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Definition Of Obesity

Obesity used to be considered a cosmetic problem that was a result of overeating and too little self-control. However, the W.H.O. and scientific and medical societies worldwide now understand that it is a disease that is both progressive and chronic, and there are many genetic and environmental factors.

A Chronic Disease

In the U.S., more than 78 million people suffer from obesity. It is one of the top preventable causes of death in the U. S.

Obesity is a costly disease that hurts its sufferers financially and harms their physical health, emotional health, and well-being as a whole. Obesity is a progressive disease that gets worse over time.

Today in the U.S., more than one out of every three Americans is obese.

Since 2003, the obesity rates in the U.S. have remained steady, but they are more than double the rate they were in 1980. The obesity rate is the highest among all the wealthy countries in the world.

If the trend continues, by 2030, about half of all adults will be obese.

This disease is pervasive and chronic, and it gives sufferers a higher risk of many health problems, including high blood pressure, diabetes, and heart disease.

Obesity is a multifactorial disease, and genetics plays a strong role. Genetics come into play via many factors, including metabolic, behavioral, cultural, hormonal, and psychological factors that cause fat accumulation and lead to weight gain.

Positive Energy Balance

Having a positive energy balance leads to weight gain. When the energy intake, the number of calories taken in, is more than the energy expenditure or the number of calories used in exercise, daily activities, and biological functions. This positive energy balance can be caused by not doing enough physical activity, or it can be a result of overeating.

There are also other conditions that affect your energy balance and your fat accumulation, and these do not include overeating or being too sedentary.

  1. Not getting enough sleep
  2. Eating foods that, outside of their number of calories, cause hormonal or metabolic changes that can increase your amount of body fat. These foods include those that are high in processed grains, high in sugar, fat, high in high fructose corn syrup and processed meats.
  3. Eating not enough foods that fight fat. These include legumes, vegetables, fruits, seeds, nuts and high-quality protein.
  4. Being under heavy stress and/or psychological upset
  5. Certain medications
  6. A number of pollutants

Prevalence Of Obesity

The W.H.O. estimates that about 65% of the people in the world live in countries that have more people dying from being obese than they do from being underweight. Among the adults in the world, about 500 million are affected by obesity. Nearly a billion adults and 48 million children are affected by being overweight.

In the U.S., the data reported from a long-term study has measured thousands of Americans’ body sizes. This ongoing study has revealed that for those over age 20, more than 34 % of people are obese. A full 68% of them are overweight according to data from 2007-2008. For children ages 2-5, 10% of them are obese. Among kids between the ages of 6 and 11, 2% of them are obese. For adolescents, 18% are obese.

In the last 20-25 years, the number of those affected by obesity has risen at an alarming rate. There has been an ongoing study by the CDC since 1985 to study changes in each state of their obesity prevalence. The study has found that:

  • In 1990, most states had an obesity prevalence of 10% or even less.
  • In 1995, a prevalence of 15% was found in more than 25 states.
  • In 2000, there was a prevalence of at least 20% in almost half of the states.
  • In 2005, an obesity prevalence of more than 20% was found in 47 states, and almost a third of the states had at least 30%.
  • In 2010, most states had about 20%, and many states had at least 30%.

Measuring Obesity And Body Mass Index (BMI)

Obesity is a disease marked by the accumulation of too much body fat. Many instruments can determine how much fat is in the body versus how much lean tissue it contains. But, these instruments are expensive, and it takes time to do assessments for body fat. When clinically diagnosed, there is an estimate of the body’s fat amount based on the patient’s height, build, and weight.

Obese and overweight are the terms used for weight ranges higher than the range of healthy weights.

The body mass index, or BMI, is most commonly used to measure patients for obesity.

It gives an approximate estimate of body mass by using a calculation of both height and weight.

However, in athletes and bodybuilders, the BMI measurements may be an inaccurate way to determine obesity, as the BMI doesn’t show any difference between body fat and muscle.

The BMI can be used to define obesity and overweight, and it is more accurate than IBW in estimating fatness. Large studies have shown that BMI is a good general reflection of a patient’s extra body fat in adults. The exceptions to this include the BMI of an athlete, the elderly, a pregnant woman, and a bodybuilder. The BMI doesn’t have a way to measure the distribution of fat in a person, such as peripheral fat or abdominal fat. It also does not measure the patient’s metabolic activity of their fat tissue.

BMI has determined a number of categories of body size based on the association between BMI numbers and the risk of death. The BMI numbers and their categories are:


BMI Range

Normal Size

18.9 to 24.9


25 to 29.9

Class I, Obesity

30 to 34.9

Class II, Serious Obesity

35 to 39.9

Class III, Severe Obesity

40 and greater

Lower BMI

Lower BMI is a weight range that is between a BMI of 30 and 40. This range is on the lower end of the spectrum of obesity, but a person in this range is still obese and runs a risk of developing other health problems. Right now, those who have lower BMI have few options for weight loss- exercise and dieting are their only options, as bariatric surgery requires patients to have an MBI of at least 35 if they have comorbidities and 40 if they don’t.

Causes Of Obesity

In general, obesity is caused by having a higher number of calories taken in than is burned through activities and exercises.

Many genetic, environmental, and behavioral factors influence obesity. These include: medications, an unhealthy diet, a lack of sleep, medical problems, inactivity, pregnancy, and metabolism.

Consequences & Quality Of Life

There are more than 30 health conditions that can be caused by obesity. These chronic conditions include high cholesterol, sleep apnea, type 2 diabetes, hypertension, gastroesophageal reflux disease (often called GERD), heart disease, numerous cancers, asthma, and various other respiratory problems.

Obesity also affects a person’s general quality of life, as it causes shame, depression, sexual problems, guilt, social isolation, and performing less well at work.

Economic Impact

Obesity impacts the U.S. healthcare system directly.

The medical costs that stemmed from obesity cost $147 billion in 2008 alone.

If the trend of obesity becoming more common continues, by 2030, the medical costs associated with obesity could cost an additional $43 to $66 billion every year.