Obesity and Health
Obesity is specified by the Centers for Disease Control and Prevention as weight being higher than what is deemed healthy for a specific height.
Overweight and obesity are defined in numerical terms by health care providers using the body mass index, or BMI, a ratio based on height and weight using weight in kilograms divided by meters squared.
For adults, a BMI less than 18.5 kg/m2 is considered underweight. A BMI between 18.5 and 25 is considered normal weight.
A BMI of 25 to 30 is considered overweight, and a BMI of 30 and higher is considered obese. Obesity is further divided into three classes.
Class 1 is a BMI of 30 – 35, class 2 is a BMI of 35 – 40, and class 3 is a BMI of 40 or higher, sometimes called extreme obesity.
According to data from the CDC, approximately 40 percent of adults aged 20 years and older met the criteria for obesity in 2015-2016.
Overall, obesity in the United States is more common among adults with lower socioeconomic status and less education than middle and higher-income groups and college degrees. However, some degree of obesity persists among all income levels, education levels, and ethnic groups.
Obesity happens when the size and number of fat cells in the body increase.
Obesity can be caused by energy imbalances that prompt the body to store fat, such as when you intake more calories than you melt or when energy taken in is greater than the energy expended.
Several types of medical conditions also can cause obesity, particularly genetic syndromes and endocrine disorders.
Genetic syndromes such as Prader-Willi Syndrome and Cohen Syndrome are associated with obesity in families.
Endocrine disorders may play a role in obesity, including hypothyroidism.
Low thyroid hormone levels can promote decreased metabolism and weight gain, and Cushing’s syndrome promotes high cortisol levels that can increase feelings of hunger in response to feelings of chronic stress.
Social and environmental factors can contribute to the risk of becoming obese.
Several of the more common contributors to obesity include easy access to inexpensive, processed foods; increased portion sizes at restaurants, industry marketing of high-fat and high-sugar foods (especially to children), and the high cost or limited access to whole, healthy foods.
In addition, leptin resistance and the addiction-like response in the brain that causes high-fat and high-sugar cravings can contribute to obesity, as does a sedentary lifestyle and home, school, or work limited opportunities for physical activity.
Obesity also has a genetic component and can run in families. However, making changes to adopt a healthier lifestyle can counteract these factors and prevent obesity or improve health in obese individuals.
Such changes include quitting or avoiding smoking, getting regular exercise, and eating a healthful diet, and taking medications for chronic conditions as directed by a doctor.
For obese children, management starts with lifestyle changes to improve diet and increase exercise, although medication and surgery can be considered in adolescents if other strategies have failed.
OBESITY AND HEALTH
Obesity is associated with a range of significant health problems in adults and children, and teens.
Obesity can increase an individual’s risk of developing type 2 diabetes, high blood pressure, heart disease, and particular types of cancer, notably breast cancer, colorectal cancer, endometrial cancer, and kidney cancer.
In addition, obese individuals are at increased risk for having a stroke. Being overweight or obese also contributes to trouble breathing.
More belly fat and a larger body make it harder for the lungs to fully expand, so obese individuals may get winded more quickly doing basic activities such as climbing stairs or carrying groceries.
Obesity also can make symptoms worse for individuals with asthma or chronic obstructive pulmonary disease.
Other conditions common among obese individuals than those who aren’t obese include fatty liver disease, osteoarthritis, gallstones, high cholesterol, sleep apnea, and complications during pregnancy.
OBESITY AND SURGERY
For some individuals with extreme obesity or who have weight-related health problems and cannot achieve or maintain a healthy weight in other ways, bariatric surgery may be an option.
There are several subtypes of bariatric surgery used to help manage obesity. Gastric bypass surgical procedure is one of the most popular because of the lower rate of complications.
However, all weight-loss surgeries are major procedures and should not be chosen without thoughtful consideration of the potential risks and benefits.
Different types of bariatric surgery work in slightly different ways. Still, in general, the procedures change the formation of the digestive system to limit how much you can eat or reduce the ingestion of nutrients in the digestive system. Some procedures do both.
Regardless of the type of surgery chosen, obese patients must commit to healthy lifestyle changes, including regular exercise and a consistent, healthy diet to help ensure successful weight management after surgery.
“Bariatric Surgery.” Mayo Clinic. November 22, 2018. https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258 (accessed December 2, 2018).
“Overweight & Obesity.” CDC. September 17, 2018. https://www.cdc.gov/obesity/index.html (accessed November 28, 2018).
“Overweight and Obesity.” National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/overweight-and-obesity (accessed December 3, 2018).