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Why Weight Matters: Obesity and Your Health

By: Robert Kushner, MD

We are a growing nation. In fact, according to the National Institutes of Health, more than sixty percent of Americans aged twenty years and older are overweight, and one-quarter of American adults are also obese.

What does this mean for the health of our nation? Nothing good. Obesity-related diseases are "implicated" in more than a quarter million deaths every year. Below, Dr Robert Kushner, Director of the Wellness Institute at Northwestern Memorial Hospital, discusses the grave consequences of our growing sizes.

How serious is the problem of obesity?

ROBERT KUSHNER, MD: It's the most serious problem we are facing today. Next to cigarette smoking, overweight is the second leading cause of preventable death in this country. It's estimated that 300,000 deaths per year is attributable to our diet, physical inactivity and resulting obesity.

What are the current statistics on overweight and obesity?

One in four is obese, and about one in three is considered overweight. Combined, over 60% of adult Americans are now overweight or obese. That means that the minority of this population is able to maintain a healthy body weight.

We're now hearing a lot about children being obese. What is the number there?

It's about 1 in 10, or 10%. The troubling factor there is that children are following in our oversized footsteps. An overweight or obese child is more likely to be an obese adult. So we are looking at an epidemic among our children as they become adults, and are likely to be more obese than we are today.

Why has the number of heavy people increased?

That's still debatable, and a lot of research is being done. But most of us think that it's due to our society and culture. We really live in an obesogenic society where food is plentiful, physical inactivity is everywhere. Those two factors combined lead to gaining weight.

How is obesity defined?

We currently define obesity by using a term called the body mass index, also known as the BMI. Everyone knows their cholesterol and everyone knows their blood pressure. It's equally important that everyone knows their BMI. It's a weight for height relationship that's fairly easily calculated on tables. A BMI between 25 and 30 is defined as overweight. A BMI of 30 or more is obese.

Roughly speaking, about 30 or more pounds overweight already defines one as obese.

Just 30 pounds?

Just 30 pounds. It doesn't take much to have the health complications that are associated with obesity.

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Talk about those complications, the health effects of obesity

Obesity is the major cause of type 2 diabetes in this country. Obesity is the number one reason why diabetes is increasing in this country. It is fueling that disease. In addition to diabetes, obesity is also linked to increased risk of high cholesterol, high blood pressure, gastroesophageal reflux disease, certain cancers, in addition to psychological and emotional problems, as well as quality of life changes. It eventually leads to earlier death.

What are the leading causes of obesity?

The most significant factor really is our lifestyle. That's the only way that we can understand why the numbers of obese patients or individuals has risen so quickly. Again, that's the food that's everywhere and the physical inactivity.

But genetics plays a role as well. We currently think that genetics determines a vulnerability to our environment, which then brings out the obesity.

There are other causes, although less common. They include drug-induced obesity, such as people on different corticosteroids or different hormonal agents. Those medications can increase body weight, not to mention things like antidepressants and other drugs used for mental health disorders.

Rarely is an underlying medical condition a cause for obesity. That would be something like Cushing's syndrome or different kinds of glandular problems. But they are, once again, very uncommon.

What is the first step in getting treatment for obesity? Where does a person go for help?

There are several places an individual can go for help. One is, and the first that I would recommend, is to see his or her doctor. A doctor should be an active partner to a patient who is trying to get control of body weight. The doctor can also make sure that you don't have an underlying problem that is either being caused by obesity or causing the obesity itself. That needs to be ruled out right away.

Once you've done that, you can either work with your doctor or work with a registered dietitian or seek help with some of the commercial programs that are available, which can be very helpful.