Today, 64.5 percent of adult Americans (about 127 million) are categorized as being overweight or obese. Each year, obesity causes at least 300,000 excess deaths in the U.S., and healthcare costs of American adults with obesity amount to approximately $100 billion. We all have and need fat tissue in our bodies. When there is too much body fat, the result is obesity. Obesity is not a sign of a person being out of control. It is a serious medical disease that affects over a quarter of adults in the United States, and about 14% of children and adolescents. It is the second leading cause of preventable death after smoking.

Obesity is an excess of total body fat, which results from caloric intake that exceeds energy usage. A measurement used to assess health risks of obesity is Body Mass Index (BMI). BMI is calculated by dividing body weight (lbs.) by height in inches squared (in2) and multiplying that amount by 704.5. The metric calculation for BMI is kg/m2.

The ideal Body Mass Index (BMI) is between 19 and 25. If you have a Body Mass Index of between 25 and 30, you are considered to be overweight. At a BMI of 30 or over, you are considered obese. A BMI of 40 or more indicates severe or "morbid" obesity.

Morbidly obese patients are those who are least 100 pounds overweight, a BMI greater than 40, and with conditions called co-morbidities. Co-morbidities are things such as diabetes, osteoarthritus, hypertension and sleep apnea. There is also an increased risk of early death due to obesity.

Co-Morbidities

Co-morbidities are secondary illnesses that are caused by a person being obese. Patients may experience emotional and social effects of their disease as well.

High Blood Pressure

Persistently elevated blood pressure, or hypertension, is much more common in people who are obese. Hypertension can lead to the development of heart disease, kidney disease, stroke and arterial blockage.

Heart Disease

Heart Disease is seen 6 times more commonly in obese persons which can lead to heart attack and congestive heart failure. In fact,severely obese persons are 40 times more likely to die suddenly from a heart attack.

High Cholesterol

Level High blood cholesterol levels are more commonly associated with obesity and contribute to heart disease and high blood pressure.

Diabetes

Diabetes mellitus, specifically Adult-Onset or type II, is 10 times more common in obesity. Persistently elevated blood sugar leads to tissue damage including kidney failure, blindness, heart failure, stroke, and arterial blockage which can result in amputation.

Respiratory Problems

Being overweight is commonly accompanied by the feeling of "being winded" and the need to stop and catch a breath. This is caused by a heavier chest wall which makes full expansion of the lungs more difficult. Any activity that requires a greater demand for oxygen, results in shortness of breath. Exercise, or even daily activities such as climbing up stairs, housework or running to catch a train, become difficult to perform. Respiratory insufficiency becomes disabling.

The major breathing problems caused by severe obesity are sleep apnea syndrome and obesity hypo ventilation syndrome. Sleep apnea is when a person stops breathing during sleep. In an overweight person, this is caused by fat compressing on the neck, which causes loud snoring and periods of apnea. This results in poor quality and restless sleep due to the lack of oxygen, and the subsequently daytime drowsiness. Most people are unaware that they have this problem, but the health effects can result in cardiac rhythm disturbances, and even sudden death. Obesity hypo ventilation syndrome typically occurs in people over 350 pounds, and manifests as shortness of breath, even when resting. These people are unable to bring enough oxygen to their organs and tissues, and this may result in heart failure, lung failure and thicker blood which may predispose to blood clots.

Gastroesophageal Reflux

Acid reflux, or heartburn, is a common occurrence in obese persons for several reasons. The acid in the stomach is normally prevented from going back up the esophagus, or swallowing tube, by a valve. The valve can be overcome by increased pressure in the stomach, which can be caused by a large meal especially if one lies down afterwards. The weight of a heavy belly pushing on the stomach can not only cause food and acid to go up into the esophagus to cause burning, but if severe, can go all the way up into the air-pipe (or trachea) and be inhaled. This can result in a severe pneumonia or lung injury. Constant exposure of the esophagus to acid can also increase the risk of cancer.

Stress Urinary Incontinence

Pressure of a heavy belly against the bladder is the cause of urinary incontinence in women. The increased pressure from a cough, sneeze or laugh can overcome the strength of the bladder valve to result in leakage of urine.

Degenerative Arthritis

Degenerative arthritis of the lower back and weight-bearing joints (hips, knees, ankles, feet) is the "wear and tear" of bones which are carrying a greater body weight. Arthritis in the lower back can lead to nerve compression and chronic pain. Arthritis in the joints can cause problems walking and may eventually require joint replacement surgery. Many orthopedic surgeons refuse to perform surgery in severely obese patients.

Venous Stasis Disease/Ulcers

The veins of the legs successfully carry blood back to the heart against gravity because they have one-way valves. These valves are more likely to breakdown if there is a greater resistance for the blood to flow against. This resistance is caused by the weight of a heavy abdomen. When the valves fail, the legs become swollen, discolored and may even develop ulcers. Venous disease can be debilitating and rarely improves without weight loss.

Cancer

Studies have shown that overweight women have a higher risk of cancer of the breast, uterus and ovaries. Obese men have a higher risk of having colon and prostate cancer.

Skin Infections

Many overweight persons have skin that folds over on itself. The areas within the creases can become irritated from sweating and chafing. This can often lead to infections despite frequent bathing, and causes pain and discomfort. Skin cuts created from bra straps can also cause pain and become infected.

Infertility

The excess fat in women plays a significant role in changing the levels of estrogen and progesterone, resulting in irregular menstrual cycles and infertility. This is reversible once weight loss is achieved, and in fact, women should be aware of using birth control if pregnancy is not desired.