Obesity Facts, Causes and Treatment
According to the WHO (World Health Organization) obesity is defined as "abnormal or excessive body fat that may impair health".
The Body Mass Index is a ratio of the weight of a person in kilograms and square of the height of a person in meters. It is used to define the body type of a person that may be underweight, normal, overweight or obese as displayed in the table below. This index is most commonly used to define obesity. A BMI calculator may be found here.
WHO BMI Classification
≥ 35 and ≥ 40
According to the World Health Organization (WHO) obesity is a global epidemic since it has doubled from 1980 until 2008. Childhood obesity has also increased dramatically constituting currently one of the biggest health challenges. The WHO estimates that 2.8 million people die every year as a result of being overweight or obese.
According to the CDC more than one third of adults in the United States are obese, with non-Hispanic blacks having the highest rates of obesity. Interestingly there seems to be a link between socioeconomic status and obesity. Non-Hispanic blacks and Mexican-Americans with higher incomes were more likely to be obese, whereas the opposite was true for women since high income females were more likely not to be obese.
State Variance in the United States
According to the CDC the South of the United States, followed by the Midwest, Northeast and West (in that order) had the highest rates for obesity with Mississippi having the highest prevalence of obesity in 2011 at 34.9%.
Medical costs were estimated in 2008 to be $ 1,429 higher in obese persons compared to people with normal body weight.
In the United States around 17% of children and adolescent are obese with numbers tripling since 1980 and mostly prevalent with low-income preschool children.
Since 1997 the WHO has acknowledged obesity as a global epidemic that seems to not only affect high income countries but is also affecting low and medium income countries. According to the WHO in 2008 more than 1.4 billion people were overweight and more than half a billion obese, with 40 million preschool children being overweight globally.
Obesity Health Risk Assessment
1. Your Body Mass Index that is explained above.
2. Your Waist Circumference
People with more abdominal fat rather than fat on the hips for example (with a body type that emphasizes weight in the abdominal area) are of greater risk for Diabetes Type 2 and heart diseases. A waist circumference of more than 35 inches for women and 40 inches for men denotes a higher health hazard risk.
3. Other Conditions combined with Obesity
If you are obese and have one or more of these conditions as well:
- high blood pressure,
- high cholesterol levels,
- you smoke,
- you have a family history of heart disease,
- have high blood sugar levels or
- a sedentary lifestyle,
then you are at greater risk for heart disease.
Obesity Health Consequences
According to the CDC overweight and obesity increase the risk for the prevalence of health conditions such as:
1. Type 2 Diabetes
2. Cardiovascular disease such as hypertension, and coronary artery disease
3. Cancers such as endometrial, breast, colon
4. Sleep apnea and respiratory disorders
5. High cholesterol or triglyceride levels
7. Women's health (infertility or abnormal period)
8. Liver and gallbladder diseases
9. Painful joints due to osteoarthritis (less cartilage between bone and joint)
The primary cause of obesity according to the WHO is the imbalance between calorie uptake and physical activity. In other words we eat more than we can burn so we store it as fat. According to the US Surgeon General obesity is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status where behavior and environment play the largest role.
Diet and Physical Activity
As stated above the primary cause of obesity is the consumption of energy rich foods especially fats and carbohydrates that are not 'burnt' with physical activity and therefore are stored as fat supplies. The combination of a inappropriate diet and sedentary lifestyle are the most important preventative methods against being overweight and obese.
A decrease in the caloric intake together with a increase in physical activity can prevent obesity both in children and adults. The caloric intake necessary to sustain or lose weight can be calculated using a variety of variables such as age, weight and height and an example of a calorie calculator may be found here. The National Institutes of Health recommend a healthy eating plan with portion control and reducing caloric intake.
According to the National Institutes of Health a weekly physical activity ranging between 150 to 300 minutes of moderate-intensity is recommended. Common chores and sporting activities that define moderate-intensity activity include for example washing and waxing the car for 45-60 minutes, or walking 2 miles in 30 minutes.
