April 2011

Overcoming obesity: the broader perspective shaping individual choice

Annual meeting symposium will look at treatment, prevention and complications of obesity.

State-specific percentage of adults categorized as obese, by black/white race or Hispanic ethnicity. From the Center for Disease Control’s Behavioral Risk Factor Surveillance System surveys, United States, 2006-2008.


Overcoming the obesity epidemic continues to be a concern for scientists, epidemiologists, health professionals, policy makers and millions of overweight men and women. According to the World Health Organization, more than 200 million men and nearly 300 million women worldwide are obese (1). In the United States, where the abundance of food and the reliance on labor-saving technology have increased in the past 50 years, the incidence of obesity, defined as body mass index greater than 30 (BMI = kg/m2), continues to rise. An obesity prevalence of 30 percent or greater has been reported in almost 20 percent of the states in the continental U.S. (2).

There is little argument that the consequences of obesity are detrimental. It has been documented that obesity is a risk factor for other chronic diseases, such as diabetes, hypertension, cardiovascular disease and cancer. Obesity reduces life expectancy (3), and it costs us billions of dollars in health care. Research demonstrates that the accumulation of fat that characterizes obesity impacts physiological processes through biochemical mechanisms such as inflammation, mitochondrial dysfunction, oxidative stress, increased apoptosis and lipotoxicity. However, it also is well established that the consequences of obesity both as a disease risk and as a precursor to abnormal biochemical processes do not carry an equal burden in all individuals.

To address this issue, the American Society for Biochemistry and Molecular Biology Minority Affairs Committee is presenting a symposium titled “Treatment, prevention and complications of obesity” at the annual meeting in Washington, D.C. When comparing the prevalence of obesity in racial/ethnic groups across the U.S., data show a greater prevalence in African Americans and in Hispanic Americans than in European Americans. These are striking statistics that present scientists with intriguing questions. From the perspective of complications, it is known that most of the comorbidities associated with obesity differ among groups. However, the extent that molecular and biochemical mechanisms resulting from obesity also differ within and among racial/ethnic groups and the mechanisms underlying these differences remain unknown. From the perspective of prevention, the statistics challenge us to explore the multifactorial etiology of obesity in innovative ways that account for the uniqueness of different groups in developing preventive strategies. From the perspective of treatment, we need to understand whether pharmacological agents and other treatments will deliver comparable results among individuals of diverse backgrounds. Certainly, we do not want to repeat previous mistakes of using medications targeted to specific racial/ethnic groups without a clear idea of an appropriate biological racial/ethnic marker.

Click here to read the 2011 annual meeting thematic overviews.

For information on the annual meeting, click here.

Eliminating the racial/ethnic barriers underlying complications, treatment and prevention of obesity will require the awareness that a one-size-fits-all approach might not be the most effective model in the fight against obesity. However, as we collectively work to overcome obesity as an epidemic in the population, it is necessary to keep an appropriate perspective. The development of obesity as a disease starts with the basic and essential need for food. Therefore, moving toward an individualized approach to fight obesity will require understanding which foods and what quantities are necessary for a healthy weight range based on biological, cultural, physiological and behavioral characteristics and practices. Individualized approaches must be complemented by education – every morning, people should ask themselves two questions: how well did they monitor their energy intake and expenditure the previous day, and how well will they monitor it today? Perhaps the most relevant question right now is, have you started to ask these questions yourself?

References

1. World Health Organization. Obesity and overweight. Fact sheet N°311.
2. Center for Disease Control and Prevention. U.S. Obesity Trends.
3. Fontaine, K. R., Redden, D. T., Wang, C., Westfall, A. O., and Allison, D. B. (2003) Years of life lost due to obesity. J. Am. Med. Assoc. 289, 187 – 193.

Jose R. Fernandez (jose@uab.edu) is an associate professor and vice-chairman for education in the department of nutrition sciences at the University of Alabama at Birmingham.


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