Numbers of Severely Obese Rising Sharply

< Apr. 11, 2007 > -- The proportion of severely obese Americans - those with a body mass index (BMI) of 40 or more - increased by 50 percent from 2000 to 2005, twice as fast as the increase in moderate obesity, a new study finds.

During that same period, the proportion of overweight people (BMI of 30 or more) increased by 24 percent, and the proportion of those with a BMI of 50 or more increased by 75 percent. In the past 20 years, the largest percentage increases have occurred in the heaviest weight groups, the RAND Corporation study says. RAND is a nonprofit research organization.

Body mass index is a ratio of weight to height. A typical severely obese man weighs 300 pounds at a height of 5 feet 10 inches, while a typical severely obese woman weighs 250 pounds at a height of 5 feet 4 inches.

Excess Weight and Health Costs Increase In Tandem

"The proportion of people at the high end of the weight scale continues to increase at a brisk rate despite increased public attention on the risks of obesity and the increased use of drastic weight loss strategies, such as bariatric surgery," reports author Roland Sturm, PhD, a RAND  economist.

The study concluded that three percent of Americans are severely obese. Health costs for severely obese people are expected to be double that of normal weight people, while health costs for moderately obese people are expected to be 25 percent more.

One Popular Option: Bariatric Surgery

From 1998 to 2003, the number of bariatric surgeries in the US increased from 13,000 to 100,000. An estimated 200,000 bariatric procedures were done in 2006, the study says.

There are several approaches to bariatric surgery, but all procedures are either malabsorptive, restrictive, or a combination of the two.

Malabsorptive procedures change the way the digestive system works. Food is re-routed past a large portion of the stomach and part of the small intestine that absorbs some calories and nutrients. With some procedures, a portion of the stomach is removed. These procedures are commonly referred to as “gastric bypass” procedures.

Restrictive procedures severely reduce the size of the stomach to hold less food, but the digestive functions remain intact. This type of procedure may be referred to as a "gastric stapling" procedure.

Typically, malabsorptive procedures result in more weight loss than restrictive procedures.

"The explosion in the use of bariatric surgery has made no noticeable dent in the trend of morbid obesity," according to Dr. Sturm.

Gradual Weight Loss is Best

Dr. Sturm says the study findings suggest that severe obesity is not a rare condition among certain genetically vulnerable people but, rather, is an integral part of the US population's weight distribution. As the entire population becomes heavier, there are more and more severely obese people.

Treatment for obesity works best if it the goals are individualized. For example, it is safe to lose one to two pounds per week, but a person may be more comfortable losing at the rate of one-half pound per week. Over one year, that is a 24-pound loss and, if that rate is maintained over three years, will lead to a significant 78-pound loss.

Whatever treatment plan a person follows, losing weight slowly will be more effective and healthy over the long term because quick weight loss often spurs weight regain.

Always consult your physician for more information.

Major Health Effects of Obesity

Obesity has a far-ranging negative effect on health. Each year obesity-related conditions cost over 100 billion dollars and cause an estimated 300,000 premature deaths in the US. The health effects associated with obesity include:

• high blood pressure
  Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels.

• type two diabetes
  Obesity is the major cause of type 2 diabetes. Obesity can cause resistance to insulin, the hormone that regulates blood sugar.

• heart disease
  Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese.

• osteoarthritis
  Obesity can affect the knees and hips because of the stress placed on the joints by extra weight.

• sleep apnea
  Sleep apnea, which causes people to stop breathing for brief periods, interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. Sleep apnea is also associated with high blood pressure.

Always consult your physician for more information.