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Journal: From Issue to Persuasion (GRADED)

Now that you’ve spent some time writing down some potential issues for your project, it’s time to narrow the focus. Reviewing the

Opposing Viewpoints database

– that’s the link provided–>

(

https://go-gale-com.ezproxy.snhu.edu/ps/browseCategory?userGroupName=nhc_main&inPS=true&prodId=OVIC&category=Health+and+Medicine

and reviewing your brainstorming activity, select two potential issues that are related to your career of Nursing. Again, be sure you’re selecting and writing about two separate issues.

As you work on the journal, remember to refer to the assignment guidelines and rubric below to make sure you’re fulfilling each critical element.

Assignment Guidelines and Rubric

Overview: The journal activity in this course is private between you and the instructor. This week, you spent some time reflecting on persuasion in your everyday life, and you shared some potential topic ideas with your peers and instructor. But why is persuasion so important? Let’s think about that a little bit in this journal assignment.

Specifically, the following critical elements must be addressed:

After exploring the Opposing Viewpoints Database and reviewing your brainstorming activity, identify two issues that are related to your career or degree:
Write a fully developed paragraph for issue one (5–8 sentences each).

Explain at least two clear arguable sides to the issue.
Explain how the issue relates to your field or degree or potential field or degree.

Write a fully developed paragraph for issue two (5–8 sentences each).

Explain at least two clear arguable sides to the issue.
Explain how the issue relates to your field or degree or potential field or degree.
After exploring the arguments related to your issues, take a moment to consider the bigger picture. Then, briefly reflect (in 1 to 2 paragraphs) on the importance of persuasion for the issue you are most likely to write about. Be specific in your assignment; this information will help guide you as you work on your project in the coming weeks.
Identify which side you might argue if you plan to pursue this issue in your final persuasive essay.
Identify your potential audience and why your topic would be relevant to them.

Guidelines for Submission: Save your work in a Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Then, check your writing for errors.

Please use link provided above to retrieve your two separate issues and please also use reading attched called modle 1below as additional reference.

Module 1: The Keys to Persuasion

Welcome to ENG-123: English Composition II! In this course, you will uncover the foundations of persuasive writing and explore
the research process through analysis and evaluation of various sources.

In this first module, you’ll start by introducing yourself on the course-long discussion boards. Next, you’ll explore problem solving
and persuasion with your classmates. Finally, you’ll brainstorm and develop ideas for your persuasive essay (due in Module
Seven) by submitting a journal entry to your instructor.

1-1 Discussion: Class Mixer (UNGRADED)

This assignment does not contain any printable content.

1-2

Reading: Problem Identification

We encounter problems in every aspect of our lives. On a personal level, we are constantly working on such things as mending
relationships with friends and family members, managing a hectic household, and addressing health concerns. In our
professional lives, we also encounter problems on a daily basis, both on a small and a large scale. For example, if you are a
teacher, you may spend one class period managing poor student behavior and then spend the next class period scrambling to
figure out how to finish your lesson plan before the bell rings. There are also the larger-scale issues that you may deal with,
particularly if you teach in a public school system, such as reconciling the tension between government-mandated initiatives and
your own beliefs about what works well in the classroom.

In response to these types of industry-specific problems, researchers are continually investigating ways to fix these issues. The
results of such research will impact the types and availability of careers in various fields, while also impacting people’s personal
lives. For example, in the fast food industry, many companies are responding to society’s ever-growing interest in “eating clean”
and “being green.” Takeout containers are made with recycled materials, and many fast food chains are ceasing to use artificial
colors and ingredients in their food. Individuals in the food industry now feel the pressure to join the “clean and green”
movement in order to attract and maintain customers. And as with all change, debate follows. There will always be dissenters
from every viewpoint.

Introduction to Persuasion

In this course, you will practice the art of persuasion. You will
think about a problem in your field of study/profession that
has at least two clear arguable sides and compose a
persuasive argument that clearly states your point of view on
the issue. Your goal is to convince the audience to adopt
your viewpoint. In order to do this, you will make a claim—an
assertion with which your audience might disagree—and
then support that assertion with evidence.

Argument in Everyday Life

The word “argument” has a negative connotation, or
suggested meaning. When people hear the word argument,
they often assume it is a hostile conversation about a topic.
But argument can also simply mean a well-reasoned point
being made about a topic, done so in a respectful, logical
way. Arguments can occur between respectful parties who strongly disagree with one another’s argument, but it does not
have to be hostile.

Let’s say you are sitting at Thanksgiving dinner, and you are a bit nervous because your uncle, who feels very differently
about politics than you, will inevitably bring up the latest political hot topic. Knowing you have to be level-headed and
reasoned in your conversation with him, in order to avoid any hostility, you choose an even tone, respectfully acknowledge
what he is saying, but still hold your ground on your position toward the hot topic. Since it is different than his position, and
you want to hold your own in this argument, you present him with reasons that are clear and logical. Although he may not
agree with you, and you will likely not persuade him, he is more likely to at least listen to your point of view. Making sure you
do not slip into insulting language, eye rolling, or walking away when he disagrees with you are all important to having an
effective argument.

