Obesity+and+the+Proper+Treatment (2)

Running Head: THE PROPER TREATMENT OF OBESITY 1
Obesity and the Proper Treatment
Edwin Miranda
Cameron University
April 20, 2015

The Proper Treatment of Obesity 2
Abstract
The purpose of this paper is to educate people in the treatment of obesity through a combination
of physical and psychological approaches. A majority of the time, obesity is only treated
physically and rarely ever through a psychological approach. Obesity is classified as an
overabundance of accumulated fat; this happens when there is an increase of caloric diet and
sedentary lifestyle. In most cases, the best attempt at managing a mental illness is with a
combination of medicine and therapeutic counseling. A combination of physical and
psychological approaches could benefit individuals who are dealing with obesity. Not only
would they benefit from the increase of physical fitness and a healthy diet, they also but
psychologically understand why they are overeating.
Keywords: Obesity, sedentary, body mass index, composition, physical fitness, basal
metabolic rate, caloric, Diagnostic and Statistical Manual of Mental Disorders

Obesity and the Proper Treatment
There are multiple reasons why the obesity rates among American have risen. One reason
why the calorie intake has risen is that society wants its technology, food, and income fast.
Americans are on the go and have little to no time to hold traditional family activities that once
took place in the fifties. Modern families either have both parents working full-time or are
single-parent families. The years of a June Clever household are in the past; no longer are
children asking what they are having for dinner but where. Secondly, the reason why the obesity
rate has risen in the last 30 years is that the more technology speeds up, the less physically active
humans become. People can shut off lights, set the burglar alarm, pay bills, and order a meal all
on a smart phone during a commercial break. A prevalent link exists between obesity and the
changes of time through technology. A third reason that depression affects almost five percent of
the global population; a common symptom of depression is overeating or emotional eating.
Overeating is the simplest form of healing, sometimes viewed as a Band-Aid or quick fix for
those who are dealing with depression. Obesity should be treated similar to how other diseases
are treated; not all patients with the same disease are treated in the same manner. If individuals
can be assisted in finding out why they are eating so much, or if doctors can discover why they
do not seek therapy to live active lives, then maybe the obesity rate would decrease as the world
and technology keeps evolving. This research paper will explain the following questions; what is
Obesity? What is the physical approach for Obesity? Can a Psychological approach assist in the
treatment of obesity? Is the best treatment for obesity a combination of a physical/psychological
approach? These questions need to be answered in order to understand the core of obesity and
help solve this new disease.

What Obesity Is
Obesity is defined by Webster dictionary as “a condition characterized by the excessive
accumulation and storage of fat in the body.” Obesity is a result of taking in more calories than
needed or expended. There is a certain amount of calories that individuals need in a day to keep
themselves alive; this is known as basal metabolic rate (BMR)(Heyward, 2014). The formula to
finding one’s BMR is a starting point to figuring the minimum calories need in one day. The
formula reads as follows:(Orlov, 2015, para 4):
For men: BMR = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) + 5
For women: BMR = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) – 161
The value that comes from the BMR will be the baseline, and depending on how active an
individual is, that amount of calories are added on top of the BMR to equal total energy intake.
When the individual exceeds that total amount of calories needed in a day, they are stored
as fat. These actions being repeated over a period of time will increase the body mass index
(BMI). A normal BMI for adults is between 18-25%; once above 25%, it is considered
overweight, and anything above 30% is obese (Heyward, 2014). Men and women store excess
fat in different areas. Men store it mainly in the upper body, also known as android obesity, and
women store their fat mainly in the lower body, also known as gynoid obesity. According to the
Centers for Disease Control, heart disease, stroke, and diabetes are in the top seven reasons for
the cause of death in America. Obesity is a risk factor for each of those causes of death; this is
why obesity is serious epidemic that is sweeping across America.
The Physical Approach to Obesity
There are multiple physical approaches that can be taken to defeat obesity. Obesity is
commonly viewed as a medical condition; obesity, as of recent is only treated as a medical

