Sunday, November 14, 2010

Introduction to the Ecological Model and Obesity

   Many different factors come into play when looking at the risks of adult obesity and having a BMI of over thirty. The Ecological Model can help us understand where these different factors fit in within a person's life. Whether it is a financial situation, genetic disorder, belief, or a poor lifestyle choice, every aspect to the increasing risk of obesity matters. We can separate each factor into five different categories of the Ecological Model: intrapersonal, interpersonal, institutional, community, and public policy. Each of the five parts of the model are important and all may play a major role in the risk of adult obesity.

Intrapersonal Factors

   Many intrapersonal factors can come into play with obesity of adults.
  One main part of the intrapersonal part of the Ecological Model is perception. Some people may think that they are at either a high or low risk level for developing cardiovascular and/or respiratory disease because of their weight. If a person does not think that they are at a high risk for cardiovascular or respiratory disease and they are overweight or obese, they may not do much to improve their lifestyle choices so that they can avoid developing these diseases. A study done by the Morehouse School of Medicine showed that women who were at a healthy weight and women who were overweight all perceived themselves to be at the same level of risk for disease related to weight. However, women that were obese reported that they were at a higher level of risk compared to women who were overweight or at a healthy weight.
   Another intrapersonal variable that can affect one's weight is the way that the person views themselves. If a person believes that he or she is capable of maintaining a healthy lifestyle, they may be more likely to do so. According to a study done by the Cancer Prevention Fellowship Program, people who had higher self-efficacy were less likely to be eating a diet high in fat. I think this is interesting because not many people would think that one's motivation and perception of themselves could really be a leading factor of living a healthier lifestyle.
   A third variable from the intrapersonal level of the Ecological Model is knowledge. One's knowledge can tremendously affect how he or she lives. If a person does not have much knowledge about correct serving size, proportioning, and amount of fat to take in, they may end up overeating and gaining lots of weight. A study was done on this topic by the Department of Kinesiology. The data showed that women who overestimated the amount of food in one serving tended to be overweight or obese. This is interesting to me because many of the serving sizes in restaurants and stores are exceptionally bigger than they were even five or ten years ago. I think that people must become knowledgeable about serving sizes when it comes to losing weight and being at risk for becoming overweight.

Interpersonal Factors

   One factor that can come into play when looking at someone's physical activity is the influence of family and friends on the person. If a person is raised in a family that is very physically active, he or she might not be at as high of a risk as someone who is raised to live a sedentary lifestyle. Similarly, when a person associates his or herself with people who are very physically active, he or she may be influenced by this. He or she could very well become more engaged in physical activity compared to someone who is friends with people who do not do vigorous or moderate physical activity. A study was done on this topic by the Division of Cancer Control and Population Sciences. What was looked at was the impact that family and friends has on one's physical activity level. It was shown that if an exericise is done alone, it is more likely to be vigorous than if it is done with more than one person. However, a conclusion was made that the more people are involved in the activity, the longer it will be. I think it is important for us, as health educators, to encourage our students and clients to bring in physical activity to their social settings. Many different activities can be fun and healthy at the same time, and we need to give the people we are educating good ideas of what they can do to make their exercise fun.
   I think that the influence of family and friends on one's physical activity can be either extremely positive or extremely negative. If someone is not encouraged enough to become physically active, he or she may be at a higher risk of being obese. According to the study done by the Cancer Prevention Fellowship Program, people who were encouraged by their family and friends to live a healthy lifestyle were less likely to be at risk for becoming obsese. These people had a fat intake that was significantly less than the people who did not have the positive encouragement to live a healthy and active lifestyle. One job we have, as health educators, is to encourage people who do not have a strong social support to become engaged in physical activity and to eat correctly. If a person does not have close ties with his or her family, we need to be the people who can push them a bit further into becoming healthier.

Institutional and Organizational Factors

   Many different organizations and institutions can be looked at when assessing the risk factors for being obese or overweight.
   A large percent of adults are in college. It seems as though going away to college can increase someone's risk for becoming overweight or obese. Many college students are busy with classes, homework, part-time or full-time jobs, children, and friends. College can be a huge factor of why people in adulthood become obese. The Department of Epidemiology did a study on college students and an intervention program for weight loss. It has been shown that the weight loss programs do work for college students, as long as the participants remain active in the programs. Overall, I think that the college population is one of the main groups that are at risk for becoming obese. Although most health educators target younger students and older adults, intervention within colleges should be critical as well. If these weight-based intervention programs were at all colleges, maybe college students would not be at such a high risk for obesity.
   One group that seems to have an effect on the risk of being obese is faith-based programs. It seems like the support group of churches and communities of faith can really help someone to live a healthier lifestyle. One study done by the College of Public Health focused on the differences between Catholic and public intervention programs for weight loss. The data showed that although both were very effective with the amount of weight that the groups of people lost, the Catholic-based program had a higher amount of satisfaction from the participants. It seems like belonging to a faith-based program can really be effective because of the amount of support a person can get from a large amount of people. It would be very positive for a person that believes in some sort of religion and wants to lose weight because he or she can join a group of people who believe in the same things religiously that also want to lose weight. Although the belief in any type of religion does not play a direct role in the amount of risk someone is at for being overweight or obese, it is important to know that faith-based programs can really help someone who is struggling with his or her weight.

