The Obesity Epidemic: Are Minority Individuals Equally Affected?

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There is a greater prevalence of obesity in ethnic and racial minorities than in non-Hispanic whites. This disparity is multifactorial, with culture, environment, and genetics playing a role. There are limited data on successful interventions to prevent and treat obesity in minority populations.

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Epidemiology

Despite its prevalence in all segments of the American population, obesity imposes a larger burden on, and poses a larger threat to, minority populations. Statistics show that overweight and obesity occur disproportionately among minorities and those of lower socioeconomic status. Epidemiologic data demonstrate that ethnic and racial minorities have a greater prevalence of obesity compared with that in whites (Fig. 1).1 It has been estimated that by the year 2040, minority groups will make up

Obesity in older minorities and children

The effects of obesity do not discriminate; they have affected the health of both young and old. Elderly members of minority groups, a rapidly growing population in the United States, are adversely affected by the increased prevalence of obesity and all comorbid factors directly and indirectly associated with excessive weight.3 Excessive weight negatively affects the progression of many degenerative diseases seen in older adults. As excessive weight increases, morbidity and mortality of chronic

The psychosocial perspective

Several factors may increase overweight risk among racial and ethnic minorities. Psychosocial disorders are known to affect obesity through central nervous system dysfunction, and these mechanisms are now being researched extensively. Efforts are underway to articulate environmental, psychosocial, and biological conditions that may predispose the development and maintenance of obesity. There is increasing evidence that adverse childhood experiences, such as childhood abuse, may be implicated in

The socioeconomic determinant

In the United States in particular, obesity has a strong socioeconomic etiological relationship. It seems related to limited social and economic resources and may be linked to disparities in access to healthy foods. Foods enriched in refined sugars and unhealthy fats are affordable and tasty, whereas the recommended lean meats, whole grains, and fresh vegetables and fruit are expensive. The financial disparity in access to healthier diets may contribute to the higher rates of obesity and

Implications for access and quality of health care

It has been clearly established that the prevalence and severity of obesity are growing rapidly, along with obesity-related comorbidities and mortality. Given the increased health risks associated with obesity, it is vital that obese individuals have adequate access to, and make consistent use of, medical care services. Assuming obese people have access to medical care that is comparable to that for nonobese individuals, one would expect to observe greater use of medical services among those

The influence of genetic makeup

Although related to greater caloric intake and lesser caloric utilization, obesity is not just an imbalance of energy input and expenditure. Clinical evidence and epidemiologic data clearly show that weight control is more complex than was expected by this simple equation. It is now known that common variants in genes play critical roles in determining susceptibility to the exposure to toxins and other environmental threats. For instance, neurologic research has proven that both addiction and

Intervention strategies

Traditional approaches to treating overweight and obese adults by focusing on individual weight loss have not been effective in reducing the increased rate of obesity in the general population. Recent research has identified critical factors that, if they accumulate and interact during an individual's life span, may put a person at risk for obesity. These factors include rapid weight gain in infancy and childhood, early puberty, and excessive weight gain in pregnancy. Based on this research, a

Summary

It is evident that obesity is a growing medical concern worldwide. It is an epidemic that has dramatically affected the health of all Americans. Minorities carry excess burden of cardiovascular risk factors, particularly high blood pressure, diabetes, obesity, physical inactivity, and psychosocial stress. Further research describing the link between obesity and atherosclerosis and heart disease is much needed.

Cultural factors in symptom recognition and health care–seeking behavior are of great

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