Conditions InDepth: Obesity

by Ricker Polsdorfer, MD

Overweight and obesity are defined as having a body mass index [BMI] greater than or equal to 25 and 30, respectively. In children, the BMI is based on growth charts. Being overweight and obese occur when calorie intake is consistently greater than the number of calories burned through activity and basic metabolic processes.

According to the World Health Organization (WHO), there are 1.6 billion overweight adults and more than 400 million obese adults worldwide. And these numbers are expected to rise. In the US, the National Health and Nutrition Examination Survey reports that an estimated 66% of adults are either overweight overweight of which 33% are considered obese. American children and teens are also affected. An estimated 32% of children and young adults aged 2-19 are either overweight or obese.

Complications of Obesity

Being obese can increase your risk of death. For example, being overweight or obese during late adolescence can shorten life expectancy in adulthood. Obese people over the age of 65 face this risk, as well. Researchers have also found that people with a high waist circumference or waist-to-hip ratio have an increased risk of death.

Other complications of untreated obesity include:

Decreased energy
Heart disease
High blood pressure
High blood pressure during pregnancy
Type 2 diabetes
Gallstones
Worsening arthritis symptoms
Joint problems, back pain
Increased risk of certain cancers
Gout
Infertility
Sleep apnea
Poor self-image, depression
Urinary incontinence

What are the risk factors for obesity?
What are the symptoms of obesity?
How is obesity diagnosed?
What are the treatments for obesity?
Are there screening tests for obesity?
How can I reduce my risk of obesity?
What questions should I ask my doctor?
Where can I get more information about obesity?

References:

August GP, Caprio S, Fennoy I, et al. Prevention and Treatment of Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion. J Clin Endoc Met. 2008;93:4576-99.

Barlow SE, and Expert Committee: Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007;120(Suppl)S164-S192).

Mechanick JI, Kushner RF, Sugerman HJ et al: American Assocaition of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nautritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient. Endocrine Practice. 14(Suppl 1) July/August 2008.

Snow V, Barry P, Fitteman N, Qaseem A et al: Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med. 2005;142:525-31.

American Obesity Association website. Available at: http://www.obesity.org/ .

Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA . 2002;288:1723-1727.

Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Obesity and overweight. World Health Organization website. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html . Updated September 2006. Accessed April 16, 2009.

Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA . 2002;288:1728-1732.

Trends. Center for Disease Control website. Available at http://www.cdc.gov/nccdphp/dnpa/obesity/trend/index.htm . Updated July 2008. Accessed April 16, 2009.

9/30/2008 DynaMed's Systematic Literature Surveillance http://www.epnet.com/dynamed/what.php : Samuels-Kalow ME, Funai EF, Buhimschi C, et al. Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am J Obstet Gynecol. 2007;197:490.e1-6. Epub 2007 Aug 21.

12/2/2008 DynaMed's Systematic Literature Surveillance http://www.epnet.com/dynamed/what.php : Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105-2120.

2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.

4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Neovius M, Sundström J, Rasmussen F. Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ. 2009 Feb 24;338:b496.

10/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7:352-356.

1/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171(2):135-54.

1/29/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Kuk JL, Ardern CI. Influence of age on the association between various measures of obesity and all-cause mortality. J Am Geriatr Soc. 2009 Sep 15.

Last reviewed November 2009 by David Juan, MD
Last Updated: 1/29/2010

Headlines

Conditions InDepth: Obesity

Complications of Obesity

References: