# The Beast of Obesity

So, you may have noticed the numbers on the scale creeping up over the last few years. Don’t ignore that. The definition of “obesity” in its most basic form is an excess amount of body fat. The specifics on that definition depend on what source you read.

Medical and dietary literature list the normal amount of body fat (listed as a percentage)to be 25-30% for women and 18-23% for men. Women with more than 30% body fat and men with more than 25% body fat would be considered obese.

You have probably read or heard of the term BMI – which stands for Body Mass Index. This is simply a calculation that is used to standardize measurements of an individual.

The BMI is equal to a persons weight in Kilograms (kg) divided by the square of their height in meters. [For all you mathematicians   BMI=kg/m 2. This BMI measurement has been found to correlate very strongly with percentage of body fat because it describes an individuals weight in relation to their height. Using the BMI, obesity is defined as anyone who has a BMI (body mass index) greater than 30. Another way that is used to measure obesity is the waist-to-hip ratio (WHR). This measurement looks at the proportion of fat stored on the waist, hips and buttocks. A waist circumference over 40cm in men and 35cm in women is concerning for placing that individual at risk.

Obesity has reached epidemic proportions here in the United States, and is trending upwards in other countries that did not have that problem as little as 20 years ago. In the US, there are about 300,000 deaths per year that are directly related to obesity and more than 80% of these deaths were in people whose BMI was higher than 30.

Obesity also raises the risk of a person going on to develop other chronic and debilitating diseases and conditions.

Osteoarthritis – especially of the knees, hips and lower back(degeneration of the cartilages and joints due to excess wear and tear partly due to the increased weight bearing)

Gallstones – formation of “stones” in the gallbladder

Cardiovascular disease – which includes coronary artery disease, stroke and hypertension.

A study by investigators in Norway found that weight gain tended to cause an increase in the blood pressure in women more so than in men.

High cholesterol

Insulin resistance – fat cells are more resistant to insulin (a substance the body makes that is used to transport glucose into the cells so that the cells can use the glucose for energy. This is a pre-diabetic condition

Type 2 Diabetes – the end result of insulin resistance. The risk of developing type-2 diabetes increases with the amount of obesity (how much over-has been obese)

Sleep Apnea and respiratory problems – sleep apnea causes people to stop breathing for brief periods at night, interrupts sleep and causes drowsiness during the day. It also causes heavy snoring. Sleep apnea is also associated with high-blood pressure.

Gynecological Problems – such as infertility and abnormal menses

Cancer – in women, obesity had been shown to increase the risk of breast, colon and uterus. In men it causes as risk for colon and prostate cancer.

Another alarming fact is that obesity is on the rise in children and adolescents. A study revealed that between the years 2003-2006, 16% of children between the ages of 2 o 19 were at or above the 90th percentile for their BMI.   I personally believe that the omission of “recess” in a majority of our elementary and middle schools has played a role in this, as well as the “fast-food” culture of our society.

Obesity can be treated. Several options for managing weight are

– Nutrition and diet counseling

– Modification of diet and calorie intake

– Increased exercise or participation in an exercise program

– Behavior modification

– Individual or group therapy

– Surgical treatment (an entire sub-speciality of medicine and surgery called Bariatric Medicine deals with this)

Managing obesity requires a lifestyle change, but it is do-able. Anyone dealing with this issue should have realistic goals that are focused on a modest reduction of caloric intake, a change in eating habits and incorporating a healthy exercise-oriented lifestyle. Before embarking on any of these , it is essential that the individual consults with his or her physician or health-care provider.