What is ?Statistics on Risk Factors for Progression of Symptoms of Clinical Examination of How is Diagnosed?Prognosis of How is Treated? ReferencesWhat is ?
Virtual Medical Centre Video
Watch a video on Management
is defined as being 20% or more over the maximum desirable weight for a man's height or 25% or more in females. It is now considered a chronic health problem of the Western world. Being obese is different from being overweight. is also defined as having a BMI (body mass index) over 30 kg/m2. Your BMI is calculated by dividing your weight (in kilograms) by your height (in metres) squared. A BMI between 18.5 and 24.9 is generally associated with good health. As the BMI gets higher, more health problems develop.
Calculate your BMI using the calculator below. Then compare your result to the BMIs in Table 1.
Body Mass Index (BMI) Calculator Enter your height and weight below to find out your BMI. Weight (kg): Height (m): Body Mass Index: What does this mean?This tool needs Javascript enabled to run.
The formula for calculating your body mass index is:
BMI = weight (kilograms) / (height (metres) * height (metres))
For example:
A man who weighs 85 kilograms and is 1.8 metres tall would have a BMI of
BMI = 85 / (1.8 * 1.8)
BMI = 85 / 3.24
BMI = 26.2
Table 1: Classification of adults according to BMI
is an important condition which causes significant morbidity and mortality through increased rates of type 2 diabetes mellitus, heart disease, some cancers and arthritis (joint disease) amongst other conditions. In addition, can cause sleep disturbances (such as obstructive sleep apnoea) and lead to reduced fertility rates in females.
Morbid refers to very severe which poses significant risks to your health. This occurs when you are greater than 40 kg above your desired weight.
Statistics on
The number of people who are obese is rising rapidly worldwide, making one of the fastest developing public health problems. The World Health Organisation (WHO) has described the problem of as a "worldwide epidemic".
Table 2: prevalence in several countries worldwide
* males and females combined
** IOTF estimate
Source: International Task Force
Incidence of according to profession
Recent studies have suggested that lower levels of education and lower levels of occupation are associated with increased rates of . In women these factors have a synergistic (combined to have a greater impact) effect. Overall however, lower level of education is a more important determinant of . One particular study showed that individual job can impact on rates of . Salespersons; personal service workers; plant-machine operators, drivers, labourers and related employees (lower status occupations) have higher BMI and rates of than men and women in managerial, administrative, clerking or professional positions. There is no obvious differences between rates of in employed and unemployed individuals. However in the past it has been thought that unemployment may be associated with higher rates of .
Risk Factors for
The cause of is complex and depends on both genetic and environmental influences. Most patients suffer from 'simple ' (weight gain due to an increased intake of calories) but the following conditions can have as an associated feature:
In a general sense, results when the intake of calories exceeds the amount of energy your body burns.Thus the following are considered risk factors:
Genetics: Various genes may impact on the development of . Research into genetic helps people understand the causes of and possible treatments. Food intake: Overeating and consumption of fatty foods plays a role in the development of . The home environment and finances can influence which foods are eaten. Note that many obese patients underestimate their food intake. Lack of exercise: This lowers energy expenditure and promotes weight gain. Lifestyle changes over recent decades to more sedentary lifestyles is a key contributing factor to the rise in the rates of . Excess alcohol consumption Progression ofduring childhood and adolescence is associated with an increased risk of during adulthood and its associated health problems. Adolescent males with moderate-to-severe seem to be at particular risk. The impacts of childhood and infant are less clear, but generally the greater the degree of and the older the age of the children, the more likely will develop in adulthood. is associated with risks of early death from diabetes, heart disease and stroke. Gout and bowel cancer increased among men who had as adolescents. Women who had as adolescents have increased rates of arthritis.
