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About Obesity

What is Obesity?

Obesity is emerging as a health epidemic around the world. 


According to the Centers for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups. Obesity is the second leading cause of preventable death after smoking.


Obesity is not a simple condition, it is a serious, chronic disease where  your body fat has accumulated to the extent an abnormally high amount of body fat in relation to lean body mass.


Obesity occurs when an individual’s body weight is in excess of the healthy range for their height leading to a high percentage of body fat. It is a serious, chronic disease that impairs health.


Obesity is commonly measured by body mass index (BMI) and this is used to assess health risks of obesity. Your BMI calculates the relationship of weight to height. An adult with a BMI of 30 or more is considered obese. 

Who is Affected by Obesity?

The incidence of obesity in Australia is increasing at an alarming rate. Australia is today ranked as one of the fattest nations in the developed world. The prevalence of obesity in Australia has more than doubled in the past 20 years.
Too many Australians are at high risk of serious diseases and premature death because of excess body weight or obesity.
  • 7 million Australian adults are overweight or obese, 
  • Over 68% of Australian adult males are either overweight or obese 
  • Over 55% of Australian adult females are either overweight or obese, and alarmingly
  • 23% of children younger than 16 are either overweight or obese.
% of adult population classified as obese or overweight
The results of the survey reveal that there has been increasing rate of weight gain in the Australian population when compared to the past years. This relates to the changes in the environmental and socio-economic conditions. 
References:
  • Talbot ML, Jorgensen J and Loi KW. Difficulties in the provision of bariatric surgical services to the morbidly obese. Med J Aust 2005; 182: 344-47
  • O'Brien PE, Brown WA and Dixon JB. Obesity, weight loss and bariatric surgery. Med J Aust 2005. 183(6); 310-314.
  • World Health Organisation (WHO). Obesity and Overweight. 2006
  • Australia's Health. Australian Government, Department of Health and Ageing. 2008

How Does Obesity Affect You?

Experts estimate that between 12,000 to 17,000 Australians die prematurely from obesity each year. 

Obesity substantially contributes to:
  • preventable, non-communicable diseases, 
  • shortened life-expectancy and
  • impaired quality of life.
Obesity is a major risk factor for chronic conditions, if left untreated, obesity can lead to a number of serious health issues including: such as:
  • Type 2 Diabetes, 
  • Coronary Heart disease, 
  • Hypertension or High Blood Pressure, 
  • Stroke, 
  • Musculoskeletal Disorders and Arthritis, and 
  • Impaired psychosocial functioning.
  • Certain cancers
  • Respiratory disorders
  • Sleep apnea
Obesity is now challenging smoking as the major cause of potentially preventable death in Australia

The good news is that major weight loss can lead to partial or complete control of a wide range of these diseases and related health problems.

Changing Perceptions

Before

In the past, obesity was seen as a weakness or failure of the individual. Diet and exercise were prescribed treatments and weight loss surgery viewed as dangerous and extreme.

Today

Now, obesity is considered a disease and the cause of many serious health conditions. Obesity is no longer considered a cosmetic issue due to eating too much. The World Health Organisation (W.H.O) from 2013 recognizes obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

Weight Loss Surgery has gained acceptance as a proven method to treat this disease. But surgical treatment is not for all obese patients.

What are the Causes of Obesity?

