

Ne'Kiya Jackson: Probably because we're African American, one. And we're also women. So I think-- oh, and our age. Of course our ages probably played a big part.

Bill Whitaker: So you think people were surprised that young African American women, could do such a thing?

Calcea Johnson: Yeah, definitely.

Ne'Kiya Jackson: I'd like to actually be celebrated for what it is. Like, it's a great mathematical achievement.

Achievement, that's a word you hear often around St. Mary's academy. Calcea and Ne'Kiya follow a long line of barrier-breaking graduates. 

The late queen of Creole cooking, Leah Chase , was an alum. so was the first African-American female New Orleans police chief, Michelle Woodfork …

And judge for the Fifth Circuit Court of Appeals, Dana Douglas. Math teacher Michelle Blouin Williams told us Calcea and Ne'Kiya are typical St. Mary's students.  

Bill Whitaker: They're not unicorns.

Michelle Blouin Williams: Oh, no no. If they are unicorns, then every single lady that has matriculated through this school is a beautiful, Black unicorn.

Pamela Rogers: You're good?

Pamela Rogers, St. Mary's president and interim principal, told us the students hear that message from the moment they walk in the door.

Pamela Rogers: We believe all students can succeed, all students can learn. It does not matter the environment that you live in. 

Bill Whitaker: So when word went out that two of your students had solved this almost impossible math problem, were they universally applauded?

Pamela Rogers: In this community, they were greatly applauded. Across the country, there were many naysayers.

Bill Whitaker: What were they saying?

Pamela Rogers: They were saying, "Oh, they could not have done it. African Americans don't have the brains to do it." Of course, we sheltered our girls from that. But we absolutely did not expect it to come in the volume that it came.  

Bill Whitaker: And after such a wonderful achievement.

Pamela Rogers: People-- have a vision of who can be successful. And-- to some people, it is not always an African American female. And to us, it's always an African American female.

Gloria Ladson-Billings: What we know is when teachers lay out some expectations that say, "You can do this," kids will work as hard as they can to do it.

Gloria Ladson-Billings, professor emeritus at the University of Wisconsin, has studied how best to teach African American students. She told us an encouraging teacher can change a life.

Bill Whitaker: And what's the difference, say, between having a teacher like that and a whole school dedicated to the excellence of these students?

Gloria Ladson-Billings: So a whole school is almost like being in Heaven. 

Bill Whitaker: What do you mean by that?

Gloria Ladson-Billings: Many of our young people have their ceilings lowered, that somewhere around fourth or fifth grade, their thoughts are, "I'm not going to be anything special." What I think is probably happening at St. Mary's is young women come in as, perhaps, ninth graders and are told, "Here's what we expect to happen. And here's how we're going to help you get there."

At St. Mary's, half the students get scholarships, subsidized by fundraising to defray the $8,000 a year tuition. Here, there's no test to get in, but expectations are high and rules are strict: no cellphones, modest skirts, hair must be its natural color.

Students Rayah Siddiq, Summer Forde, Carissa Washington, Tatum Williams and Christina Blazio told us they appreciate the rules and rigor.

Rayah Siddiq: Especially the standards that they set for us. They're very high. And I don't think that's ever going to change.

Bill Whitaker: So is there a heart, a philosophy, an essence to St. Mary's?

Summer Forde: The sisterhood—

Carissa Washington: Sisterhood.

Tatum Williams: Sisterhood.

Bill Whitaker: The sisterhood?

Voices: Yes.

Bill Whitaker: And you don't mean the nuns. You mean-- (laughter)

Christina Blazio: I mean, yeah. The community—

Bill Whitaker: So when you're here, there's just no question that you're going to go on to college.

Rayah Siddiq: College is all they talk about. (laughter) 

Pamela Rogers: … and Arizona State University (Cheering)

Principal Rogers announces to her 615 students the colleges where every senior has been accepted.

Bill Whitaker: So for 17 years, you've had a 100% graduation rate—

Pamela Rogers: Yes.

Bill Whitaker: --and a 100% college acceptance rate?

Pamela Rogers: That's correct.

Last year when Ne'Kiya and Calcea graduated, all their classmates went to college and got scholarships. Ne'Kiya got a full ride to the pharmacy school at Xavier University in New Orleans. Calcea, the class valedictorian, is studying environmental engineering at Louisiana State University.

Bill Whitaker: So wait a minute. Neither one of you is going to pursue a career in math?

Both: No. (laugh)

Calcea Johnson: I may take up a minor in math. But I don't want that to be my job job.