condition (Bardick, Ireland, McVey, and Russell-Mayhew, 2012). Today, humans have life
obvious convent compared to those of the past, the days of hunting and gathering for most are
long gone. Since food is more readily available, it has caused us to become less active and since
there commonly is an abundance of food, an increase of calorie intake has resulted in a positive
energy balance (Dietrich and Horvath, 2009). Positive energy balance means that there are more
calories being brought into the body than going out. A negative energy balance is considered to
be a lack of calories coming in and too much energy being expelled. Limiting caloric intake is
just one tool for reducing obesity; the other tool is physical activity. According to the American
College Sports Medicine (ACSM), at least 30 minutes a day for five days a week of moderate-
intensity physical activity or 20 minutes of more vigorous activity, three days per week, is
recommended. Moderate-intensity is activity that increases the heart rate and causes a person to
sweat and lasting more than ten minutes. Vigorous-intensity is defined as exercise that causes
rapid heart rate (Heyward, 2014).
The intensity of exercise is measured in a MET. One MET is the ration of a person’s
exercising metabolic rate to the resting rate or 1kcal/kg/ hour. One MET is equivalent to just
sitting in a seat, so if an exercise is five METs, it is describing that it takes five times more
energy than sitting in a chair. Moderate-intensity is between three to six METs, and vigorous is
anything above six METs (Heyward, 2014, p. 3). 150 minutes per week is only to reduce disease
risk; The Institute of Medicine states that (as cited in Heyward, 2014, p.7) “in order to maintain a
healthy weight or lose weight it is recommended that one perform a daily 60 minutes of
moderate-intensity workout.” Examples of moderate intensity exercise are walking briskly (3+
mph); Water aerobics, and tennis. Vigorous intensity exercises are race walking/jogging/running,
swimming laps and jumping rope to name a few (Heyward, 2014, p. 7).

Physical fitness is defined as the ability to perform daily activities without becoming
fatigued (Heyward, 2014). There are five components of physical fitness; cardiorespiratory
endurance, which is the functions of the heart and lungs to supply the muscles with oxygen and
nutrients; musculoskeletal fitness, which is the ability of the muscles and skeletal system to
perform work; body composition, which is the absolute and relative amount of bone, fat and
muscle; flexibility, which is the ability to move joints through a full range of motion; and
balance, which is keeping the body’s center of gravity within the base of support (Heyward,
2014, p. 48). A good fitness plan includes each one of the components. Increased physical
fitness will help someone who is obese by burning those calories that are more than their daily
intake. If they are within their calorie intake, then the excess fat that is stored would be reduced.
In order for one pound of fat to be lost, a total of 3500 calories need to be burned (Heyward,
2014).
The Psychological Understanding of Obesity
Very little research has been produced to explain the mind of an individual suffering from
obesity or the effects it has on the mind (Bardick, Ireland, McVey, and Russell-Mayhew, 2012).
Bentz and Collins (2009) state in their article that “obesity is as much a psychological as a
physical problem” and “psychological issues can not only foreshadow the development of
obesity” (p. 124). The question of why someone is overeating or avoiding physical activity needs
to be answered to help manage obesity. People can watch what they eat and increase their
activity, but if they encounter a trigger that causes them to resort to their previous behavior, all
improvements are lost. Everyone who is obese is not believed to be dealing with a mental illness;
due to the extreme effects of anxiety and depression in a weight-loss program, a mental health
evaluation should be performed. The evaluation may possibility may lead to an in-depth

evaluation (Flint and Newson, 2011). Prior to performing a bariatric surgery on a patient, he or
she needs to undergo a physiological evaluation. The two reasons for the pre surgery evaluation
is to identify those who have a severe psychopathology that might prevent the success of the
surgery; the second reason is that it helps predict those individuals who are stable and possibly
may have a successful bariatric surgery (Bentz and Collins, 2009). The rapid weight loss will
increase their mood and happiness, and it is less likely that the individual would be dealing as
much with their depression compared to before surgery. There is enough research to connect
depression and obesity but none to link anxiety and obesity (Bardick, Ireland, McVey, and
Russell-Mayhew, 2012).
According to Bardick, Ireland, McVey, and Russell-Mayhew, (2012) Even though
obesity not considered a psychological disorder, many argue that it should be at least viewed as a
mental or behavioral issue. Binge eating disorder (BED) is currently included in the Diagnostic
and Statistical Manual of Mental Disorders, the book that is used to diagnose mental illnesses
(Bentz and Collins, 2009). BED is described as overeating in one setting with the feelings of
guilt and distress following these events. Bentz and Collins (2009, p.124) explain that “BED has
to occur at least twice a week in a six month period in order to be diagnosed with it; BED affects
two percent of the population and 10-25 percent of bariatric population.”
Classical and operant conditioning two examples of behavioral therapy models that last a
positive result is the loss of an average of 10% of their starting weight (Bentz and Collins, 2009).
Breaking bad habits is very important to identify in classical conditioning. A person who
watches a particular program on TV and eats the same meal or snack at the same time will
develop a pattern or habit. When that program is watched, he or she will have the craving for that
certain food, so a simple substitution of switching that snack with a healthy alternative would

