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Obesity in the USA and Indonesia

Introduction

Obesity is a multifaceted medical concern that involves excess fats in the human body. Increased fat levels in the human body increase the risk of other diseases such as high blood pressure, cancer, and cardiovascular disorders (Blüher, 2019). There is a significant difference between being overweight and being obese. While excessive weight may be caused by muscles, bone, and water in the body, obesity is solely due to taking too much fat compared to what is broken down into calories. Obesity is a global concern, and its prevalence has been increasing, which puts many nations in danger. The World Health Organization (WHO) uses the body mass index scale to classify people as either obese, underweight, or overweight. The WHO statistics show that one in every five children and adolescents worldwide is obese. Further, 39% and 13% of the world’s adult population are overweight and obese, respectively (Harbuwono et al., 2018). The obesity rate in the USA and Indonesia is impacted by poverty, low education levels, and economic disparity, such as low-income levels.

Obesity prevalence can be understood through a multidisciplinary approach by analyzing the economic, and biological domains. The paper covers the lens of economy and biology through which obesity risk factors can be identified and prevented. The economic lens checks the ability of people to maintain healthy lifestyles, while the biological lens investigates how fat intake and irregular meals affect the body. Obesity is a dangerous disease, and countries worldwide must enhance policy changes in the medical departments to cushion citizens from the disease.

General Causes of Obesity

The most common cause of obesity that has led to increased global obesity rates is excess fat intake and removing little fats from the body. Similarly, lifestyle changes like the ones introduced by the Covid-19 pandemic, where people work from home, make them less active and prone to the disease. Therefore, a poor diet is the primary cause of obesity as it is prone to people who eat large amounts of processed foods, consume excessive alcohol, sugary drinks, and comfort eating (Blüher, 2019). Lack of physical activity is another critical component likely to cause obesity since it is one of the fundamental avenues for removing excess fats in the body. Failure to exercise means that a person cannot get rid of the excess fats in the body (Blüher, 2019). The world health organization recommends that a person undertakes at least one hundred and fifty minutes of physical activity to eliminate the excess calories in the body. Genetics and medical reasons are further likely to increase obesity rates in countries.

Obesity Prevalence in the Selected Countries

Obesity Prevalence in the USA

The obesity prevalence concerning age in the USA shows an outgoing concern as the young population is at high risk. Young Americans aged 12-19 are at high risk of contracting obesity due to their eating habits (Blüher, 2019). Generally, obesity in the USA has been increasing steadily since 1962, and the changing lifestyles contribute much. Due to changes like work, many people take in excess fat and do not carry out adequate exercises to eliminate the fat in their bodies. On average, 43.4% of Americans are obese, per the 2020 CDC report. 36.5% of American youths are at risk of obesity, while 21% of adults are in danger (Jastreboff et al., 2019). Based on gender, female adults are prone to obesity compared to their male counterparts. Over the years, numerous political, economic, and social changes have been observed, increasing the obesity rate in its population from 317 million recorded in 2012 to 338 million recorded in 2022 (Fanzo et al., 2022). Healthcare strategies need to be implemented to lower obesity and improve quality of life.

Obesity Prevalence in Indonesia

The rate of obesity in Indonesia is increasing exponentially in both the poor and the rich as most people are shifting from traditional foods to more processed foods. Processed foods are prone to be consumed by more people because they are more affordable and have higher sugar and fat levels (Brown et al., 2019). According to the introductory health research survey conducted in Indonesia, in every five adults is obese or overweight, while one in seven adolescents is obese and overweight. One in five children aged five to twelve years is also obese putting Indonesia at risk of other opportunistic diseases (Jastreboff et al., 2019). In 2021, 23.6% of the deaths reported in Indonesia were related to obesity and the associated diseases (Harbuwono et al., 2018). The Indonesian health ministry, in conjunction with WHO and UNICEF, is working towards reducing the obesity rates.

Socio-Economic Factors

Obesity rates in the USA are higher in African American communities than in whites. Social factors associated with blacks in the USA include poverty, unemployment, and low-level education leads to obesity (Brown et al., 2019). Similarly, obesity in Indonesia is more profound in poor households. Poverty-stricken households cannot control their eating habits and therefore eat whatever is available (Jastreboff et al., 2019). Since junk and processed foods are cheaply available, the people in poor households are prone to consume processed foods putting them at a higher risk. In the USA, the obesity rate directly correlates with poverty, and the people who live below the poverty line are more likely to suffer obesity than rich people.

Although failure to take a balanced diet and adequate physical exercise is the prime cause of obesity, skipping meals have a similar effect. Biologically, skipping meals makes a person’s metabolism rate slow, and the conversion of fat to calories is jeopardized (Jastreboff et al., 2019). Since poor people cannot afford a balanced diet or take regular meals, the body changes into survival mode and consequently make a person crave food more. As the body struggles to save energy by going into survival mode, most of the fats are stored, leading to excessive fats in the body and increasing the rate of obesity in the discourse. It is further paramount to note that poor people with a lower education level may not understand the risk factors of obesity and therefore ignore them. In the long run, they suffer from obesity.

