Obesity and Diabetes Surgery Center
What is Obesity?
Body mass index (BMI) is a calculation that takes a person’s weight and height in Consideration to measure body size. In adults, obesity is defined as having a body mass index of 30.0 or greater, according to the Centers for Disease Control and Prevention (CDC).
Obesity is associated with an increased risk of serious diseases. Such as type 2 diabetes, heart disease and cancer.
But BMI is not everything, it has some limitations as a measurement. According to the CDC source, age, gender, ethnicity, and muscle mass can influence the relationship between BMI and body fat. The BMI doesn’t distinguish between excess fat, muscle or bone mass, and doesn’t provide any indications of distribution of fat between individuals.
Despite these limitations, BMI is still widely used as a means of measuring body size.
How is obesity classified?
Adults who are at least 20 years old:
| Class | BMI |
| Weight loss | 18.5 or less |
| Normal weight | 18.5 to >25 |
| Overweight | 25.0 to >30 |
| Class 1 obesity | 30.0 to >35 |
| Class II obesity | 35.0 to >40 |
| Class III obesity (also known as severe, or morbid obesity). | 40.0 or more |
What is childhood obesity?
In order for a doctor to diagnose an obese child over two years old, his or her BMI must be in the 95th percent. for people of the same age and biological sex:
| Class | BMI percentile range |
| Weight loss | 5 % > |
| Normal weight | 5 % to >85% |
| Overweight | 85% to >95% |
| Obesity | 95% or more |
What are the causes of obesity?
Eating more calories than you burn in daily activity and exercise- on a long- term basis can lead to obesity. Overtime, these extra calories accumulate and cause weight gain.
But it’s not always about calories taken in and calories out, or a secondary lifestyle. While these are really the cause of obesity, there are some causes that you cannot control.
Specific and common causes of obesity include:
- Genetics: which can influence how your body processes food into energy and how it stores fat.
- Getting old: as you getting old, your muscle mass decreases and your metabolism rate slows, making it easier to gain weight.
- Not getting enough sleep, which can lead to hormonal changes that make you feel hungrier and want to eat certain high-calorie food.
- Pregnancy, as it may be difficult to lose weight gained during pregnancy and may eventually lead to obesity.
Certain health conditions can also lead to weight gain, which can lead to obesity, they include:
- Polycystic ovary syndrome (PCOS): a condition that causes an imbalance in the female reproductive hormones.
- Prader-Willi Syndrome: a rare condition that appears at birth and causes excessive hunger.
- Cushing’s Syndrome: a condition caused by high levels of cortisol (the stress hormone in your system).
- Hypothyroidism (underactive thyroid): A condition in which the thyroid gland doesn’t produce enough of important hormones.
- Osteoporosis (OA): it is one of the other conditions that cause pain, which may lead to decreased activity.
Who are at risk of obesity?
A complex combination of factors can increase a person’s risk of developing obesity:
- Genetics: some people have genes that make it difficult for them to lose weight.
- Environment and Society: your environment at home, school, and in your community can all affect how you eat and how active you are.
You may be more likely to become obese if you:
- You live in a neighborhood with limited healthy food options, such as fast-food restaurants.
- Unable to cook healthy meals
- There is no suitable place to play or walk in your area.
Psychological and other factors:
- Depression can sometimes lead to weight gain, as some people may resort to food for emotional comfort, and some antidepressants can increase the risk of weight gain.
- Quitting smoking is always a good thing, but quitting smoking can also lead to weight gain. In some people, it may lead to excessive weight gain. For this reason, it is important to focus on diet and exercise while quitting smoking, at least after the initial withdrawal period.
- Medications, such as steroids or birth control pills, can also increase the risk of weight gain.
How is obesity diagnosed?
BMI is an approximate calculation of a person’s weight relative to their height. Other, more accurate measures of body fat distribution include:
- Skin thickness tests
- Comparisons from waist to hip
- Examination, such as us ultrasound and x-rays
Your doctor may also order certain tests to help diagnose the health risks associated with obesity. Which includes:
- Blood tests (checking cholesterol and glucose levels).
- Liver function tests
- Diabetes check up
- Thyroid test
- Heart tests, such as Electrocardiogram (EKG, ECG )
Measuring the fat around your waist is a good indicator of some obesity-related diseases.
What are the complications of obesity?
Obesity can lead to more than just weight gain. The presence of a high percentage of fat in the body, especially in the muscles, stresses your bones as well as your internal organs. It also increases inflammation in the body. Obesity is also believed to be a risk factor for cancer. It is also a major risk factor for type 2 diabetes.
Obesity has been linked to a number of health complications. Some of them can be life threating if not treated:
- Type 2 diabetes
- Heart disease
- Hypertension
- Some types of cancer (breast, colon, uterus).
- Apoplexy
- Gallbladder disease
- Fatty liver disease
- High cholesterol
- Sleep apnea and other breathing problems
- Arthritis
- Infertility
What changes in lifestyle and behavior can help with weight loss?
Your health care team can educate you about food choices and help develop a healthy eating plan that works for you. A structured exercise program and increased daily activity- up to 3000 minutes per week- will help build your strength, endurance and metabolism.
Changes in lifestyle and behavior are the preferred methods of weight loss for children, unless they are extremely overweight.
What are the types of weight loss surgery?
Weight loss surgery is often called Bariatric Surgery. This type of surgery works by limiting the amount of food you can comfortably eat or by preventing your body from absorbing food and calories. Sometimes you can do both.
Weight loss surgery is not a quick solution. It is a major surgery and can involve serious risks. After that, people who have undergone surgery will need to change the way they eat and how much they eat, otherwise they will face the risk of disease.
However, non-surgical options are not always effective in helping obese people lose weight and reduce the risk of developing comorbidities.
Type of weight loss surgery include:
- Gastric bypass surgery: in this procedure, the surgeon creates a small pouch at the top of your stomach that connects directly to the small intestine. Food and liquids pass through the pouch into the intestines, bypassing most of the stomach.
- Laparoscopic Gastric Banding (LAGB): the LAGB separates your stomach from the two pockets using a band.
- Sleeve Gastrectomy: this procedure removes part of your stomach.
- Biliary pancreatic diversion with duodenal switch: this procedure removes most of your stomach.
Candidates for surgery
for decades, experts have recommended that adult candidates for weight-loss surgery have a BMI of least 35.0 (Category 2 and 3).
In 2018, the American Society for Metabolic and Bariatric Surgery ( ASMBS) approved weight- loss surgery for adults with a BMI of 30.0 to 35.0 ( Category 1) and who:
- Have related comorbidities especially type 2 diabetes.
- We did not see sustainable results from non-surgical treatments, such as eating and lifestyle modifications.
For people with obesity of the first degree, the Surgery is most effective for people between the ages of 18 and 65 years.
People often have to lose some weight before undergoing surgery. In addition, they will usually undergo counselling to ensure that they are emotionally prepared for the surgery and ready to make the necessary lifestyle changes that it requires.
How can obesity be prevented?
On a personal level, you can help prevent weight gain and obesity by making healthy lifestyle choices:
- Do moderate exercise such as walking, swimming or cycling for 20 to 30 minutes every day.
- Eat well by choosing nutritious foods, such as fruits, vegetables, whole grains and lean proteins.
- Eat foods rich in fat and calories in moderation
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