Obesity Overview

Posted: Jan. 1, 2005

Obesity is a serious, chronic disease affecting over 25% of American adults and 14% of American children (an increase of 75% over the last 20 years).

Definition of obesity
The term "obesity" refers to an increase in body weight from an excess accumulation of stored body fat. This deceptively simple definition does not reflect the complexity of the condition.

Obesity is usually measured in pounds over ideal body weight and body mass index:

Mild Obesity — 20 to 49 pounds overweight
Moderate Obesity -— 50 to 74 pounds overweight
Severe Obesity — 75 to 100 pounds overweight
Morbid Obesity — More than 100 pounds overweight

Calculation of Body Mass Index, or BMI, is traditionally used by physicians as a more specific method of determining levels of obesity.

Causes of obesity
It is a common misunderstanding that the obese have directly caused their condition by overeating and/or a lack of willpower.

According to the American Obesity Association: "The underlying cause of obesity is not fully understood, though obesity appears to be a complex, multifactorial disease involving genetics, physiology, metabolism and appetite regulation by the brain, as well as environmental, psychosocial and cultural factors."

Treatment Options for Morbid Obesity

Diet/behavior modification. To greatly increase the chances of success, a course of diet, exercise and behavioral therapy must be supervised by qualified physicians. The "yo-yo" effect of weight loss and subsequent gain common to self-administered diet plans can actually create additional physical and psychological problems.

The course of treatment will focus on severely restricting caloric input while maintaining nutritional needs. A progressive exercise plan to increase the body's metabolism counteracts the natural slowing of metabolism when caloric intake is restricted. Finally, behavior modification therapy can help to alter negative impulses and promote healthier food (and life) choices.

Unfortunately, while many patients respond with rapid and significant weight loss on programs such as the one above, results tend to diminish over time.

Prescription drug treatment. Usually prescribed along with a program of diet and exercise, new medications have been shown to increase the rate at which weight loss occurs.

However, weight loss plateaus for most people after several months and weight is often regained if the course of medication is discontinued. Current drugs can also have serious side effects, which must be carefully considered by physician and patient.

Weight loss surgery. While research continues into non-surgical alternatives to combat severe obesity, surgery is currently the most effective method of achieving dramatic and sustained weight loss.

Bariatric surgery is major surgery involving risks and possible complications. Usually, the minimum qualification to be considered a candidate is a Body Mass Index of 40 or greater (at least 100 lbs. above ideal body weight). Surgery is primarily viewed as an option to alleviate chronic, debilitating disease caused by morbid obesity.

Patients must also be highly motivated. Extensive dietary, exercise and medical guidelines must be followed for the rest of their lives after surgery.

Source: U.S. Health and Human Services Dept.

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