Obesity

Overview

When a person is overweight and if their Body Mass Index (BMI) measures over 30 the person is considered obese. The body mass index measures obesity through a measurement that involves a ratio between height and weight. A BMI of 25 to 29 is considered overweight rather than obese. It is important to understand that BMI is only a rough guideline for measuring obesity. A person may have a high BMI for reasons other than obesity including muscle mass and bone density. A doctor considers additional factors including your diet and lifestyle when determining whether you are obese.

Obesity is common and is a risk factor for several other conditions like hypertension, type II diabetes, heart disease, stroke, and cancer. There are varying levels of obesity. A "fat" person is not necessarily obese.

Types

• Simple obesity (alimentary obesity): This makes up about 95% of obesity cases and results when a person consumes more calories than the amount of calories that the body can burn.
• Secondary obesity: This type of obesity results from underlying conditions such as Cushing's syndrome, polycystic ovary syndrome, and insulin tumors. Other conditions can cause secondary obesity.
• Childhood obesity: When children and adolescents are above the normal body weight for their age and height, they are at risk for long term problems such as diabetes, hypertension, thyroid problems, and high cholesterol. These problems are more common among older adults, but they can occur among children who are obese. Childhood obesity can stunt healthy growth and development.

Symptoms

Symptoms of obesity include weight gain and an excess of fatty tissue all over the body. People may experience pain in the joints and arthritis flare ups due to the amount of pressure put on the joints by the excess weight, backaches, sleep apnea, heartburn and indigestion. Obesity can also result in high cholesterol and triglycerides, high blood sugar, irregular menstruation, shortness of breath, and a host of other complications.

Causes/Risk Factors

While poor eating habits and overeating are main causes of most obesity, hereditary also plays a vital part in becoming obese. Some medications like steroids can also cause obesity as a side effect.

Tests/Diagnosis

Diagnosis of obesity is made based on the visual appearance, weight, and BMI rating. Calipers are tools that measure the amount of body fat in a given area. However, most cases of obesity are quite obvious on a visual examination.

A doctor can also examine the type of weight gain in order to determine risk for specific diseases. Normally, if the fat is concentrated around the stomach and middle area, then the person is more at risk for certain conditions like cancer, heart disease, and diabetes. When fat is concentrated in the hips and thighs, then the person is at less risk of developing those above conditions.

Treatment

For those with secondary obesity, the underlying cause such as PCOS or Cushing's syndrome must be treated before starting the treatment for obesity.

For those with primary obesity, a healthy eating plan combined with exercise is generally the first course of treatment. A healthy diet plan helps the person to burn more calories than they consume, so that the weight comes off slowly over a period time, giving them the best chance of not regaining the weight later. Sometimes, doctors will also prescribe appetite suppressant medication.

In extreme cases, surgery is performed to cut part of the stomach that prevents the person from overeating. This leads to weight loss in a very short period of time.

Weight Loss Surgery

Bariatric surgery is a term used to describe all weight loss surgical procedures. Two bariatric surgical procedures have gained popularity for treating obesity. They are gastric bypass surgery and the laparoscopic adjustable gastric band (Lap-Band).

• The Lap-Band is inflatable and made out of silicone. Through laparoscopic surgery, the doctor places the band around the top portion of the stomach. The band helps to create a space at the top of the stomach that limits how much food patients can eat at any given time. The band helps people feel full and eat less at each meal. Over time, the lap band patient will lose weight. Doctors recommend the Lap-Band for patients who have a BMI above 40. Unlike other weight loss surgeries, the Lap-Band does not permanently alter the digestive tract. Doctors can deflate and remove the band in order to reverse the surgery.
• Gastric bypass is a permanent surgical option. The surgeon will divide the stomach into two parts and then reconnect the intestine. There are several techniques used to reconnect the intestine, and many gastric bypass surgeries have different names. Gastric bypass surgery causes permanent changes to the stomach and digestive tract, and effects usually cannot be reversed. More and more doctors are performing gastric bypass procedures through a technique called laparoscopy, where the doctor creates small incisions and inserts a video camera. The doctor can perform the surgery using a video camera.