Ne'Kiya Jackson: Yeah. People might expect too much out of me if (laugh) I become a mathematician. (laugh)

But math is not completely in their rear-view mirrors. This spring they submitted their high school proofs for final peer review and publication … and are still working on further proofs of the Pythagorean Theorem. Since their first two …

Calcea Johnson: We found five. And then we found a general format that could potentially produce at least five additional proofs.

Bill Whitaker: And you're not math geniuses?

Bill Whitaker: I'm not buying it. (laughs)

Produced by Sara Kuzmarov. Associate producer, Mariah B. Campbell. Edited by Daniel J. Glucksman.

Bill Whitaker is an award-winning journalist and 60 Minutes correspondent who has covered major news stories, domestically and across the globe, for more than four decades with CBS News.

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The Problem of Obesity in the America Essay

Introduction, argument against government intervention, argument for government intervention, analysis of both arguments.

Obesity has been recognized as a national problem in America affecting well over 50% of the population. This condition has been blamed for many a medical complication as well as death in adults. Owing to the prevalence of obesity there have been calls for action to be taken so as to alleviate the condition.

These calls for action can broadly be categorized as government driven initiatives and the personal driven ones. There is contention as to whether the government should be allowed to directly intervene on a person’s eating habits as eating is deemed to be a hugely personal matter.

This paper shall compare two essays; one that opposes government intervention and another one that supports government intervention. The claims advanced by both essays shall be discussed and support offered on behalf of the claims analyzed. This shall be in a bid to ascertain which argument is of a higher quality.

The essay by Balko Bradley proposes that each person should be held accountable for their own diet and lifestyle and that government intervention only serves to absolve a person from taking responsibility for his dietary decisions. The author traces the origins of the problem to the move towards a nationalized health care system which leads to the whole American population collectively bearing the burden caused by the obese population.

Balko insists that this government intervention only serves to “remove the financial incentive for making healthy decisions” since the law dictates that health insurance premiums be kept uniform. This leads to a situation whereby a person who practices a healthy lifestyle is forced to subsidize the cost of the unhealthy lifestyle person.

In my opinion, Balko is not fair in his arguments against government intervention. He begins by somewhat ridiculing the government efforts and takes on a skeptical note as to the success that government interventions would have in reducing obesity prevalence. The author also fails to credibly back up his claims that the current health care system is responsible for the obesity problem and the reader can therefore not able reconcile the health-care system and the obesity problem as the author proposes throughout the essay.

Brownwell and Nestle theorize that the government is responsible for creating an environment in which healthy diets and lifestyles are promoted in the interest or all. This they argue is the only way that the prevalence of obesity in recent years can be curtailed.

The authors begin by stating that the food industry is a profit making enterprise and as such, the industry’s primary objective is increased sales even if at the cost of the public’s health and subsequently proceed to draw parallels between the increase in obesity through the years and the increase in the marketing efforts by the food industry.

Brownell and Nestle also perform a deductive reasoning in their counterclaims against the personal responsibility argument. The authors assert that irresponsibility cannot be on a constant uniform increase across the world as is the case with obesity.

The authors are fair in their arguments since they give both sides of the argument fair thought. They then proceed to refute each opposing view by credible argument. For example, the argument that the food industry only reacts to demand by the consumers is refuted by the authors claim that eating is a biological matter and “humans are hardwired to like sweet foods”.

In my opinion, Brownell and Nestle’s essay presents a superior argument on the matter. The authors make use of statistical information to make their point; this not only reinforces their arguments but it also shows that a lot of research has gone into coming up with the essay. Brownell and Nestle make use of historical events to reinforce their claims.

This is evident in their reference of the tobacco issue which also presented similar arguments; for and against government intervention. The authors assert that just as the reliance on personal responsibility failed in the tobacco case; it is bound to fail in the obesity debate. This historical perspective gives depth to their argument.

On the other hand, the essay by Balko fails to support most of the assertions it makes and also takes on a skeptical tone therefore not appealing to the reader’s intellect. Balko also fails to give any statistical backing to claims such as the role that the health care system plays in advancing obesity. This greatly weakens his arguments.

To the credit of both essays, they do not only restrict themselves to supporting government intervention or opposing it; instead, they also take into consideration the other side of the argument and proceed to point out the fallacies in the opposing views. This enables the reader to know of the other side’s story and therefore make a more informed decision when taking a stand on the matter.

Obesity is a nationwide problem and solutions should be sought before its effects reach catastrophic levels. This paper offered a brief analysis of two essays that propose differing views as to how solving this problem should be undertaken. From the arguments presented herein, it can be proposed that government initiatives aimed at reducing obesity are the best means through which this disaster can be contained.

While appealing to personal responsibility may be the ideal means in a society that is build on the basis of personal freedom, this may prove to be disastrous especially in the face of the aggressive advertisement and marketing schemes undertaken by the food industry players.

