There are simpler methods to estimate body fat. One is to measure the thickness of the layer of fat just under the skin in several parts of the body. Another involves sending a harmless amount of electricity through a person's body. Results from these methods, however, can be inaccurate if done by an inexperienced person or on someone with extreme obesity.
Because measuring a person's body fat is difficult, health care professionals often rely on other means to diagnose obesity. Weight-for-height tables, used for decades, have a range of acceptable weights for a person of a given height. One problem with these tables is that there are many versions, all with different weight ranges. Another problem is that they do not distinguish between excess fat and muscle. According to the tables, a very muscular person may be classified obese when he or she is not. The BMI is less likely to misidentify a person's appropriate weight-for-height range.
Morbid obesity sometimes called "clinically severe obesity" is defined as being 100 lbs. or more over ideal body weight or having a Body Mass Index (BMI) of 40 or higher.
According to the NIH Consensus Report, morbid obesity is a serious chronic disease, meaning that its symptoms build slowly over an extended period of time. Today 97 million Americans, more than one-third of the adult population, are overweight or obese. An estimated 5-10 million of those are considered morbidly obese.
Environment also includes the world around us—our access to places to walk and healthy foods, for example. Today, more people drive long distances to work instead of walking, live in neighborhoods without sidewalks, tend to eat out or get “take out” instead of cooking, or have vending machines with high-calorie, high-fat snacks at their workplace. Our environment often does not support healthy habits.
In addition, social factors including poverty and a lower level of education have been linked to obesity. One reason for this may be that high-calorie processed foods cost less and are easier to find and prepare than healthier foods, such as fresh vegetables and fruits. Other reasons may include inadequate access to safe recreation places or the cost of gym memberships, limiting opportunities for physical activity. However, the link between low socio-economic status and obesity has not been conclusively established, and recent research shows that obesity is also increasing among high-income groups.
Although you cannot change your genetic makeup, you can work on changing your eating habits, levels of physical activity, and other environmental factors. Try these ideas:
Some illnesses may lead to or are associated with weight gain or obesity:
Emotional suffering may be one of the most painful parts of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages make overweight people feel unattractive.
Many people think that individuals with obesity are gluttonous, lazy, or both. This is not true. As a result, people who are obese often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection, shame, or depression may occur.
Health care providers generally agree that people who have a BMI of 30 or greater can improve their health through weight loss. This is especially true for people with a BMI of 40 or greater, who are considered extremely obese.
Family history of certain chronic diseases. If you have close relatives who have had heart disease or diabetes, you are more likely to develop these problems if you are obese.
Preexisting medical conditions.High blood pressure, high LDL cholesterol levels, low HDL cholesterol levels, high triglycerides, and high blood glucose are all warning signs of some obesity-associated diseases.
Large waist circumference. Men who have waist circumferences greater than 40 inches, and women who have waist circumferences greater than 35 inches, are at higher risk of diabetes, dyslipidemia (abnormal amounts of fat in the blood), high blood pressure, and heart disease.
Fortunately, a weight loss of 5 to 10 percent of your initial body weight can do much to improve health by lowering blood pressure and other risk factors for obesity-related diseases. In addition, research shows that a 5- to 7-percent weight loss brought about by moderate diet and exercise can delay or possibly prevent type 2 diabetes in people at high risk for the disease.
In a recent study, participants who were overweight and had pre-diabetes—a condition in which a person’s blood glucose level is higher than normal, but not high enough to be classified as diabetes—were able to delay or prevent the onset of type 2 diabetes by adopting a low-fat, low-calorie diet and exercising for 30 minutes a day, 5 days a week.
Normally, as food moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process.
The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion. Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.
Bariatric surgery, or weight loss surgery, is a method of weight loss for the severely obese who are unable to lose weight by any other means. As people learn more about the many health risks of being obese, greater numbers seek what may seem like a drastic solution: surgery.
Bariatric surgery includes a spectrum of procedures from restrictive to malabsorptive to those combining the two. Restrictive procedures such as Adjustable Gastric Banding (LapBand®) and Vertical Banded Gastroplasty (VBG) reduce the size of the stomach, and malabsorptive and combined procedures such as Roux-en-Y Gastric Bypass (RGB),Biliopancreatic Diversion, Fobi Pouch and Duodenal Switch (DS) reduce the body's ability to absorb calories and nutrients from food.
Surgical approaches include laparoscopic procedures, in which surgery is performed through small abdominal openings. Such minimal-access surgery offers a faster, less painful recovery. But not everyone qualifies for less-invasive surgery. It depends on medical history, surgical difficulty, and body shape.
Once the only method used for surgical procedures, traditional open surgery involves making a 10- to 12-inch incision to access the stomach and intestines. Depending on surgeon expertise incision size can vary on the open surgeries.
In minimally invasive, or laparoscopic, surgery, the surgeon uses five or six small incisions (each 1/4 and 1/2 inch long) to gain access to the stomach and intestines. The laparoscope is a telescope attached to a video camera.
The surgeon inserts the laparoscope through the incisions and gets a magnified view of the patient’s organs on a television monitor. The entire operation is performed inside the abdomen after gas has been inserted to expand the abdomen. Minimally invasive surgery techniques have reduced hospital and recovery times for many operations. The incidences of complications have also been reduced.
Both approaches have excellent long-term results, allowing patients to lose 80-90% of their excess weight in 10-24 months, with most patients maintaining 48-74% of their initial weight loss after five years. However, there are risks involved. This option, therefore, is usually restricted to patients who cannot lose weight on one of the dietary programs discussed in Non-Surgical Weight Loss.
The BMI is a tool used to assess overweight and obesity and monitor changes in body weight. Like the weight-for-height tables, BMI has its limitations because it does not measure body fat or muscle directly. It is calculated by dividing a person's weight in pounds by height in inches squared and multiplied by 703.
Two people can have the same BMI but different body fat percentages. A bodybuilder with a large muscle mass and low percentage of body fat may have the same BMI as a person who has more body fat. However, a BMI of 30 or higher usually indicates excess body fat.