Addressing the obesity epidemic: Why should psychologists care?

Obesity has reached epidemic proportions in the United States. More than onethird of U.S. adults and 50 percent of African-American women are obese.¹ The number of obese Americans rapidly increased from 13 percent of the population in 1960–62 to 35 percent in 2005–06.² Obesity is now the second leading cause of death in the United States, and is likely to become the first.³

Unless this epidemic is successfully addressed, U.S. life expectancy will decline.⁴ Meanwhile, the economic costs of obesity are enormous. Health-care costs of patients who are obese are 42 percent greater than the health-care costs of normal weight individuals.⁵ The human toll is worse. Not only is obesity associated with higher mortality rates and shorter life expectancy, it also diminishes quality of life. Obese people are far more likely to suffer from diabetes and its complications (kidney failure, blindness, leg amputations), as well as stroke, breast and colorectal cancer, osteoarthritis and depression.⁶

Unfortunately, the obesity epidemic is not confined to adults: 17 percent of all U.S. children are obese, with obesity rates highest for African-American adolescent girls (29 percent) and Hispanic adolescent boys (27 percent).⁷ Childhood obesity is linked to psychological problems, asthma, diabetes and cardiovascular risk factors in childhood. Because obese children often grow up to become obese adults, childhood obesity is strongly linked to mortality and morbidity in adulthood.⁸

The obesity epidemic is not a product of changing genes or biology. It has its roots in the social environment and human behavior. Psychologists are experts at understanding human behavior as well as initiating and maintaining behavior change. Many psychologists have contributed to our understanding of obesity, its treatment and prevention, yet most psychologists are unaware of the obesity epidemic or view it as the domain of the medical establishment.

Expanding psychology’s role in advancing health is one of the core elements of APA’s strategic plan. To successfully address this goal, psychology must play a larger role in addressing the obesity epidemic, from basic science to prevention to treatment to public policy. I have spent my career helping children who have diabetes and their families. For many years, all of my patients had Type-1 diabetes, a form of the disease usually diagnosed in childhood that results from complete pancreatic failure. A few years ago, I started to see children and adolescents with Type-2 diabetes. This was a shocking development since Type-2 diabetes is a disease of overweight older adults. It soon became apparent that Type-2 diabetes in childhood was the consequence of the childhood obesity epidemic consuming our nation. I found that 30 percent of children in our local school system entered kindergarten overweight or obese. These rates escalated to 41 percent of sixth graders, with African-American girls (43 percent) and Hispanic boys (46 percent) most affected.

Type-2 diabetes in childhood is a travesty. The fact that 50 percent of African-American women are expected to get Type- 2 diabetes in their lifetimes is unacceptable. Type-2 diabetes is a preventable disease directly attributable to the obesity epidemic. Consequently, I am highlighting the role psychology can play in addressing the obesity epidemic as one of my presidential initiatives. Psychological research and interventions are critical to addressing the obesity epidemic at all levels: The developing child, the family, the school and work environments, the physical environment, public policy, as well as advertising and the media. It is time for psychologists to care and to bring their skills, expertise and passion to bear on the most serious health challenge facing our nation.

¹ JAMA. 2010;303:235–241.
² National Center for Health Statistics Health E-Stats. 2010.  
³ JAMA. 2004;291:1238-45.
⁴ Ann of Intern Med. 2003;138:24-32.
⁵ Health Affairs. 2009;28(5):w822–w831.
⁶ Women’s Health Med. 2004; 1:38-41.
⁷ National Center for Health Statistics Health E-Stat. 2010.
⁸ Arch Dis of Childhood.2003;88:748-752.
⁹ J of School Health. 2007;77:630-636.