Physical exercises can be conducted in many forms, such as privately at home or as a team in specialized sporting and gym facilities. The rate of people registered in the gym facilities in the USA and Indonesia is comprised of people in the high society who boast high incomes and luxurious lives. Most people living in poverty-stricken neighborhoods have no access to gym and sporting facilities which makes them unable to practice effectively. Unemployed people are therefore less likely to register for the gym and sporting facilities leading to less physical activity, which consequently leads to higher rates of obesity.

Poverty and Alcohol Intake

Drug and substance abuse, especially alcohol, is partly caused by stress and other depressive disorders. Since alcohol is one of the obesity risk factors, the people prone to more alcohol are therefore likely to be at a higher risk of obesity than those who do not take excessive alcohol. In the USA and Indonesia, alcohol consumption is higher in poor neighborhoods, which puts them at a higher risk than the rich, who take alcohol for enjoyment (Jastreboff et al., 2019). Since most people in the lower social class are depressed and consume more alcohol to feel better, obesity is likely higher in poor neighborhoods. The rich take alcohol for enjoyment only and are therefore more likely to regulate their intake than the poor, who drink to keep off the challenges of day-to-day life. The efforts to fight obesity, especially in impoverished neighborhoods, must be prefaced with alleviating poverty and educating the people on the need for a balanced diet to stay safe.

Low Education Levels

Education level is an essential determinant for the spread of obesity among the population. In the USA, people who dropped out of high school are at a higher risk of contracting obesity than those who graduated and proceeded to higher education levels. In Indonesia, education has an inverse proportion to the rate of obesity among the people. The groups with lower educational attainment are more likely to be obese. Both whites and blacks in the USA have a similar obesity-education relationship, and among people aged 25-44, the rate of obesity is higher in the less educated people (Blüher, 2019). The differentials are, however, more significant in men than women, as less educated women are more likely to be obese than males who are less educated. It is imperative to note that education levels directly correlate with employment, income level, and living environment, all factors affecting obesity. For example, a highly educated person is likely to secure employment with a higher income, afford a balanced diet, and have additional money to enrol in fitness programs.

Obesogenic Environments

An obesogenic environment is the surrounding that promotes gaining weight and is not conducive to achieving weight loss, even if people would love to reduce it. Both work and home environments are major contributing factors to the rate of obesity in both the USA and Indonesia (Harbuwono et al., 2018). The population growth, which leads to congestion in the urban environments, makes the work environment obesogenic. For example, building skyscrapers increases the use of elevators and lifts, making people unable to lose weight, as using lifts discourages physical exercise. Similarly, lunch breaks in busy working environments are reduced, and people hire food merchants to serve the employees in their offices (Dewi et al., 2020). Consequently, the environment increases the uptake of junk foods and reduces the chances for people to exercise by walking. The modernization of the working environment among the working class is prone to increase the obesity rate and put more people in danger.

The urban setting encourages driving compared to walking, which jeopardizes physical exercise, essential in reducing obesity. Further, the modern environment has made more fast food joints than hotels that cook whole-grained foods with fewer fats. As the junk food business increases in modern cities in Indonesia and the USA, the rate of obesity is likely to increase over the years. Obesogenic environments are risk factors primarily found in high-income nations and must be reduced to contain global obesity prevalence (Jastreboff et al., 2019). Mississippi, for example, has the highest rate of obesity in the USA because most of the environments in the region are prone to obesity and discourage healthy eating and physical exercise. In Indonesia, Jakarta has some everyday environments that discourage physical exercise and healthy eating.

Food Availability

Food availability is an economic factor that drastically affects obesity prevalence in both developed and developing countries. As the population grows and more young people become unemployed, they are empowered to start businesses to sustain their livelihoods. Of all the startups in the USA, 32% are fast food outlets, making junk and processed food more common in American neighborhoods (Dew et al., 2020). Indonesia has a large pool of junk food stores which therefore increases the food availability in the region, putting children and adults at risk of excess intake of fats. KFC, for example, is the Indonesian market leader, which increases the levels of fatty foods in the region (Jastreboff et al., 2019). As it increases its consumption in the region, it makes people prone to be obese as many people now prefer taking junk foods to the fresh foods prepared at home. Junk and fatty foods are cheaper than healthy foods and attract more people, especially those in poor neighborhoods.