In all aspects of our lives, we present arguments to those around us: to car salespeople, to our children when they don’t want
to do something we know is good for them, to our partners when they want to spend more money than we do, or to our
grandparents when we try to get them to see the benefits of using video chats. Whether we are writing or talking to people
who matter to us, argument is all about drawing people in and persuading them to at least see our point of view, if not to
adopt it.

The examples in the video show us how argument and persuasion can function successfully (or unsuccessfully) in everyday life.
Although the examples provided are in the first person (since they are examples from everyday life), the premise in persuasive
writing is the same:

be respectful of potentially opposing positions
use logic to ground your stance
be clear, concise, and precise in the presentation of your argument, using indicator words such as “must,” “should,”
“support,” “because,” or “oppose” to present your core argument

Opposing Viewpoints

When making a persuasive argument, it is also important to factor in any counterarguments, or opposing viewpoints, and
consider how to respond to them.

Most topics generate a variety of positions, not simply two positions that sit in direct opposition to each other. In fact, it is helpful
to picture the potential positions on any given topic in a circular format rather than imagining two distinct points at opposite ends
of a straight line. Few topics lend themselves to such an oversimplified black and white division. As most topics are complex and
layered, some of the most potent arguments can be found in the grayer areas. The more complex issues give rise to multiple
points of view along a continuum, something writers need to keep in mind.

Take, for example, the topic of sex education in public schools. One position on the topic is the “absolutely not” position held by
some people due to their religious and/or moral ideologies. According to this position, sex education should never be taught in
America’s public schools under any circumstances. Opposing the “absolutely not” position are a range of positions, not just one.
Here are only four of the many possibilities:

Yes, sex education should be taught in public schools, depending on what material is covered.
Yes, if it concentrates on abstinence.

No, if it concentrates on abstinence.
No, if it begins in elementary school.

If you are writing on sex education in public schools, you will have
to be familiar with all of the positions on both sides of the
argument. Additionally, you will need to understand the reasons
people hold these positions. Refuting any opposing position is
impossible if you are unfamiliar with the issue as a whole.

The first step in composing a persuasive argument is to do a little
preliminary research and brainstorm topics for your written piece.
The next few pages in the module will help you get started.

1-3 Discussion: Persuasion in Everyday Life (GRADED)

This assignment does not contain any printable content.

1-4

Reading: Brainstorming Ideas

This week, in your 1-6 Journal assignment, you’ll be asked to look at some issues related to your potential field or degree.
Before you practice some brainstorming strategies, it might help to take a look at possible issues related to your field. In module
two, we’ll take a closer look at conducting keyword searches and gathering sources, but for now, to prepare for brainstorming
and constructing your Journal submission this week, you can take a look at the freewriting instruction steps previously outlined—
with that idea as your starting point.

Remember that the most important part of freewriting is reflecting on your writing. So, after your loop, be sure to ask yourself the
same reflective questions you asked during your initial freewrite.

Freewriting Questions

After you finish freewriting, read your writing carefully to decide which ideas are most worthy of exploration. As you read over
your writing, ask yourself these questions:

Do I stay on topic in most of the writing, or do I shift to another topic? Am I more interested in my initial or my new topic?
What words are repeated in my writing? Words that you repeat are likely to indicate an interest in that particular aspect of
the topic?
Which of my ideas can be backed up with research during the subsequent research process? Opinions can help point you
toward an interest, but if your freewrite consists only of opinion, you may need to conduct another freewrite that focuses
more on facts, you may want to conduct a preliminary search, or you may need to pick a new topic.
Can I identify one or two questions that most of my freewrite responds to? If you can, you might have found yourself a
research question.

If you’d like to compare a freewriting session against a looping session, compare the loops below to the freewrites from above.

Looping Example #1

Feeding America’s poor won’t be easy. Not with one out of seven of us living at the poverty level. It’s especially bad for
kids. I mean, how can a kid concentrate on learning when he hasn’t eaten in two days? When you think about how much
food goes to waste every single day in this country, you’d think there wouldn’t be a problem. Just think about the food
fights that go on in cafeterias all over the country. With that wasted food alone we could probably feed all the poor
people. And I know a lot of people let vegetables sit in their refrigerators until they rot and then they have to throw out all

that food. Also, just think about all the restaurants that throw away food every single day. You’ve probably seen
homeless people doing “dumpster digs.” I know I have. At least, they are getting some nourishment out of what’s being
discarded, but who’d want to eat food that’s mixed with garbage? I think we should have more public service
announcements to make people aware of what they are wasting. That would be a first step. Maybe parents could also
be advised not to put so much food on their kids’ plates at suppertime. That would solve two problems–the food waste
problem and the obesity problem. Then, we could use the money that is saved to help the hungry more than we do. It’s
true that some celebrities like Sandra Lee have started a campaign, but not everybody watches her on the food network
channel. I guess we need more celebrities getting the word out. I know the President and First Lady are working on this
and that’s helping a lot. But there’s really a lot to do. There are food banks, of course. But we really need more than
famous people getting the word out. We need the average Joe thinking twice about waste.