There are a number of health, social and psychological consequences associated with overweight and . Associated health consequences include:
Coronary heart disease (CHD);Diabetes mellitus;High blood pressure (hypertension);High blood cholesterol; Gallbladder disease; Osteoarthritis;Gout;Certain types of cancer (e.g. breast, endometrial, cervical, colon);Reproductive hormone abnormalities; Polycystic ovary syndrome;Impaired fertility; Breathlessness; Sleep apnoea; Low back pain (due to ); Premature death.Generally, the more overweight you are, the more likely you are to have health problems related to the excess weight. Excess fat in the abdominal region (the 'apple' body) is of particular concern as it is associated with greater risks to health than is fat distributed around the body (the 'pear' body). Psychosocial consequences include:
Social bias; Discrimination; Low self-esteem; Body shape dissatisfaction; Eating disorders (e.g. binge-eating disorder);Isolation; Depression. Therefore, preventing weight gain is important not only for health and wellbeing, but also for preventing the development of overweight and and therefore the development of associated health and psychosocial problems and diseases.
Symptoms ofYour doctor will take a thorough history regarding your dietary habits and levels of activity. They will also screen you for symtoms of other comorbid conditions such as heart disease, depression and diabetes. Secondary causes of , such as dry skin, constipation and cold intolerance, will also be questioned suggesting hypothyroidism. Family history of weight problems is another important aspect of the clinical history.
Clinical Examination ofUsing Body mass index or other measures such as skin fold are usually sufficient when it comes to a diagnosis of . A complete examination is needed as well including examining your lungs, heart and abdomen because can cause disease in many different areas of the body.
How is Diagnosed?Laboratory work-up should include the following:
Blood cholesterol;Liver function tests;Thyroid function tests: will detect a thyroid that is underactive;24 hour urine cortisol if Cushing's is suspected;Fasting blood glucose and insulin levels-to test for diabetes. Prognosis of
As forementioned is associated with significant morbidity and mortality. Increased BMI increases risks of coronary heart disease, stroke and heart failure and risks are greater for higher BMI values. Overall, is estimated to be associated with a 4-fold increased cardiovascular mortality rate and a 2-fold increased cancer-related mortality rate. People who are severely obese have a very high overall mortalities.
Treatment of is important to reduce the health risks described earlier and to improve your overall quality of life. Treatment of generally requires a multi-disciplinary approach including various health professionals. People involved in your health care may include physicians, dieticians, surgeons, psychologists and psychiatrists. An overview of the treatment options is provided below:
Lifestyle modification
Treatment focuses on lifestyle modifications which aim to lower energy intake and increase energy expenditure. Lifestyle modification is the single most important factor in the treatment of , as other treatments are often not successful without modifying lifestyle. In addition, the following should be avoided:
Excess alcohol consumption;Stress;Depression;Boredom and frustration;Poor eating habits (eating habits of women, eating habits of men);Sedentary lifestyle. Perform aerobic exercise for at least 30 minutes a day, 3 times a week and try to increase physical activity in general by walking rather than driving, and climbing stairs rather than using an elevator or escalator. A professional exercise physiologist or physiotherapist can help you to devise an appropriate exercise regimen;Reduce consumption of food that is high in fat and sugar. A nutritionally balanced diet, high in vegetables and fruits, where energy intake is lower than expenditure (through physical activity) is recommended. A dietitian can develop an individualised nutrition plan for you.Note that the above measures may be sufficient for people who are just overweight. However, for the obese or morbidly obese, additional treatments such as drugs or surgery may be needed to adequately lose weight. You must also recognise that weight loss requires lifelong changes to your eating and exercise habits. It has been shown that many people put back on the weight they had lost during supervised commercial weight loss programs. Therefore you must continue your healthy behaviours beyond just the time frame of your diet or program to avoid weight regain in the next few years.
Meal replacement programs (low calorie diet with monitoring)
Meal replacement programs with low calorie diet is another alternative option and can also help an obese person lose weight, as they combine a meal replacement regimen with additional health supports such as physiotherapists. These programs work by replacing meals per day with specialised formula food, which is a complete meal. The program is a combination of LCD (Low Calorie Diet) and the natural process of ketosis. Ketosis happens after 48 hours when body detects that it isn't getting enough carbohydrates to operate as it usually does, therefore it 'switches over' to a different method of providing fuel for itself - your fat stores. These programs may not be for everyone, as it is a strict regimen and lifestyle modifications are still essential.
