What is obesity?

The American Society of Bariatric Surgeons describes obesity as a life-long, progressive, life-threatening, costly genetically-related, multi-factorial disease of excess fat storage. The National Institute of Diabetes & Disease & Kidney Disease defines both obesity and overweight.

Overweight refers to an excess of body weight compared to set standards. The excess weight may come from muscle, bone, fat, and/or body water. Obesity refers specifically to having an abnormally high proportion of body fat. One can be overweight without being obese, as in the example of a bodybuilder who has a lot of muscle. However, many people who are overweight are also obese.

What causes obesity?

It is multi factorial.

In basic terms, it is that energy in is greater than energy out. The multiple factors involved are a combination of genetic, neuroendocrine, environmental, and metabolic issues.

How is obesity measured?

Multiple methods of measuring obesity exist. The most commonly used method in medicine is the Body Mass Index (BMI). The formula for the BMI is:

weight (kg) / height squared (m2)

Since in this country we use pounds and feet, our BMI calculator is available for you. The World Health Organization (WHO) has developed a classification to help numerically define obesity based on BMI.

WHO Classification
Ideal weight 20-24.9
Overweight 25-29.9
Moderate obesity(class I) 30-34.9
Severe obesity (class II) 35-39.9
Morbid obesity (class III) 40-49.9
(Super obesity) over 50

What are the risks of obesity?

There are multiple medical and psychosocial issues associated with obesity. To discuss in detail even a fraction of them here would be impossible. A few of the medical risks include heart disease, diabetes, sleep apnea, high blood pressure, high cholesterol levels, osteoarthritis, gallbladder disease, respiratory problems, stroke, certain types of cancer, menstrual irregularities, and depression. The psychosocial issues associated with obesity are usually obvious and may often stem from discrimination (conscious and subconscious) against obese people. Many formal and informal studies have demonstrated this discrimination in all parts of society.

The major risk of obesity is risk of life. Obesity is known to decrease life expectancy. BMI correlates negatively with life expectancy. In other words, the heavier someone is the shorter his/her life span is.

Links for obesity:

Do you know the health risks of being overweight? (by the NIDDK) Statistics related to overweight and obesity. (by the NIDDK) Understanding adult obesity. (by the NIDDK)

Medical treatment

Despite the billions of dollars spent yearly by consumers on weight loss programs and dietary supplements, no medical treatment has been demonstrated to sustain a long term weight loss in a significant portion of men or women. In fact in the 1991 NIH consensus statement concerning obesity, medical treatment was considered ineffective in 95% of patients! While some patients can and do lose weight with diet and exercise, these are very few in number. The conclusion of this statement was that surgery is the only way to obtain consistent, permanent weight loss for morbidly obese patients.

Surgery is indicated for patients with documented failed dietary attempts and who have (1) a BMI of 40 or over and (2) a BMI of 35-40 with significant co-morbidity

Surgical Treatment

The surgical treatment of morbid obesity has been the only therapy that has been proven to provide consistent weight loss.

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