WHAT IS “MORBID” OBESITY?
Obesity is the most prevalent nutritional disorder in the United States. More than one half of U.S. adults are overweight or obese, and the rate has steadily climbed since 1960. Approximately 600,000 Americans die each year from diseases directly attributed to morbid obesity. Obesity is therefore the second leading cause of preventable death among adults in the United States, second only to cigarette smoking related diseases. Morbid obesity is a disease in and of itself.
Obesity is actually defined by a standard weight per height measurement called Body Mass Index, or BMI. BMI is a ratio of an individual’s height and weight in the formula: “Height in meters, divided by weight in kilograms squared”. Generally, a man or woman would be considered overweight with a BMI of greater than or equal to 25 kg/m2. Obesity is defined as a BMI greater than or equal to 30 kg/m2. Any adult who is 30 pounds over ideal body weight will likely meet obesity BMI. Extreme or “morbid” obesity is a BMI of greater than or equal to 40 kg/m2. Adults, who are at least 100 pounds over ideal body weight, will likely meet morbid obesity BMI.
WHAT CAUSES MORBID OBESITY?
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 important to understand that all current medical interventions including weight loss surgery, are attempts to reduce the effects of excess weight and alleviate the serious physical, emotional, and social consequences of the disease.
HEALTH CONSEQUENCES OF MORBID OBESITY
Obesity is a serious problem in that it is associated with the development of a host of medical complications and health problems, also known as comorbidities. With obesity, there is an increase in heart disease and cardiovascular mortality, which can be explained by increases in cardiovascular risk factors such as high blood pressure, high blood cholesterol and triglycerides, and diabetes mellitus. In fact, 65% of patients with a BMI greater than 27 have significant comorbidities as a direct consequence of their obesity. Other common comorbidities include sleep apnea syndrome, respiratory insufficiency, heartburn or reflux disease (GERD), asthma, bronchitis, gallbladder disease, stress urinary incontinence, degenerative disease of the spine and weight bearing joints, venous stasis disease and others.
Quality of life for the obese person is diminished in countless ways. Frequently the obese person struggles with depression, hopelessness, and despair. It is no wonder. Typically, obese people have tried dozens of weight loss methods including diets and medications, only to realize that no matter how hard they try, they cannot lose the excess weight without taking drastic measures such as liquid diets. When they lose weight, they cannot keep the weight off.
The general public does not understand this and what is worse is the fact that few healthcare professionals understand this either. Doctors continuously tell their obese patients to lose weight because they truly believe patients can. Most doctors do not realize (unless they too are obese) that their patients cannot lose the weight.
Life in society is a daily challenge for obese people. Society’s continued misunderstanding of and discrimination against obese people remains unchecked. Studies show that most people have about as much respect for the obese person as they do for the alcoholic or drug addict. One needs only to look inside the cabin of one of our modern airliners to witness total discrimination against the obese. It is common knowledge that coach seating is too narrow and uncomfortable for slender people. To fly, the larger person must choose among the options of 1) flying in great discomfort, embarrassment, and fear of overlapping into the space of adjacent passengers, 2) paying double airfare and occupying two seats, or 3) not flying at all.
It is difficult to understand in this era of heightened sensitivity to fairness, and equality for all people…that in most public places there is no comfortable place for obese people to sit (and, in many cases there is no place to sit). Restaurants, amusement park rides, trains, planes, buses, movie theaters, opera houses, airports, public restrooms, and waiting rooms everywhere, continue to stand in a kind of silent violation of humanity.
Obese people are simply overlooked, forgotten, and left out.