Understanding Obesity


Before you can truly understand bariatric surgery – and the reason that so many people turn to it as a last resort – you must understand obesity itself. Sadly, there are many people who consider obesity to be some sort of moral failure on the part of the overweight person – an inherent weakness that does not allow them to say no to food. But the staggering facts tell us that obesity is a medical epidemic that kills people. Obesity is a complicated physical and emotional condition that is responsible for an estimated 400,000 deaths every year.

In 2004 the U.S. Centers for Disease Control and Prevention (CDC) ranked obesity as the number one health risk facing America, because obesity-related – and therefore preventable – conditions such as stroke, type 2 diabetes, and heart disease have had an increasingly devastating impact on our population.

So what’s the difference between being overweight and being obese?

Weight standards are measured by Body Mass Index or BMI – a calculation of a person’s weight relative to his or her height. The standard for recommended weight has been set by assessing the BMIs from a general sampling of the U.S. population.

Overweight, as defined by the National Institutes of Health (NIH), is when an individual is at least 10% over his or her recommended weight, or has a BMI between 25 and 29.9.

An adult is considered obese when they are at least 30% over their ideal weight for their specified height or with a BMI of 30 or over.

The measurement of body mass index can be tricky because while it calculates body weight to height, it does not directly measure body fat. So, there are some people – especially athletes  – who tend to have higher muscle mass and, as a result, may be considered obese by BMI standards. That’s why it’s so important to assess your BMI and weight goals under the care of a doctor.

My BMI says I’m overweight or obese. What conditions am I at risk of developing?

Being overweight or obese puts you at risk for:

  • Respiratory Conditions
  • Type 2 Diabetes
  • Stroke
  • High Blood Pressure/Hypertension
  • Coronary Heart Disease
  • High Cholesterol
  • Endometrial, Breast, and Colon Cancers
  • Gynecological Problems Including Abnormal Menses and Infertility
  • Sleep Apnea
  • Osteoarthritis and Other Joint Conditions
  • Liver and Gallbladder Disease

Based on this list, it’s not surprising that in 2008, medical costs pertaining to obesity and its related conditions in the U.S. came with the shocking price tag of $147 billion. In fact, those who are obese have medical costs of more than $1,400 more than those who are considered normal weight.

Obviously obesity is a medical concern, but it also has an emotional impact – often resulting in depression, lowered self-esteem, diminished social interactions, and an overall reduction in quality of life.

Still, even with all these factors, more than one-third of all adults, and 17% of children and young adults ages 2 to 19 in the U.S. are classified as obese. Why is that?

What Causes Obesity?

There is no one reason that an individual becomes overweight or obese; rather there are many contributing factors including:

Genetics – Why does one person gain weight more rapidly than another? Science tells us that in some cases, a link exists between genetics and obesity. If you are genetically pre-disposed to obesity and you live a lifestyle that involves overeating, eating high calorie and high fat foods, and engaging in minimal activity, then you are more likely to gain weight and become obese. In this case, genes are only a part of the equation; lifestyle is the other.

There has been enormous research into the link between genetics and obesity; examining how our bodies expend energy, how our hormones can impact the way we process calories, and how the function of our organs can affect appetite. As endocrine researchers continue their research on appetite, metabolism, and satiety, there will certainly be greater advancement in understanding obesity and weight loss.

Lifestyle: Weight gain is a simple caloric equation. If you ingest more calories than your body needs, your weight will increase. To balance that equation you need to ingest fewer calories and/or burn calories through exercise. If you are living a sedentary lifestyle and/or consuming high calorie, high fat food, you are at risk of becoming obese.

Medical and physical contributors: Some medical conditions cause people to gain weight, as do some medications. This can happen even if you are eating well and exercising.