Balko, R, Brownell, K & Nestle, M. “ Are You Responsible for Your Own Weight? “. 2004 Web.

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1. IvyPanda . "The Problem of Obesity in the America." January 24, 2024. https://ivypanda.com/essays/weight-responsibility/.

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IvyPanda . "The Problem of Obesity in the America." January 24, 2024. https://ivypanda.com/essays/weight-responsibility/.

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Essay on Obesity in America

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Published: Mar 5, 2024

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Thomas L. Friedman

Why the Campus Protests Are So Troubling

By Thomas L. Friedman

Opinion Columnist

Readers have been asking me, and I have been asking myself of late, how I feel about the campus demonstrations to stop the war in Gaza. Anyone reading this column since Oct. 7 knows that my focus has been on events on the ground in the Middle East, but this phenomenon has become too big to ignore. In short: I find the whole thing very troubling, because the dominant messages from the loudest voices and many placards reject important truths about how this latest Gaza war started and what will be required to bring it to a fair and sustainable conclusion.

My problem is not that the protests in general are “antisemitic” — I would not use that word to describe them, and indeed, I am deeply uncomfortable as a Jew with how the charge of antisemitism is thrown about on the Israel-Palestine issue. My problem is that I am a hardheaded pragmatist who lived in Beirut and Jerusalem, cares about people on all sides and knows one thing above all from my decades in the region: The only just and workable solution to this issue is two nation-states for two indigenous peoples.

If you are for that, whatever your religion, nationality or politics, you’re part of the solution. If you are not for that, you’re part of the problem.

And from everything I have read and watched, too many of these protests have become part of the problem — for three key reasons.

First, they are virtually all about stopping Israel’s shameful behavior in killing so many Palestinian civilians in its pursuit of Hamas fighters, while giving a free pass to Hamas’s shameful breaking of the cease-fire that existed on Oct. 7. On that morning, Hamas launched an invasion in which it murdered Israeli parents in front of their children, children in front of their parents — documenting it on GoPro cameras — raped Israeli women and kidnapped or killed everyone they could get their hands on, from little kids to sick grandparents.

Again, you can be — and should be — appalled at Israel’s response: bombing everything in its path in Gaza so disproportionately that thousands of children have been killed, maimed and orphaned . But if you refuse to acknowledge what Hamas did to trigger this — not to justify what Israel has done, but to explain how the Jewish state could inflict so much suffering on Palestinian men, women and children in reverse — you’re just another partisan throwing another partisan log on the fire. By giving Hamas a pass, the protests have put the onus on Israel to such a degree that its very existence is a target for some students, while Hamas’s murderous behavior is passed off as a praiseworthy adventure in decolonization .

Second, when people chant slogans like “liberate Palestine” and “from the river to the sea,” they are essentially calling for the erasure of the state of Israel, not a two-state solution. They are arguing that the Jewish people have no right to self-determination or self-defense. I don’t believe that about Jews, and I don’t believe that about Palestinians. I believe in a two-state solution in which Israel, in return for security guarantees, withdraws from the West Bank, Gaza Strip and Arab areas of East Jerusalem, and a demilitarized Palestinian state that accepts the principle of two states for two peoples is established in those territories occupied in 1967.

I believe in that so strongly that the thing I am most proud of in my 45-year career is my interview in February 2002 with the Saudi crown prince, Abdullah bin Abdul Aziz, in which he, for the first time, called on the entire Arab League to offer full peace and normalization of relations with Israel in exchange for full withdrawal to the 1967 lines — a call that led the Arab League to hold a peace conference the next month, on March 27 and 28, in Beirut to do just that. It was called the Arab Peace Initiative .

And do you know what Hamas’s response was to that first pan-Arab peace initiative for a two-state solution? I’ll let CNN tell you . Here’s its report from Israel on the evening of March 27, 2002, right after the Arab League peace summit opened:

NETANYA, Israel — A suicide bomber killed at least 19 people and injured 172 at a popular seaside hotel Wednesday, the start of the Jewish religious holiday of Passover. At least 48 of the injured were described as “severely wounded.” The bombing occurred in a crowded dining room at the Park Hotel, a coastal resort, during the traditional meal marking the start of Passover. … The Palestinian group Hamas, an Islamic fundamentalist group labeled a terrorist organization by the U.S. State Department, claimed responsibility for the attack.

Yes, that was Hamas’s response to the Arab peace initiative of two nation-states for two peoples: blowing up a Passover Seder in Israel.

Hey, Friedman, but what about all the violence that Israeli settlers perpetrated against Palestinians and how Bibi Netanyahu deliberately built up Hamas and undermined the Palestinian Authority, which embraced Oslo?

