UNDERSTANDING SEVERE (MORBID) OBESITY
Morbid obesity is characterized by an individual weighing more than 40 kilograms (100 pounds) over their ideal body weight, or having a body mass index (BMI) of 40 or higher.
Throughout this site, the term “morbidly obese” is used to define an individual weighing more than 40 kg over their ideal body weight. Mass media and the public sometimes refer to morbid obesity using the term “severely obese.” These two terms may be used interchangeably.
What is the difference between obesity and morbid obesity?
Obesityis a serious health epidemic. About 30 million Indians are obese. Obesity is a disease characterized by excessive body fat or by having a BMI greater than 30. Morbid obesity is characterized by an individual having a BMI greater than 40. In addition, it also includes people with a BMI of more than 35 and associated weight related co-morbid conditions, such as diabetes, heart disease and many more.
Measuring Morbid Obesity
Morbid obesity is most commonly calculated using BMI. BMI is calculated by dividing a person’s weight in kilograms by his or her height in square meters. Patients with a BMI of 40 or higher are classified as morbidly obese. To calculate your BMI, please click here.
BMI is not used to determine a person’s actual percentage of body fat, but it is a good indicator to categorize weight in terms of what is healthy and unhealthy.
What are the risks associated with morbid obesity?
- High blood pressure
- High cholesterol
- Heart disease
- Gallbladder disease
- Sleep apnea and respiratory problems
- Some cancers (endometrial, breast and colon)
- Liver disease
- Venous disease
- Acid reflux
- Menstrual irregularities and infertility
Causes of Morbid Obesity
Morbid obesity is simply not a result of overeating. It is a serious disease that needs to be prevented and treated. The causes of morbid obesity are widespread, but target three main contributors: behavior, environment and genetics.
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of morbid obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health.
The increase in caloric intake has also decreased the nutrients consumed that are needed for a healthy diet. This behavioral problem also relates to the increase in portion sizes at home and when dining out.
The influence of television, computers and other technologies discourage physical activity and add to the problem of obesity in our society.
Environment plays a key role in shaping an individual’s habits and lifestyle. There are many environmental influences that can impact your health decisions. Today’s society has developed a more sedentary lifestyle. Walking has been replaced by driving cars, physical activity has been replaced by technology and nutrition has been overcome by convenience foods.
Science shows that genetics play a role in obesity and morbid obesity. Genes can cause certain disorders which result in obesity. However, not all individuals who are predisposed to obesity become morbidly obese. Research is currently underway to determine which genes contribute most to morbid obesity.
What are the social effects of morbid obesity?
Individuals affected by morbid obesity often face obstacles far beyond health risks. Emotional suffering may be one of the most painful parts of morbid obesity. Society often emphasizes the importance of physical appearance. As a result, people who are morbidly obese often face prejudice or discrimination.
Effects at Work
Due to the negative stigma associated with morbid obesity, morbidly obese employees are often viewed as less competent, lazy and lacking in self-discipline by their co-workers and employers. Often times, discriminatory attitudes can negatively impact wages, promotions and employment status for obese employees.
In Healthcare Settings
Negative attitudes about morbidly obese patients also exist in the healthcare setting. Morbidly obese patients that are often reluctant to seek medical care may be more likely to delay important preventative healthcare services and may more frequently cancel medical appointments. Delaying medical attention can lead to delayed discovery or treatment of co-morbid conditions, such as diabetes and cardiovascular disease, while becoming more physically damaging.
The consequences of discrimination against the morbidly obese can seriously impact an individual’s quality of life and only further intensify the negative stigma associated with obesity.
Treating Morbid Obesity
(*Note: Please consult with the doctor before beginning any treatment program.)
Because the health risks associated with morbid obesity are life-threatening, clinical programs, such as medically managed weight-loss, weight-loss surgery and other options are available for treatment.
Medically Managed Weight-Loss
Medically managed weight-loss programs provide treatment in a clinical setting with a licensed healthcare professional, such as a bariatric surgeon, nutritionist, nurse and/or psychologists. These programs typically offer services such as nutrition education, physical activity and behavioral therapy. Often, these programs incorporate total meal replacement programs.
Currently there are few medications that are approved for weight-loss which can be discussed to the doctor. All are to be used in conjunction with a reduced-calorie diet, exercise and behavior modification. As with all therapies, medically managed weight-loss needs to be approached with a focused treatment plan, which includes a team of healthcare providers. The team should include dietitians, psychologists and exercise specialists, in addition to the medical providers to provide care at all stages of the weight-loss treatment process.
Bariatric Surgery (Weight-loss Surgery)
If your BMI is more than 50 you are said to be Super Obese.In that case you may consider bariatric surgery (also called weight-loss surgery). It is important to speak with your surgeon to determine which surgery is right for you.
Today, for morbid obese these are the most commonly selected procedures for weight-loss surgery are:
- Laparoscopic Roux-en-Y Gastric Bypass
- Laparoscopic Sleeve Gastrectomy(As a stage one procedure and RYGB as second stage procedure)
When considering weight-loss surgery, you must balance the personal risk of being morbidly obese with the potential risk of the surgery. This treatment option is a tool that you will continually use to lose weight. Surgery is a resource to help you reduce your weight. Behavioral, physical and psychological changes are required for you to maintain a healthy quality of life. Continued positive weight-loss relies upon your desire and dedication to change your lifestyle with a proactive approach.
Additional Treatment Options
In addition to weight-loss surgery and medically managed weight-loss, the following therapies are also utilized to treat morbid obesity.
Behavior plays a significant role in morbid obesity. Modifying behaviors that have contributed to developing obesity is one way to treat the disease either alone or in conjunction with other treatments. A few suggested behavior modifiers include: changing eating habits, increasing physical activity, becoming educated about the body and how to nourish it appropriately, engaging in a support group or extracurricular activity and setting realistic weight management goals.
Increasing or initiating a physical activity program is an important aspect in managing morbid obesity. Routine physical activity can greatly impact your health. Set realistic goals and make sure to consult with your physician before initiating any exercise program.
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