Words that matter: What is obesity and why does it matter?

Healthcare professionals, educators, employers, and elected officials agree that overweight and obesity (I will explain the difference later) are significant health problems in the United States, and now worldwide. It is one of the most written and talked about issues in the media; every health and fitness publication gives extensive coverage to it, as well as lifestyle, women’s, and even news magazines.

We need to understand what it is and what it is not. When I was in an office  practice, patients often wanted to discuss their weight, and how to weight less. Some people felt overweight because they weighed more than they did as a young adult, or  more than they weighed five years ago. Sometimes it was because they no longer fit into their clothes, or because it was harder to be physically active. Some of these people met the medical definition of overweight/obesity, but often they did not.

Conversely, some people who were significantly overweight ,even obese,  never mentioned their weight as an issue of concern. Sometimes they seemed surprised when I told them that they weighed too much. I supposed they had been heavy for so long that they considered it normal, or were just resigned to it.

The simplest definition of overweight/obesity is excess weight specifically due to excess body fat ( adipose tissue.)

In Stedman’s Medical Dictionary it is “excess subcutaneous fat in proportion to lean body mass.” 

To determine excess weight,  physicians use the body mass index, BMI, which is the weight in kilograms divided by height in meters squared. Since most of us in the United States are not fluent in the metric system, or capable of math computing in our head, there are charts, apps and on-line calculators which do the work for us. Electronic health records calculate it automatically also.

So depending on what your BMI is, you may be underweight, normal weight, overweight or obese as illustrated by this chart.

via BMI Chart – Printable Body Mass Index Chart – BMI Calculator.

BMI Chart created by Vertex42.com. Used with permission.
BMI Chart created by Vertex42.com. Used with permission.

There are similar charts for children which also take into account age.

You can purchase a tape measure that includes BMI calculation at this affiliate link.

Weight matters because both underweight and overweight/obesity are associated with significant health issues. (I’m only going to address excess weight right now.)

 

Some of the medical conditions that have been associated with excess weight include

Cancers of the breast, uterus, colon and esophagus

Coronary artery disease (CAD) aka ischemic heart disease,  which can lead to heart attacks, congestive heart failure and sudden cardiac death

Hypertension, a risk factor for CAD and stroke

Diabetes mellitus

Gout

Obstructive sleep apnea

Osteoarthritis (degenerative arthritis)

Non alcoholic fatty liver disease

Infertility

Pregnancy complications including diabetes, pre-eclampsia

 

And there is another factor that helps us recognize and define obesity- Waist size- it matters too.

 

Here is more information about the health risks of obesity from the Harvard School of Public Health

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