Obesity Current Medical Knowledge – Part One.

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By: Suheil Khuri M.D.
I- How to Measure Obesity
Body fat can be measured in several ways. Some are very simple as in the use of a tape measure. Others use advanced and expensive equipment with sophisticated equations that more accurately estimate fat mass, muscle mass, water content and bone density. Each body fat assessment method has pros and cons.
However, the most commonly used and basic method of measuring body fat is the body mass index (BMI). The BMI can be calculated by diving the weight of a person in kg. by the square of his/her height in meters. This can also be approximately measured using pounds and inches as below with a 703-multiplication factor.
BMI = Weight (kg) / Height (m)2, or BMI = 703 X (Weight (lb) / Height (in)2).
BMI tables as noted below, and online calculators make it easy for individuals to determine their own BMIs.

BMI –>	19	20	21	22	23	24	25	26	27	28	29	30	31	32	33	34	35
Height	Weight in Pounds
4’ 10”	91	96	100	105	110	115	119	124	129	134	138	143	148	153	158	162	167
4’ 11”	94	99	104	109	114	119	124	128	133	138	143	148	153	158	163	168	173
5”	97	102	107	112	118	123	128	133	138	143	148	153	158	163	168	174	179
5’ 1”	100	106	111	116	122	127	132	137	143	148	153	158	164	169	174	180	185
5’ 2”	104	109	115	120	126	131	136	142	147	153	158	164	169	174	180	186	191
5’ 3”	107	113	118	124	130	135	141	146	152	158	163	169	175	180	186	191	197
5’ 4”	110	116	122	128	134	140	145	151	157	163	169	174	180	186	192	197	204
5’ 5”	114	120	126	132	138	144	150	156	162	168	174	180	186	192	198	204	210
5’ 6”	118	124	130	136	142	148	155	161	167	173	179	186	192	198	204	210	216
5’ 7”	121	127	134	140	146	155	161	167	173	179	186	192	198	204	211	217	223
5’ 8”	125	131	138	144	151	158	164	171	177	184	190	197	203	210	216	223	230
5’ 9”	128	135	142	149	155	162	169	176	182	189	196	203	209	216	223	230	236
5’ 10”	132	139	146	153	160	167	174	181	188	195	202	209	216	222	229	236	243
5’ 11’	136	143	150	157	165	172	179	186	193	200	208	215	222	229	236	243	250
6’	140	147	154	162	169	177	184	191	199	206	213	221	228	235	242	250	258
6’ 1”	144	151	159	166	174	182	189	197	204	212	219	227	235	242	250	257	265
6’ 2”	148	155	163	171	179	186	194	202	210	218	225	233	241	249	256	264	272
6’ 3”	152	160	168	176	184	192	200	208	216	224	232	240	248	256	264	272	279

Source: US Department of Health and Human Services, National Institute of Health.
BMI Classification:
Underweight: <18.5
Normal : 18.5 – 24.9
Overweight: 25 – 29.9
Obese Class I (Moderately Obese): 30 – 34.9
Obese Class II (Severely Obese): 35 – 39.9
Obese Class III (Morbidly/Very Severely Obese): >40
 
II- Prevalence of Obesity in USA
 
The most recent national data on obesity prevalence among U.S. adults, adolescents, and children show that more than one-third of adults (78 million) and almost 17% (12.5 million) of children and adolescents were obese in 2009–2010 as noted in the table below. Obesity is now an epidemic that affects a major part of our society.

	Women	Men	Girls	Boys
1999-2000	33.4 %	27.5 %	13.8 %	14.0 %
2009-2010	35.8 %	35.5 %	15.0 %	18.6 %

 
 
Source: National Health and Nutritional Examination survey (NHAYNES)
Differences in prevalence between men and women diminished between 1999–2000 and 2009–2010, with the prevalence of obesity among men reaching the same level as that among women.
The prevalence of obesity was higher among older women compared with younger women, but there was no difference by age in obesity prevalence among men.
Between 1999–2000 and 2009–2010, there was a significant increase in the prevalence of obesity among boys but not as significant among girls.
Also the prevalence of obesity was higher among adolescents than among preschool-aged children.
III- Causes of Obesity:
The general conception is that obesity occurs because of eating too much and lack of motivation and exercise. Though those may be contributing factors, however obesity is a complex disorder with multiple causes. Obesity has not been classified as a disease until June 18, 2013 when for the first time the House of Delegates of the American Medical Association adopted a policy recognizing obesity as a disease with multiple pathophysiological aspects necessitating a large range of interventions.
The following are the more accepted causes for obesity:

1. Genetic.
2. Sedentary Behavior. With a sedentary lifestyle, you can easily take in more calories every day than you consume through exercise and normal daily activities.  This leads to weight gain.
3. Medical Problems. Certain disease as Prader-Willi syndrome, Cushing’s syndrome, polycystic ovary syndrome and possibly hypothyroidism are associated with obesity. Arthritis also, can lead to decreased activity, which may result in weight gain.
4. Medications. Some medications can lead to weight gain if one does not compensate for that through dieting and exercise. These medications include some antidepressants, anti-seizure medications, some diabetes medications, antipsychotic medications, steroids and some hypertension medications.
5. Unhealthy diet and eating habits. High calorie diets, fast food, skipping breakfast, eating most of your calories at night, high-calorie beverages and oversized portions all contribute to weight gain.
6. Pregnancy. During pregnancy, a woman’s weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
7. Lack of sleep. Getting less than seven hours of sleep a night can cause changes in hormones that increase one’s appetite. This may also have you crave foods high in calories and carbohydrates, which can contribute to weight gain.

However, of all above causes the genetic cause is believed to be the most common cause for obesity. Previous twin studies estimate genetic influence on obesity to be 60 – 70% and all other factors to contribute 30 – 40%.
It is also estimated that with one obese parent the chance that the child will be obese is 50%. However, if both parents are obese that chance increases to 80%.
Call us at: 561-427-2232 or e-mail us at Jupiter.florida@drgsweightloss.com for a free consultation at Dr. G’s WeightLoss and Wellness Center of Jupiter.
 
Next month we will cover:
Obesity Current Medical Knowledge – Part Two.