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This is the first of several articles Dr. Fortier is writing articles for the MN Health Magazine.

The Obesity Epidemic

 

What is obesity?

 

Obesity is formally defined as a significant increase above ideal weight, with ideal weight being

defined as that which maximizes life expectancy.  Actuarial tables indicate that life expectancy is

reduced when body mass index (BMI), (defined as mass in kilograms divided by the square of the

height in meters), an indicator of adiposity or fatness is significantly increased above the ideal level.  Obesity is a chronic life-threatening disease resulting from excessive body fat, not only externally

but also internally surrounding the organs. It is an independent risk factor or an aggravating agent

for at least 30 other health conditions or comorbidities.  Obesity leads to significant medical, psychological, social, physical, and economic impacts. 

 

Using BMI as a unit of measure: 

 

BMI 18.5-24.9  Normal Weight

BMI  25-29.9    Overweight

BMI  30-34.5    Obese

BMI  35-39.9    Severely Obese

BMI  >40          Morbidly Obese

BMI  >50          Super Obese

 

What causes obesity? There are many factors leading to human obesity.  These include a genetic predisposition, physiologic alterations, behavioral attitudes, gender, psychosocial coping mechanisms, and societal influences.  The view advanced by the diet industry that obesity is a result of a fundamental lack of discipline on the part of affected individuals is over simplified and does not address the many other factors causing obesity.  This is supported by the fact that more than 90% of individuals who lose weight by dieting eventually return to their original weight.  The alternative view supported by experimental evidence, suggests that body weight is physiologically controlled and that deviations in weight in either direction, elicit a potent counter response that resists that change.  The human biological system balances energy input (food intake) and energy expenditure.  While humans are well adapted to starvation, they are poorly adapted to over-nutrition.  It has only been for the past 100 years that humans have had a continuous surplus of food.  The modern high fat, high calorie diet, combined with physical inactivity, has resulted in an epidemic of obesity and overweight individuals, not only in the United States, but worldwide. 

 

What is the obesity epidemic?

The epidemic is that 3 in 5 Americans are either overweight or obese.  In the past 20 years, adult obesity has more than doubled.  It has led to more than 300,000 premature deaths annually and is continuing to rise.  In comparison, there are some 400,000 deaths per year from smoking, a rate that is decreasing, and 90,000 deaths per year from colon and breast cancer combined.  Studies have shown that 75% of obese children will become morbidly obese adults.  As body mass index increases, the risk of death increases exponentially. 

What are some of the medical implications of obesity?

Some of the diseases directly associated with obesity include type II diabetes mellitus, hypertension, lipid disorders, heart disease, asthma, sleep apnea, urinary incontinence, gastroesophageal reflux, degenerative joint disease, infertility and menstrual problems, depression, an increased risk of several types of cancer, and extremity problems related to increased venous pressure.

 

What is the annual economic impact of obesity in the United States?

It is estimated that there are some $200 Billion in obesity-related costs; $93 billion of this is for medical bills, $33 billion is spent on weight loss products and services, $3.93 billion in lost productivity.  It is estimated that this accounts for approximately 9.1% of the national medical costs.

 

SUMMARY: 

Obesity in the United States of America is truly an epidemic.  There are 10 million people in the United States who are considered severely or morbidly obese and it is predicted that the life expectancy in the United States will decrease based on the prevalence of obesity in our society. 

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