Community Factors

   Having a low socioeconomic status can have a great impact on obesity. Since healthier foods tend to be more expensive, people with a low SES may buy more unhealthy food for cheap. Because of this, people with low SES are at a much higher risk for being obese or overweight. Not only is healthy food expensive, but gym memberships and health insurance may not be affordable to people with a low SES. The Research Department of Epidemiology and Public Health did a study on low SES, obesity, and the health-related quality of life. What they concluded was that people with a low socioeconomic status are at a higher risk of being obese and tend to have a lower health-related quality of life compared to those at a higher socioeconomic status. People that are obese and have a low SES also have a lower level of health-related quality of life compared to people that are at a normal weight and are at the same socioeconomic level. This is a hard barrier to break for many people. Having a low SES is not something that can be changed over night. Healthy food prices will almost always be higher than food that is not as healthy. As health educators, we must be aware of this and show our students and clients that there may be ways around it. If certain unhealthy activities, such as cigarette smoking and drinking alcohol can be cut out of their lives, they may be able to afford the more expensive, healthier food. On the same note, we must encourage people to exercise, whether or not they can afford a gym membership. Taking a jog outside, riding a bike, and playing basketball at a park are activities that are free or fairly cheap. As long as physical activity is somehow incorporated in people's lives, they may be able to reduce their risk of being overweight or obese.
   The geography of where a person lives may play a role in increasing the risk of obesity. If a person lives in a rural area, he or she may not have enough access to health care, exercise facilities, doctors, etc. He or she may have to travel very far in order to reach a doctor's office. The nearest exercise facility could be twenty or more miles from his or her house. The University of North Dakota School of Medicine and Health Sciences did a study on American Indians living in very rural areas in the northern plains of the United States. What they have found is that the American Indians living in this area had a higher rate of health problems, including diabetes, heart disease, and obesity than the national level. It is interesting to look at rural, urban, and suburban areas and see how they differ in their amounts of people who are obese. What health educators need to do is help the people in rural areas to find better access to health care. We must encourage that although living a health lifestyle may be pricey at times, it is important to do so because of the high rates of obesity in rural areas.

Public Policy Factors

One way that the risk of obesity can be affected is by public policy. If taxes are raised on certain foods or drinks, such as fast food, candy, and soda, people may be less likely to buy them. However, some people may not be impacted by this. It all depends on the individual. This debate is comparable to the argument of taxes on tobacco. Although taxes have gone up on certain tobacco products, it does not seem as if the amount of smokers in the United States has decreased dramatically. Some may say that the same thing would happen with fast food, candy, and soda. The Department of Nutrition and Food Studies says that in order for a successful intervention program to work, experts, educators, researchers, and not-for-profit organizations all need to collaborate to come up with some sort of plan to intervene. I think that the more people that are involved, the stronger the intervention program could be.
   According to the National Cancer Institute, many people favor tax breaks for employers that provide a good exercise facility in the workplace. This would be a great idea because it would give the employees and employers an incentive to exercise before or after work. The employers would not only benefit financially, but they would be able to use the facility as well in order to improve their physical activity. Overall, I think that policies like these would only prevent the risk of obesity.

Works Cited

Dunton, GF., Berrigan, D., Ballard-Barbash, R., Graubard, BI. &Atienza AA. (2009). Environmental Influences on Exercise Intensity and Duration in a U.S. Time Use Study. Medicine and Sciences in Sports and Exercise: Division of Cancer Control and Population Sciences. 41(9): 1698-705. Retrieved from

Fuemmeler, BF., Baffi, C., Masse, LC., Atienza, AA. & Evans, WD. (2007). Employer and Healthcare Policy Interventions Aimed at Adult Obesity. American Journal of Preventive Medicine: National Cancer Institute. 32(1): 44-51. Retrieved from

Holm, JE., Vogeltanz-Holm, N., Poltavski, D. & McDonald, L. (2010). Assessing Health Status, Behavioral Risks, and Health Disparities in American Indians Living on the Northern Plains of the U.S. Public Health Reports: University of North Dakota School of Medicine and Health Sciences. 125(1): 68-78. Retrieved from

Krukowski, RA., Lueders, NK., Prewitt, TE., Williams, DK. & Smith West, D. (2010). Obesity Treatment Tailored for a Catholic Faith Community: A Feasibility Study. Journal of Health Psychology: Fay W. Boozman College of Public Health. 15(3): 382-90. Retrieved from

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Sailors, MH., Jackson, AS., McFarlin, BK., Turpin, I., Ellis, KJ., Foreyt, JP., Hoelscher, DM. & Bray, MS. (2010). Exposing College Students to Exercise: The Training Interventions and Genetics of Exercise Response (TIGER) Study. Journal of American College Health: Department of Epidemiology. 59(1): 13-20. Retrieved from

Shah, M., Adams-Huet, B., Hubbard, S. & Carson K. (2010). Food Serving Size Knowledge in African-American Women and the Relationship with Body Mass Index. Journal of Nutrition Education and Behavior: Department of Kinesiology. 42(2): 99-105. Retrieved from

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