Follow-Up Questions

Do I stay on topic in most of the writing, or do I shift to another topic? Am I more interested in my initial or my new
topic? ANSWER: I really did focus on the poor and how much food-waste there is in this country. I also talked about
what famous people and ordinary people can do to solve the problem of people going hungry.

What words are repeated in my writing? ANSWER: “Poor” (poverty), “food,” “waste,” “celebrities.”

Which of my ideas can be backed up with research during the subsequent research process? ANSWER: There has to
be a lot of data about poverty in America and also wasted food. I could also learn more about Sandra Lee and what
people like her are doing to help.

Can I identify one or two questions that most of my freewrite responds to? ANSWER: What are celebrities doing to help
the poor? What can the average person do?

Research Question

Topic: Feeding the hungry

Research Question: What are the characteristics of an effective anti-hunger program?

Looping Example #2

What will I do to earn a living? Right now I’m studying liberal arts and there are a lot of possibilities in front of me,
assuming I don’t change my major. There are a lot of things I know I wouldn’t do–no matter how much money I could
make. Even if I was desperate, like Stephen King, I wouldn’t dig graves to earn money. I also wouldn’t do anything that
would harm animals. And I would never steal from people the way Madoff did. But, as a liberal arts generalist, especially
a generalist with some computer skills, I could probably enter any field I wanted to. There really are a lot of choices.
Plus, I could always learn on the job. Most businesses have orientation and training programs that help new hires learn
what they need in order to do a specific job. And, a lot of places will actually pay for employees to take additional
college courses. Of course, I could pay for further education myself if I had to. I could get a Master’s Degree or some
other degree that would help me get promotions once I’ve started working. Plus, there’s always stuff I could learn about
on my own by doing research on the Internet or by taking some online courses. Things are changing so fast that I’d
probably have to take additional courses anyway. Take electrical engineers, for example. I read that by the time they
graduate, half their knowledge is obsolete. So maybe I shouldn’t worry too much about what I’m learning right now.
Instead, I should concentrate on getting a good solid academic base, rather than a narrow or too-specific body of
knowledge. Being able to communicate well is critical for career success, no matter what field I choose and I’ve always
had A’s in my written and oral communications classes. Being a good problem-solver is important, too. I like challenges
and have often been complimented on my analytical skills. Another thing that’s going to serve me well are my people
skills. Everybody tells me I’m both a good leader and a great team player. So, I guess, now that I think about it, I won’t
have to dig graves. I should be able to get any job I want…assuming the economy is better by the time I graduate.

Follow-Up Questions

Do I stay on topic in most of the writing, or do I shift to another topic? Am I more interested in my initial or my new
topic? ANSWER: I did stay on the topic of my future–work I’d like to do and work I definitely wouldn’t do.

What words are repeated in my writing? ANSWER: “earn a living,” “money,” “job,” “learning”

Which of my ideas can be backed up with research during the subsequent research process? ANSWER: I should be

able to research jobs in general, especially those available to liberal arts majors. I’d also have to find out what skills are
required for entry-level jobs in certain industries.

Can I identify one or two questions that most of my freewrite responds to? ANSWER: What jobs does a liberal arts
degree lead to? How soon does knowledge become obsolete?

Research Question

Topic: Job economy

Research Question: What can one do with a liberal arts degree?

Clustering

Clustering is another method of brainstorming ideas. You can use it by itself, or you can organize some of the ideas you
discovered during your freewrite. Watch the following video to learn more about the clustering method.

1-5

Activity: Brainstorming Ideas (UNGRADED)

Now it’s time to put into practice one of the brainstorming exercises discussed in the previous page. Please select one of the two
UNGRADED brainstorming activities below.

You may want to choose a topic that is related to your career or degree, since you will be completing a journal assignment on
the next page with that focus.

1-6 Journal: From Issue to Persuasion

This assignment does not contain any printable content.

1-2 Reading: Problem Identification

Reading: Problem Identification
Introduction to Persuasion
Opposing Viewpoints

1-3 Discussion: Persuasion in Everyday Life (GRADED)
This assignment does not contain any printable content.

1-4 Reading: Brainstorming Ideas

Reading: Brainstorming Ideas
Freewriting Questions
Looping Example #1
Follow-Up Questions
Research Question
Looping Example #2
Follow-Up Questions
Research Question
Clustering

1-5 Activity: Brainstorming Ideas (UNGRADED)

Activity: Brainstorming Ideas (UNGRADED)
1-6 Journal: From Issue to Persuasion
This assignment does not contain any printable content.

