What is obesity?
Obesity is a disease characterized by excessive body fat. People who are affected by obesity usually are affected by behavioral, genetic and environmental factors that are difficult to control with dieting. Obesity increases the likelihood of certain diseases and other related health problems that can affect your quality of life and reduce your lifespan.
Who is affected?
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.
“Overweight” and “Obesity” – What is the difference?
Stages of weight are medically defined by body mass index (BMI). An individual with a BMI of 25 to 29.9 is clinically classified as “overweight.” A BMI of 30 or more is classified as “obesity.”
Individuals affected by excess weight are also at risk for developing health problems, such as heart disease, stroke, diabetes, certain types of cancer, gout (joint pain caused by excess uric acid) and gallbladder disease. Excess weight can also cause problems such as sleep apnea (interrupted breathing during sleep) and osteoarthritis (wearing away of the joints).
Weight-loss can help improve the harmful effects of excess weight. However, many individuals affected by excess weight have difficulty reaching their healthy body weight.
Body Mass Index (BMI)
BMI is a number calculated by dividing a person’s weight in kilograms by his or her height in meters squared. BMI is used in determining obesity.
Obesity is most commonly calculated using BMI. An adult with a BMI of 30 or greater is clinically affected by obesity.
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 health risks associated with obesity?
There are more than 40 medical conditions that are associated with obesity. Individuals affected by obesity are at risk of developing one or more of these serious medical conditions, causing poor health or, in severe cases, early death. In fact, more than 112,000 annual deaths are attributable to obesity. The most prevalent obesity-related diseases include:
- Type 2 Diabetes
- High blood pressure
- High cholesterol
- Heart disease
- Gallbladder disease
- Gastroesophageal Reflux Disease (GERD)
- Sleep apnea and respiratory problems
- Some cancers
What causes obesity?
Obesity is due to an individual taking in more calories than they burn over an extended period of time. These “extra” calories are stored as fat. Although there are several factors that can lead to this energy imbalance in individuals affected by obesity, the main contributors are behavior, environment and genetics.
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health. Based on food choices, many people now select diets that are calorie-rich, but nutrient-poor. This behavioral problem also relates to the increase in portion sizes at home and when dining out.
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, basic physical activity has been replaced by technology and nutrition has been overcome by convenience foods.
Science shows that genetics play a role in obesity. Genes can cause certain disorders which result in obesity. However, not all individuals who are predisposed to obesity will become affected by obesity. Research is currently underway to determine which genes contribute most to obesity.
What are the social effects of obesity?
Individuals affected by obesity often face obstacles far beyond health risks. Emotional suffering may be one of the most painful parts of obesity. Society often emphasizes the importance of physical appearance. As a result, people who are affected by obesity often face prejudice or discrimination in the job market, at school and in social situations.
Effects at Work
Due to the negative stigma associated with obesity, employees affected by 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.
Finding a job can also be a difficult task. Studies show that applicants affected by obesity are less likely to be hired than thinner applicants, despite having identical job qualifications. There has been an increase in court cases involving employees affected by obesity who are fired because of their weight, despite the fact that they are competent to perform their jobs.
Effects at School
Educational settings also provide the possibility for discriminatory situations. Children affected by childhood obesity face numerous obstacles, ranging from harassment, teasing and rejection from peers, to biased attitudes from teachers. At a young age, children are exposed to obesity’s negative stigma. Children affected by childhood obesity are sometimes characterized as being unhappy, lazy, mean and not having many friends.
In Healthcare Settings
Negative attitudes about patients affected by 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 more frequently cancel medical appointments. Delaying medical attention can lead to delayed discovery or treatment of co-morbid conditions, such as diabetes and cardiovascular disease, while becoming more physically damaging.
The consequences of this discrimination can seriously impact an individual’s quality of life and only further intensify the negative stigma associated with obesity.
What treatments are available for obesity?
Obesity treatment strategies vary from person-to-person. Beginning treatment early is an essential part of success, and it is important to talk with your physician before beginning any weight-loss program. There are several methods for treating obesity, such as behavior modification, physical activity, non-clinical weight management programs, medical weight management, medications, and bariatric surgery.
Behavior plays a significant role in 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.
Increasing or initiating a physical activity program is an important aspect in managing obesity. Today’s society has developed a very sedentary lifestyle, and routine physical activity can greatly affect health. Individuals affected by excess weight or obesity should consult with their 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 to be involved in a non-clinical weight-loss program.
Medical Weight Management
Medical weight management is provided by an obesity medicine physician in a clinical setting. Other healthcare professionals such as nurse practitioners, physician assistants, nurses, registered dietitians and psychologists may also be a part of the program. These programs typically offer services such as nutrition counseling, physical activity and behavioral therapy. Often, these programs incorporate total meal replacement plans and/or the use of FDA-approved medications for the treatment of obesity.
Currently, there are several medications that are FDA-approved for chronic weight management:
- phentermine products (Adipex-P®, Lomaira®)*
- orlistat (Xenical®, alli®)+
- lorcaserin HCI (BELVIQ®)+
- phentermine-topiramate ER (Qsymia®)+
- naltrexone HCI and bupropion HCI (CONTRAVE®)+
- liraglutide injection (Saxenda®)+
*Approved for short term use
+Approved for chronic (long term) use
All are to be used in conjunction with a reduced-calorie diet, exercise and behavior modification. As with all therapies, medical weight management needs to be approached with a focused treatment plan.
Surgical treatment of obesity is an option for those who are classified as being affected by ”severe obesity.” Severe obesity is defined as an individual having a BMI of 40 or greater, or weighing more than 100 pounds over their ideal body weight. In addition, an individual with a BMI of 35 or greater with one or more obesity-related diseases is also classified as being affected by obesity. After bariatric surgery, individuals must still modify their lifestyle habits, adjust their diet and increase their physical activity.
There are a few different types of bariatric surgery treatment options, such as Roux-en-Y Gastric Bypass, Laparoscopic Adjustable Gastric Banding, Laparoscopic Sleeve Gastrectomy Biliopancreatic Diversion with Duodenal Switch, and Neuromodulation (VBLOC®).
The information contained in the Understanding 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 provider.
To download a PDF of the Understanding Obesity Brochure, click here.