create a new condition over time. Operant conditioning is using food as a reward and is
associated with pleasure. Simple changes of award from food to something else such as time-off,
shopping, or money, will condition other items more pleasurable other than food.
Cognitive behavioral therapy (CBT) is another form of therapy that can help turn an
individual’s eating from negative habits to a healthy lifestyle (Rich, 2004). By simply using a
food or exercise journal, one can turn his or her views on food and exercise around. There are so
many social media apps and blogs that have helped a large percent of individuals to succeed in
weight loss. My Fitness Pal is one that currently manages a daily account of calories eaten and
exercise performed. The calorie count reduces when food is eaten and increases when exercise is
performed. An action as simple as the counting of daily steps can be included on the app; the
accountability of all activity is measured. Blogs help individuals hold themselves accountable to
what they eat and help maintain a successful workout plan. Motivation and words of
encouragement mean the world to individuals who may feel or have found themselves
sidetracked. Treating the particular cause of why the increase of calorie intake will be more
beneficial than just developing a fitness or diet program. Flint and Newson, (2011) state in their
article that “Focusing on behavioral and cognitive needs will yield a better success rate” (p. 31);
more and more attention is focusing on the psychological approach, but is it being put to use.
Combining the physical and psychological approaches
Understanding the mind of those suffering from obesity is still not fully understood. The
arcuate nucleus (ARC) helps regulate energy balance and is located at the lowest part of the
hypothalamus. Leptin is a hormone that is produced by the fat tissue and enters the brain through
the ARC; leptin reduces food intake and can help reduced appetite (Dietrich and Horvath, 2009).
Jeffrey Friedman’s study (as cited in Dietrich and Horvath, 2009) found that the mind of an

obese mouse lacked Leptin. The problem that presents itself is that the minds’ of obese
individual have an inability to sense the Leptin hormone; “Understanding the causes of leptin
resistance in obese people, though, may help researchers identify new targets for treatment
designed to restore their sensitivity to this hormone” (Dietrich and Horvath, 2009).
Who will ever come up with the best treatment for obesity? It is similar to asking who
will find a cure for cancer in order to prevent others from suffering. It’s very difficult to separate
and treat the physical and psychological aspects of obesity (Flint and Newson, 2011). “Obesity is
a combination of a psychosocial, environmental, and genetic or biological attributes.” (Bentz and
Collins, 2009, p.124) Each one of these attributes needs to be addressed in order to achieve
success in obesity. In adults a positive success rate in weight loss is ten percent of the initial
weight, and psychologists are helping people reach this goal by using multiple therapeutic tools
(Rich, 2004).
Key Health Institute in Edmond, OK is the best answer thus far, in helping the epidemic
known as obesity. The institute is divided into a gym and wellness center, the wellness center
also has an urgent care unit to treat minor injuries and illnesses. There they prescribe exercise to
their clients instead of using pharmaceutical drugs. Exercise is their drug of choice. They
perform a series of physical activity test to best produce a proper workout for the individual. The
workouts can be tailored in order to reverse the effects of certain diseases such as diabetes and
obesity. These programs are known as Technology-Supported Rx-Prescribed Achievable Results
Clinically-Driven, or T.R.A.C. These programs are stated to be “prescribed by physicians,
administered and delivered by exercise physiologists and dietitians "(Key Health, 2015).
Simply Fit is a program that the institute offers to individuals to help unlock their DNA
coding for exercise. The program performs a DNA test and sends it off to a lab, the results is

