Obesity facts
·
Obesity means
having excess body fat. For adults 35 and older, having a BMI greater than 30
is considered obese.
·
Obesity is not just
a cosmetic consideration. It is a chronic medical disease that can lead to
diabetes, pressure, heart, gallstones,
and other chronic illnesses.
·
Obesity is
difficult to treat and has a high relapse rate. Greater than 95% of those who
lose weight regain the weight within five years.
·
Even though
medications and diets can help, the treatment of obesity cannot be a short-term
"fix" but has to be a life-long commitment to proper diet habits,
increased physical activity, and regular exercise.
·
The goal of
treatment should be to achieve and maintain a "healthier weight," not
necessarily an ideal weight.
·
Even a modest weight loss of
5%-10% of initial weight and the long-term maintenance of that weight loss can
bring significant health benefits by lowering blood pressure and lowering the
risks of diabetes and heart disease.
·
The chances of
long-term successful weight loss are enhanced if the doctor works with a team
of professionals, including dietitians, psychologists, and exercise
professionals.
The definition of
obesity varies depending on what one reads. In general, overweight and obesity
indicate a weight greater than what is considered healthy. Obesity is a chronic
condition defined by an excess amount body fat. A certain amount of body fat is
necessary for storing energy, heat insulation, shock absorption,
and other functions.
Obesity is best
defined by using the body mass index. The body mass index is calculated using a
person's height and weight. The body mass index (BMI) equals a person's weight
in kilograms (kg) divided by their height in meters (m) squared. Since BMI
describes body weight relative to height, it is strongly correlated with total
body fat content in adults. An adult who has a BMI of 25-29.9 is considered
overweight, and an adult who has a BMI over 30 is considered obese.
How common is obesity?
Obesity has reached
epidemic proportions in the United States. Over two-thirds of adults are
overweight or obese, and one in three Americans is obese. The prevalence of
obesity in children has increased markedly, with approximately 20%-25% of
children either overweight or obese. Obesity has also been increasing rapidly
throughout the world, and the incidence of obesity nearly doubled from 1991 to
1998.
Obesity is not just
a cosmetic consideration; it is a dire dilemma directly harmful to one's
health. In the United States, roughly 300,000 deaths per year are directly
related to obesity, and more than 80% of these deaths are in patients with a
BMI over 30. For patients with a BMI over 40, life expectancy is reduces
significantly (as much as 20 years for men and five years for women). Obesity
also increases the risk of developing a number of chronic diseases, including
the following:
· Insulin resistance. Insulin is necessary for the transport of blood
glucose (sugar) into the cells of muscle and fat (which is then used for
energy). By transporting glucose into cells, insulin keeps the blood glucose
levels in the normal range. Insulin resistance(IR) is the condition
whereby the effectiveness of insulin in transporting glucose (sugar) into cells
is diminished. Fat cells are more insulin resistant than muscle cells;
therefore, one important cause of insulin
resistance is obesity. The pancreas initially responds to insulin resistance by
producing more insulin. As long as the pancreas can produce enough insulin to
overcome this resistance, blood glucose levels remain normal. This insulin
resistance state (characterized by normal blood glucose levels and high insulin
levels) can last for years. Once the pancreas can no longer keep up with
producing high levels of insulin, blood glucose levels begin to rise, resulting
in type 2 diabetes, thus insulin resistance is a pre-diabetes condition.
· Type 2 (adult-onset) diabetes. The risk of type 2 diabetes increases
with the degree and duration of obesity. Type 2 diabetes is associated with
central obesity; a person with central obesity has excess fat around his/her
waist, so that the body is shaped like an apple.
· High blood pressure (hypertension). Hypertension is common among obese adults. A
Norwegian study showed that gain tended to increase blood pressure in
women more significantly than in men. The risk of developing high blood
pressure is also higher in obese people who are apple shaped (central obesity)
than in people who are pear shaped (fat distribution mainly in hips and
thighs).
· High cholesterol (hypercholesterolemia)
· Stroke (cerebrovascular
accident or CVA)
· Heart attack. A prospective
study found that the risk of developing coronary artery disease increased three
to four times in women who had a BMI greater than 29. A Finnish study showed
that for every 1 kilogram (2.2 pounds) increase in body weight, the risk of
death from coronary artery disease increased by 1%. In patients who have
already had a heart attack, obesity is associated with an increased
likelihood of a second heart attack.
·
Congestive heart failure
· Cancer. Obesity has been
linked to cancer of the colon in men and women, cancer of the rectum
and prostate in men, and cancer of the gallbladder and uterus in women. Obesity
may also be associated with breast cancer, particularly in postmenopausal
women. Fat tissue is important in the production of estrogen, and prolonged
exposure to high levels of estrogen increases the risk of breast cancer.
·
Gallstones
·
Gout and gouty arthritis
· Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back
·
Sleep apnea
Reviewed by Melissa Conrad Stöppler, MD on 7/18/2012
good job
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