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Drug Abuse
Date: 2019
From: Gale Opposing Viewpoints Online Collection
Publisher: Gale, a Cengage Company
Document Type: Topic overview
Length: 1,934 words
Content Level: (Level 5)
Lexile Measure: 1440L

Full Text:
Drug abuse refers to a pattern of hazardous or harmful drug use for recreational or mood-altering purposes. It is a form of substance
abuse, a term that encompasses the abuse of illegal drugs, prescription drugs, alcohol, and other intoxicating substances. Illegal
drugs are substances that have not been approved for medical use and are banned by law. Prescription drugs have been approved
for medical use but must be prescribed by a licensed physician. Some professionals also use the term drug misuse to describe
situations in which people consume prescription drugs for off-label purposes inconsistent with their approved medical applications.
Drug misuse and abuse are major social problems in the United States, largely because these behaviors can lead to physical or
psychological addiction, which is defined by the National Institute on Drug Abuse as a “chronic, relapsing disorder characterized by
compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain” and considered a
complex brain disorder and mental illness.

In the United States, commonly abused and misused drugs include opioids and other painkillers; illegal substances such as heroin,
cocaine, methamphetamines, and hallucinogens; prescription stimulants and sedatives; marijuana; and alcohol. The distribution of
marijuana is illegal under federal law. Distribution and use of marijuana for medicinal or recreational purposes are subject to
individual state laws and regulations. As of June 2019, thirty-four states and several territories permit medical marijuana use. Of
those states, fourteen have passed laws that allow adults to purchase marijuana and use it recreationally. Alcohol is available for
purchase in all fifty states to those who meet specified age and other legal requirements. The Controlled Substances Act (1970),
which was last amended in 2017, serves as the primary piece of federal drug legislation. States and municipalities also maintain their
own laws related to drug possession, distribution, use, and other related matters.

Despite continuous public awareness campaigns and stiff legal penalties, drug abuse and misuse remain common in the United
States. According to data published by the Substance Abuse and Mental Health Services Administration (SAMHSA), 134.7 million
Americans over the age of twelve reported using illicit drugs at least once in their lives in a 2017 survey, including 51.8 million in the
past year and 30.5 million in the past month. Marijuana was by far the most commonly used drug, followed by prescription painkillers,
cocaine, and hallucinogens. Among survey respondents aged twelve to seventeen, 23.9 percent had used illegal drugs at least once,
with 16.3 percent using within the past year and 7.9 percent within the past month. SAMHSA also reported that 2.8 percent of
Americans over age twelve had an illicit drug use disorder in 2017, while 5.3 percent had alcohol dependence or an alcohol abuse
disorder. As reported by the Centers for Disease Control and Prevention (CDC), 28,466 people in the United States died of a drug
overdose caused by fentanyl or other synthetic narcotics (other than methadone) in 2017. The second leading cause of fatal drug
overdoses was prescription opioids (17,029 deaths), followed by heroin (15,482) and cocaine (13,942).

Main Ideas

US law bans substances that produce significant physical or psychoactive effects but have few or no legitimate medical uses.
Substances with legitimate uses that have high risks of misuse are prohibited unless prescribed by a physician.
Drug abuse and drug misuse are types of substance abuse characterized by a pattern of hazardous, harmful, or off-label use
of illicit substances for recreational, mood-altering, or other nontherapeutic purposes.
Despite decades of awareness campaigns and harsh legal penalties, drug abuse remains a major problem. Commonly abused
drugs include prescription painkillers, stimulants, and sedatives; heroin, cocaine, and methamphetamines; marijuana; and
alcohol.
Drug abuse has significant negative effects on individuals and families. It can change a user’s brain chemistry and cause major
organ damage, and it is associated with domestic violence, job loss, and arrest and imprisonment.
Drug abuse also has negative effects on public health and safety. Prevention and treatment programs, high rates of hospital

visits, drug-impaired driving, and financial and compulsive crime all exert strain on public resources and services.
The impact of drug abuse on the US economy—including productivity losses, hospitalization and treatment costs, and costs
associated with enforcement and incarceration—was an estimated $1 trillion in 2017.

Risk Factors and Warning Signs

People use drugs for many different reasons, and drug abuse occurs in people of all ages, races and ethnicities, genders, and
socioeconomic statuses. However, experts and government health agencies identify numerous risk factors that may make certain
people more likely to abuse drugs. They include family dysfunction, trouble at work or school, a family history of substance abuse, an
individual or family history of mental health problems, and normalized drug use in an individual’s social circles. The CDC also
identifies youth high-risk substance use as a specific issue, defining it as an adolescent’s use of drugs that carries a high likelihood of
causing negative health outcomes or other adverse consequences like dropping out of school, expulsion, or contact with the juvenile
criminal justice system. Factors known to lead to high-risk substance abuse include a family history of drug or substance abuse, low
parental involvement in the adolescent’s life, mental health problems, poor academic achievement, and disconnectedness from the
school community. Teens who are the victims of previous sexual, emotional, physical, or psychological abuse are also at elevated
risk, as are teens whose gender or sexual identities have been rejected by their parents or peers.

