What to do? - Focus on Yourself First!
Many of us don't want to know the facts about our health but it
can be a matter of life and death! Please remember that the primary
concern of overweight and obesity is one of health and not appearance.
- The first thing we want to learn about our selves is: am I obese
or morbidly obese?
- Then we will look into what causes our obesity?
Am I obese?
The Centers for Disease Control and Prevention estimates that 64.5
percent of adults and 15 percent of children in the United States
are overweight. According to a recent RAND Corp. study, the number
of extremely obese American adults - those who are at least 100
pounds overweight - has quadrupled since the 1980s to about 4 million,
or about one in every 50 adults.
This prevalence has nearly tripled for adolescents in the past
2 decades. These increases in overweight and obesity cut across
all ages, racial and ethnic groups, and both genders. As a result,
300,000 deaths each year in the United States are associated with
obesity which is preventable through weight loss surgery (stomach
stapling [gastric bypass surgery], lap band [adjustable gastric
banding]) and non surgical weight loss methods (nutrition, diet,
exercise). So this is a very important question! Lets understand
what obesity is.
Obesity is defined as being 20% or more over ideal weight
(BMI >25). Ideal weight is the weight associated with the longest
life. Ideal weight tables show the ideal weight as it relates to
gender and height. There are different tables and some controversy
over what actually is ideal weight but a commonly used table is
Metropolitan Life Insurance Table. A rule of thumb often
used by physicians to calculate ideal weight is to allow 100 lbs.
for the first 5 feet of a woman's height and 5 lbs. For each inch
over 5 feet. For men it is 106 lbs. For the first 5 feet and 6 lbs.
For each inch thereafter.
Example: A 5 foot 6 inch woman should therefore weight 130 lbs.
Morbid obesity is a much more severe form of obesity. A person
who is 100 or more pounds overweight or twice the ideal body weight
and has a BMI of 40 or a BMI of 35 with multiple co-morbidities
is morbidly obese. Morbid obesity affects an estimated 9 million
Morbid obesity is a common condition that can have profoundly negative
health and social consequences. It is considered a serious disease
and has been linked to shortened life expectancy. Most morbidly
obese patients are candidates for the various forms of weight loss
surgery (restrictive - lap band, Roux-en-Y Gastric Bypass surgery,
Gastroplasty, or Malobsorbtive - biliopancreatic diversion, Duodenal
Switch). According to C. Everett Koop, M.D. former Surgeon General
of the United States, obesity is the second leading cause of preventable
death in America! And more and more insurance companies are realizing
that weight loss surgery is not a cosmetically motivated treatment
but instead a life saving weight loss surgery treatment making weight
loss treatments such as stomach stapling (gastric bypass surgery)
or the lap band financially affordable to those in need.
OK, so how do I determine if I am obese and at risk?
According to the National Heart Lung and Blood Institute
guidelines, assessment of overweight involves using three key measures:
- body mass index (BMI)
- waist circumference, and
- risk factors for diseases and conditions associated with obesity.
The BMI is a measure of your weight relative to your height and
waist circumference measures abdominal fat. Combining your BMI and
your waist circumference with information about your additional
risk factors yields your risk for developing obesity-associated
diseases and determines whether your a candidate for weight loss
surgeries such as gastric bypass surgery, the lap band or other
weight loss procedures. So your BMI is a good number to start with
in identifying your risk due to your weight.
Lets find out your BMI.
1. Body Mass Index (BMI):
BMI is a reliable indicator of total body fat, which is related
to the risk of disease and death. The BMI score is valid for both
men and women but it does have some limits. The limits are:
- BMI may overestimate body fat in athletes and others who have
a muscular build or those who are exceptionally tall.
- BMI may underestimate body fat in older persons and others who
have lost muscle mass.
Use the BMI calculator below to estimate your total body fat.
|Apply your BMI score to the following:
- BMI = 18.5 Underweight Below
- BMI = 18.5 - 24.9 Normal
- BMI = 25.0 - 29.9 Overweight
- BMI = 30.0 Obese
- BMI = 35.0 - 40 Morbidly Obese (with risk factors)
- BMI = 40.0 and up Morbidly Obese
2. Waist Circumference:
Determine your waist circumference by placing a measuring
tape snugly around your waist. It is a good indicator
of your abdominal fat which is another predictor of
your risk for developing risk factors for heart disease
and other diseases. This risk increases with a waist
measurement of over 40 inches in men and over 35 inches in women.
The table, Risks of Obesity-Associated Diseases by
BMI and Waist Circumference, provides you with an idea
of whether your BMI combined with your waist circumference
increases your risk for developing obesity associated
diseases or conditions.
This table from the NHLBI is a classification of overweight
and obesity by BMI, waist circumference,and associated disease risks:
* Disease risk for type 2 diabetes, hypertension, and CVD.
Disease Risk* Relative to Normal Weight and Waist Circumference:
Men 102 cm (40 in) or less
Women 88 cm (35 in) or less
Men > 102 cm (40 in)
Women > 88 cm (35 in)
|| < 18.5
|| 18.5 - 24.9
|| 25.0 - 29.9
|| 30.0 - 34.9
|| Very High
|| 35.0 - 39.9
|| Very High
|| Very High
|| 40.0 +
|| Extremely High
|| Extremely High
+ Increased waist circumference can also be a marker for
increased risk even in persons of normal weight.
3. Other Risk Factors
Besides being overweight or obese, there are additional risk factors to consider.
