Obesity, Morbid Obesity and Super-Morbid Obesity
Obesity is often defined in terms of its relationship to the body mass index (BMI). Although the use of the BMI over-estimates obesity in muscular individuals it is a very useful test to help draw the line between those that are overweight and the truly morbidly obese.
There is much debate as to whether being “overweight” by BMI numbers actually has an adverse overall impact on health, wellness or lifespan – the caveat being that one must be physically active – but there is no such debate once the BMI exceeds 40.
As the name suggests, morbid obesity means that the degree of obesity is such that illness (morbidity is the fancy name for this) results. It IS associated with an increased risk of premature death (mortality) and, as such, needs to be taken seriously.
Simplistic analysis observes that obesity relates to diet and exercise.
As a gastroenterologist I do have an interest in nutrition. Not the latest fad “diet” (which is usually used to mean restricting types or amounts of certain foods) but rather meaningfully understanding how our regular food intake, our true diet, shapes us literally (our real body shape) not figuratively (imaginatively).
The types and forms of foods eaten has a direct impact on, for example, the amount of blood sugar rise and the rate of such rise, the glycemic index, has an impact on the body’s hormonal – regulatory and counter-regulatory – response. These hormones are produced by the stomach and elsewhere in the GI tract including the pancreas. These, in turn, have effects on our brains, influence our desired or subsequent intake, and an impact on our perception of fullness. But eating has emotional and social components as well. And it possible, over time to “train” the brain to ignore feelings of fullness and to overeat as a habit.
Interestingly one’s existing body fat also elaborates hormones that influence our metabolism.
Furthermore, one of the latest lines of research reveals that our normal flora (also known as the biome, the bugs that live within us), also have an impact on the body’s metabolism. This has raised the potential for beneficial effects of altering our biome though the use of probiotics.
Medication side-effects may contribute to obesity. There are rare conditions that can contribute to this health issue.
As always, a thoughtful history and physical exam by a gastroenterologist go a long way to determine what is going on. Recommendations to change diet, increase exercise and fluid/fiber intake may well follow. Trials of probiotics may be suggested.
Based in the heart of uptown and the Garden District of New Orleans, Dr. Huilgol (”Dr. Viv”) and the team at NOLA Gastro is committed to working with you to investigate what is going on, so you can make the correct choices for you.
GI health matters. Let’s work it out together.
Call 504-249-5901 and make an appointment.