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The definition of obesity
varies depending on what one reads, but in general,
it is a chronic condition defined by an excess
amount body fat. A certain amount of body fat is
necessary for storing energy, heat insulation, shock
absorption, and other functions. The normal amount
of body fat (expressed as
percentage of body fat) is between 25-30% in
women and 18-23% in men. Women with over 30% body
fat and men with over 25% body fat are considered
obese.
How common is obesity?
Obesity has reached epidemic proportions in the
United States. One in three Americans is obese.
Obesity is also increasing rapidly throughout the
world, and the incidence of obesity has nearly
doubled form 1991 to 1998.
What are the health risks
associated with obesity?
Obesity is not just a cosmetic
consideration; it is a dire health dilemma
directly harmful to one's health. In the United
States, roughly 300,000 deaths per year are
directly related to obesity, and more than 80% of
these deaths are in patients with a BMI
(body mass index, which
will be discussed later in this article)
over 30. Obesity also increases the risk of
developing a number of chronic diseases including:
Insulin Resistance. Insulin is necessary for the
transport of blood glucose (sugar)
into the cells of muscle and fat
(which is then used for
energy). By transporting glucose into
cells, insulin keeps the blood glucose levels in
the normal range. Insulin resistance
(IR) is the
condition whereby the effectiveness of insulin in
transporting glucose (sugar)
into cells is diminished. Fat cells are more
insulin resistant than muscle cells; therefore,
one important cause of IR is obesity. The pancreas
initially responds to IR by producing more
insulin. As long as the pancreas can produce
enough insulin to overcome this resistance, blood
glucose levels remain normal. This IR state
(characterized by normal
blood glucose levels and high insulin levels)
can last years. Once the pancreas can no longer
keep up with producing high levels of insulin,
blood glucose levels begin to rise, resulting in
type 2 diabetes, thus IR is a pre-diabetes
condition. In fact scientists now believe that the
atherosclerosis (hardening
of the arteries) associated with diabetes
likely develops during this IR period.
Type 2 (adult-onset)
diabetes. The risk of type 2 diabetes increases
with the degree and duration of obesity. Type 2
diabetes is associated with central obesity; a
person with central obesity has excess fat around
his/her waist, so that the body is shaped like an
apple.
High blood pressure (hypertension).
Hypertension is common among obese adults. A
Norwegian study showed that weight gain tended to
increase blood pressure in women more
significantly than in men. The risk of developing
high blood pressure is also higher in obese people
who are apple shaped
(central obesity) than in people who are
pear shaped (fat
distribution mainly in hips and thighs).
High cholesterol (hypercholesterolemia)
Stroke (cerebrovascular
accident or CVA)
Heart attack. The Nurses Health Study found that
the risk of developing coronary artery disease
increased 3 to 4 times in women who had a BMI
greater than 29. A Finnish study showed that for
every one kilogram (2.2 pounds) increase in body
weight, the risk of death from coronary artery
disease increased by one percent. In patients who
have already had a heart attack, obesity is
associated with an increased likelihood of a
second heart attack. Congestive heart failure
Cancer. While not conclusively proven, some
observational studies have linked obesity to
cancer of the colon in men and women, cancer of
the rectum and prostate in men, and cancer of the
gallbladder and uterus in women. Obesity may also
be associated with breast cancer, particularly in
postmenopausal women. Fat tissue is important in
the production of estrogen, and prolonged exposure
to high levels of estrogen increases the risk of
breast cancer.
Gallstones
Gout and gouty arthritis
Osteoarthritis (degenerative
arthritis) of the knees, hips, and the
lower back
Sleep apnea
Pickwickian syndrome (obesity,
red face, underventilation, and drowsiness) |