Warning signs of drug abuse cover clues and signals that a friend, family member, or loved one is using drugs. Experts frequently
divide these signs into physical, behavioral, and psychological cues. Physical warning signs include bloodshot eyes; dilated pupils;
changes in sleeping or eating patterns; a constant runny nose or sniffling; sudden changes in weight; and changes in speech,
coordination, or balance. Behavioral signs include suspicious or secretive activity; poor performance at work or school; financial
problems or a sudden need for money; run-ins with law enforcement; involvement in fights, accidents, or illegal activities; and driving
under the influence. People who abuse drugs may also display an abrupt or dramatic change in friends or hobbies. Psychological
cues cover warning signs such as paranoid behavior; sudden personality changes; an uncharacteristic lack of ambition or motivation;
and mood swings or nervous or unstable behavior, especially when it occurs in spurts and is inconsistent with the individual’s usual
disposition.

Individual and Social Impacts

Drug abuse is associated with many negative individual and familial impacts. Drug abuse can lead to long-term or permanent
changes in brain chemistry as well as heart, lung, stomach, kidney, and liver problems. Intravenous drug users are also at
significantly increased risk for contracting HIV/AIDS and hepatitis. Drug use by pregnant women may cause harm to the fetus or lead
to birth defects. Drug abuse is also associated with child abuse and neglect, domestic violence, household financial difficulties, job
loss, and arrest and imprisonment. Families can also be affected in other, more complex ways. For example, non-using parents may
develop overprotective or other unhealthy relationships with their children as they seek to compensate for the behavior of the other
partner. Children in households affected by drug abuse may also compensate by taking on the role of parent to their younger siblings.

On a broader societal level, drug abuse also has numerous public health, public safety, and economic impacts. The costs of drug
prevention and treatment programs are high and put a significant strain on public resources. Drug abuse drains finances from the
health care system, given the high rate of emergency room visits for problems associated with overdoses and adverse reactions to
drugs. Drug-impaired driving persists as a major public safety issue. Law enforcement has observed a link between drug abuse and
crime, noting that individuals may commit crimes because they are under the influence of drugs or are seeking money for drugs.
Estimates from 2017 place the total impact of drug abuse on the American economy at $1 trillion, including productivity losses and
costs associated with the hospitalization of drug abusers and the incarceration of drug offenders.

Critical Thinking Questions

Do you agree that society views the use of some illegal or illicit substances as less problematic than the use of others? If so,
what factors do you believe contribute to this? If you disagree, explain your reasoning.
Which approach to individual treatment for drug misuse and addiction do you think would be most effective: harm reduction,
abstinence, or maintenance? Why?
In your opinion, are the problems of drug misuse and addiction more appropriately addressed through the criminal justice
system or the health care system? Explain your answer.

Treatment, Prevention, and Policy

Approaches to treating drug abuse vary, and include measures that promote harm reduction, abstinence, and maintenance. Harm
reduction endeavors to reduce or neutralize the individual health impacts of drug abuse and its broader effects on society. For
example, a growing number of cities in Europe, Australia, and Canada offer safe injection sites where intravenous drug users can
obtain clean needles and use drugs under the supervision of health professionals who can immediately react in the event of an
overdose. Efforts to establish such sites in the United States have encountered significant pushback with federal prosecutors and
others expressing concern that they would normalize drug use. Abstinence treatments aim to eliminate an individual’s drug use,
either abruptly or by reducing it over time. Maintenance approaches seek to minimize unpleasant withdrawal symptoms associated
with the discontinuation of addictive drugs, usually by substituting the drug of abuse with another, less harmful analog administered in
controlled and carefully monitored doses.

Individuals who enter drug abuse treatment programs undergo initial case assessments that evaluate their level of addiction, the
underlying causes of their drug abuse, and their medical history, personal history, family situation, employment history, academic
performance, job performance, and other indicators related to past substance abuse, treatment efforts, and prognosis for recovery.
Care planning also considers the individual’s frequency of drug use, level of addiction or dependence, and underlying health issues,
among other factors.

Public agencies like SAMHSA offer many different types of programs meant to curtail drug abuse and provide users and addicted
individuals with helpful, supportive information and resources. SAMHSA supports drug-free workplace programs, criminal and
juvenile justice system services, early intervention programs for students and at-risk youth, first responder training, and extensive
resource centers. Another noteworthy nationwide program is National Prescription Drug Take Back Day, sponsored by the DEA,
which gives people an opportunity to safely dispose of unneeded prescription drugs in an effort to prevent their misuse and abuse.
Many states and municipalities offer a myriad of locally focused drug abuse prevention and treatment programs that address regional
problems and trends.

