WHAT IS OBESITY?

Obesity is a condition that is associated with having an excess of body fat, defined by genetic and environmental factors that are difficult to control when dieting. Obesity is classified as having a Body Mass Index (BMI) of 30 or greater. BMI is a tool used to measure obesity. Obesity increases your risk of developing related conditions such as diabetes, hypertension and sleep apnea, to name a few. Many individuals are affected by obesity and are not aware of it.

How Obesity is measured

Obesity is measured by various means, but the most common methods used are Body Mass Index (BMI) and Waist Circumference. There is no perfect method to measuring obesity, however these two indicators are most commonly used by clinicians as a tool to diagnose weight.

BMI
BMI is a measurement used to indicate obesity and morbid obesity in adults. BMI is calculated by dividing a person’s weight in kilograms by his or her height in meters squared. An adult with a BMI of 30 or greater is considered obese. Once you find your measurement, you will want to find your weight classification that is accompanied on the BMI chart or calculator. Knowing your BMI is a good starting point in addressing your weight. If you find you are in an unhealthy range, you will want to talk with your doctor to address this issue.

There is no separate BMI chart used for men and women. Both sexes use the same chart to measure obesity. In addition, the same classifications of obesity apply to both men and women.

BMI Calculator

Waist Circumference

Waist circumference is a less-common method used to measure obesity in an individual. This simple measurement indicates obesity and morbid obesity in adults by measuring your waist. To find your waist circumference, wrap a tape measure around the area above your hip bone and below your rib cage.

For females, a waist circumference of 35 inches or greater is considered unhealthy. For men, a waist circumference of 40 inches or greater is considered unhealthy. There is not a classification chart or various ranges used with this method to determine obesity. Only the simple thresholds for men and women noted above apply.

Risks Associated with Obesity
There are more than 40 medical conditions that are associated with obesity. Individuals who are obese are at risk of developing one or more of these serious medical conditions.

The most prevalent obesity-related diseases include:

• High blood pressure
• High cholesterol
• Diabetes
• Heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis
• Sleep apnea and respiratory problems
• Some cancers (endometrial, breast, and colon)

Behavior
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health.

Americans are consuming more calories on average than in past decades. The increase in calories has also decreased the nutrients consumed that are needed for a healthy diet. This behavioral problem also relates to the increase in portion sizes at home and when dining out. While Americans are consuming more calories, they are not expending them with enough physical activity. Physical activity is an important element in modifying and shaping behaviors. The influence of television, computers and other technologies discourage physical activity and add to the problem of obesity in our society.

Environment
Environment plays a key role in shaping an individual’s habits and lifestyle. There are many environmental influences that can impact your health decisions. Today’s society has developed a more sedentary lifestyle. Walking has been replaced by driving cars, physical activity has been replaced by technology and nutrition has been overcome by convenience foods.

Genetics
Science shows that genetics play a role in obesity. Genes can cause certain disorders which result in obesity. However, not all individuals who are predisposed to obesity become obese. Research is currently underway to determine which genes contribute most to obesity.

What can you do about Your Obesity?

Deciding what to do about your obesity in terms of treatment varies from person to person. If you or someone you know is obese, addressing this issue early is an essential part of success. It is important to talk to your physician about your weight and work with him/her when deciding which treatment is right for you. There are several methods available to address the issue.

Behavior Modification and Physical Activity
As discussed above, behavior plays a large role in obesity. Modifying those behaviors that may have contributed to developing obesity is one way to treat the disease. A few suggested behavior modifiers include:

• Changing eating habits
• Increasing physical activity
• Becoming educated about your body and how to nourish it properly
• Engaging in a support group or extracurricular activity
• Setting realistic weight management goals

It is important to make a solid commitment to changing a behavior or lifestyle. Involve your family and/or friends and ask them to help you make the necessary changes to positively impact your health.

Increasing or initiating a physical activity program is an important aspect in managing obesity. Today’s society has developed a very sedentary lifestyle and routine physical activity can greatly impact your health.

You should consult with your physician before initiating any exercise program. Set realistic goals and make sure they are measurable. Involving your family or friends can also help to maintain your physical activity level and reach your goals.

Physician-supervised Weight-loss

Physician-supervised weight-loss programs provide treatment in a clinical setting with a licensed healthcare professional, such as a medical doctor, nurse, registered dietitian and/or psychologist. These programs typically offer services such as nutrition education, pharmacotherapy, physical activity and behavioral therapy. Deciding if surgery is right for you, as well as choosing which surgical option is best for you is a decision to be made by you and your doctor.

Bariatric Surgery 

(Severe Obesity)

*Bariatric surgery is a safe and effective treatment option for those affected by severe obesity. Moreover, these same procedures have also been recognized for their impact on metabolic or hormonal changes that play a major role in hunger (the desire to start eating) and satiety (the desire to stop eating) as well as improvement and/or resolution of conditions that can occur as a result of severe obesity. Bariatric surgery is a recognized and accepted approach for both weight-loss and many of the conditions that occur as a result of severe obesity; however, not all people affected by severe obesity will qualify for bariatric surgery. There are certain criteria that a person must meet in order to be a candidate for bariatric surgery.

Indications:
At the 1991 National Institutes of Health (NIH) Consensus Conference, bariatric surgery was considered an accepted and effective approach that provides consistent, durable weight-loss for individuals affected by severe obesity. Furthermore, the NIH identified several criteria for candidacy for bariatric surgery, including:

• Body Mass Index (BMI) = a number calculated based on a person’s height and weight:
• BMI >40, Severe obesity (or weighing more than 100 pounds over ideal body weight)
• BMI 35-40 with significant obesity-related conditions (type 2 diabetes, high blood pressure, sleep apnea or high cholesterol)
• No endocrine causes of obesity
• Acceptable operative risk
• Understands surgery and risks
• Absence of drug or alcohol problem
• No uncontrolled psychological conditions
• Failed attempts at medical weight-loss (diets, other weight-loss options)

Benefits:
Within two to three years after the operation, bariatric surgery usually results in a weight-loss of 10 to 35 percent of total body weight, depending on the chosen procedure. Those considering bariatric surgery should talk to their PCP about what their personal expectations should be for loss of excess weight. In addition, co-morbidities, such as diabetes, high blood pressure, sleep apnea and others are often reduced or may go into remission. Most will find they require fewer medicines throughout time and many will discontinue their medicines completely.