What is obesity? Why is it so important I lose weight? I’ve been trying to lose weight for years but have not been successful; is there something else wrong with me? How can I lose weight and keep it off?

These are some of the questions we hear from our patients regularly. It may even be a question you have had for your health care provider.

The fact is, according to the Centers for Disease Control and Prevention (CDC), nearly two out of three Americans are either overweight or obese. Obesity increases the risk for development of numerous medical problems such as diabetes, hypertension, cardiovascular disease, lung disease, osteoarthritis and certain cancers.

In 2002 alone, it was estimated that both direct and indirect costs of being overweight and obese were in the range of $100 billion.

The current widely used screening tool for initial assessment of weight is called the BMI or Body Mass Index. BMI was first developed in the mid-1800s by Adolphe Quetelet, a Belgian mathematician. It is calculated by dividing a person’s weight in kilograms by the height in meters squared.

According to the World Health Organization, this BMI number is interpreted in adults above the age of 20 as follows: BMI below 18.5 is underweight, 18.5-24.9 is normal, 25-29.9 is overweight, 30-39.9 is Class I and II obesity, 40-45 is severe obesity, and 45-50 is morbid obesity.

BMI calculation is the most convenient and economical method, but it does have some nuances that slightly reduce its accuracy. BMI does not take into account the increased muscle mass of an athlete, nor variations based on age, sex and race.

Other methods of assessing body weight are measurement of skin fold thickness, bioelectrical impedance, underwater weight, computerized tomography and dual-energy X-ray absorptiometry. These methods are cumbersome and are not the most cost-effective.

The most common cause of obesity is increased calorie consumption compared to expenditure. Some poor choices and modern conveniences such as computers, cars, fast food and increase in food portion size have limited our daily physical activity and increased our calorie intake.

But did you know that some other factors can play a role in why we gain weight and are unable to lose it?

Certain foods such as chocolate, dairy products, and sugar can cause the release of neurotransmitters, which can bind to receptors of the brain causing a sense of pleasure, similar to opiates like morphine. It has also been shown that some carbohydrate-rich foods can increase serotonin levels to cause an elevation in mood, similar to some antidepressant medications. This is some of the science behind the term “food addiction.”

There are a host of medical and hereditary conditions, medications, and other lifestyle patterns, such as poor sleep, which contribute to obesity. Some of these factors may contribute to gaining weight or making weight loss difficult. Discuss this with your doctor so you can reap optimal results in your weight loss plan.

As always, please consult with your health care provider before initiating any significant changes to your diet, medications, and lifestyle as these changes may affect your current medical regimen and condition. This article is not a substitute for the personalized medical care of your physician.

For more information about obesity, visit these Web sites:

Centers for Disease Control and Prevention: www.cdc.gov

U.S. National Library of Medicine and National Institutes of Health: www.nlm.nih.gov

World Health Organization: www.who.int

Obesity in America: www.obesityinamerica.org

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