Medical matters: The slim deal on obesity epidemic

med­ic­al column 1-1-13

Med­ic­al Mat­ters

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 (, 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.

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