The so-called War on Drugs, first declared by President Richard Nixon (1913–1994) in 1971 in response to the countercultural
movements of the 1960s, persists as a major focus of federal policy. It involves a punitive approach to drug offenses, seeking to
curtail drug abuse through deterrents and stiff legal penalties. Proponents of the War on Drugs also advocate the incarceration of
drug offenders over addiction treatment and other behavioral interventions. Policy analysts and social justice activists widely
characterize the War on Drugs as a failure, and lawmakers have moved to introduce new approaches after decades of limited results.
Legislation like the 21st Century Cures Act (2016), Comprehensive Addiction and Recovery Act (2016), and Substance Use-Disorder
Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (2018) have begun to treat
drug abuse more as a public health issue than a problem to be handled solely by law enforcement. Such policies emphasize
treatment and recovery over incarceration and criminalization, which many experts believe to offer a more productive and positive
path forward.

Full Text: COPYRIGHT 2019 Gale, a Cengage Company
Source Citation (MLA 8th Edition)
“Drug Abuse.” Gale Opposing Viewpoints Online Collection, Gale, 2019. Gale In Context: Opposing Viewpoints, https://link-gale-

com.ezproxy.snhu.edu/apps/doc/PC3021900054/OVIC?u=nhc_main&sid=OVIC&xid=3e06dcda. Accessed 12 Jan. 2020.
Gale Document Number: GALE|PC3021900054

Obesity
Date: 2019
From: Gale Opposing Viewpoints Online Collection
Publisher: Gale, a Cengage Company
Document Type: Topic overview
Length: 2,566 words
Content Level: (Level 5)
Lexile Measure: 1450L

Full Text:
Obesity in adults is defined by a body mass index of 30 or above. Body mass index (BMI) is determined using a person’s weight and
height to calculate an estimate of the amount of fat in that person’s body. For children and adolescents, the Centers for Disease
Control and Prevention (CDC) defines obesity as “a BMI at or above the 95th percentile for children and teens of the same age and
sex.” Obesity in adults is not measured against a reference population. Obesity can be taxing on the body and is associated with
higher risks for a variety of health problems, such as heart disease, diabetes, liver disease, high blood pressure, infertility, gallbladder
disease, depression, several forms of cancer, stroke, and sleep apnea. During pregnancy, obesity and excessive weight gain
increase the likelihood of miscarriage, gestational diabetes, preeclampsia, and complications during labor. As stated by the American
College of Obstetricians and Gynecologists, children born to obese mothers face an increased likelihood of birth defects and may
encounter related issues throughout their development and into adulthood.

According to a 2018 World Health Organization (WHO) report, worldwide obesity has almost tripled since 1975. The WHO report
estimates that 1.9 billion adults ages eighteen and older, 340 million children ages five to nineteen, and 41 million children under age
five worldwide were overweight or obese in 2016. The CDC reported that more than one-third of US adults (39.8 percent) and more
than one-sixth of children ages two to nineteen (18.5 percent) were considered obese in 2016, leading many health care
professionals to identify obesity as a national epidemic. Obesity rates have risen substantially since 1990, when no state had an
obesity rate over 15 percent. As detailed in the annual report The State of Obesity 2019, a project of the Robert Wood Johnson
Foundation, US adult obesity rates exceeded 25 percent in forty-eight states, nine of which recorded rates above 35 percent.
According to the CDC, obesity more often affects non-white Americans. In 2018, the highest prevalence of obesity, 39.1 percent, was
reported by non-Hispanic African Americans. Prevalence among people of Hispanic ethnicity was 33.3 percent, followed by non-
Hispanic whites at 29.3 percent.

In light of the growing incidence of obesity, some health care professionals have warned against normalizing obesity, as doing so can
deter obese people from seeking medical help. A 2017 report in the Journal of the American Medical Association (JAMA) found that
the number of overweight and obese Americans attempting to lose weight is decreasing. In a study of more than 27,000 overweight
and obese US adults, 55.6 percent reported trying to lose weight during the initial time period studied, 1988 to 1994, while only 49.2
percent were trying to lose weight between 2009 and 2014. Other health care professionals discourage a singular focus on weight or
body mass, stressing instead the importance of monitoring other health indicators. Many body positivity activists contend that a
person can more effectively address health concerns by accepting their size and concentrating on improving overall health.

Main Ideas

Obesity in adults is determined by calculating body mass index (BMI), which uses weight and height to estimate the amount of
fat in a body. Adults with a BMI of 30 or above are classified as obese.
Obesity rates have risen substantially since 1990, when no US state’s rate exceeded 15 percent. As of 2019, adult obesity
rates exceeded 25 percent in forty-eight US states, nine of which exceeded 35 percent, according to The State of Obesity.
Obesity is associated with higher risks of health problems ranging from heart disease, diabetes, liver disease, and high blood
pressure to infertility, depression, cancer, and complications during pregnancy and labor.
Researchers have determined that obesity results from a combination of biological and social factors but have identified
behavioral habits, home environment, race and ethnicity, genetics, and household income as contributing factors.
Some health care professionals worry that normalizing obesity deters people from seeking medical help, while others worry
that the singular focus on weight or BMI stigmatizes obesity and contributes to weight discrimination.
People who are obese confront many types of bias, including hiring, wage, and workplace discrimination. Weight discrimination

among medical professionals has also emerged as a significant and potentially fatal barrier to providing effective care.

