About Obesity - What is obesity?

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Article - About Obesity

What is obesity?
Obesity used to be understood in fairly simple terms: excess body weight resulting from eating too much and exercising too little, due in large part to a lack of willpower or self-restraint. Unfortunately for the millions of American adults who are overweight, obesity is now regarded as a chronic medical disease with serious health implications caused by a complex set of factors.

Recognized since 1985 as a chronic disease, obesity is the second leading cause of preventable death, exceeded only by cigarette smoking. Obesity has been established as a major risk factor for hypertension, cardiovascular disease, Type 2 diabetes, and some cancers in both men and women. Obesity affects 58 million people across the nation and its prevalence is increasing. Approximately one-third of American adults are estimated to be obese, and 60% are overweight.

Obesity results from an interaction of genetic, behavioral and environmental factors, causing an imbalance between energy intake and energy expenditure. According to the National Institute of Health, an excess of 20 percent or more above desirable weight is the point at which excess weight becomes an established health hazard. Even some excess weight can constitute a health risk, particularly in the presence of other disorders like diabetes, hypertension and heart disease.

How prevalent is obesity?

Obesity is a chronic, debilitating and potentially fatal condition, marked by an excess accumulation of body fat sufficient to endanger health. The United States is currently suffering an obesity epidemic that contributes to the premature death, sickness and suffering of millions of Americans.
The U.S. Census Bureau estimates that approximately 58 million American adults (26 million men and 32 million women) are obese.
According to the National Institutes of Health, 55% or 97 million adults in the U.S. are overweight or obese, with at least 33% (58 million) of adults considered overweight and 22% (39 million) considered obese.
The combined prevalence of overweight and obesity in the US has increased from 46% of the adult populations (NHANES II, 1976 to 1980) to over 60% of the adult population in NHANES III (1988-1994).
The prevalence of obesity increased from 12.0% in 1991 to 17.9% in 1998. A steady increase was observed in all states; in both sexes; across age groups, races and educational levels; and occurred regardless of smoking status. (JAMA 1999;282: 1519-1522)
Approximately one third (33.4 percent) of adults are estimated to be obese. Over 60% are overweight.
Adult men and women are nearly 8 pounds heavier than they were 15 years ago. Mean body mass index (BMI), a standard measure of obesity, has increased from 25.3 to 26.3 kg/m2.
At any given time 33 to 40 percent of women and 20 to 24 percent of men are trying to lose weight.
Maintaining weight loss over the long term is exceedingly difficult. Most people regain as much as two-thirds of weight lost within one year and regain all of it within five years.

What are the costs associated with obesity?
The total cost attributable to obesity amounted to $99.2 billion in 1995. Approximately $51.65 billion of those dollars were direct medical costs. Compared with 1988 data, in 1994 the number of restricted-activity days, bed-days, and work-lost days increased substantially. The number of physician visits attributed to obesity increased 88% from 1988 to 1984. (Obesity Research 1998;6(2):97-106)

The cost of obesity to US business in 1994 was estimated to total $12.7 billion. The health-related economic cost of obesity to US business is substantial, representing approximately 5% of total medical care costs. (American Journal of Health Promotion 1998;13(2): 120-127)

Sustained modest weight loss among obese persons would yield substantial health and economic benefits. (American Journal of Public Health 1999;89(10): 1536-42)

We found that as BMI increases, so do the number of sick days, medical claims and health care costs and that the mean annual health care costs for the BMI "at risk" population was $2,274 versus $1,499 for the "not at risk" group. (Statistical Bulletin of the Metropolitan Insurance Co. 1999 Jul-Sep;80)

What are the health implications of obesity?
Obesity has been established as a major risk factor for diabetes, hypertension, cardiovascular disease and some cancers in both men and women. Other associated conditions include sleep apnea, osteoarthritis, infertility, idiopathic intracranial hypertension, lower extremity venous stasis disease, gastro-esophageal reflux, and urinary stress incontinence. Obesity-related medical conditions contribute to 300,000 deaths each year, second only to smoking as a cause of preventable death. (JAMA, 1996;276:1907-1915)

