The prevalence of obesity in U.S. adults has risen to epidemic proportions. Sixty-one percent of the population is classified as being overweight (i.e., having a body mass index [BMI] greater than 25). Even more concerning is the increase in morbidly obese adults (those having a BMI of 40 or greater); this translates to approximately 100 pounds over ideal body weight. Morbid obesity is a disease characterized by severe accumulation of fat, strong resistance to dietary management, greatly increased risk of health problems and a shortened life span. According to the National Institutes of Health (NIH), even people who are 50 to 100 pounds overweight are putting their health at risk.
Many people think obesity is simply a result of overeating. Although this is true for people with certain eating disorders or glandular abnormalities, it's not that simple. Ongoing research shows that obesity is a complex combination of hereditary (genetic) and environmental factors that, once established, is almost impossible to control by dieting. The disease is also considered chronic and worsens with time. This means that obesity will require lifelong control and treatment.
Unfortunately, medical weight-loss programs – diet, exercise, medication, behavior modification – fail in at least 90% of morbidly obese patients no matter how much they want to lose weight or how hard they try. Even patients who are 50 to 100 pounds overweight may be unable to shed pounds and improve their health without some form of medical intervention.
Hereditary and environmental factors also play a role in obesity. Clearly, lifestyle can foster obesity in people whose bodies store fat efficiently. In the United States, the convenience of fast food, large portions, little or no structure in meal planning, high-fat, high-calorie snacks and sugar-laden sodas, along with a lack of proper and regular exercise, magnify the hereditary factors that underlie obesity.
Obesity Related Diseases
Eventually, obesity will damage your body and shorten your lifespan. The most common and serious obesity-related diseases are:
- Type 2 Diabetes (Diabetes Mellitus) About 95% of patients with Type 2 diabetes are overweight. Obesity can cause the body to develop a resistance to insulin, which results in high blood sugar levels. Over time, too much sugar in the blood seriously harms various tissues of the body, including the circulatory and nervous systems.
High Cholesterol "High cholesterol" is shorthand for the medical term
hypercholesterolemia, a common abnormality of lipid (fat) metabolism. When the blood contains too much low-density cholesterol and other lipids, these substances begin to stick to and build up on the artery walls, restricting blood flow through the arteries. This disease is more commonly known as "hardening of the arteries" or
arteriosclerosis. Its presence increases the risk of hypertension and coronary heart disease, which can result in a stroke or heart attack.
- Heart Disease and High Blood Pressure In obese people, the heart is forced to work much harder than it was designed to work. Over time, this stress can damage the heart and the kidneys. When such damage is accompanied by high blood pressure, the result often is a heart attack, stroke or congestive heart failure.
- Osteoarthritis / Degenerative Arthritis Excessive weight on the joints which are weight-bearing - especially the hips, knees, ankles and feet - eventually leads to joint damage and inflammation, causing pain and loss of mobility. In the obese population, osteoarthritis can also affect the spine.
- Cancer Obesity increases the risk of endometrial, uterine and breast cancer in women and prostate cancer in men. In both sexes, the risk of colon cancer is increased and the presence of any type of cancer increases the risk of mortality.
Sleep Apnea In some people, the body stores excess fat in the tongue and neck. During sleep, these tissues relax and obstruct the air passage, making breathing difficult and often completely obstructing the airway during sleep. Each year, millions of Americans suffer needlessly from sleeping disorders and are unaware that help is available. Nearly seven of every 10 people report significant problems with their sleep, yet fewer than 20 percent seek relief. Sleep disorders can have a detrimental effect on one's health and well-being. Poor sleep exacerbates many health problems such as diabetes and hypertension. (Learn more by visiting the
St. Joseph Hospital Sleep Disorder Center's web page).
- Gastric Esophageal Reflux Disease / Heartburn Referred to by doctors as gastroesophageal reflux, heartburn and acid indigestion occur when gastric acid flows backward into the esophagus (food pipe) through a valve at the top of the stomach. Habitual overeating weakens this valve. This condition can cause extreme discomfort if left untreated. Gastroesophageal reflux also increases the risk of esophageal cancer.
- Psychological Depression Depression is common in people who are morbidly obese. Feelings of extreme sadness or emptiness, an inability to take pleasure in any activity, insomnia, constant fatigue, feelings of worthlessness or unnecessary guilt, and the inability to concentrate only add to the difficulty of coping with physical problems.
- Urinary Stress Incontinence A large abdomen and weak abdominal muscles can weaken the urinary bladder enough to allow urine to leak from it during coughing, sneezing and laughing. Embarrassing and difficult to live with, urinary incontinence adds to the social and psychological damage caused by morbid obesity.
- Social and Psychological Effects Obesity also has significant social, psychological and even economic effects. Almost everything in life is more difficult for the obese -— shopping for clothes, driving a car, traveling on a plane, going to the theater, finding and maintaining employment, advancing in a career, obtaining medical insurance, maintaining good family relationships and relationships in general. However unfair and in some cases illegal, social and economic difficulties are very real and can be very devastating.
- Venous Stasis in the Legs Heart or kidney disease caused by excess weight can keep the veins in the legs from functioning properly, making it difficult for the blood in the legs to return to the heart. As a result, the legs and ankles often become swollen and ulcers may develop on the legs.
Weight-loss surgery for obesity should be considered a last resort. The surgery is considered a tool and not a cure for obesity. A life-long commitment of regular exercise, dietary discipline, support group participation and follow-up with bariatric surgeons is an essential component to the success of weight-loss surgery.