Over the last 30 years, obesity has become the most prevalent disease in the world. More people suffer from the effects of obesity than any other disease. As our country’s leading cause of mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the U.S. healthcare system. The medical community is in need of new strategies for treatment and prevention of this pervasive, chronic disease. This article is the first in a series that will examine this disease, its causes and treatments, and its effect on society.
Obesity is a disease that affects more than one-third of the U.S. adult population (approximately 78.6 million Americans). This number has steadily increased since 1960, a trend that has moderately slowed in recent years, but shows no sign of reversing. Today, almost 35 percent of all adults and 17 percent of children ages 2-19 years are obese.
Obesity is simply defined as an excess of adipose (fat) tissue in the body. There are several different methods for determining excess fat; the most common being the Body Mass Index (BMI). The BMI is a mathematical calculation and can be easily computed using any online calculator. The general categories are:
| BMI below 18.5 | Underweight |
| 18.5-24.9 | Normal weight |
| 24.9-29.9 | Overweight |
| 30 and greater | Obese |
| 40 and greater | Morbid or extreme obesity |
While studies have shown that a BMI definition is not accurate for everyone, such as bodybuilders and athletes, it is a readily available tool for most people. Waist circumference is another widely used measurement to determine abdominal fat content. Men with a waist measurement exceeding 40 inches are considered at risk. Women are at risk with a waist measurement of 35 inches or greater.
According to the CDC, an estimated 112,000 deaths per year are associated with obesity. Obesity puts individuals at risk for more than 30 chronic health conditions. They include: type 2 diabetes, high cholesterol, hypertension, gallstones, heart disease, fatty liver disease, sleep apnea, GERD, stress incontinence, heart failure, degenerative joint disease, birth defects, miscarriages, asthma and other respiratory conditions, and numerous cancers.
The healthcare costs of American adults with obesity amount to approximately $190 billion per year. Discrimination and mistreatment of persons with obesity is widespread and, sadly, often considered socially acceptable.
Obesity is increasing throughout the world. In total global burden of disease, it now ranks with major health problems such as childhood and maternal under-nutrition, high blood pressure, high cholesterol, sexually transmitted diseases, iron deficiency, smoking, alcohol abuse and unsafe water.
Often, obesity has been stigmatized because of the perception that the condition is caused mostly by the modifiable behavioral factors of poor diet and physical inactivity. Nevertheless, a rich body of literature demonstrates that obesity is a complex condition mediated through the interplay of multiple genetic, biologic, metabolic, behavioral, social, economic and cultural determinants.
As this article series continues, I will look at the multiple social and biological causes of obesity, and discuss the stigma of obesity and its effect on adults and children. I will evaluate the association between obesity and diabetes, cancer and other health problems. Also, I will present the emerging evidence of obesity as a neurochemical disease, and how treatment options can be tailored to the individual and to society.
Obesity is a disease that affects more than one-third of the U.S. adult population (approximately 78.6 million Americans).
