1.) What classifies someone as obese?
Obesity is defined as a BMI >30 kg/m2. Online height and weight charts or BMI calculators are easy available tools to use that make this calculation easy.
Average US man: height 5’9″ and weight 191, has a BMI of 28, which is considered overweight. For the average man, obesity would be height of 5’9″ and weight > 202 lbs.
Average US woman: height 5’4″ and weight 164 lbs, has BMI of 28, which is overweight. For the average woman, obesity would be a height of 5’4″ and weight > 174 lbs.
Normal body weight is defined as BMI 18.5-24.9
Overweight is BMI 25-29.9
Class 1 obesity is BMI 30-34.9
Class 2 obesity is BMI 35-19.9
Morbid or extreme obesity is BMI >40
Obesity rates have risen dramatically and it is now a chronic disease considered to be a global epidemic. Health care costs rise with obesity and it is associated with increased risk of multiple health conditions:
- Diabetes
- Hypertension
- High cholesterol
- Heart disease
- Stroke
- Sleep apnea
- Cancer
- Liver disease
2.) What percentage of women are obese? What are the demographics? Do genetics play a role?
In the US 36% of women are obese and 33% of men are obese.
Worldwide 38% of women are obese and 60% are overweight.
Non-hispanic black women have an obesity rate of 58%
Hispanic women 45%
Non-hispanic white women 35%
Obesity is highest among middle aged adults ages 40-59 with an obesity rate of 40%
Behavioral, environmental and genetic factors determine weight.
Genetic changes in human population occur too slowly to be responsible for the obesity epidemic.
If both parents are obese, a child’s risk of adult obesity is 6-15x the risk of a child whose parents that are not obese.
There is a lot of research being done on obesity genetics but currently there are no helpful genetic tests that are available. Most obesity probably results from complex interactions among multiple genes and environmental factors that remain poorly understood.
3.) Where does Louisiana rank among the other states?
Louisiana is ranked #4 among states, with an adult obesity rate of 34.9%
It is associated with population demographics- ethnicity, cultural behaviors, and socioeconomic factors.
43% of African Americans in LA are obese
31% of Latinos
30.5% of Whites
Poorest states have the highest obesity rates. Poor people eat cheaper, processed food and may not be in areas safe for exercise.
Sedentary behavior is a big part of the obesity epidemic. Environmental factors including social and community influences and decreasing school fitness requirements play a role.
4.) What are the biggest misconceptions about obesity?
The biggest barrier is that it is difficult to discuss. It is a sensitive and psychologically stressful issue, it is sometimes viewed as a character flaw. People may feel blame or feel ashamed for having weight problems.
Unfortunately there are no ‘quick fixes” for obesity. I recommend lifestyle changes. Fad diets that promise rapid weight loss are not sustainable. Losing weight and then regaining it is extremely frustrating for patients.
Our culture is obsessed with diets and we still have an epidemic of obesity.
There are beliefs that people have “slow metabolism”, however resting metabolism actually increases as people become heavier according to research. Being physically fit and increasing your lean muscle tissue is one way to increase metabolism.
There is also a general belief that people weigh more because they are “big boned”, which is partially true- increased muscle mass and increase in physical frame does cause heavier musculoskeletal weight but may not account for the degree of excess weight that we like to attribute to it.
5.) What is the treatment for obesity?
Initially I recommend that you discuss your weight and individualized goals and plan with your physician. It is important to make sure there are not underlying medical problems causing weight gain such as endocrine diseases or medications that contribute to weight gain. Lab evaluation to evaluate underlying illnesses or complications of obesity need to be performed.
Lifestyle modifications
Diet
Exercise
Medications
Surgery– reserved only for the most severe obesity cases, BMI >40 or BMI> 35 with weight-related health problems
6.) What is something that people may not know about obesity?
I think that people are aware that obesity is epidemic. People are often surprised when we discuss BMI and find that they are overweight or obese, since this has become a norm in our society. Over 60% of adults are overweight and the average person is overweight. People are also surprised when they hear the recommended amount of daily physical activity recommendations. A lot of people feel they are doing great if they exercise 30 minutes three times a week. This actually falls short by 1 hour of the weekly recommends exercise time, which is 150 minutes weekly for adults. I am surprised how many adults admit that they do not exercise at all. I recommend starting slowly with exercise such as 3 10 minute walks daily, finding something you enjoy doing, and setting a goal for 30-60 minutes of exercise daily. With busy schedules, a goal of hourly activity may actually achieve 150 minutes a week.
Additional information:
- Try not to get overwhelmed, depressed, or anxious about being overweight or obese.
- Set the goal of a healthier lifestyle.
- I am happy when I see obese patients and they have increased activity, controlled htn and diabetes and stopped progressively gaining weight.
- Do not avoid your doctor if you have failed to achieve weight goals- we are there as your advocate and want to help you maintain the best lifelong health possible.
- See your physician to make sure you are controlling weight related diseases.
- Monitor weight. Consider other barriers to weight gain such as alcohol intake or depression.
- Use lifestyle improving apps- such as fit bit, step counters, or lose it app which help you measure diet and activity, so that you can balance them for a healthy lifestyle.