What Defines Obesity

Obesity is considered a chronic condition that is now a global health problem and is steadily increasing in prevalence. In 2008, obesity was responsible for over $147 billion in medical expenditures in the US. From 2015 to 2016, almost 94 million adults in the United States have obesity. Today, approximately a third of Americans are obese. Obesity is associated with multiple medical conditions including type 2 diabetes mellitus, high blood pressure, high cholesterol, stroke, and cardiovascular disease. In turn, these risk factors result in diminished quality of life and increased risk of premature and preventable deaths.

BMI Reference Range:

Underweight: BMI < 18.5 Normal range: 18.5 to 25 Overweight range: 25 to 30 Obese: > 30
Morbidly Obese: 40 and above

What contributes to obesity?
Obesity can be multifactorial in contributing factors. Generally speaking, however, risk of development of obesity increases over time as you consistently consume more calories than you expend. Behavior therefore plays an integral role in contributing to obesity. In particular, poor dietary choices and a sedentary lifestyle often lead to weight gain. Genetics and family history may play a role in contributing to obesity, although research remains inconclusive. Weight gain may also be a side effect of certain medications such as intensified insulin therapy and tricyclic antidepressants. Individuals who have Cushing’s syndrome, hypothyroidism, polycystic ovary syndrome, and growth hormone deficiency can also experience weight gain.

How does obesity affect health?
In addition to mentioned cardiovascular risk factors that may arise from obesity, depression and cancer can also result as potential complications, leading to poorer health outcomes across both mental and physical domains. Sleep apnea and osteoarthritis, for example, can lead to poor daily functioning due to associated fatigue and persistent joint pain respectively. Knee osteoarthritis (OA) tends to affect adults with advancing age and is a byproduct of wear-and-tear process over time. Obesity can exacerbate this degenerative process with knees and hips being commonly affected joints. Chronic joint pain is an elusive problem to manage and weight loss is typically one of the more effective modalities of treatment for knee osteoarthritis. OA is common in women and the overall prevalence of OA rises to almost 10% in those over 40 years of age. The end game for persistent pain is total knee replacement, if conservative measures fail. Keeping your weight under control can go a long way in avoiding these invasive procedures.

Sleep apnea (OSA) is another common morbidity associated with obesity. OSA occurs due to upper airway narrowing during sleep, triggering common symptoms such as nighttime snoring witnessed by partners. Affected individuals may also experience periodic nighttime awakening from sleep due to airway obstruction and poor oxygenation. This leads to poor sleep quality and daytime fatigue/sleepiness. OSA leads to other cardiovascular outcomes including hypertension, diabetes and heart disease. Its correlation with obesity places emphasis on weight management as a key factor in preventing sleep apnea.

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