Frequently Asked Questions (FAQs)
What is Obesity?
Obesity results from a complex interaction of genetic, behavioral and environmental factors causing an imbalance between energy intake and energy expenditure. According to the National Institutes of Health (NIH), an increase in body weight of 20 percent or more above desirable weight is the point at which excess weight becomes an established health hazard. Lower levels of excess weight can also constitute a health risk, particularly in the presence of other disorders like diabetes, hypertension and heart disease. Obesity has been recognized since 1985 as a chronic disease and is the second leading cause of preventable death, exceeded only by cigarette smoking. The United States currently is suffering an obesity epidemic contributing to the premature death, sickness and suffering of millions of Americans.
How are Overweight and Obesity Defined?
There are several methods to measure obesity levels including Bio-electrical Impedance Analysis, Hydrostatic (underwater) Weighing and Dual Energy X-ray Absorptiometry. Bio-electrical Impedance Analysis is typically the most practical and convenient method used by bariatricians. The Body Mass Index (BMI) is a screening tool to identify people who may be at increased health risk due to being overweight or obese. 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)
Waist-to-hip measurements are also critical. These are 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.
What is a Bariatrician (aka, Obesity Medicine Physician)?
A bariatrician is a licensed physician (M.D. or D.O.) who has received special training in obesity medicine--the medical treatment of obesity and its associated conditions. Bariatricians address the obese patient with a comprehensive program of proper diet and nutrition, appropriate exercise, lifestyle changes and, when indicated, the use of prescription anti-obesity medications and other appropriate medications. The word “bariatric” stems from the Greek word baros, which translates to “weight.” While any licensed physician may offer a medical obesity treatment program to patients, members of the Society have been exposed, through an extensive continuing medical education (CME) program, to specialized knowledge, tools and techniques to enable them to design specialized medical obesity treatment programs tailored to the needs of individual patients and to modify the programs, if needed, as the treatment progresses. Physician-supervised medical obesity treatment programs support overweight and obese patient’s overall health, since these frequently are accompanied by other medical conditions (e.g., type 2 diabetes, hypertension, cancer). An obesity medicine physician is trained to detect and treat these conditions, which might otherwise go undetected and untreated by a non-medical weight-loss program.
How Prevalent is Obesity?
More than one-third of U.S. adults were obese in 2007-08. A 2007-08 data analysis indicated that the prevalence of obesity was 33.8 to 32.2 percent among men, and 35.5 percent among women. The estimates for overweight and obesity combined (BMI greater than or equal to 25) were 68.0 percent overall: 72.3 percent among men and 64.1 percent among women. Obesity prevalence varied by sex, age, race and ethnicity. These height and weight measurements were obtained from 5,555 adult men and women aged 20 years or older as part of the National Health and Nutrition Examination Survey (NHANES).
What About Childhood Obesity?
Obese children and adolescents are more likely to remain obese through adulthood. The prevalence of childhood obesity more than doubled from 1980 to 2008. An estimated 17 percent of children and adolescents ages 2- to 19-years old are obese. These results are from the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
What Costs are Associated with Obesity in the United States?
In 2008, the estimated medical cost of obesity was $147 billion, nearly double the 1998 cost of $78.5 billion. (Health Affairs Journal). The annual health cost of obesity is recorded to be as high as $147 billion. (RTI and the Centers for Disease Control and Prevention).