Weight gain and long-term obesity can be caused by a number of factors. These multifactorial can involve a combination of causes or risk factors including:
  • Energy Imbalance: Obesity happens gradually if the amount of energy or calories you consume (caloric intake) is more than the amount of energy usage on your daily activities. 
  • Sedentary Lifestyle: People leading an inactive or sedentary lifestyle are more likely to become obese as they do not burn down the calories they consume. Injuries causing a lack of exercise can also contribute to less movement and calorie burn.
  • Environmental Factors: Lack of safe places for exercising and walking (sidewalks or parks), busy work schedule, eating larger food portions, and junk food are contributing factors to gain weight.
  • Family History: The genes inherited from your parents have an effect the amount of fat stored in your body and your chances of being obese is higher if one or both your parents are obese. Obesity tends to run in families. Scientists have discovered several genes, which predispose people to obesity. These genes are the FTO, PCSK1 and ENPP1 genes. This explains why obesity often runs in families and why, for the majority of sufferers, diet and exercise alone are simply ineffective, and patients cannot seem to be able to maintain long term weight loss.
  • Excessive Appetite & Overeating: It is thought that the hunger regulating part of the brain called the hypothalamus does not function correctly in people with obesity. In these people the hypothalamus continues to stimulate hunger and food desire all the time, even when your body has plenty of energy reserves. This is frequently genetic, and promotes both overeating 
  • Poor Diet: Poor food choices, and over time leads to obesity. Another important observation is that people who are constantly hungry often seem drawn toward foods that are rich in calories. Such foods are often high in sugar and fat, such as chocolate, fried foods, and sweets.
  • Emotional Factors: Unusual eating habits such as excessive eating when under stress or anger. Overeating will cause weight gain. Comfort eating by turning to food to cope with stress, anxiety and low mood is very common. Chocolate, ice-cream, lollies and chips are usually used as they give a temporary 'hit'. Sometimes a serious or traumatic life event may trigger a person to revert back to using food to help feel better.
  • Age: Ageing results in muscle loss in the body which is even more if you are inactive. Muscle loss reduces the calorie consumption and consequently uncontrolled diet may increase the chances of becoming obese.
  • Disease Conditions: Hormonal disorders such as hypothyroidism, Cushing’s syndrome, and polycystic ovarian syndrome may cause weight gain.
  • Medicines: Certain medicines such as corticosteroids, antidepressants and seizure medications are known to decrease the rate of metabolism, increase your appetite and retain excess water in the body leading to weight gain.

Symptoms of Obesity

Clinical obesity and weight gain can have a negative impact on your physical and mental health. Some symptoms or side effects of obesity include:
  • Low back pain or Backaches.
  • Feeling tired all the time.
  • Heavy sweating.
  • Joint pain (especially weight-bearing knee and hip joints).
  • Low confidence or self-esteem.
  • Shortness of breath.
  • Snoring or Sleep Apnoea.

Obesity Diagnosis

The Body Mass Index (BMI) is the most commonly used method for determining a patient’s weight category. The BMI is calculated by measuring the height and weight of the patient.

Other methods for diagnoses include:
  • Blood tests.
  • Physical exam.
  • Review of family history.
  • Waist measurement.
A GP may ask additional questions about your lifestyle and any potential underlying health issues.

Obesity Classification

Morbid obesity, also referred to as “clinically severe obesity” or “extreme obesity,” 

Clinical Obesity was defined as the criteria for bariatric surgery by the 1991 NIH Consensus Conference Statement on Gastrointestinal Surgery .

Severe Obesity can benefit from Bariatric Surgery when: 
  • BMI Range ≥ 40, or 
  • BMI Range ≥ 35 combined with a high-risk co-morbid condition.
Obesity Classification BMI Range
Healthy Range 18.9 to 24.9
Overweight 25 to 29.9
Class I, Obesity 30 to 34.9
Class II, Serious Obesity 35 to 39.9
Class III, Severe Obesity 40 and over

Obesity Treatments

There are a number of options available for those who want to treat their obesity:
  • Diet
  • Exercise
  • Medication
  • Behavioural modification
However - for individuals suffering from obesity or long-term issues associated with excess weight, Bariatric (weight loss) Surgery is the only proven long term effective treatment.

Obesity surgery or weight loss surgery helps over 25,000 Australians per year manage their hunger and weight related illnesses.

There has been an increase in the number of weight loss procedures performed in Australia in the last 10 years according to Medicare data using item number #30511 (morbid obesity, gastric reduction or gastroplasty for, by any method).
REFERENCE; Meta-Analysis. JAMA 2004;292:1724
  • reduces overall and cause-specific mortality
  • reduces obesity-related co-morbidities
  • reduces medication costs
  • reduces sick days
  • improves QOL.
  • benefits strongest in BMI>40
  • 61% mean overall EWL
  • greatest weight loss with LRYGB
  • overall mortality < 1%
  • morbidity approx. 20%
  • Diabetes -77% resolved, 86% improved
  • Hypertension - 62% resolved, 79% improved
  • Hyperlipidemia - >70% improved
  • Obstructive Sleep Apnea - 86% resolved, 84% improved
  • Gastro Oesophageal reflux improved
  • Urinary stress incontinence decreased by 47%New Paragraph
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