Convenience stores in the regions sell soda, processed foods, and candy easily stored. As the logistical challenges of storing healthy foods increase, more traders in the USA and Indonesia prefer storing junk in their convenience stores. In most urban areas, it may be more expensive or difficult to find whole and fresh foods, leaving people with no choice but to buy junk foods. In the economic domain, most fast food producers are aggressive marketers and convince people to take unhealthy foods (Jastreboff et al., 2019). Like human thinking, the most advertised food is likely to be healthier and more acceptable. Therefore, many people in the USA and Indonesia fall into the trap of buying unhealthy foods advertised in the market. Most junk food companies use misleading claims which attract children to junk foods. Further, the aggressive advertising jeopardizes children, and hence may not be able to make an informed decision about the foods they eat.

Medically Underserved Populations

Poverty levels and health disparity in the USA and Indonesia affect the rate of medically underserved societies prone to obesity compared to other communities. High societies have increased access to medical treatment where people have access to knowledge about obesity and how it can be prevented. Heredity, for example, is one of the causes of obesity which can easily be controlled when the person has access to information on the correct lifestyle (Dewi et al., 2020). In places where primary healthcare is available for the entire population, it becomes for people who inherited obesity to be educated on the best ways of living to overcome the risk of obesity. In areas with no healthcare facilities, people who inherit obesity may not access the correct information and may not be healed from the challenge of obesity (Brown et al., 2019). Primary care providers in the towns in USA and Indonesia have developed health promotion programs to educate people on obesity prevalence and help them overcome the challenge of obesity. The medically underserved communities cannot access promotional and educational material to protect them from obesity risk factors.

Economic and Social Intervention to Lower Obesity Prevalence

The exponential increase in obesity prevalence threatens public health, and intervention must be implemented to reduce the rate. The rising cases of obesity in Indonesia and the USA can be attributed to socio-economic factors that must be stopped to achieve a healthier population. Governmental regulation on the production and distribution of junk food must be implemented to ensure that all advertisements are done on an ethical framework and that no one is misinformed about food choices (Inoue et al., 2018). Further, health promotion can be initiated country-wide to educate people on the risk factors and make people safe from obesity. Since obesity is a lifestyle disease, it can be controlled by changes in lifestyle which can be achieved through healthcare promotion. Although the fight against poverty is long-term, short-term interventions such as regulation and education on the risk factors must be available. Once society is educated on the dangers of obesity, people are likely to adjust their lifestyles for better health outcomes in the discourse.

Conclusion

Obesity is a global healthcare concern whose prevalence is on a steady trajectory. Indonesia and the USA are some affected nations whose prevalence among the youths is alarming. Social and economic factors are the leading causes of the disease, and interventions must be focused on the socio-economic domains. Obesity is a lifestyle disease whose principal cause is excessive uptake of fat and low physical exercise. The antidote to overcoming obesity is eating a healthy diet and physical exercise. However, socio-economic factors such as poverty deprive people of the ability to access a balanced diet, physical exercise equipment, and knowledge. The poor are also prone to have low education levels and higher alcohol consumption which increases the risk. Fighting obesity must therefore be prefaced by alleviating the socio-economic factors and implementing nationwide healthcare promotions to enable people to change their lifestyles and embrace healthy living.

Reference List

Blüher, M., 2019. Obesity: global epidemiology and pathogenesis. Nature Reviews Endocrinology15(5), pp.288-298. https://doi.org/10.1038/s41574-019-0176-8

Brown, T., Moore, T.H., Hooper, L., Gao, Y., Sayegh, A., Ijaz, S., Elwenspoek, M., Foxen, S.C., Magee, L., O’Malley, C. and Waters, E., (2019). Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.cd001871.pub4

Dewi, N.U., Tanziha, I. and Solechah, S.A., 2020. Obesity determinants and the policy implications for the prevention and management of obesity in Indonesia. Current Research in Nutrition and Food Science8(3), p.942. http://dx.doi.org/10.12944/CRNFSJ.8.3.22

Fanzo, J., Rudie, C., Sigman, I., Grinspoon, S., Benton, T.G., Brown, M.E., Covic, N., Fitch, K., Golden, C.D., Grace, D. and Hivert, M.F., (2022). Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium. The American Journal of Clinical Nutrition115(1), 18–33. https://doi.org/10.1093/ajcn/nqab315

Harbuwono, D.S., Pramono, L.A., Yunir, E. and Subekti, I., 2018. Obesity and central obesity in Indonesia: evidence from a national health survey. Medical Journal of Indonesia27(2), pp.114-20. https://doi.org/10.13181/mji.v27i2.1512

Inoue, Y., Qin, B., Poti, J., Sokol, R. and Gordon-Larsen, P., (2018). Epidemiology of obesity in adults: latest trends. Current obesity reports7(4), 276–288. https://doi.org/10.1007/s13679-018-0317-8

Jastreboff, A.M., Kotz, C.M., Kahan, S., Kelly, A.S. and Heymsfield, S.B., (2019). Obesity as a disease: the obesity society 2018 position statement. Obesity27(1), 7–9. https://doi.org/10.1002/oby.22378

 

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