Chronic health conditions such as type 2 diabetes, hypertension, coronary heart disease (Kumanyika et al., 2008; Patterson et al., 2004), respiratory illnesses (Chen et al., 2006; Murugan & Sharma, 2008), and osteoarthritis (Yanovski & Yanovski, 2002) are related to overweight and obesity. Since 1960, the percent prevalence of diabetes for all ages has increased by more than 400%. Major risk factors for diabetes are obesity, high-fat diet, and physical inactivity (CDC, 2001). Additionally, diabetes is the fifthleading cause of death and is responsible for
new-onset blindness, kidney failure, and lower limb amputations (Hogan, Dall, Nikolov, & American Diabetes Association, 2003).

Diabetes has reached epidemic levels, and the prevalence of diabetes in the United States continues to increase. The National Health and Nutrition Survey found that 9.3% of Americans 20 years and older (approximately 19 million people) had diabetes; two-thirds had an actual diagnosis and one-third were not diagnosed (Sheehy, Coursin, & Gabbay, 2008). Further, it has been estimated that by 2050, about 43 million people will be diagnosed with diabetes (Narayan, Boyle, Geiss, Saaddine, & Thompson, 2006).

Coronary heart disease, used interchangeably with cardiovascular disease, occurs because the body builds plaque that clogs the inner walls of the arteries. Coronary heart disease is responsible for heart attacks, strokes, and chest pain and is the principal cause of death in the United States (Wallace, Fulwood, & Alvarado, 2008). Cardiovascular disease is associated with poor dietary practices, physical inactivity, overweight, obesity, and cigarette smoking (Lee & Cubbin, 2002).

Obesity is now recognized as a risk factor for developing respiratory diseases such as asthma, pneumonia, and sleep apnea, a condition in which a person will stop breathing several times during the sleep cycle. Weight reduction has been shown to reduce the possibility of developing these conditions or improving the episodes of these conditions (Murugan & Sharma, 2008).

Arthritis is responsible for physical disabilities in elders. Arthritis affects about 70 million Americans. Osteoarthritis is the most common form of arthritis and leads to muscle weakness, which in turn results in decreased physical activity and problems with balance. When this occurs, people are at increased risk for physical disability. Weight reduction and moderate exercise have been shown to improve mobility in overweight and obese adults diagnosed with knee osteoarthritis (Messier et al., 2004). Considering the increasing prevalence of overweight children and adolescents in America, one questions what the future holds for these young individuals as they move into adulthood with regard to these chronic illnesses as well as the corresponding morbidity and mortality rates.

Individuals diagnosed with such mental illnesses as schizophrenia, depression, and bipolar disorder may be at a higher risk for becoming overweight and obese because of psychotropic medications, decreased physical activity, and inadequate attention paid to nutrition. The prevalence of obesity among people with diagnosed mental health disorders is more than the general population. Women schizophrenics had higher BMIs than nonschizophrenic women, whereas male schizophrenics and nonschizophrenics had comparable BMIs. Experiencing a depressed mood during adolescence may have a role in the prevalence of obesity in this group, but being obese in adolescence does not necessarily cause depression. Young women, however, who were overweight or obese were more likely to experience a depressed mood, which is defined as “feeling sad, blue, or depressed for at least 7 days during the previous month” (Allison et al., 2009).

The prevalence of metabolic syndrome is higher among individuals diagnosed with a mental health disorder than in the general population. Metabolic syndrome is a group of risk factors such as high blood pressure, obesity in the abdominal area, elevated blood sugar levels, elevated bad cholesterol, and lower levels of the good cholesterol (high-density-lipoprotein cholesterol). These conditions often occur together
and increase one’s risk of developing heart disease, stroke, and diabetes (Newcomer, 2007).

The fattening of America is a result of worsening diets, higher carbohydrate intakes, physical inactivity, genetics, sedentary lifestyles, food overproduction because of subsidies, increased portion sizes, and aggressive food marketing of snacks and fast foods (Seiders & Petty, 2004). Aggressive food marketing strategies have also resulted in Americans eating more fast foods, and the “supersizing” trend has resulted in larger portion sizes. Another example of this excessive eating is noted as follows. U.S. food companies produce about 3,800 calories/day per person, whereas food production in 1970 was 3,300 calories/day per person. Further, Americans have vast amounts of food choices in supermarkets, and approximately 12,000 new food products are developed yearly (Blair & Nichaman, 2002). Family-prepared meals have become less frequent because of work schedules, and this has contributed to poorer dietary habits (CDC, 2000). As family-prepared meals have decreased, eating outside the home has increased, resulting in meals that are 20% higher in fat (Ward & Martens, 2000).

Urban sprawl has also contributed to increased rates of overweight and obesity in Americans. Urban sprawl is defined as patterns of housing development that are considered low-density residential areas; therefore, people residing in these areas live in larger houses and commute longer distances to their jobs, often relying on automobiles because of inadequate public transportation (Lopez, 2004). Because these areas lack pedestrian amenities such as walking to school, shopping locally, and socializing with friends within walking distances, urban sprawl is considered a risk factor of overweight and obesity for those residing in those communities.

The composition of a neighborhood can contribute to the overweight and obesity of the residents. Lower BMIs have been associated with neighborhoods that have higher population density, access to public transportation, and mixed land uses that includes houses, apartments, parks, green spaces, access to healthy foods, and private and public resources that encourage healthier lifestyles (Lovasi, Neckerman, Quinn, Weiss, & Rundle, 2009).

Children spend a large portion of their day in educational institutions. In 2000, approximately 53 million children attended public and private schools in the United States. Further, schools serve as the location for preschool, after-school, and child-care programs (Koplan, Liverman, & Kraak, 2005). Additionally, many children receive their meals at their schools. Schools, because of loss of monies, may sell foods that are not part of federally reimbursable lunches. Additionally, many schools have become distributors of vending machines that carry candy, beverages, and chips. Vending machines are found in about 43% of elementary schools, 74% of middle schools, and most high schools. These vending machines provide schools with about 50% of the profits from the machines (Seiders & Petty, 2004). On the surface, these profits may appear very attractive to financially struggling schools.