By Caroline Cederquist, M.D.
In September, the State of Obesity 2018 Report was released which showed that the rates of medically significant overweight (also known as obesity) continue to climb in all states. The report found that from 2015 to 2106, almost forty percent (39.4%) of adults in the United States met the criteria for obesity.
Many people have issues with the term obesity and I try to avoid using it. Research shows that many people associate the term obesity with other terms like lazy, or sloppy but the medical definition of obesity simply means that a person has passed a threshold for weight relative to his or her height. The measurement for weight relative to height is called the body mass index or BMI. If you are at a BMI of 30 or above, you fit the criteria for obesity. The BMI is not perfect as it will over-estimate the amount of body fat in a person who is very muscular such as a body builder. It will also underestimate risk in a person who has a lot of body fat but also does not weight a lot due to the loss of muscle mass such as many older adults have experienced. However, it works fairly well for such large country wide or worldwide reports.
People often estimate that a person who is obese would weight 300 pounds or more. However, the average woman in the U.S. is 5’4” and if she is 175 pounds, she is considered obese. The average man in the U.S. is 5’10.5” and if he weighs 213 pounds, he fits the definition of obesity as well.
At a BMI of 30, medical illness and disease risks really increase. The illnesses and diseases that significantly increase at or above a BMI of 30 are diabetes, heart disease, many types of cancer including breast, lymphoma, uterine, gallbladder, kidney disease, fatty liver and cirrhosis, arthritis, sleep apnea, stroke and even dementia. In fact, the leading causes of chronic disease and death in the U.S. are conditions that are increased or aggravated by being medically significantly overweight.
Importantly, this is not just a problem for the United States as worldwide, one third of people are overweight or obese. This is usually surprising to most people as this worldwide population includes large populations in the developing world who are undernourished.
The health risks of excess weight have been known for quite a long time and the fact that almost 40% of the U.S. population fits the criteria for obesity really shows that gaining weight is very easy in our modern environment and maintaining a normal weight is very challenging for the majority of people. There are so many contributors such as the accessibility of highly palatable food, the way our cities and towns are designed that make driving more feasible than walking, automation which has decreased manual labor, and the fact that we sleep so much less than we did in previous generations. The effects of food additives, chemicals and pollution which can disrupt hormone function and the fact that our work lives have become more and more sedentary for most people are also contributing factors.
However, after working in medical weight management for more than twenty years, I still have hope because I am able to see people successfully lose weight every day. There are many things that help make someone successful in obtaining and maintaining a normal weight. The first is personalized information. Knowing what is going on within your body with regards to hormone function and nutritional status is key. We are all biochemically unique and it is really true that what works for one person
may not work for another. The more you understand your unique metabolic situation, the better a nutrition and exercise plan will work for you.
The second success principle is to create a plan. A specific plan of action based upon your metabolism that takes into account what you are willing and able to do with all that is going on in your life, is key for success. A third element of success is tracking and accountability. Our environment and genetic make up really pulls for ongoing weight gain and our population studies prove it. However, this cycle can get interrupted by creating an individualized, specific plan and having the support system to follow it and adjust it as needed over time. New research into genetics, the effect of gut bacteria, the effect of hormones that affect hunger is actively occurring and will offer additional tools for people to manage a healthy weight.
Cederquist Medical Wellness Center
1575 Pine Ridge Road Suite 19
Naples, FL 34109