Medication therapy
Drugs may be used to help reduce weight such as Xenical (Orlistat) or Sibutramine (Reductil). These drugs work by either suppressing appetite (e.g. Sibutramine) or by reducing the absorption of fats to help weight loss (e.g. Orlistat). However, many of these drugs have nasty side effects (such as diarrhoea) and are still being investigated in clinical trials. In order for medications to really work, they need to be combined with lifestyle modifications such as a low fat diet and regular exercise. Medications for weight loss should always be given under the supervision of a medical practitioner.
Surgical treatments
Surgery is usually considered when other therapies have repeatedly failed or when is very severe (i.e. greater then 40kg overweight or if associated health problems are present). Banding of the stomach (gastric banding) is the preferred approach in Australia but other treatments are also available.
Gastric banding is a restrictive surgery where an adjustable silicone band is placed around the stomach. This reduces the amount of food that needs to be eaten before you feel full. Gastric surgery is a safe procedure and can be reversed or adjusted ir required. In the majority of cases, the surgery is performed laparoscopically (keyhole surgery).
Other surgical treatments include the old fashioned gastric stapling (also a restrictive procedure), gastrectomy (removing part of the stomach) or gastric bypass. The latter operation is often performed in the United States and involves creating a pouch in the stomach, then connecting it to the intestine. This reduces the amount of food that can be eaten and delays the time to digestion.
Gastric surgery can help you lose up to 60% of your excess weight. Furthermore, gastric surgery is often more successful than other treatments in overcoming some of the problems of . Surgery can help improve shortness of breath, sleep, mobility and your overall quality of life. However, surgery is a major undertaking and there are major risks and complications.
The first complications are those of any major operation. These include the possibility of blood transfusion (5-20%), and pulmonary embolism (clots in the lungs) 1%. Anaesthetic complications are very serious, especially as obese patients are complex cases. Infections may also result and there is the risk that the operation was not successful and re-operation is needed. In some cases, the band can slip, cause leakage at the site or cause a puncture in the wall of the stomach.
Therefore, any decision for surgery must be undertaken with great care and thought and is not a decision to be made rashly. It should also not be seen as a 'cure' for . Once again, lifestyle modification is essential for the success of surgical treatment as well. If appropriate diets are not followed after surgery you can develop symptoms such as indigestion and diarrhoea.
Other
Cognitive behavioural therapy (CBT) is another treatment that may be used. This involves group therapy to help you understand the reasons behind your eating patterns and how you can change your thinking and behaviour to overcome them. This type of treatment is often performed by a trained psychologist.
Article kindly reviewed by:
The DAA WA Oncology Interest Group
and
Food4Health (Helen Baker Dietitian-APD)
More information
For more information on , health and social issues, and methods of weight loss, as well as some useful tools, see Weight Loss.
For more information on nutrition, including information on types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition.
AIHW, Are all Australians gaining weight? Differentials in overweight and among adults 1989-90 to 2001, Bulletin 2003; 11: 1-17. Ball K. Mishra G. Crawford D. Which aspects of socioeconomic status are related to among men and women? International Journal of & Related Metabolic Disorders: Journal of the International Association for the Study of , 2002; 26(4):559-65. Barsh GS, Farooqi IS, O'Rahilly S: Genetics of body-weight regulation. Nature 2000 Apr 6; 404(6778): 644-51. Reproduced from: : Preventing and Managing the Global Epidemic, 2000, WHO, GenevaAustralian Government, Department of Health and Ageing, 'About Overweight and ' Fact Page, http://www.health.gov.au/internet/wcms/publishing.nsf/content/health-pubhlth-strateg-hlthwt-.htm, 30th September 2002. Reproduced from: : Preventing and Managing the Global Epidemic, 2000, WHO, GenevaCameron A, Welborn T, Zimmet P, Dunstan D, Owen N, Salmon J, Dalton M, Jolley D, Shaw J, Overweight and in Australia: