Chapter II Review of Literature We know that the problem ofobesityis a world-wide epidemic and is becoming an even greater threat to the United States. Currently the U. S is the world’s most obese country and with a large margin between second place (James, Leach, Kalamara, Shayegh 2001). America is also the front runner in a new trend: morbid obesity. Not only does America have the highest population of obese individuals, America also has the largest population of morbidly obese individuals (WorldHealthOrganization 2009).
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Morbid obesity affects both males and females of all ages and ethnicities from different socioeconomic statuses, however, the Black female population that has been affected the most (Lorenzen, (2010). This trend of overweight Black American females has only recently become an epidemic (Davis, 2008). What if any factors played into this abrupt change in obesity levels of the Black-American woman? Obesity and BMI Obesity can be classified as a condition characterized by excessive body fat to the magnitude that is becomes detrimental to one’s health (Ho-Pham, et al. , 2010).
There are different methods to measuring ones body mass index with the more common methods being height to weight ratio measurement, waist to hip ratio measurement, skin fold tests, and bioelectrical impedance measurement. For most of these references BMI’s were calculated between a mixture of bioelectrical impedance and skin fold measurement tests. A person should have a BMI of 18. 5 to 24. 99 be considered “ normal” (World Health Organization, 2010). Once a BMI reaches 30 or greater the individual is classified as obese. The term obesity is broken down into 3 different Body Mass Index (BMI) classifications. Having a BMI greater than 30. is considered Class I Obesity. A BMI greater than 35. 0 is considered Class II Obesity and a BMI greater than 40. 0 is Class III Obesity or morbid obesity (World Health Organization, 2000). The Obesity Epidemic Obesity is a worldwide epidemic (Deitel, 2003). 1 out of every 10 adults suffering from obesity worldwide (WHO, 2009) and this number will be doubled by 2015 (Withrow, Alter, 2011). Stemming from this large occurrence there are over 2. 5 million obesity related deaths worldwide each year (CDC 2011). However in America the problem is even greater in that 35. 7 percent of the adult population is obese (CDC 2011).
The most current figures available come from a 2005-2006 survey station that 6 percent of Americans suffer from morbid obesity (Journal of the American Medical Association, 2012). The obesity epidemic in the United States represents a critical public health crisis. The increase in obesity can be directly linked to the increase of other major health issues such asdiabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status ( Mokdad, et al. , 2001). Not only does it encompass life threatening consequences such as diabetes and cardiovascular diseases but it also results in major healthcare costs (Brown, et al. 2009). The United States spends upwards of $147 billion annually in obesity related healthcare costs (The Washington Post). The rise in obesity is giving way to a new epidemic- morbid obesity. Morbid Obesity and Women Morbid obesity is classified as having a BMI greater than 50. 0 (Strum, 2007). Like in obese people, morbid obese people see the same list of health complications such as high cholesterol, high blood pressure, infertility and breathing problems such as asthma and sleep apnea to more severe problems such as diabetes and high premature mortality rates.
Both obesity and morbid obesity are a major problem in the United States. It is apparent that morbid obesity is on the rise in the U. S however it is more prevalent in women than in men. Morbid obesity tends to affect women more than men. Currently morbid obesity cases affect females 24% more than males and it is estimated that by the year 2020, 40. 2% of men will be obese with 3. 1% of that population being morbidly obese and 43. 3% of women will be obese with 5. 8% of that population being morbidly obese (C. J. Ruhm, 2007).
Morbid Obesity in Black-American Women Morbid obesity continues to rise throughout America however the most significant increase is seen in Black women. Over 78% of Black-American women are overweight or obese (Davis, 2008), and it is predicted that by 2030, 96. 9% of Black women will be either overweight or obese (Wang, et al. , 2008). In 2002 morbid obesity among Black-American women was more than double that among White andMexican-American women. 13. 5 % of Black-American women were morbidly obese as opposed to 5. 5% and 5. % in White and Mexican-American women (Wang, Beydoun, 2007). Why it is that Black women are most vulnerable to not only obesity, but to morbid obesity? Could socioeconomics place a factor in these figures? A study was done in 2007 that looked at race, socioeconomic status andfoodquality availability. It was found that in low income urban areas, there was significantly less access to not only major food chains but foods of quality such as fresh fruits and vegetables while having a significantly higher access to convenience store than the rest of the population. Powella, et al. , 2007). Since majority of low income urban areas are made up of black residents then why aren’t Black men’s morbid obesity rates just as high? Both Black men and Black women of the same socioeconomic status have the same access to the same food distribution centers. Both also share the same body compositions as naturally having a greater lean mass to fat mass ratio (Flegal, Carroll, C. L. Ogden, Curtin, 2010). Could there be another factor playing a role in Black women’s prevalence to morbid obesity? Body Image
A study was conducted at Tennessee State University where 218 Black- American females were asked to rate their body image confidence. The findings of this study suggested that the obese and morbidly obese women rated themselves as having a high level of body image confidence and life satisfaction as opposed to that of the women who were normal or overweight (Lorenzen, L. , 2010). Another study was conducted in 2007 looking at the preferred body images between 80 White- American and 80 Black-American participants. All participants were asked to look at female models and silhouettes of women.
The models BMI’s ranged from low to obese. From there the participants were asked to rate each model and silhouette. The study found that there was a significant difference in ratings between Black- American and White-American participants in that model silhouettes with a higher BMI received higher attractiveness ratings amongst the Black-American participants than compared to White-American participants (Davis 2008). Although these studies yielded relatively small samples the results are conclusive in that Black-Americans view a female with a larger BMI as having a more attractive body image.
This obesity epidemic in Black-American women is fairly new. If we go back only a few decades ago, the obesity rates of Black- American women has doubled between 1988 and 2004. In addition, various longitudinal studies have shown that there are higher rates of weight gain in black women than in white women. Also during the first BMI examinations in the 1970s, white and black girls had similar levels of BMI but the annual increase in BMI were 30-40% larger among the black girls throughout bothchildhood and adulthood(Freedman et al, 2005).