Obesity is a serious, chronic disease affecting more than 34 percent of American adults and 17 percent of American children (an increase of 75 percent throughout the last 20 years). Every day hundreds of people in the United States will die from obesity and its related health conditions. Obesity is a complex, multi-faceted disease that has been misunderstood by medical professionals, governmental agencies and the general public.

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 most commonly calculated using body mass index (BMI). BMI is calculated by dividing a person's weight in kilograms by his or her height in meters, squared. An adult with a BMI of 30 or greater is clinically obese. To calculate your BMI, please click here.

BMI is not used to determine a person's actual percentage of body fat, but it is a good indicator to categorize weight in terms of what is healthy and unhealthy.

Waist circumference is a less-common method used to measure obesity in an individual. This simple indicator measures your waist circumference by wrapping a tape measure around the area above your hip bone and below your rib cage. For females, a waist circumference of 35 inches or greater is considered unhealthy. For men, a waist circumference of 40 inches or greater is considered unhealthy.

Causes of Obesity

It is a common misunderstanding that an obese individual has directly caused their condition by overeating and/or a lack of willpower. Negative stereotypes have contributed to the lack of adequate support, education, research and treatment for this disease. Obesity is a complex disease with many factors contributing including behavior, environment and genetics.

Health Problems and Co-Morbid Conditions Related to Obesity

People suffering from morbid obesity are at an increased risk for a number of serious health conditions that alone, or in combination, significantly reduce life expectancy, including:

• Type 2 Diabetes - Obesity is a major factor in the development of a resistance to insulin, which regulates the body's blood sugar levels. The resulting high level of sugar in the blood causes serious tissue, nervous system and circulatory system damage.
• Heart Disease - Excess body weight forces the heart to work harder to meet the body's needs. The strain can cause significant heart and kidney damage and, if accompanied by hypertension (high blood pressure), can lead to heart attack or stroke.
• Cancer - Studies have shown that obesity increases the risk of prostate cancer in men and uterine and breast cancer in women.
• Osteoarthritis - Excess weight causes strain and inflammation of the joints, especially the hips, knees and ankles, causing pain and decreased mobility.
• Respiratory Problems - Fat stored in the neck can cause obstruction of the air passage, especially during sleep. Sleep apnea caused by interruptions in breathing can result in a variety of problems, including fatigue, daytime drowsiness, headaches, heart failure and even death.
• Depression - Many obese people face the unfortunate reality of daily discrimination in an appearance-oriented society. In addition, disappointment from repeated failure at dieting and unnecessary feelings of guilt and frustration at physical pain and limitations can result in severe depression.

Treatment of 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 effect of weight loss and subsequent regain, commonly known as "yo-yo" dieting, can actually create additional physical, emotional and psychological problems.

Unfortunately, while many patients respond short-term to diet programs, only 3 - 5 percent maintain significant weight loss over a five year period.

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

However, weight loss plateaus occur for most people after several months and weight is regained if the course of medication is discontinued. Drugs can also have serious side effects, which must be carefully considered by physician and patient. New drugs, potentially having fewer side effects, are on the horizon.

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

Surgical treatment focuses on severely restricting caloric intake while maintaining nutrional needs.

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), or a BMI of 35 or greater with two co-existing comorbidities. Surgery is primarily viewed as a "last option" to alleviate the chronic, debilitating disease of morbid obesity.

Individuals must be highly motivated. Extensive dietary, exercise and medical guidelines must be followed for one's lifetime after surgery.

Once the decision to have surgery is made, there are several different procedures available, each with associated benefits and risks. Today, the preferred procedures include:

• Gastric Bypass Roux-en-Y
• Duodenal Switch
• Laparoscopic Adjustable Gastric Banding (LAGB)

For more information on the different types of weight-loss surgeries, please refer to the links on the right.

More Information

For more information about obesity, please visit the following pages:

American Society of Bariatric Physicians. Offers information about obesity for the public and education programs for the medical community.
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American Society for Metabolic and Bariatric Surgery. Information about the ASMBS, articles including a rationale for surgery and a history of bariatric surgery.
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BAM! Kids' health issues and recommended ways to make their bodies and minds healthier, stronger and safer.
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Center for Disease Control. Overweight and Obesity information and resources.
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NIDDK Weight Control Information Network. Obesity-related statistics.
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Obesity Action Coalition. Resources to promote the Coalition's mission to elevate and empower those affected by obesity through education, advocacy and support.
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The Obesity Society. Promotes research, education and advocacy to better understand, prevent and treat obesity and improve the lives of those affected.
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Office of the Surgeon General. The Surgeon General's call to action to prevent and decrease obesity.
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