Obesity is a complex disease with multiple causes that results in an unhealthy and inappropriate accumulation of stored fat in the body. Obesity substantially increases the risk for many associated diseases including high blood pressure, diabetes, sleep apnea, heart disease, and cancer. It will soon overcome smoking as the number one cause of preventable death in the United States.
The epidemic of obesity threatens the health of millions of Americans. Over 100 million Americans are overweight (two-thirds of the population), 60 million people are obese (nearly 33 percent), and 11 million people are severely or morbidly obese and the numbers continue to rise. Healthcare costs in the United States for obesity-related diseases are approaching $100 billion dollars annually, approximately 5.5 percent of the total annual health care costs. Thirty percent of U.S. adolescents are overweight and 15 percent are obese. Childhood obesity has doubled in the last several decades, and we know that 75 percent of obese children will become obese adults. Click here to view updated statistics on overweight and obesity in the U.S. from the American Obesity Association.
What Causes Obesity?
The exact cause of obesity remains unknown, but there are many plausible theories. We do know that obesity is a disease and not simply a disorder of willpower. The drive to eat is a very powerful biological drive. There appears to be a command center in the brain which controls food intake like a thermostat controls temperature. Obese patients seem to have too high a set point for this appetite control system, so they take in more calories than they need to maintain their ideal body weight. There are multiple factors that play a role in the development of obesity:
- Genetic or inherited factors
- Strong familial component to obesity
- Genes that regulate metabolism, appetite and satiety
- Behavioral or psychological factors
- Using food as a coping mechanism
- Eating disorders such as binge eating and others
- Learned eating behavior
- Medical or endocrine causes
- Cultural or environmental causes
- Sedentary lifestyle
- Technology reduces our daily activity (TV remote, elevator)
- High-calorie food readily available and inexpensive
Unfortunately, obesity is the last socially acceptable form of discrimination. The misconception that an obese person is weak and has poor eating habits hampers their ability to obtain reasonable health insurance coverage of their disease. Lack of respect for the obese person is a serious problem. In a survey of obese individuals, 80 percent reported disrespectful treatment by their doctor. There are widespread negative attitudes that obese people are lazy, weak-willed, ugly, awkward, self-indulgent and immoral. This intense prejudice transects age, sex, religion, race and socioeconomic status. Numerous studies have documented the stigmatization of obese persons in most areas of social functioning. Obesity represents a management challenge for physicians and a psychological and biological challenge for patients. Obese people often consider their condition to be a greater handicap than deafness, dyslexia or blindness.
What are the Risks of Obesity?
Obesity increases the risk for a whole host of medical problems including:
- Diabetes
- High Blood Pressure
- Heart disease and stroke
- Sleep apnea
- High cholesterol
- Joint disease
- Esophageal reflux
- Loss of bladder control
- Infertility
- Reduced life expectancy, early death
- Increased risk for cancer
- Prone to accidents
- Gallstones
- Liver disease
In short, obesity is very harmful for your health. The good news is that most associated medical problems are reversible once you lose the weight. The risk for Type 2 diabetes is 400 percent greater for obese individuals compared to those of normal weight. Obesity increases the risk for cancer and the risk of dying from that cancer. In obese women, the cancer mortality rate for endometrial cancer is increased 5.4 times; gallbladder cancer, 3.6 times; uterine cancer, 2.4 times; ovarian cancer, 1.6 times; and breast cancer, 1.5 times. In obese men, cancer mortality rates for colorectal cancer are increased 1.7 times; and prostate cancer, 1.3 times. Insurance companies have long recognized this, which is the origin of the Ideal Body Weight tables. There is a direct association between the degree of obesity and medical problems, and as the weight goes up, the risk of early death rises exponentially. If you weigh more than 1 1/2 times your ideal body weight, your annual risk of dying is twice as high as if you were at your ideal weight. Morbidly obese patients have four times the increased risk of dying early than for a person of ideal body weight. Young men have twelve times increased risk of dying early.
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