Category Archives: Obesity
Back in the 1950s, an actuarial calculation known as the Metropolitan Life (MetLife) Height-Weight Table gave us a straightforward range of ideal body weights. While the underlying data was criticized as inconsistent, it considered age, body frame size, and gender. The tables were revised in the 1980s. However, the Body Mass Index, or BMI soon supplanted this widely used calculation. Interestingly, the BMI is an even older height/weight comparison that provides an easy-to-understand double-digit number showing where one lands on the scale between underweight and morbidly obese. When the underlying formula for BMI was created in the late 1800s, it was not meant to be a measure of obesity but has been adapted and adopted as such.
Today, governments, medical practices, and individuals use this calculation as the primary criterion to determine a person’s eligibility for bariatric surgery. Insurance companies even use the BMI to assess the coverage of weight loss procedures, medications, and programs. As you probably know, a BMI of 30 or more is considered obese, while a BMI of 40 or more is morbidly obese.
Obesity and its related diseases represent one of the modern world’s most significant public health crises. If we take the US alone, upwards of a third of the population is obese, while almost two-thirds are overweight. This widespread presence of obesity has begged the question of whether you can be obese, yet healthy. The answer is nuanced, so let’s dive right in.
First, we must talk about obesity, which represents a BMI or body mass index of 30 or higher by today’s measurement standards. The body mass index is a rudimentary calculation that doesn’t consider several factors, including muscle tone, body frame, gender, age, and ethnicity, all of which can influence whether a person is genuinely suffering from weight-related problems. However, regardless of the accuracy of the BMI, it is not unreasonable to think that somebody of average stature and frame would be at a higher risk for the diseases associated with excess weight once they cross the 30 BMI threshold.
One of the most common reasons our patients consider bariatric surgery is that they want to be around for their kids or grandkids. This is a great reason to get healthy and a noble goal for getting started on a weight loss program. However, a more profound and arguably even more important reason revolves around those same kids. Kids tend to mimic and follow the behaviors and habits that they see from their parents and grandparents.
So yes, while you may get to enjoy your kids more than you do now, you may also be saving them from severe metabolic disease later in life.
Atrial fibrillation, or AFib, is a heart condition in which a person has an irregular or abnormally fast heartbeat. The risks associated with AFib can remain low if dealt with properly, but if left untreated, AFib can lead to life-threatening heart conditions such as blood clots, stroke, or heart failure. AFib is a very common heart condition – it is estimated that over 5.5 million adults are living with it in the United States.
Groups and individuals fighting to eliminate the stigma associated with weight have made leaps and bounds over the past many years. This movement has likely helped millions of people overcome significant the mental health issues that surround the weight-based bullying that has increasingly plagued modern society both in the United States and around the world. One of the mantras used in the movement is that what we, medically, consider to be an unhealthy weight can exist alongside overall good health. The concept is that an overweight individual may not be at far greater risk of medical issues if they are exercising and practicing other healthy habits.
Obesity is a systemic disease. Not only does it affect our waistline, how we feel and what we do, but it can also contribute to a host of related diseases known as comorbidities. From diabetes and heart disease to gallbladder problems and even hernias due to added abdominal pressure, it affects every part of our lives. Obesity has even been linked to certain forms of cancer including esophageal cancer, breast cancer and colorectal cancer.
We often hear about the adult obesity rate in the United States because of the generally staggering numbers. In many southern states, we’ve hit close to 40% of the population suffering from obesity. As a result, the incidence of diabetes, colon cancer, esophageal cancer and more has increased dramatically as well. These numbers are even higher for Hispanic adults and African Americans.
And while we do see some reports of adolescent obesity, the percentages are not as high, and many believe that the problem may not be as severe as it truly is. Approximately 19% of adolescents from 2-19 are obese and this is even more pronounced in Hispanics (almost 26%) and blacks (22%) according to the CDC. And this presents an incredibly dangerous situation. During these young ages, our metabolisms are at their highest, and typically, we are at our most active. Imagine the difficulties these adolescents, and others who may be overweight, will experience when they are older, less active and more stressed with slower metabolisms.
The obesity trend continues to rise in the United States with exceptionally severe consequences. Along with the exponential rise in obesity over the past several decades, we have seen a commensurate rise in type-2 diabetes, pre-diabetes, esophageal cancer and the incidence or worsening of many other cancers including breast, uterine and prostate. Unfortunately, the standard advice on how to lose weight, diet and exercise, begins to lose effectiveness once the patient becomes obese. Indeed, only about 5 to 10% of all of these patients are able to lose weight and maintain that weight loss over the long-term using diet and exercise alone. For those other 90 to 95% of patients, life can continue with yo-yo dieting, binge eating and a great deal of frustration that goes along with it. Similarly, weight loss pills are merely temporary solutions that will allow patients to regain the weight once the pill is no longer being taken.
Please take the time to read a recent article from MedScape.com regarding Bariatric Surgery Tied to Lowered Risk of Colorectal Cancer.
Weight loss is hard. Even harder is keeping the weight off. There is a theory, known as the Set Point Theory, that some believe explain why our bodies fight weight loss and so easily regain weight after we have worked hard to lose it. While traditional thinking about how our bodies regulate weight have long said calories in versus calories out equals the balance of weight gain or loss, this very simplistic view does not account for many factors that contribute to how our body works. These factors include intricate systems and feedback mechanisms that allow for our body and brain to communicate.