Body Mass Index

Though health care professionals, fitness experts, and nutritionists commonly use BMI to appraise how a person’s body size relates
to overall health, BMI, like all measurements, has limitations. Relying too much on BMI can result in misleading conclusions because
body fat is stored differently depending on a person’s age, sex, and overall body composition. An adult woman who is five feet, four
inches tall would have a BMI of 30 at 175 pounds, placing her in the obese category. In comparison, an adult woman who is five feet,
seven inches in height and also 175 pounds would have a BMI of 27 and would be categorized as overweight rather than obese.
People with a BMI between 25 and 29.9 are considered overweight, while people with a BMI under 18.5 are considered underweight.

Critics have argued against the use of BMI as a measurement of an individual’s relative health. BMI, they note, is not an accurate
measurement of body fat. Muscle is denser than fat, with the volume of a pound of muscle measuring about 80 percent the volume of
a pound of fat. This means that many athletes in good health would classify as overweight based on BMI alone. The BMI rating
system also does not consider where fat is concentrated in a person’s body. For example, although excess fat around the midsection
is associated with more health complications than fat in other areas, this could go unnoticed in a person with a healthy BMI.

A BMI in the healthy range also does not guarantee that a person is protected from the physical health concerns associated with
obesity. A 2016 study published in the International Journal of Obesity assessed the health of more than 40,000 adults by examining
six different metrics for health, including blood pressure, cholesterol, and blood sugar levels. Of these adults, 47 percent who were
classified as overweight by their BMI and 29 percent of those classified as obese were found to be healthy when using the other
metrics. Over 30 percent of those classified as having a healthy BMI, meanwhile, were found to be unhealthy according to the other
metrics.

Causes and Risk Factors

Obesity is most commonly described as occurring when the body consumes more energy, typically measured in calories, than it
expels through normal functioning and physical exercise. However, researchers have noted that obesity results from a combination of
factors. Researchers at the National Heart, Lung, and Blood Institute at the National Institutes of Health (NIH) have found that risk
factors for obesity include lifestyle and behavioral habits, unhealthy environments, race and ethnicity, use of certain medications, and
genetics. A lack of sleep has also been known to slow metabolism and contribute to excessive weight gain. Men and women store fat
differently, which can contribute to different susceptibilities to obesity. Additionally, transgender people face higher rates of being
overweight or obese, with 72.4 percent of transgender people found to have BMIs equal to or greater than 25 compared to 65.5
percent of cisgender people.

Environmental contributors include a lack of access to affordable healthy foods and a lack of safe places to exercise. Communities
with limited food options, commonly referred to as food deserts, experience higher rates of obesity than people in areas with more
diverse options. Likewise, obesity rates are higher in food swamps, or areas where retailers selling fast food and junk food outpace
those offering healthier options. Sedentary work, including most office work and jobs with low physical demands, contributes to a
general lack of exercise. Additionally, long-term unemployment has been linked to obesity.

Researchers have also noted that eating habits and family food culture can affect the likelihood of obesity. Generally, families that eat
together and eat without the television on have lower rates of obesity than families that do not eat together or eat with the television
on. Links between chronic stress and excessive weight among British men and women ages fifty and older were identified in a 2017
study published in the journal Obesity. The results showed that during extended periods of stress, people reported both overeating
and eating more foods high in sugar, fat, and calories. The relationship between stress and eating habits is compounded the fact that
cortisol, the stress hormone, slows metabolism and can cause the body to store more fat.

Prevention Strategies and Related Challenges

Preventing obesity can be as complex as identifying its causes, though behavioral and environmental changes can help mitigate
excessive weight gain. Health care professionals recommend increasing physical activity, reducing the consumption of unhealthy
foods, improving sleep, and reducing stress as means to combat obesity on the individual level. Certain social and economic factors,
such as lack of access to affordable and nutritious foods, can present challenges for overcoming obesity. A poor diet can also
negatively affect how dopamine, a neurotransmitter associated with pleasure and reward, reacts to food consumption, causing
increased cravings for unhealthy foods high in sugar and fat content.

Negative social bias against people who are obese and overweight can commonly result in what has been termed body shaming,
also referred to as fat shaming. While some people cite body shaming as a potential factor in motivating people to lose weight,
evidence suggests that body shaming can have the opposite effect. In a 2015 study published in the journal Psychological Science,
researchers reported that body shaming can increase the likelihood of developing mental health conditions that make it more difficult
to lose weight. In addition, increased social acceptance of diverse body types, the development of community initiatives that
encourage self-advocacy, and a focus on well-being have been shown to have better outcomes than programs that focus only on
weight loss. A 2017 study published in Obesity concluded that people seeking treatment for obesity often internalize prejudices,
which could contribute to an increased risk of stroke, heart disease, and diabetes.

