Causes :: Consequences :: BMI :: Treatment

Obesity: A Disease

Obesity is a chronic disease in which fat has accumulated throughout the body, in such a manner and extent to become life threatening.

It is rapidly becoming one of the most serious worldwide health issues of this century with over 250 million people affected. It is difficult to find a more common problem as a cause of other serious medical conditions. It has the potential to reduce life expectancy and it certainly reduces the quality of life.

The United States lead the world with the highest incidence of obese patients per capita of population. We have a similar problem in Australia. In 2004-05, about 54% or 7.4 million people aged 18 years and over were classified as overweight or obese. An increase from 45% (5.4 million adults) in 1995.

Obesity also affects children and its incidence is increasing. Among students aged 7 to 16, the prevalence of overweight and obesity combined has risen from 11% in 1985 to 25% in 2004.

The body mass index (BMI) is regarded as the best available method to measure obesity.

Click here to find out more about Body Mass Index BMI.

Causes of Obesity

Obesity can be the result of one or more causes. It is generally accepted that it can be caused by one or more of:

• Genetic predisposition
• Physiologic factors
• Psychological
• Behavioural
• Socioeconomic
• Societal factors

Consequences of Obesity

Obesity has been clearly shown to reduce life expectancy. The risk increases with an increasing BMI.

Obesity is directly implicated in the cause of or for its negative impact on the management of a number of medical conditions, such as:

• Diabetes type 2
• Hypertension
• Asthma
• Sleep Apnoea
• Heart Disease
• Gastro-oesophageal Reflux
• Cancer ( (breast, colorectal, prostate)
• Depression
• Deep vein thrombosis (DVT)
• Infertility
• Obstetric complications

Obese patients also experience physical limitations and social isolation, greatly reducing their quality of life. Simple activities become great challenges.

Consideration also should be given to the increased medical costs to manage those conditions which are directly caused or affected by obesity.

Treatment Options

It is impossible to be able to treat all obese patients, when the problem is present in such high prevalence. Clearly, prevention of obesity is the most desirable aim in the long term.. This is particularly applicable in the case of children and adolescents, where education should be the first option.

For those patients with severe obesity, available treatment can be subdivided in non surgical and surgical.

Non-surgical treatment consists of diets, exercise, behavioural change and pharmacotherapy. Using one or more of these methods, the long term results are ineffective in about 90%. These methods are often doomed to failure by high attrition rates and the fact that lost weight is regained, eventually.

Surgical treatment has been shown over the years to be an effective long term form of treatment for obesity. Its goals are to improve health, improve the quality of life and increase life span. The more commonly used surgical options can be subdivided into:

1. Restrictive  (ie. reduce the amount of food the stomach can hold)

• Laparoscopic Gastric Banding
• Laparoscopic Sleeve (tube) Gastrectomy

2. Malabsorptive (ie. shorten the digestive tract and can cause malabsorption syndromes)

• Bilio-Pancreatic Diversion

3. Combined

• Gastric Bypass (Roux-en-Y)