the 1999-2000 Australian Diabetes, and Lifestyle Study (AusDiab), MJA 2003; 178 (9): 427-432.Galobardes B, Morabia A & Bernstein MS 2000. The differential effect of education and occupation and body mass and overweight in a sample of working people of the general population. Annals of Epidemiology 10:532-7. Hamdorf, J. The Management of [video], 2007.Kumar and Clark. Clinical Medicine 4th Edition, W.B Saunders, 1998.NSW Department of Health, Childhood , http://www.health.nsw.gov.au//adult/background/background.html, 16th August 2006NHMRC. Clinical Practice Guidelines for the Management of Overweight and in Adults; 2003. Available from http://www.health.gov.au/internet/main/publishing.nsf/Content/guidelines-guidelines-adults.htmAustralasian Society for the Study of , http://www.asso.org.au/home/quicklinks/fastfacts, ASSO, 15th June 2005Proietto J, Baur L, Management of , MJA 2004; 180 (9): 474-480.National Institute of Diabetes and Digestive and Kidney Diseases. Understanding . U.S. Department of Health and Human Services (DHHS); NIH. NIH Publication No. 01-3680 October 2001, Updated March 2006Lyzniki, JM, : Assessment and Management in Primary Care, M.S., M.P.H, American Family Physician, June 2001, Vol 63 No. 11Drugs/Products Used in the Treatment of This Disease:Duromine
(Phentermine)Reductil
(Sibutramine hydrochloride)Xenical
(Orlistat)
Connect
Sign up for free newsletters 
Subscribe to RSS feeds 
Discuss on Forum 
Article Dates:
Modified: 3/6/2010 Reviewed: 3/8/2007 Created: 19/4/2004 List Diseases by Medical Area All Diseases Men's Health Diseases Women's Health Diseases Children's Health Diseases Allergy Diseases Blood Diseases Bone Diseases Brain Diseases Cancer Diseases Dental Diseases Eye Diseases Fitness Diseases Gastro Diseases Heart Diseases Hormone Diseases Infection Diseases Joints Diseases Kidney Diseases Lungs Diseases Mental Health Diseases Pain Diseases Pregnancy Diseases Skin Diseases Weight Loss Diseases New on VMC
Orange and Avocado Salad more... 
As the weather warms up – preparing kids for toilet training more... 
Dr Joe: Ear health more... 
Recovering from disaster and trauma more... 
VMC NewslettersVMC newsletters are FREE on subscription. See VMC's previous newsletters here.
Free Membership & NewslettersNot yet a member?Stay up to date with the latest health news
Resend Activation Email -Forgot your Password?Today's medical surveyTrauma
Have you ever suffered second-hand trauma, for example after watching a disaster on TV/internet/or a loved one going through it?
Yes, I sought help from a counsellor/other professional
Yes, I talked through it with loved ones
Yes, but I was too embarrassed to talk about it
No
Other (please comment)
Comment:What is 2 + 2 =
View Results » Current Sponsors About Virtualmedicalcentre.com
Australia�s leading source for trustworthy medical information written by health professionals.
Please be aware that we do not give advice on your individual medical condition,
if you want advice please see your treating physician.
Virtual Medical Centre © 2002 - 2013 | Privacy Policy Last updated 1 Nov 2013
Parenting information is available at Parenthub.com.au
About Us Careers Advertise with us Advertising policy Contact Us Copyright Information Corrections Editorial Advisory Board Investor Information Partners Sitemap Terms of Use User-generated Content
^ Back to Top Partners and Accreditations 
This site complies with the HONcode standard for trustworthy health information: verify here.
For banner advertising
Website and videos by 
Titan Web Clients
Web Design Perth
E F G H
I J K L
M N O P
Q R S T
U V W X
Y Z Medical Information Health Topics Anatomy Devices Diseases Doctor Videos Drugs Health & Lifestyle Investigations Medical Dictionary My Experiences Symptoms Supplements Supportive Care Tools Treatments Useful Links News News & Events Latest News Events Newsletter Newsletters Lifestyles Health and Lifestyles Exercise Family General Mental Health Nutrition Occupational Health and Safety Pregnancy Preventative Health Recipes Sexuality Sleep Smoking and Alcohol Win Competitions Current Competitions Competition Winners Health Professionals Health Professionals Editorial Advisory Board Conferences Events Case Studies Research & Trials Publications Consult Magazine Pro Newsletters Pro Membership
Read more detailed and referenced information written by Australian health professionals, make sure you select health professional in the signup form!
Sign up Login About VMC | Contact Us | Sitemap Follow us on:
No comments:
Post a Comment