Effects of Obesity

The CDC reports that obesity-related conditions, such as heart disease, stroke, and type 2 diabetes, are among the leading causes of
preventable death in the United States. According to WHO, about 2.8 million people die each year from complications related to
obesity and excess weight. The Trust for America’s Health and the Robert Wood Johnson Foundation have estimated that more than
half of the US population will be obese by 2030. They predict dramatic increases in the prevalence of obesity-related diseases and
health care costs as well as significant losses in economic productivity.

To accommodate larger numbers of people with obesity, businesses and public infrastructure will incur additional expenses. For
example, hospitals will need to invest in equipment such as larger beds and toilets; schools and offices may require larger seats and
desks. According to the 2016 Gallup-Healthways Well-Being Index, medical expenses related to overweight and obese adults in the
United States contribute more than $142 billion in annual health care costs. Compared to individuals with lower BMIs, people who are
overweight pay an additional $378 in annual health care costs while people with obesity typically pay an additional $1,580 each year.

People classified as obese also often face biases from health care providers and are at an increased risk of suffering from depression
and anxiety. An article published in JAMA in 2019 identified pervasive weight bias among medical and health care providers as a
serious problem with potentially fatal consequences. Encountering weight bias in health care settings has been shown to have
detrimental effects on overweight and obese patients, who may find unhealthy habits harder to break and treatment plans harder to
follow. When people with obesity visit a doctor, they are often advised to lose weight and exercise regardless of the complaint that
brought them in for a visit. In some instances, this common practice of focusing primarily on weight loss has prevented patients from
receiving accurate diagnoses of life-threatening conditions. As evidenced in the JAMA article, medical professionals and educators
are beginning to consider weight bias and stigma as barriers to effective clinical practice.

In addition to bias in health care, many obese people experience employment discrimination and encounter weight bias that limits
their earning potential. Discrimination in the hiring process results in obese people losing career opportunities and experiencing
longer periods of unemployment between jobs. In the workplace, weight discrimination can result in lower wages for obese and
overweight workers, particularly women. An analysis by researchers at the University of Florida and the London Business School
estimated that, compared to the annual incomes of women of average weight, the incomes of women who were obese or overweight
were lower and the incomes of women who were perceived as thin were higher. While Massachusetts state lawmakers considered a
bill in 2019 to prohibit employment discrimination on the basis of height and weight, Michigan remains the only state that explicitly
prohibits weight discrimination by law.

Critical Thinking Questions

What is body shaming, and what is its impact on people who are overweight or obese?
Do you think body mass index (BMI) is an adequate tool for assessing people’s health? Why or why not?
In your opinion, what could schools, workplaces, and other organizations do to address the problem of weight discrimination?
Explain your answer.

Weight Loss Medications and Bariatric Surgery

Weight-loss surgery or medication can assist some people with obesity who wish to lose weight but are not able to do so effectively
through diet and exercise alone. Physicians caution, however, that both surgical and pharmaceutical weight-loss interventions carry
significant side effects and can lead to adverse events. A landmark example is the once-popular diet medication fen-phen, short for
fenfluramine/phentermine, which was linked heart-valve disease and pulmonary hypertension and pulled off the market in 1997.
Some weight-loss medications approved by the Federal Drug Administration (FDA) have particularly bothersome or dangerous side
effects such as loose stools following high-fat meals, birth defects, and increased suicidality. Health care professionals increasingly
believe that weight loss cannot be accomplished by medication alone, and they urge patients to follow instructions precisely and
remain in regular contact with their doctors.

Weight loss, or bariatric, surgery has become increasingly popular in the United States, with about 228,000 procedures performed in
2017, up from an average of sixteen thousand performed annually in the early 1990s, according to the American Society for
Metabolic and Bariatric Surgery. One of the most well-known forms of bariatric surgery is gastric bypass surgery, where a portion of
the stomach is sectioned off into a small pouch and reconnected to the lower part of the small intestine to reduce the amount of food
absorbed by the body. After surgery, the patient’s stomach is so small that it can hold only a few ounces of food or liquid at a time.
Candidates for gastric bypass must make significant lifestyle changes regarding diet and physical activity both before and after the
surgery, and those who do typically lose between 65 and 70 percent of their excess weight in the first year following surgery.
Recovering from bariatric surgery, however, can be difficult and painful. Patients must follow strict guidelines to ensure they receive
proper nutrients and hydration, and even moderate overeating can cause severe pain and nausea. Other forms of bariatric surgeries,
including laparoscopic gastric band surgery and sleeve gastrectomy, also require significant lifestyle and diet changes.

Full Text: COPYRIGHT 2019 Gale, a Cengage Company
Source Citation (MLA 8th Edition)
“Obesity.” Gale Opposing Viewpoints Online Collection, Gale, 2019. Gale In Context: Opposing Viewpoints, https://link-gale-

com.ezproxy.snhu.edu/apps/doc/PC3010999129/OVIC?u=nhc_main&sid=OVIC&xid=cab06343. Accessed 12 Jan. 2020.
Gale Document Number: GALE|PC3010999129

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