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Obesity is a disease, but it also poses a threat as a common risk factor for various adult diseases. Persons with obesity are at risk of developing one or more serious medical conditions, which can cause poor health and premature death.  Obesity is associated with more than 30 medical conditions. Compared to non-obese people, obese people have incidence rate of high blood pressure, diabetes, hyperlipidemia, and fatty liver.

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Due to obesity, physical changes and vascular system abnormalities occur, such as an increase of fat in blood. Increased body weight puts strain on the body’s joints, especially the knees, so there is a high chance of degenerative arthritis. Cholelithiasis, amenorrhea, and infertility are also associated with obesity. (Madhav, 2006, 17)

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This report outlines an action plan to cover critical dimensions of the obesity problem in United States. The report also provides guidelines for the United States Food and Drug Administration’s authorities. The recommendations in the report focus on a “calories count” emphasis and are centered on the scientific fact that weight control is primarily a function of caloric balance. The recommendations in the report provide a plan of action that is founded on science, FDA’s public health mission and legal authorities, and the importance of considering consumer and other stakeholder views and needs in addressing obesity.

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According to currant estimation, about 64 percent of all Americans are overweight and over 30 percent are obese. The trends for children show that about 15 percent of children and adolescents aged 6 to 19 are overweight. The estimate is almost double of what it was two decades ago.

It has been observed the prevalence of obesity varies by socioeconomic status, ethnicity, sex, and race and age. Even though rate of obesity among children has increased, but the prevalence of overweight is considerably higher among non-Hispanic black and Mexican-American adolescents than among non-Hispanic white teens. It is seen that most non-Hispanic black women over 40 years of age are overweight or obese.

According to the estimations the total economic cost of obesity in the United States is about $117 billion per year, including more than $50 billion in avoidable medical costs, more than 5 percent of total annual health care expenses.

Researches have proved that overweight and obesity increase the risk of coronary heart disease, type 2 diabetes, and certain cancers. According to the estimates, at least three hundred thousand deaths each year are attributed to obesity.

Report Recommendations:

Food Labeling:

The following actions should be taken by the United States Food and Drug Administration to control the problem of obesity in the nation.

The United States Food and Drug Administration should publish an advance notice of proposed rulemaking (ANPRM) to seek public comment on how to give more prominence to calories on the food label, such as including a percent Daily Value column for total calories, eliminating the listing for calories from fat, and increasing the font size for calories.

The United States Food and Drug Administration should publish an ANPRM to seek public comment on authorizing health claims on certain foods that meet the international standard definition of reduced or low calorie. The health claims for reduced or low calorie food should put forward the fact that diets low in calories may reduce the risk of obesity, which is associated with type 2 diabetes, heart disease, and certain cancers.

The FDA should publish an ANPRM to seek comment on the requirement of additional columns on the NFP to list quantitative amounts and percent Daily Value of an entire package on those products/package sizes that can reasonably be consumed at one eating occasion or declare the whole package as single serving.

The FDA should publish an ANPRM to seek public comment on which, reference amounts customarily consumed of food categories have changed the most over the past decade and have need of updating.

The FDA should  consider the received file petitions that ask the agency to define terms such as “low,” “reduced,” and “free” carbohydrate; and as well provide guidance for the use of the term “net” in relation to carbohydrate content of food.

The United States Food and Drug Administration should encourage manufacturers to use dietary guidance statements, such as, “To manage your weight, balance the calories you eat with your physical activity”.

The FDA should encourage manufacturers to take advantage of the flexibility in current regulations on serving sizes to label as a single-serving those food packages where the entire contents of the package can reasonably be consumed as a single serving.

The United States Food and Drug Administration should encourage manufacturers to use proper comparative labeling statements that help consumers in making healthy substitutions. (Lamb, 2004, 32)

 Enforcement:

The NFP on products must contain accurate information regarding the product. The information is very crucial for consumers to monitor their intake of calories and nutrients. Especially, the meaningful serving sizes are of great help to consumers in understanding how many calories they consume. The report recommends that FDA should consider enforcement activities against those manufacturers who declare inaccurate serving sizes, highlight in the Food Labeling Compliance Program enforcement against inaccurate declarations of serving sizes, and work with the Federal Trade Commission in targeting dietary supplement products with fake or misleading weight-loss claims.

Education:

The report recommends that the United States Food and Drug Administration should focus its education policies on influencing behavior, as well as providing knowledge which help consumers in making healthy eating choices. It should convey the basic message that “Calories Count.” The report particularly recommends that FDA should take actions like establishing associations with private and public sector groups to provide consumers with a better understanding of the food label and also the use the label in making healthier and wiser food choices. The FDA should also pursue associations with youth-oriented organizations, such as the Girl Scouts of the USA and the 4-H program, to launch educational programs that call attention to caloric balance and proper diet for weight management.

       Restaurants/Industry:

In present social culture, eating in Restaurants or buying ready made packed food is considered trendy and fashionable. American consumers now spend about 46 percent of their food budget on food consumed outside of the home, and these foods account for a considerable portion of total calories consumed, particularly from quick service restaurants.

The report specifically suggests that the United States Department of Health and Human Services should take certain actions like urging the restaurant industry to launch a nation-wide, voluntary, and point-of-sale nutrition information campaign for consumers, encouraging consumers routinely to request nutrition information when eating out, developing various options for providing voluntary, standardized, simple, and understandable nutrition information, including calorie information, at the point-of-sale to consumers in restaurants, exploring the concept of third-party certification of weight-loss diet plans and related products. (Mukherjee, 2004, 327)

         Therapeutics:

 The United States Food and Drug Administration should recognize that overweight and extremely obese individuals need medical intervention to reduce weight and alleviate associated diseases and other adverse health effects. The report suggests that FDA should take the following actions:

Organize meetings of a standing FDA advisory committee to address challenges, as well as gaps in knowledge, about existing drug therapies for obesity.

Carry on negotiations with pharmaceutical and medical device sponsors about new obesity medical products.

Amend and improve the 1996 “Guidance for the Clinical Evaluation of Weight-Control Drugs” draft guidance on developing obesity drugs and re-issue it for comment.          

 Research:

The United States Food and Drug Administration should identify applied and basic research needs that include the development of healthier foods as well as a better understanding of consumer behavior and motivation. The report suggests that it should support and collaborate, as appropriate, on obesity-related research with others, including NIH. The FDA should also collaborate with the U.S. Department of Agriculture/Agricultural Research Service in developing healthy, nutritious and fat free food products that will help in solving the obesity problem.

The report suggests FDA to pursue other areas of obesity research information to facilitate consumers’ weight management decisions. It should make the consumers aware of the relationship between overweight/obesity and food consumption patterns, and as well provide incentives for product reformulation. Some FDA-regulated products unintentionally contribute to or result in obesity. Thus basic research findings should be extended of to the regulatory environment.

This report discusses the problem of obesity in the United States. The report focuses on obesity in both children and adult, providing horrifying statistics of the increase of this disease. The report identifies the medical problems that are caused by extreme overweight. The report describes the importance of planning and implementing comprehensive obesity control programs at the community level and in primary health care settings. The report provides a range of short- and long-term recommendations that, if implemented, will make a worthy contribution to confronting the Nation’s obesity epidemic and help consumers lead healthier lives through better nutrition.

References:

Lamb, Davis; (2004); Cult to Culture: The Development of Civilization on the Strategic Strata; National Book Trust. 32

Madhav, S. (2006); Effective Measures; Cities Today; Alliance Publishers; 3 (6); 17, para 6

Mukherjee, Sachin D; (2004); Strategies; IBL & Alliance Ltd. 327

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