Morbid Obesity

What is Morbid Obesity?

Obesity is a condition in which you have a high body mass index (BMI), or too much body fat for your height. Obesity is the not the same as being overweight, which is when your weight is higher than what is healthy for your height. In people who are overweight, the excess weight may be caused by high bone density, body structure, or excess body fat.

Morbid obesity occurs when the excess body fat becomes a danger to your overall health.

What Causes Morbid Obesity?

When you eat, your body stores the calories you consume for energy in your muscles and tissues. If those calories are not used, the body stores them as fat. If you continue to eat more calories than your body can use during daily activities and exercise, your body will build up fat stores. Obesity and morbid obesity are the result of too much fat being stored in your body.

Many behavioral factors play a role in obesity, including your eating habits and daily activity level. Many people develop their eating habits as children and have trouble refining them to maintain proper body weight as they age. As an adult, you may be inactive at your job and have less time for exercise, meal planning, and physical activity.

Other factors, such as stress, anxiety, and lack of sleep, can lead to weight gain. People who quit smoking often experience temporary weight gain. Women may also have trouble losing the weight they gain during pregnancy or gain additional weight during menopause. These rarely lead to morbid obesity by themselves, but can be a contributing factor.

Certain medications, such as birth control pills and antidepressants, can cause weight gain. Medical conditions such as hypothyroidism can lead to weight gain, but do not usually lead to obesity.

Genetic factors can play a role in how your body stores energy, but this relationship has not been fully researched. Current research is investigating the relationship between genetics and body weight.

Who is at Risk for Morbid Obesity?

Anyone can gain weight and become obese if they eat more calories than their bodies can use.

Symptoms and Complications of Morbid Obesity

The symptoms of obesity are weight gain and a body mass index (BMI) above 30. BMI is an estimate of your body fat content and is calculated using your height and weight measurements.

Without proper treatment, obesity can lead to other serious health problems, such as:

• osteoarthritis
• heart disease
• stroke
• diabetes
• sleep apnea (when you periodically stop breathing during sleep)

Diagnosing Morbid Obesity

Calculating BMI

Your doctor will measure your weight and height in order to calculate your BMI. Your BMI is an estimate of your body fat and is used as a primary screening tool for obesity. Your provider may also take a measurement of your waist circumference. These combined measurements will help estimate how much body fat you have and determine your risk of diseases, such as heart disease, stroke, and type 2 diabetes.

The acceptable percentage of body fat can vary by age, sex, and ethnicity, but typically ranges between 10 and 22 percent for men and 20 to 32 percent for women. Your doctor will provide more specific information about your BMI and what it means for you.

BMI Ranges are as follows (CDC):

BMI	Weight Status
Under 18.5	Underweight
18.5 to 24.9	Normal
25.0 to 29.9	Overweight
30.0 and above	Obese

Calculating Body Fat Percentage

A skinfold test may also be done to check your body fat percentage. In this test, a doctor measures the thickness of a fold of skin from the arm, abdomen, or thigh with a caliper.

Other Tests

Your healthcare provider may also ask questions about your lifestyle to find out more about your eating and exercise habits. Your doctor may order additional blood tests to look for hormonal or other medical problems that could be causing your weight gain.

Treating Morbid Obesity

Diet & Exercise

The most effective way to lose weight is to adopt healthy eating habits, exercise routines, and stress management techniques. Regular exercise and healthy eating are important, and even modest weight loss will improve your health. It is also important to learn stress management tools that can be used in place of overeating or snacking during stressful times.

You should work with your doctor and a dietician to set realistic goals that will help you lose weight slowly through diet and exercise. It may be helpful to find support from friends, family, or your community in order to make lifestyle changes that will lead to long-term weight loss.

Weight Loss Drugs

Sometimes, weight loss drugs may be prescribed. While these medications may cause weight loss, most people regain the weight once they stop taking the medication. There are many herbal and over-the-counter supplements that claim to help you lose weight, but many of these claims have not been verified.

Surgery

Surgery may also be an option to treat obesity if you have tried other methods for losing weight but have not been successful in maintaining long-term weight loss. It can often help reduce the risk of other diseases (e.g. diabetes, heart disease, sleep apnea) that are associated with severe obesity.

Surgery may cause complications, and you should talk with your doctor to determine if this is an option for you. There are two common types of weight-loss (bariatric) surgeries:

Laparoscopic gastric bypass: In this procedure, the surgeon will place a band around the upper part of your stomach. This limits the amount of food you can eat at one time by making you feel full after eating small amounts of food.

Gastric bypass surgery: This surgery will change how the food you eat travels through your digestive tract by bypassing a portion of your stomach and small bowel. It will make you feel full when you’ve eaten less food.

Preventing Morbid Obesity

Obesity and morbid obesity are serious and potentially life-threatening conditions. A healthy lifestyle that includes a healthy diet and regular exercise are important for preventing obesity.

Diet and Exercise

People who are morbidly obese should avoid “fad” diets and focus instead on changing eating behaviors. Recommendations include:

• adding more fruits and vegetables to your diet
• eating smaller meals
• count calories
• avoid saturated fats, trans fats, and refined sugars

Physical activity is good for overall health and is especially important if you’re trying to lose weight. To begin losing weight, you will need to do moderate to vigorous exercise for more than three hours per week. Vigorous activity raises your heart rate significantly. Examples include:

• running or jogging
• swimming
• jumping rope

Moderate exercises include brisk walking or biking, and can also include everyday activities like shoveling snow or yard work (CDC).