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In the doctor’s office obesity is determined by measuring the Body Mass Index or BMI, the waist circumference and determining the occurrence of risk factors and weight related health issues. When evaluating obesity rates for epidemic research only the BMI is used to determine obesity.

BMI is a percentage measurement which is a ration of fat to muscle mass. To obtain a BMI the weight in kilograms is divided by height in meters and the result used as an index of obesity.

Obesity Weight loss

Here are the scales for BMI

• A BMI less than 18.5 is underweight
• A BMI of 18.5 - 24.9 is normal weight
• A BMI of 25.0 - 29.9 is overweight
• A BMI of 30.0 - 39.9 is obese
• A BMI of 40.0 or higher is severely (or morbidly) obese

What Causes Obesity?
Obesity occurs when more calories are consumed than burned. Fat cells and some liver and muscle cells take in energy and store it as fat. In most people, the extra energy used to generate fat reserves is small when compared to the total number of calories consumed. Small changes in a body’s energy intake and expenditure can result in extreme weight fluctuations over time.

Some conditions that may be the cause of Obesity are:

• Sedentary lifestyle
• Underlying illness (e.g. hypothyroidism)
• Certain medications (e.g., atypical antipsychotics)
• Genetic factors and some genetic disorders (e.g., Prader-Willi syndrome)
• A high glycemic diet (i.e., a diet that consists of meals that give high postprandial blood sugar)
• Weight cycling, caused by repeated attempts to lose weight by dieting
• Eating disorders (such as binge eating disorder)
• Stressful
• Insufficient sleep
• Smoking cessation

Obesity is often a combination of genetic and environmental factors. Changes in various genes that control metabolism, appetite and the release of adipokine make some people predisposed to obesity. Having a caloric imbalance will lead to Obesity if an individual is predisposed to this disease. There are some genetic conditions such as Prader-Willi Syndrome and leptin receptor mutations that have been identified as causing Obesity. It is believed that there are still a large number of genes to be identified. Probably it is many genes interacting that cause Obesity.

Binge Eating Disorder or BED is associated with obesity. Patients with BED are prone to over eat or binge. The binging serves to reduce anxiety similar to substance abuse. BED patients may also lack to ability to feel hunger or satiety which is normally learned in childhood. Some learning theories suggest that early childhood conceptions lead to an association between eating, food and a healthy mentality.

What are the Health Issues that May Result from Obesity?

When making a diagnosis of Obesity, the clinician will examine the patient for the following diseases:

• Coronary Heart Disease
• Type 2 Diabetes
• Sleep Apnea – difficult or temporary loss of breathing during sleep
• Hypertension or High Blood Pressure

How is Obesity Treated?
Obesity is treated with exercise and calorie control. Medication is also available that can block the absorption of fat and lead to reduced weight. Smoking, hypertension, age and family history are other risk factors that may indicate treatment.

Two surgeries are used to treat the severely or morbidly obese. They are Vertical Banded Gastroplasty (VBG) and Gastric Bypass. Like any surgery there are associated risks, but the benefits of having a healthy weight usually outweigh the risks. Check the surgical record of your doctor before proceeding. Vertical Banded Gastroplasty is an elective surgical procedure in which the stomach is partitioned with staples and fitted with a plastic band to limit the amount of food that the stomach can hold at one time. Gastric Bypass is more involved. Gastric Bypass is a surgical procedure that creates a new, smaller stomach. The small intestine is attached to the new stomach, allowing the lower part of the stomach to be bypassed. Both surgeries are designed to reduce food intake and increase the feeling of fullness. A doctor who specializes surgery for the obese is a Bariatric Surgeon.

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