The estimated number of annual deaths attributable to obesity among US adults is approximately 280,000 based on relative hazard ratio from all subjects and 325,000 based on hazard ratio from only non-smokers and never-smokers. (JAMA, 1999;282: 1530-1538)

One-third of all cases of high blood pressure are associated with obesity, and obese individuals are 50% more likely to have elevated blood cholesterol levels. (American Family Physician 1997;55(2): 551-558)

Adult onset diabetes (Type 2, non-insulin dependent) accounts for nearly 90% of all cases of diabetes. Researchers estimate that 88 to 97% of Type 2 diabetes cases diagnosed in overweight people are a direct result of obesity. (Shape Up America, December 1995)

Excess weight is an established risk factor for high blood pressure, type 2 diabetes (adult-onset), high blood cholesterol level, coronary heart disease and gallbladder disease. (JAMA, 1999;282:1523-1529)

http://www.cdc.gov/nccdphp/dnpa/obesity/faq.htm

How many American adults are overweight or obese?

In 1999, an estimated 61 percent of U.S. adults were either overweight or obese, defined as having a body mass index (BMI) of 25 or more.
In 2000, a total of 38.8 million American adults met the classification of obesity, defined as having a body mass index score of 30 or more.

What is the difference between overweight and obese?

An adult is considered "overweight" when he/she is are above a healthy weight, which varies according to a person's height.
The standard used by researchers to define a person's weight according to their height is body mass index (BMI). An individual is overweight when their BMI is between 25-29.9.
An adult with a BMI of 30 or more is considered obese. For example, for a 5'4" woman, this means that she is 30 or more pounds over her healthy weight.

Why are so many people overweight or obese today?
There are a number of factors that influence overweight or obesity, including:

Behavior - eating too many calories while not getting enough physical activity.
Environment - home, work, school, or community can provide barriers to or opportunities for an active lifestyle.

Behavioral and environmental factors are the main contributors to overweight and obesity and provide the greatest opportunities for prevention and treatment. How do overweight and obesity affect your health?

If you are overweight, you are more likely to develop health problems such as:

heart disease
stroke
diabetes
cancer (such as colon cancer, endometrial cancer, and postmenopausal breast cancer)
gallbladder disease
sleep apnea (interrupted breathing during sleep)
osteoarthritis (wearing away of the joints)

The more overweight you are, the more likely you are to have health problems. Weight loss and regular exercise can help improve the harmful effects of being overweight. Studies show if you are overweight or obese, losing 5-10% of your body weight can improve your health.

What can be done about this major public health problem?
The Surgeon General recently called for a broad approach to avoid and reduce obesity. He challenged families, schools, work sites, health care providers, communities, and the media to work together to prevent and reduce obesity through:

Communication - by educating, motivating, and empowering decision makers at all levels to create healthier communities.
Action - by helping Americans balance healthy eating with regular physical activity.
Research and Evaluation - by improving the general public's understanding of the causes, prevention, and treatment of overweight and obesity.

What are the costs associated with overweight and obesity?

In 2000, the cost of obesity in the United States was more than $117 billion.
Poor nutrition and physical inactivity account for some 300,000 premature deaths in the United States each year.

What is CDC doing to address the problem of overweight and obesity?
In October 2000, CDC's Division of Nutrition and Physical Activity funded a number of state health departments to help them develop and carry out targeted nutrition and physical activity interventions in an effort to prevent chronic diseases, especially obesity.

What does CDC recommend to help people lose weight?

The safest and most effective way to lose weight is to reduce calories and increase physical activity. It is best to consult with your personal physician or health care professional for advice to meet your needs.
Government research and recommendations can provide the facts based on science so that people can make informed choices about appropriate weight loss. The fact is the majority of people who are attempting weight loss are not using the correct method to achieve or maintain positive results.

Dr. Kelly Boswell, a leading provider of psychology services in North Florida and an expert in the treatment and prevention of obesity and eating disorders, heads the Boswell Center. The Center offers personalized treatment and follow-up processes that are second to none, with a full spectrum of services, including registered dietitians.

For more information, call (904) 332-9100.