There are genetic obesity syndromes that are syndromes that affect many systems and are also characterized by obesity. Such syndromes include among others the Prader-Willi syndrome, the Bardet-Biedl syndrome, the Cohen syndrome, the Alstrom syndrome, the Carpenter syndrome, MOMO syndrome, Rubinstein-Taybi syndrome, maternal uniparental disomy of chromosome 14, fragile X syndrome and Börjeson-Forssman-Lehman syndrome.
Nevertheless apart from these genetic obesity syndromes there does seem to be a complex link between genetics, environment and behavior in overweight and obese people. Multiple genes seem to play a role in obesity some of which may affect behavior and others metabolism meaning that a person may for a example have an increased hunger drive.
The "thrifty gene hypothesis" postulates that because of the fact that food had been scarce in man kinds past, evolution favored the development of genes that helped store fat in order to survive periods where no food was available. Now that environmental parameters have changed and there is a loss of balance between food consumed and physical activity these genes contribute in making people obese.
Researches have isolated nevertheless a gene variation named the 'fat mass and obesity associated' (FTO) gene variant that as its name suggest is associated with obesity and people that carry this variation are at a higher risk of being obese. More than 30 of these 'obesity related' variations have been found on multiple chromosomes over the years.
It seems that therefore genes do play a role in the development of obesity but research and understanding of this role is still at early stages and that the role genetics play in obesity depends on multiple factors such as behavior and environment.
Early life and Childhood
According to the WHO obese children are more likely to become obese adults and acquire obesity related diseases earlier on life. Although risk factors for developing childhood obesity are similar to those for adult obesity (dietary and physical activity lifestyle, genetics, socioeconomic status since lower income children tend to be more obese etc.)
it seems that the perinatal period plays a role in the later development of obesity since birth weight, weight gain in infancy and size in early life may be predictors of obesity. Interestingly it also seems that breastfed children are at a lower risk for developing obesity that children that did not breastfeed. Facts and tips on breastfeeding can be found at this hub.
Other Diseases and Conditions
Diseases that cause obesity are mostly endocrine disorders meaning that they affect certain hormones in the body either by producing or giving out too little or too much. Such diseases and conditions that may cause obesity are:
1. Thyroid Illness such as Hypothyroidism
2. Cushing's syndrome
3. Polycystic Ovary Syndrome
5. Depression and eating disorders
Some medication may also cause obesity that may include medication that acts as hormone substitution such as corticosteroids. Also certain antidepressants may cause obesity.
Please contact your doctor or healthcare provider regarding a healthy treatment of obesity.
The NIH has issued clinical guidelines on the evaluation, identification and treatment of obesity in adults that may be found here.
The main treatment of obesity is a change in lifestyle. The combination of dietary changes in combination with at least 150 minutes weekly of moderate intensity exercise are a good start to changing lifestyle. Weight loss that is fast, causes starvation and is very low in calorie count is dangerous and should be avoided. A steady change in lifestyle habits and behavior is far healthier both in the short and long term. Counseling and group support may prove helpful for support and behavior changes.
There are millions of options available through weight loss programs, advertising on the internet, books, theories, diets, products, exercise plans, experiences that we are bombarded with daily regarding weight loss. The most important thing to remember is that everyone is unique and it is important to find healthy, steady, long term solutions that suit your character, behavior and environment. The best way to do this is to consult a health care professional and seek advise, diagnosis and therapy. Chose healthy options and use common sense.
Medication is available that may be used for the control or reduction of weight by for example absorbing less calories or changing appetite. Examples of such medication are found here. It must be stressed that these medication should only be prescribed by your health care professional, never self diagnose and self medicate.
Bariatric surgery or obesity surgery is an option for severe obesity or obesity in combination with other disease. Information regarding bariatric surgery may be found here.
The information provided in this article is intended for informational purposes only and is not advise also provided without any representations and no warranties whatsoever. The provided information should never substitute the consultation, opinion , diagnosis, and treatment options provided by a professional healthcare provider.