Today 97 million Americans, more than one-third of the adult population,
are overweight or obese. An estimated 5 to 10 million of those are considered
morbidly obese — 100 pounds or more over their ideal body weight.
They suffer from a disease called “morbid obesity.” Contrary
to common misperception, obesity is not merely a cosmetic or social issue;
it is a disease that causes many health problems and can even result in
death. The latest research also shows that obesity is strongly linked to
other chronic diseases like diabetes, high blood pressure, heart failure,
high cholesterol, gallbladder disease, and breast, prostate and colon cancer.
People with severe obesity attempt numerous conservative approaches to weight loss including countless diet programs, exercise regimes and medications. These modalities give only short-term results. It almost doesn’t matter which conservative treatment is chosen: exercise programs, expensive cans of liquid food, hypnosis, acupuncture, etc., most people probably will lose weight - just to gain it all back. This sets up a cycle of losing and gaining. At the end of the cycle, the person actually weighs more after each period of weight gain than when the diet was undertaken. It is the opinion of most experts in this field that surgery is the only effective way to help control obesity long term for most morbidly obese patients.
(American Society of Bariatric Surgeons)
The field of bariatric surgery has experienced significant development in recent years, and there is steady evidence that surgery is the most effective long-term solution for severe obesity. Nonetheless, it is only effective when combined with a consistent willingness to make positive lifestyle changes. Remember, surgery can help you diet but it is not going to do all the work for you. You can beat any surgery and regain all the lost weight if you try hard enough. Finally, but most importantly, obesity surgery is a serious surgical procedure. There are risks associated with any of these procedures and there are potential complications that can result in minor to serious health problems, and possibly the need for further surgery.
Obesity becomes "morbid" when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases (also known as co-morbidities) that result either in significant physical disability or even death. As you read about morbid obesity you may also see the term "clinically severe obesity" used. Both are descriptions of the same condition and can be used interchangeably. Morbid obesity is typically defined as being 100 lbs. or more over ideal body weight or having a Body Mass Index of 40 or higher. According to the National Institutes of Health Consensus Report, morbid obesity is a serious disease and must be treated as such. It is a chronic disease, meaning that its symptoms build slowly over an extended period of time.
The reasons for obesity are multiple and complex. Despite
conventional wisdom, it is not simply a result of overeating. Research
has shown that in many cases a significant, underlying cause of morbid
obesity is genetic. Studies have demonstrated that once the problem is
established, efforts such as dieting and exercise programs have a limited
ability to provide effective long-term relief.
Science continues to search for answers. But until the disease is better understood, the control of excess weight is something patients must work at for their entire lives. That is why it is very important to understand that all current medical interventions, including weight loss surgery, should not be considered medical cures. Rather they are attempts to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease.
The underlying causes of severe obesity are not known. There are many factors that contribute to the development of obesity including genetic, hereditary, environmental, metabolic and eating disorders. There are also certain medical conditions that may result in obesity like intake of steroids and hypothyroidism.
Numerous scientific studies have established that your genes play an important role in your tendency to gain excess weight.
- The body weight of adopted children shows no correlation with the body weight of their adoptive parents, who feed them and teach them how to eat.
- Their weight does have an 80 percent correlation with their genetic parents, whom they have never met. Identical twins, with the same genes, show a much higher similarity of body weights than do fraternal twins, who have different genes.
- Certain groups of people, such as the Pima Indian tribe in Arizona, have a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.
We probably have a number of genes directly related to weight. Just as some genes determine eye color or height, others affect our appetite, our ability to feel full or satisfied, our metabolism, our fat-storing ability, and even our natural activity levels.
The Pima Indians are known in scientific circles as one of the heaviest
groups of people in the world. In fact, National Institutes of Health
researchers have been studying them for more than 35 years. Some adults
weigh more than 500 pounds, and many obese teenagers are suffering from
diabetes, the disease most frequently associated with obesity.
But here's a really interesting fact - a group of Pima Indians living in Sierra Madre, Mexico, does not have a problem with obesity and its related diseases. Why not? The leading theory states that after many generations of living in the desert, often confronting famine, the most successful Pima were those with genes that helped them store as much fat as possible during times when food was available.
Now those fat-storing genes work against them. Though both populations consume a similar number of calories each day, the Mexican Pima still live much like their ancestors did. They put in 23 hours of physical labor each week and eat a traditional diet that's very low in fat. The Arizona Pima live like most other modern Americans, eating a diet consisting of around 40 percent fat and engaging in physical activity for only two hours a week. The Pima apparently have a genetic predisposition to gain weight. And the environment in which they live - the environment in which most of us live - makes it nearly impossible for the Arizona Pima to maintain a normal, healthy body weight.
Environmental and genetic factors are obviously closely intertwined. If you have a genetic predisposition toward obesity, then the modern American lifestyle and environment may make controlling weight more difficult. Fast food, long days sitting at a desk, and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage. For those suffering from morbid obesity, anything less than a total change in environment usually results in failure to reach and maintain a healthy body weight.
We used to think of weight gain or loss as only a function of calories ingested and then burned. Take in more calories than you burn, gain weight; burn more calories than you ingest, lose weight. But now we know the equation isn't that simple. Obesity researchers now talk about a theory called the "set point," a sort of thermostat in the brain that makes people resistant to either weight gain or loss. If you try to override the set point by drastically cutting your calorie intake, your brain responds by lowering metabolism and slowing activity. You then gain back any weight you lost.
Weight loss surgery is not a cure for eating disorders. And there are medical conditions, such as hypothyroidism, that can also cause weight gain. That's why it's important that you work with your doctor to make sure you do not have a condition that should be treated with medication and counseling.
