Understanding Severe Obesity Brochure

To view the brochure, click here.
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It is estimated that more than eight million Americans are affected by severe obesity. Severe obesity is a chronic disease characterized by an individual weighing more than 100 pounds over their ideal body weight, or having a body mass index (BMI) of 40 or higher.

What is the difference between obesity and severe obesity?
Obesity is a serious health epidemic that affects one in three Americans. It is estimated that more than 93 million Americans are affected by obesity, with that number predicted to climb to 120 million in the next five years. Obesity is a chronic disease characterized by excessive body fat or by having a BMI greater than 30. Obesity increases the likelihood of certain diseases and other related health problems.

Severe obesity is characterized by an individual having a BMI greater than 40. It also has a much higher correlation with conditions and diseases, such as diabetes, heart disease and many more.

Measuring Severe Obesity
Severe obesity is most commonly calculated using BMI. BMI is calculated by dividing a person’s weight in kilograms by his or her height in meters squared. Individuals with a BMI of 40 or higher are classified as being affected by severe obesity. 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.

What are the risks associated with severe obesity?
Many obesity-related conditions and diseases accompany severe obesity. These diseases and conditions negatively impact the quality of health for an individual affected by severe obesity.

The terminology “obesity-related conditions and diseases” relate to illnesses that are related to or negatively impacted by obesity.

The most prevalent severe obesity-related diseases and conditions include:

      • High blood pressure
      • High cholesterol
      • Type 2 Diabetes
      • Heart disease
      • Stroke
      • Gallbladder disease
      • Osteoarthritis
      • Sleep apnea and respiratory problems
      • Some cancers (endometrial, breast and colon)
      • Liver disease
      • Venous disease
      • Acid reflux
      • Menstrual irregularities and infertility

Those who are affected by severe obesity are encouraged to talk with a healthcare professional concerning the obesity-related conditions and diseases listed. The earlier these are detected, the better advantage an individual may have to keep them under control with the assistance of a healthcare professional.

Causes of Severe Obesity
Severe obesity is simply not a result of overeating. It is a serious chronic disease that needs to be prevented and treated. The causes of severe obesity are widespread, but target three main contributors: behavior, environment and genetics.

Behavior
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of severe obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health.

Americans are consuming more calories on average than in past decades. The increase in caloric intake has also decreased the nutrients consumed that are needed for a healthy diet. This behavioral problem also relates to the increase in portion sizes at home and when dining out.

While Americans are consuming more calories, they are not expending them with enough physical activity. Physical activity is an important element in modifying and molding behaviors. The influence of television, computers and other technologies discourage physical activity and add to the problem of obesity in our society.

Environment
Environment plays a key role in shaping an individual’s habits and lifestyle. There are many environmental influences that can impact your health decisions. Today’s society has developed a more sedentary lifestyle. Walking has been replaced by driving cars, physical activity has been replaced by technology and nutrition has been overcome by convenience foods.

Genetics
Science shows that genetics play a role in obesity and severe obesity. Genes can cause certain disorders which result in obesity. However, not all individuals who are predisposed to obesity will be affected by severe obesity. Research is currently underway to determine which genes contribute most to severe obesity.

What are the social effects of severe obesity?
Individuals affected by severe obesity often face obstacles far beyond health risks. Emotional suffering may be one of the most painful parts of severe obesity. Society often emphasizes the importance of physical appearance. As a result, people who are affected by severe obesity often face prejudice or discrimination.

Effects at Work
Due to the negative stigma associated with severe obesity, employees affected by severe obesity are often viewed as less competent, lazy and lacking in self-discipline by their co-workers and employers. Often times, discriminatory attitudes can negatively impact wages, promotions and employment status for employees affected by obesity.

In Healthcare Settings
Negative attitudes about patients affected by severe obesity also exist in the healthcare setting. These patients are often reluctant to seek medical care, may be more likely to delay important preventative healthcare services and may more frequently cancel medical appointments. Delaying medical attention can lead to delayed discovery or treatment of obesity-related conditions and diseases, such as diabetes and cardiovascular disease, while becoming more physically damaging.

Treating Severe Obesity
(*Note: Please consult with a healthcare professional before beginning any treatment program.)

Because the health risks associated with severe obesity can be life-threatening, clinical programs, such as medically managed weight-loss, bariatric surgery and other options are available for treatment.

Medically Managed Weight-Loss
Medically managed weight-loss programs provide treatment in a clinical setting with a licensed healthcare professional, such as a doctor specializing in obesity care, nurse, registered dietitian and/or psychologists. These programs typically offer services such as nutrition counseling, physical activity and behavioral therapy. Often, these programs incorporate total meal replacement programs.

