The Effects of Obesity on the Cardiopulmonary System: Implications for Critical Care Nursing

Kim Garrett, RN, MS, CNP; Kathy Lauer, RN, PhD; Beth-Anne Christopher, RN, MS


Prog Cardiovasc Nurs. 2004;19(4) 

In This Article

Scope of the Problem

In 2000, the Centers for Disease Control and Prevention (CDC) reported that the prevalence of obesity among adults in the United States was 19.8%, a 61% increase over rates reported in 1991. In a 2003 paper, the CDC reported that obesity rates climbed from 19.8% to 20.9% between 2000 and 2001, indicating that 20%- 25% of the US population is obese.[3] Even though this latest paper demonstrates a rapid and significant rise in the rate of obesity, the reported rates are thought to be substantial underestimates of the problem.[3]

Currently, there are an estimated 60 million obese individuals in the United States.[1,2,3] The rise in the prevalence of obesity has occurred among adults of all ages, genders, racial/ethnic groups, and income and educational levels, however, some significant differences related to race/ethnicity, gender, age, and socioeconomic status are noteworthy.[1,2,3]

The prevalence of obesity is higher within some racial/ethnic groups than in whites, with the exception of Asian Americans, for whom obesity prevalence is generally lower than in the general population. Blacks demonstrate the highest rate of obesity at 31.9%, with Hispanics at 23.7% and whites at 19.6%. Within the general population of obese individuals, the prevalence of obesity in men and women is relatively even, although there are conflicting reports[1,2,3] claiming differential prevalence rates for males and females. The contradictory results often seem to involve the use of different parameters to define obesity (e.g., some statistics combine overweight and obese individuals or use different body fat percentages to define overweight and obesity). In contrast, there are significant gender differences in obesity prevalence within and between racial/ethnic groups.[1] Obesity rates increase as the population ages and peak in the fifth decade at 26.1%. Higher socioeconomic status, increased income, and increased education levels are inversely related to obesity prevalence.[3]

The financial burden associated with obesity is considerable, both in terms of direct and indirect costs.[1,6,7] Estimates in the late 1990s calculated the total costs of overweight and obesity-based expenditures as 9.1%−9.4% of total US health care expenditures or $123 million. Direct costs, defined as those associated with preventive, diagnostic, and treatment of diseases attributed to obesity, were estimated at $64 million.[6,7] Indirect costs, defined as those associated with the value of wages lost by people unable to work because of illness or disability, as well as the value of future earnings lost by premature death, were estimated at $59 million. The indirect costs have reached levels equal to those associated with cigarette smoking.[6]


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