Morbid obesity brings with it an increased risk for a shorter life expectancy. For individuals whose weight exceeds twice their ideal body weight (that's about 2-6% of the U.S. population), the risk of an early death is doubled compared to non-obese individuals. The risk of death from diabetes or heart attack is five to seven times greater. Even beyond the issue of obesity-related health conditions, weight gain alone can lead to a condition known as "end-stage" obesity where, for the most part, no treatment options are available. Yet an early death is not the only potential consequence. Social, psychological and economic effects of morbid obesity, however unfair, are real and can be especially devastating.
Obesity-related health conditions are health conditions that, whether alone or in combination, can significantly reduce your life expectancy. A partial list of some of the more common conditions follows. Your doctor can provide you with a more detailed and complete list:
Obese individuals develop a resistance to insulin, which regulates blood sugar levels. Over time, the resulting high blood sugar can cause serious damage to the body.
Excess body weight strains the ability of the heart to function properly. The resulting hypertension (high blood pressure) can result in strokes, as well as inflict significant heart and kidney damage.
The additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.
Fat deposits in the tongue and neck can cause intermittent obstruction of the air passage. Because the obstruction is increased when sleeping on your back, you may find yourself waking frequently to reposition yourself. The resulting loss of sleep often results in daytime drowsiness and headaches.
Acid belongs in the stomach and seldom causes any problem when it stays there. When acid escapes into the esophagus through a weak or overloaded valve at the top of the stomach, the result is called gastroesophageal reflux, and "heartburn" and acid indigestion are common symptoms. Approximately 10-15% of patients with even mild sporadic symptoms of heartburn will develop a condition called Barrett's esophagus, which is a pre-malignant change in the lining membrane of the esophagus, a cause of esophageal cancer. For more information on Heartburn, its causes and possible cures, visit www.heartburnhelp.com.
Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers. They often experience discrimination at work, cannot fit comfortably in theatre seats, or ride in a bus or plane.
The inability or diminished ability to produce offspring.
A large, heavy abdomen and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing.
Morbidly obese individuals often experience disruptions of the menstrual cycle, including interruption of the menstrual cycle, abnormal menstrual flow and increased pain associated with the menstrual cycle.
Answering this question may give you the courage you need to take the first
step. Below are tools you can use to determine if you are morbidly obese
and potentially a candidate for weight loss surgery.
There are several medically accepted criteria for defining morbid obesity. You are likely morbidly obese if you are:
Select your gender, height and weight to calcluate your BMI. The results of the BMI calculations are displayed below. Note that these are approximate values, and are intended to be used only as a rough guide.
Ideal Body Weight Chart
|Height||Ideal Weight||Height||Ideal Weight|
|4' 6"||63 - 77 lbs.||4' 6"||63 - 77 lbs.|
|4' 7"||68 - 84 lbs.||4' 7"||68 - 83 lbs.|
|4' 8"||74 - 90 lbs.||4' 8"||72 - 88 lbs.|
|4' 9"||79 - 97 lbs.||4' 9"||77 - 94 lbs.|
|4' 10"||85 - 103 lbs.||4' 10"||81 - 99 lbs.|
|4' 11"||90 - 110 lbs.||4' 11"||86 - 105 lbs.|
|5' 0"||95 - 117 lbs.||5' 0"||90 - 110 lbs.|
|5' 1"||101 - 123 lbs.||5' 1"||95 - 116 lbs.|
|5' 2"||106 - 130 lbs.||5' 2"||99 - 121 lbs.|
|5' 3"||112 - 136 lbs.||5' 3"||104 - 127 lbs.|
|5' 4"||117 - 143 lbs.||5' 4"||108 - 132 lbs.|
|5' 5"||122 - 150 lbs.||5' 5"||113 - 138 lbs.|
|5' 6"||128 - 156 lbs.||5' 6"||117 - 143 lbs.|
|5' 7"||133 - 163 lbs.||5' 7"||122 - 149 lbs.|
|5' 8"||139 - 169 lbs.||5' 8"||126 - 154 lbs.|
|5' 9"||144 - 176 lbs.||5' 9"||131 - 160 lbs.|
|5' 10"||149 - 183 lbs.||5' 10"||135 - 165 lbs.|
|5' 11"||155 - 189 lbs.||5' 11"||140 - 171 lbs.|
|6' 0"||160 - 196 lbs.||6' 0"||144 - 176 lbs.|
|6' 1"||166 - 202 lbs.||6' 1"||149 - 182 lbs.|
|6' 2"||171 - 209 lbs.||6' 2"||153 - 187 lbs.|
|6' 3"||176 - 216 lbs.||6' 3"||158 - 193 lbs.|
|6' 4"||182 - 222 lbs.||6' 4"||162 - 198 lbs.|
|6' 5"||187 - 229 lbs.||6' 5"||167 - 204 lbs.|
|6' 6"||193 - 235 lbs.||6' 6"||171 - 209 lbs.|
|6' 7"||198 - 242 lbs.||6' 7"||176 - 215 lbs.|
|6' 8"||203 - 249 lbs.||6' 8"||180 - 220 lbs.|
|6' 9"||209 - 255 lbs.||6' 9"||185 - 226 lbs.|
|6' 10"||214 - 262 lbs.||6' 10"||189 - 231 lbs.|
|6' 11"||220 - 268 lbs.||6' 11"||194 - 237 lbs.|
|7' 0"||225 - 275 lbs.||7' 0"||198 - 242 lbs.|