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Obesity Medicine

What is Obesity?

Obesity refers to having excess of weight and fat due to imbalance between energy intake and energy expenditure. Obesity is causes by genetic, environmental, and behavioral factors.

Obesity can be measured by:

Bioelectrical Impedance Analysis
Hydrostatic (underwater
Weighing and Dual Energy X-ray Absorptiometry.

Bioelectrical Impedance Analysis is typically the most practical and convenient method used by obesity specialist doctors called bariatricians.

The Body Mass Index (BMI) is a the index used by doctors and insurance companies to evaluate obesity. The BMI formula = weight in pounds / (height in inches x height in inches) x 703. The following classifications for BMI were recommended by the National Heart Lung and Blood Institute:

  • Underweight: lower than 18.5
  • Normal weight: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Obesity: 30 to 34.9 (Class 1)
  • Obesity: 35 to 39.9 (Class 2)
  • Extreme Obesity: greater than 40 (Class 3)

One of the most popular tools on the NIH’s National Heart, Lung, and Blood Institute (NHLBI) Web site is the BMI (Body Mass Index) calculator

You can get a free Iphone App BMI calculator

Waist-to-hip measurements: Gut divided by butt ratio is obtained by dividing the circumference of an individual’s waist by their hips. A healthy waist-to-hip ratio for women is no more than 0.8 and a healthy ratio for men is no more than 0.95.

The health consequences due to obesity including:

  • Coronary heart disease
  • Type 2 diabetes
  • Cancers (endometrial, breast and colon)
  • Hypertension (high blood pressure)
  • Dyslipidemia (high total cholesterol or high levels of triglycerides)
  • Stroke
  • Migraine headaches
  • Liver and gallbladder disease
  • Sleep apnea and respiratory problems
  • Osteoarthritis (Degenerative arthritis)
  • Gynecological problems (abnormal menses, infertility)

ASBP developed obesity medicine practice guidelines that outline four key interventions to treat obesity:

  • dietary modification
  • exercise prescription
  • behavior modification
  • medication (when appropriate)

Like any other specialty in medicine, a general non specialist does not have the exposure to specific and advanced methods to address these four key factors.

 

A 2007-2008 data showed prevalence of obesity

  • 33.8 percent among men
  • 35.5 percent among women

Based on Body Mass Index greater than or equal to 25) were 68.0 percent overall:

  • 72.3 percent among men
  • 64.1 percent among women

Source: National Health and Nutrition Examination Survey (NHANES).http://www.cdc.gov/nchs/nhanes.html

The annual health cost of obesity is as high as $147 billion. (RTI and the Centers for Disease Control and Prevention)

To ensure the highest standard of medical practice, ASBP has developed Bariatric Practice Guidelines that outline four medical body fat reduction/weight loss methods: dietary modification, exercise prescription, behavior modification and when appropriate, medication.

 

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