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Monday, July 29, 2013

Obesity: The Pandemic

Obesity is defined as abnormal or excessive fat accumulation that may impair health.

Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2).

The WHO definition is:

a BMI greater than or equal to 25 is overweight
a BMI greater than or equal to 30 is obesity.

Obesity is a major public health problem in the world. Two thirds of adults in the  US are overweight, and one third are obese. Being obese increases the risk for other diseases: high blood pressure, heart disease, type 2 diabetes, osteoarthritis, sleep apnea, and even some cancers.

The American Medical Association (AMA) House of Delegates has in June 2013 redefined Obesity from a major public health problem to a Disease. After much debate, the majority ruled that obesity is a disease state with multiple pathophysiologic aspects requiring a range of interventions to advance obesity treatment and prevention. 

This has now given an entirely different perception to this potentially hazardous malady. 


The two sides of the coin

  • Here's the downside of calling obesity a disease. Some worry that this would medicalize obesity and intensify reliance on drugs and surgical treatments rather than relying on diet and exercise to attain a healthy weight. Another concern is that calling obesity a disease could alienate some obese individuals, especially if the emphasis is on achieving ideal weight rather than focusing on healthy eating and increasing physical activity. 
The Body mass index (BMI), that obesity is defined on the basis of, has many limitations. It was originally designed as a research tool: a rough population-level indicator. It's not a great way of measuring body fatness. Some people with a BMI in the so called "normal" range can have too much body fat, as well as metabolic problems. Some with BMIs over 30 kg/m2 -- the so-called obese range -- have plenty of muscle and no excess fat . Some with high BMIs are normal metabolically and also have normal blood pressure and cholesterol levels.

The BMI defines size, not health. 

The National Heart, Lung, and Blood Institute is now working on new guidelines on overweight and obesity in adults. 

  • Here's the pro side. Calling obesity a disease could mean greater investments by the government and the private sector: more research into causes, triggers, and treatments, including more US Food and Drug Administration (FDA)-approved drugs for treatment. Another benefit of making obesity a disease is that it could make it harder for third-party payers to deny coverage.

Obesity paradox: 

A collection of studies suggests that BMIs in the overweight or obese range may have protective effects on mortality risk. 
Experts have suggested that body fat may play a protective role, perhaps in secreting certain beneficial cytokines and hormones. Extra body fat also means extra padding and thus a physical protective barrier from traumatic injuries. In times of illnesses, the additional caloric reserve may give patients more nutritional backup in the healing process. 

However, the ill effects of the excess fat are too pronounced to be ignored. 

The most important advanced technology with which to fight obesity is the bathroom scale, used every day. Don't let that number rise. 

Obesity, after being categorized as a disease, we can now expect that the development of gray hair or the aging process- Senility, to be the next condition considered as a disease.


  1. Gud article. Obesity doesn't run in families,main problem is nobody runs in the family. Gud humor.

  2. Yes that line also struck me and the article is also good