Medications (Pharmacotherapy)
Currently there are four medications that are FDA-approved for chronic weight management: phentermine products (Adipex-P® or Suprenza®), orlistat (Xenical®, alli®), BELVIQ® (lorcaserin HCl), and phentermine-topiramate ER (Qsymia®). BELVIQ® and Qsymia® are the latest medications approved by the FDA in mid-2012. All are to be used in conjunction with a reduced-calorie diet, exercise and behavior modification. As with all therapies, medically managed weight-loss needs to be approached with a focused treatment plan,

In addition, some physicians may also use medications traditionally prescribed for other conditions/diseases for the treatment of severe obesity.

For more information on medically managed weight-loss, please visit the “Obesity Treatments“section on the OAC Web site.

Bariatric Surgery
If your BMI is more than 40, or your BMI is more than 35 and you have an obesity-related condition or disease, such as diabetes or hypertension, you may consider bariatric surgery (also called weight-loss surgery). After bariatric surgery, individuals must still modify their lifestyle habits, adjust their diet and increase their physical activity. It is important to speak with your physician to determine if surgery is right for you.

Today, the four most commonly selected procedures for bariatric surgery are:

      • Roux-en-Y Gastric Bypass
      • Laparoscopic Adjustable Gastric Banding
      • Sleeve Gastrectomy
      • Biliopancreatic Diversion with Duodenal Switch

When considering  bariatric surgery, you must balance the personal risk of being affected by severe obesity with the potential risk and complications of the surgery. This treatment option is a tool that you will continually use to lose weight. Behavioral, physical and psychological changes are required for you to maintain a healthy quality of life. Continued positive weight-loss relies upon your desire and dedication to change your lifestyle with a proactive approach.

If you are a candidate for bariatric surgery, you will likely be referred for evaluation and consultation with a psychologist. Although this may seem surprising to you, it has become a routine part of your preparation for surgery. Your follow-up care will be provided by a team of professionals and each of them, including a dietitian, exercise therapist and psychologist, will need to become more familiar with you and your individual situation and needs.

To learn more about  bariatric surgery, please visit the Obesity Treatments” section on the OAC Web site.

Additional Treatment Options
In addition to weight-loss surgery and medically managed weight-loss, the following therapies are also utilized to treat severe obesity.

Behavior Modification
Behavior plays a significant role in severe obesity. Modifying behaviors that have contributed to developing obesity is one way to treat the disease either alone or in conjunction with other treatments. A few suggested behavior modifiers include: changing eating habits, increasing physical activity, becoming educated about the body and how to nourish it appropriately, engaging in a support group or extracurricular activity and setting realistic weight management goals.

Physical Activity
Increasing or initiating a physical activity program is an important aspect in managing severe obesity. Routine physical activity can greatly impact your health. Set realistic goals and make sure to consult with your physician before initiating any exercise program.

Non-Clinical Weight Management Programs
Participating in non clinical programs is another form of treatment for obesity. Some programs may be commercially operated, such as a privately owned weight-loss chain. Counselors, books, Web sites or support groups are all ways you can be involved in a non clinical weight-loss program.

The success of any weight-loss treatment option is dependent on you continuing with your chosen treatment to improve your quality of health.

Gaining Access to Treatment with Your Insurance Provider
Individuals affected by severe obesity rely on their insurance provider to assist them in the process of seeking access to safe and effective medical treatment. Many times they experience difficulty when working with their insurance providers, such as repeated denial of claims. In addition, the process often times seems complicated, and physically and emotionally draining.

The OAC designed a resource, titled “Working with Your Insurance Provider: A Guide to Seeking Weight-loss Surgery,” to provide individuals with the knowledge needed to effectively work with their insurance provider and gain access to safe and effective treatment. Although specifically designed to assist those seeking weight-loss surgery, the information and guidance in the brochure is useful for those seeking insurance reimbursement for other medical treatments.

To view this brochure, please click here.

What can you do to learn more about severe obesity?
The OAC is a nearly 50,000 member-strong 501(c)(3) National non-profit organization dedicated to giving a voice to the individual affected by the disease of obesity and helping individuals along their journey toward better health through education, advocacy and support. Our core focuses are to raise awareness and improve access to the prevention and treatment of obesity, provide evidence-based education on obesity and its treatments, fight to eliminate weight bias and discrimination, elevate the conversation of weight and its impact on health and offer a community of support for the individual affected.

OAC Resources
The OAC produces well-rounded and comprehensive education and advocacy materials. All OAC resources are free of charge and may be requested by contacting us at (800) 717-3117 or info@obesityaction.org.

The information contained in the “Understanding Severe Obesity” Brochure is not a substitute for medical advice or treatment from a healthcare professional. The OAC recommends consultation with your doctor and/or healthcare professional.



© 2014 Obesity Action Coalition 4511 North Himes Avenue • Suite 250 • Tampa, Florida 33614 • (800) 717-3117