Medically Severe Obesity

Over the last several decades there has been a significant increase in the prevalence of obesity in the United States. According to some, more than half of U.S. adults are either overweight or obese. There is some controversy about how serious the problem is, but the average American now weighs about 7 lbs. more than those living in the U.S. 30 years ago. More importantly, many of the most serious health problems of today are strongly associated with obesity, e.g. diabetes, heart disease, sleep apnea, stroke, osteoarthritis, hypertension, and some cancers, all of which have greatly increased in prevalence. The many reasons for the increased prevalence of obesity and related health problems can be reduced to sedentary lifestyle; we expend less energy than those in previous generations and take in more energy via increased consumption of calories via a preference for high fat and high sugar foods.

Obesity Treatment Information:

• Obesity Treatment for Adults - Learn the Fastest Way to Lose Weight
• Obesity Treatment for Teens - How to Lose Weight
• Obesity Treatment for Children - Healthy Children's Weight Loss

Definition

The Centers for Disease Control (CDC) defines obesity as a range of weight that is greater than what is considered healthy for a given height. Obesity ranges are generally determined using weight and height to calculate a number called the “body mass index” (BMI). For most people, BMI correlates highly with body fat percent and is a quick and easy method to assess potential weight problems.

It should be noted that BMI is not an exact measure of body fat percent. BMI may overestimate body fat percent in highly athletic and muscular individuals, and it may underestimate body fat percent in elderly and sedentary individuals who have lost a great deal of muscle.
For more information about the Body Mass Index (BMI), go to http://www.cdc.gov/nccdphp/dnpa/bmi/index.htm.

Causes

The basic equation of weight gain is clear and consistent. Consuming more calories than you use on a daily basis will result in weight gain, because your body will store excess calories as fat.

Increased calorie consumption + limited calorie use = weight gain

While the idea is fairly simple, current research has uncovered a number of factors that influence the equation.

Factors that can influence increased consumption of calories:

• Eating Habits and Diet: Eating high-calorie foods (such as high sugar and high fat content foods) and beverages (such as sugary sodas, beer, wine, and spirits) increases the likelihood that you are consuming more calories than you can burn in a day.
• Binge Eating: A binge is defined as eating an excessive amount of food in a relatively brief period of time and experience a feeling of loss of control about the behavior.
• Pregnancy: Quite naturally women must eat more when they are pregnant to sustain the health of the fetus. Of course, with the greater intake of calories, women gain weight, which is healthy and expected. However, many women find it difficult to change eating habits and lose pregnancy weight after the baby is born.
• Quitting Smoking: Some people report that after they quit smoking they experience an increase in appetite and a renewed sense of taste and enjoyment in food, which can lead to increased calorie consumption and weight gain.
• Medications: Some people report experiencing increased feelings of hunger when taking some medications, which can lead to increased calorie consumption and weight gain.

Factors that can influence diminished use of calories:

• Inactive Lifestyle: Many people have sedentary jobs and do not engage in regular physical activity and exercise. As such, they don’t burn as many calories as they consume.
• Quitting Smoking: Research suggests that the nicotine in cigarettes increases metabolism. Therefore, when a person stops smoking and is no longer ingesting nicotine, they will burn fewer calories, with is a risk factor for weight gain.
• Medications: Some medications slow metabolic rates, thereby decreasing the number of calories a person burns.
• Physical Injury or Illness: Following an accident, surgery or injury some individuals experience a loss of mobility and are unable to continue with activities or exercise they had been doing regularly. Other individuals who suffer with chronic conditions, such as arthritis or other forms of chronic pain, may also become increasingly inactive. This inactivity is a risk factor for weight gain.
• Medical Problems: In rare cases obesity appears to be linked to medical causes, such as low thyroid functioning or Cushing’s syndrome (when the adrenal glands produce excess hormones).

Learn More About Obesity

• The Centers for Disease Control
• The North American Association for the Study of Obesity
• The American Dietetic Association

Medical Complications of Obesity

Obesity can lead to other medical conditions that, in turn, can lead to long term morbidity and mortality. Patients should be screened for abnormal hormone levels and low bone density, Type II Diabetes, hypertension, elevated lipids, and elevated cholesterol, which increase cardiovascular risk and contribute to kidney damage. Many patients are more prone to orthopedic injury, especially of the knees, back, and hips. Obesity may also contribute to risk of dementia and certain cancers. Our doctors will screen for and set up a plan to follow changes in these medical indicators of health as you change your eating and weight.