Answer: That violence and those Netanyahu actions are awful and harmful to a two-state solution as well. That is why I am intensely both anti-Hamas and anti-Netanyahu. And if you oppose just one and not also the other, you should reflect a little more on what you are shouting at your protest or your anti-protest. Because no one has done more to harm the prospects of a two-state solution than the codependent Hamas and Netanyahu factions.

Hamas is not against the post-1967 occupation. It is against the existence of a Jewish state and believes there should be an Islamic state between the river and the sea. When protests on college campuses ignore that, they are part of the problem. Just as much as Israel supporters who ignore the fact that the far-right members in Netanyahu’s own coalition government are for a Jewish state from the Jordan River to the Mediterranean Sea. How do I know? Because Netanyahu wrote it into the coalition agreemen t between himself and his far-right partners.

The third reason that these protests have become part of the problem is that they ignore the view of many Palestinians in Gaza who detest Hamas’s autocracy. These Palestinians are enraged by precisely what these student demonstrations ignore: Hamas launched this war without permission from the Gazan population and without preparation for Gazans to protect themselves when Hamas knew that a brutal Israeli response would follow. In fact, a Hamas official said at the start of the war that its tunnels were for only its fighters, not civilians.

That is not to excuse Israel in the least for its excesses, but, again, it is also not to give Hamas a pass for inviting them.

My view: Hamas was ready to sacrifice thousands of Gazan civilians to win the support of the next global generation on TikTok. And it worked. But one reason it worked was a lack of critical thinking by too many in that generation — the result of a campus culture that has become way too much about what to think and not how to think.

I highly recommend a few different articles about how angry Gazans are at Hamas for starting this war without any goal in mind other than the fruitless task of trying to destroy Israel so Hamas’s leader, Yahya Sinwar, could get his personal revenge.

I was particularly struck by a piece in The National, a newspaper in Abu Dhabi, by Ahmed Fouad Alkhatib, a Palestinian American raised in Gaza. The headline is: “Israel’s War Has Killed 31 Members of My Family, Yet It’s Vital to Speak Out Against Hamas.” Alkhatib placed Hamas’s Oct. 7 attack in the context of the rising protests against its inept and autocrat rule that have broken out periodically in Gaza since 2019, under the banner of “We Want to Live.”

Wrote Alkhatib, a political analyst who is a nonresident senior fellow at the Atlantic Council: “Having grown up in Gaza, I experienced Hamas’s rise to power and their gradual grip over the Strip and Palestinian politics and society, hiding behind a resistance narrative and using extremist politics to sabotage prospects for a peaceful resolution to the conflict with Israel. Months before Oct. 7, tens of thousands of Gazans protested in the streets in defiance of Hamas, just as they had in 2019 and 2017.”

Alkhatib added that the “‘We Want to Live’ protest movement decried living conditions and unemployment in Gaza, as well as the lack of a political horizon for meaningful change in the territory’s realities and opportunities. Hamas’s regime consisted of a criminal and despotic enterprise that used Gaza as a haven for the group’s members and affiliates and turned Palestinians there into aid-dependent subjects reliant on the international community” and turned Gaza into “a ‘resistance citadel’ that was part of a nefarious regional alliance with Iran.”

A campus with critical thinkers might have had a teach-in on the central lawn on that subject, not just on the violence of Israeli settlers.

Against this backdrop, we are seeing college presidents at places like Rutgers and Northwestern agree to some of the demands by students to end their protests. As NPR summarized them, the “demands vary by school, though they generally call for an end to the Israel-Hamas war, disclosures of institutional investments and divestment from companies with ties to Israel or that otherwise profit from its military operation in Gaza.”

What Palestinians and Israelis need most now are not performative gestures of disinvestment but real gestures of impactful investment, not the threat of a deeper war in Rafah but a way to build more partners for peace. Invest in groups that promote Arab-Jewish understanding, like the Abraham Initiatives or the New Israel Fund. Invest in management skills capacity-building for Palestinians in the West Bank and Gaza, like the wonderful Education for Employment network or Anera, that will help a new generation to take over the Palestinian Authority and build strong, noncorrupt institutions to run a Palestinian state.

This is not a time for exclusionary thinking. It is a time for complexity thinking and pragmatic thinking: How do we get to two nation-states for two indigenous peoples? If you want to make a difference and not just make a point, stand for that, work for that, reject anyone who rejects it and give a hug to anyone who embraces it.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .

Thomas L. Friedman is the foreign affairs Opinion columnist. He joined the paper in 1981 and has won three Pulitzer Prizes. He is the author of seven books, including “From Beirut to Jerusalem,” which won the National Book Award. @ tomfriedman • Facebook