tailored to the particular DNA. This helps the individual understand their body better and learn
what exercise is most beneficial to him or her, in order to have the best results form an exercise
program.
Corporate Fitness is a preventative health program that companies sign up their willing
employees in order to living a healthier lifestyle. The program helps the employer develop a
healthier staff, which will help the company save money by decrease funds for insurance
companies due to unhealthy employees. The program will reduce absenteeism from illness and
help their employees to be more productive. The best thing about the program that there is a
tracker that states the amount of fitness each company has performed. This creates a healthy dose
of competition among all the local companies that are enrolled in this program.
It would be ideal for an individual to have a team; a group of professionals that can assist
in each aspect. This ideal team would include a primary care giver or doctor that would be able
to treat illnesses, perform physicals, and help prevent diseases to the individual, secondly a
psychologist or psychiatrist to evaluate the mental wellness of the individual and prescribe
therapy and pharmaceutical aid, psychologist are not able to prescribe medication so that
individual can seek them from his or hers doctor. Third, the last part of this team would have to
be a certified physical trainer and nutritionist, so that they can develop a fitness plan and diet for
the individual. This would be a great asset to anyone who is suffering from a disease, let alone
obesity. The amount of money it would cost to build an individualized team like this would be
cheaper than treating each visit to the emergency room or therapy due to separating the disease
In conclusion, psychological treatment along with an exercise program is in fact an ideal
treatment for obesity. The severity of an individual’s mental illness would factor the need of
pharmaceutical aids or not. There is little research on psychologically curing obesity and even a

smaller amount of treatment using a psychological approach. As a whole, Americans do not view
obesity as a disease; the awareness of obesity is so easy to be overlooked. If Americans only
knew the amount of risk obesity has to the leading causes of death then maybe the awareness
would be broader. When people eat smaller portions they consume less calories; those who
exercise 30 to 60 minutes daily increase physical fitness and reduce their stress levels, high blood
pressure, and chances of developing diabetes. There are multiple negative eating patterns
associated with depression; depression is a common symptom for other mental illnesses as well.
One should treat the depression as well as take on a better well rounded diet and exercise
program to completely overcome their struggle with obesity. The inability to do so would be like
plugging three different holes in a boat, at the same time, while on water.

References
ACSM. (2011). Reducing sedentary behaviors: Sitting less and moving more [Brochure].
Retrieved from http://www.acsm.org/docs/brochures/reducing-sedentary-behaviors-
sitting-less-and-moving-more.pdf?sfvrsn=6
Bardick, A., Ireland, A., Russell-Mayhew, S., & McVey, G. (2012). Mental health,
wellness, and childhood overweight/obesity. Journal of Obesity, Volume 2012, Article
ID 281801, 1-10. doi:10.1155/2012/281801
CDC. (2015). Deaths and mortality. Centers for disease control and prevention
Retrieved from http://www.cdc.gov/nchs/fastats/deaths.htm
Collins, J. C., M.A., M.S., & Bentz, J. E., Ph.D. (2009). Behavioral and psychological
factors in obesity. Journal of Lancaster General Health. Vol 4(4) Retrieved, from
http://www.jlgh.org/Past-Issues/Volume-4---Issue-4/Behavioral-and-Psychological-
Factors-in-Obesity.aspx
Dietrich, M. O., M.D., & Horvath, T. L., Ph.D. (2009, October 27). Wired for hunger: the brain
and obesity. Retrieved April 14, 2015, from
http://www.dana.org/Cerebrum/2009/Wired_for_Hunger__The_Brain_and_Obesity/
Healthline. (2012). Unhappiness by the numbers: 2012 depression statistics. Retrieved,
from http://www.healthline.com/health/depression/statistics-infographic

Heyward, V. H. (2010). Designing weight management and body composition programs. In
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Leeds, UK: Human Kinetics.
Key Health Institute TRACS. (n.d.). Retrieved, from
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Newson, L., & Flint, B. (2000). Obesity a heavy burden in the UK. Pharmaco economics &
outcomes news, 283(1), 26-34. doi:10.1007/BF03267486
Obesity. (n.d.). Retrieved, from http://www.merriam-webster.com/dictionary/obesity
Orlov, A. (2015). How to calculate your bmr (and why it matters). Retrieved,
from http://dailyburn.com/life/health/how-to-calculate-bmr/
Rich, L. E. (2004, January). Bringing more effective tools to the weight-loss table. Retrieved,
from http://www.apa.org/monitor/jan04/bringing.aspx

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