medical column 1-1-13
Each year, the percentage of people affected by obesity continues to rise in the United States. Diagnosis, management and treatment have become essential foci in all aspects of healthcare.
According to the American Heart Association (www.heart.org), the U.S. is now in the grips of a full-blown obesity epidemic. More than 35 percent of U.S. adults and 16.9 percent of children are obese. On their current trajectory, it is estimated that obesity rates for adults could reach or exceed 44 percent in every state by 2030.
Although several classifications and definitions for obesity exist, the most widely accepted are those from the World Health Organization, a formula based on Body Mass Index. Body Mass Index, commonly referred to as BMI, is a measurement of body fat based on height and weight that applies to adult men and women. Three grades are used to designate the results of this formula. Grade one is commonly called “overweight” and is designated by a body mass index of 25-29 kg/m2. Grade two is called “obesity,” with a BMI of 30-39.9 kg/m2. Finally, grade three, “severe or morbid obesity,” has a body mass index greater than 40 kg/m2.
Recognizing and treating obesity is paramount for health practitioners worldwide. Minimizing the risk of becoming affected by obesity is essential for all adults, children and adolescents. Early recognition is the best approach. All people should be aware of their BMI to prevent the potential health hazards associated with obesity, especially those with a family history of obesity, hypertension, cardiovascular disease and diabetes. To determine your risk of obesity, your family physician can perform a screening assessment of your BMI. The physician can then effectively implement an individualized health treatment plan.
There are several treatment options available for the grades of obesity. The first step always involves two pivotal lifestyle modifications. Many physicians suggest dietary changes to lower the daily caloric intake. Consuming a smaller percentage of fats and carbohydrates and better balancing proteins and vegetables can greatly reduce your overall health risks. Physicians suggest partnering dietary changes with an exercise program. It is important to discuss all exercise options with your doctor to determine a safe level of physical activity. Safe levels of physical activity are individualized and based on a person’s overall health and medical conditions.
Other treatment options may include medications and/or surgery. These alternatives are typically reserved for those with higher grades of obesity. Your healthcare physician will determine if medication is the right treatment for you. Generally, anti-obesity prescription medications affect dietary intake, impair dietary absorption or increase energy expenditure. In addition, there are several surgical procedures used to effectively treat higher grades of obesity. A board-certified bariatric surgeon, working in conjunction with your primary care physician, can best determine which procedure is right for you.
Overall, obesity is a serious condition that requires recognition and treatment. People affected by obesity oftentimes are discouraged to seek treatment, but with motivation and a qualified team of healthcare professionals, successful outcomes can be achieved. ••
Richard Berger, D.O., practices family medicine with EPIC Physician Group at 8019 Frankford Ave. in Holmesburg.