- high blood pressure (hypertension)
- high LDL-cholesterol ("bad" cholesterol)
- low HDL-cholesterol ("good" cholesterol)
- high triglycerides
- high blood glucose (sugar)
- family history of premature heart disease
- physical inactivity
- cigarette smoking
For people who are considered obese (BMI greater than or equal to
30) or those who are overweight (BMI of 25 to 29.9) and have two
or more risk factors, the guidelines recommend the need for weight
loss. Even a small weight loss (just 10 percent of your current
weight) will help to lower your risk of developing diseases associated
with obesity. Weight loss surgery treatment such as the adjustable
lap band may be available to you. Patients who are overweight, but
do not have a high waist measurement, and have less than 2 risk
factors may need to prevent further weight gain rather than lose
Talk to your practitioner to see if you are at an increased risk
and if you should lose weight or consider weight loss surgery. Your
doctor will evaluate your BMI, waist measurement, and others risk
factors for heart disease. People who are overweight or obese have
a greater chance of developing high blood pressure, high blood cholesterol
or other lipid disorders, type 2 diabetes, heart disease, stroke,
and certain cancers, and even a small weight loss (just 10 percent
of your current weight) will help to lower your risk of developing
those diseases. And there are a variety of weight loss surgery options
available such as the less invasive lap band. Other surgeries include
stomach stapling or gastric bypass surgery which can be done laparoscopically.
What Caused My Obesity?
Overweight and obesity are a result of an energy imbalance
over a long period of time. The cause of the energy
imbalance for each individual may be due to a combination
of several factors. But generally, our behavior is out
of sink with our bodies biological, and our life's environmental
factors which together are all responsible for causing
us to be overweight and obese. Many other factors also
contribute to obesity and because of this; obesity is
a complex health issue to address. We will focus on
these three main factors: behavioral, biological and environmental.
Behavioral: Am I partially responsible!
The choices a person makes in eating and physical activity
contributes to overweight and obesity. Weight gain is
a result of consuming extra calories, decreasing the
amount of calories your body uses (through physical
activity) or both. Personal choices concerning calorie
consumption and physical activity can lead to an energy
imbalance. A difference of one 12-oz. soda (150 calories)
or 30 minutes of brisk walking most days can add or
subtract approximately 10 pounds to your weight each
year. To maintain your weight, your intake of calories
must equal your energy output. To lose weight, you must
use more energy than you take in. The Surgeon General
says "Make fitness a priority
COMMIT TO IT."
Physical exercise is a great way to burn those calories
off our bodies and maintain our energy balance. Note:
Consult with your health care provider before starting
a vigorous exercise program if you have ever had heart
trouble or high blood pressure or suffer from chest
pains, dizziness or fainting, arthritis, or if you are
over age 40 (men) or 50 (women).
Biological: How do genes affect obesity?
Science shows that genetics plays a role in obesity.
However genes do not always predict future health. It
all depends on what other factors are in play. Genes
and behavior usually both play hand in hand for those
of us who are overweight.
Bottom Line: For people who are genetically predisposed to
gain weight, preventing obesity is the best course. Predisposed
persons may require individualized interventions (including weight
loss surgery) and greater support to be successful in maintaining
a healthy weight.
It is time to stop blaming yourself. Many obesity researchers believe
that people who struggle with their weight are pushing against thousands
of years of evolution that has selected for storing energy as fat
in times of plenty for use in times of scarcity. Genes are not destiny;
in fact obesity can be prevented or can be managed in many cases
with a combination of diet, physical activity, and medication. Genetic
predisposition will usually mean that fighting obesity will be a
struggle and require a lifelong commitment to achieve better health
as will any decision to under go weight loss surgery. Treatments
such as the Lap Band, Gastric Stimulator, stomach stapling, and
gastric bypass surgery all require life long commitments to living
healthy. To learn more about genetics and obesity visit A Public
Health Perspective web site at www.cdc.gov.
Environment: How does my environment influence my behavior?
People may make decisions based on their environment
or community. For example, a person may choose not to
walk to the store or work because of a lack of sidewalks.
Communities, homes, and workplaces each shape health
decisions. With fewer options for physical activity
and healthy eating, it becomes more difficult for people
to make good choices. These are all choices, sometimes
very small choices that add up over time to make a big
difference in our health.
Other Factors Diseases and Drugs
Some illnesses may lead to obesity or weight gain. These may include
Cushing's disease or polycystic ovary syndrome. Drugs such as steroids
and some antidepressants may also cause weight gain.
A doctor is the best source to tell you whether illnesses, medications,
or psychological factors are contributing to weight gain or making
weight loss hard.
Body weight is the result of our behavior combined with our genes
(predisposition to gain weight) and our environment (opportunities
for physical activity and healthy eating). These are the greatest
areas for prevention and treatment actions prior to under going
weight loss surgery.
With a better understanding of our self (BMI, risk factors, waist
circumference) and the potential reasons for our obesity, we can
focus on our path to success (which may include weight loss surgery
treatment such as the adjustable lap band or stomach stapling).
And like the many factors that contribute to obesity, we will have
to change many factors while on our path and knowing our self is
the first step towards taking your life back from obesity.
All content is for informational purposes only. Content is not intended
to be a substitute for professional medical advice, diagnosis, or
treatment. The information provided on this site is designed to
support, not replace, the relationship that exists between a patient
and his or her existing physician. The information (including but
not limited to information contained on message boards, in programs,
or in chats) may not apply to you and before you use any of the
information provided in the site, you should contact a qualified
medical, dietary, fitness or other appropriate professional. If
you use information provided in this site, you do so at your own
risk and you specifically waive any right to make any claim against
BCC Internet, its officers, directors, employees, or representatives
as the result of the use of such information.