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What is obesity?
Many people are concerned about their weight. Society emphasizes being thin, and heavier people often are very aware of their weight and how they are seen by others. We hear in the news that more and more people are becoming overweight and obese—but what does this mean?
Obesity means having too much body fat (adipose tissue). Obesity generally is determined by calculating your body mass index (BMI) , which measures weight for height and is stated in numbers. BMI is not about how you look but rather an indication of the effect your weight has on your health. If you have too much weight for your height, you are at risk for developing health problems, such as type 2 diabetes.
A BMI of 30 or higher is considered obese in adults—you are at a higher risk for certain health problems than those with a lower BMI. As BMI increases, your risk of health problems increases.
Obesity is considered a long-term, complex disease. Many factors are involved in determining why some people are heavier than others and how much risk they have for developing other health conditions. Some of these factors are genetic (you have inherited them) and others have to do with your culture, environment, and behavior.
If your BMI is between 25 and 30, you are considered overweight (and also at increased risk for certain diseases). For information on maintaining a healthy weight, see the topic Healthy Weight.
What causes obesity?
You gain weight when you consume more calories from food than your body uses through its normal functions ( basal metabolic rate [BMR]) and physical activity. The unused calories are stored as fat. You become obese if you consistently consume excess calories over a long period of time. For example, eating an extra 100 calories per day (less than half a turkey sandwich) can lead to a gain of about 10 lb(4.5 kg) in a year. Gaining 10 pounds a year eventually will result in a BMI of 30 or higher.
However, calories alone do not explain weight gain and why some people gain (or lose) weight more easily than others. Other factors that play a major role in weight gain and obesity include:
What health problems does obesity put me at risk for?
According to the U.S. National Institutes of Health, all people age 18 or older who have a BMI of 25 or higher are considered at risk for disease and early death because of being overweight or obese.
If you are obese, you are more likely to develop type 2 diabetes, high blood pressure , coronary artery disease (CAD) , stroke , and sleep apnea , among other conditions. If you lose weight, your risk for these conditions is reduced.
Often overlooked are the psychological and cultural problems associated with being obese. Stereotypes of obese people—such as that they are lazy—and the emphasis our society places on thinness may result in low self-esteem, a poor body image, depression , and eating disorders . Stereotypes also may make it more difficult for an obese person to find a job or to progress in one.
How is obesity diagnosed?
Your health professional will take your medical and family history, do a physical examination, and use your BMI to determine whether you are obese.
Your health professional may measure your waist or determine your waist-to-hip ratio (WHR) to determine how excess fat is distributed on your body. The location of body fat helps determine your risk for other health problems.
If your weight or family history suggests you have an increased risk for developing related health problems, your health professional may want to do more tests. The most common tests are for high blood pressure and blood tests to check for type 2 diabetes, high cholesterol or triglycerides , and thyroid problems.
How is obesity treated?
Because obesity is a chronic disease, it requires long-term management. Treatment focuses on losing weight to improve or eliminate related health problems or the risk for health problems, not to attain an ideal weight. Treatment consists of modifying your eating behaviors, physical activity, and monitoring your behavior, such as tracking what triggers you to eat. Medication and surgery may be used if this treatment is not effective.
Treatment also covers the psychological and social components of obesity. Stress management and counseling may be helpful. Getting family support and creating community contacts help you deal with the stereotypes and other social issues that are associated with obesity
Health Risks Associated With Obesity
Obesity is not just a cosmetic problem. It's a health hazard. Someone who is 40% overweight is twice as likely to die prematurely than an average-weight person. This is because obesity has been linked to several serious medical conditions including:
Doctors generally agree that the more obese a person is, the more likely he or she is to have health problems. People who are 20% or more overweight can gain significant health benefits from losing weight. Many obesity experts believe that people who are less than 20% above their healthy weight should still try to lose weight if they have any of the following risk factors.
Fortunately, even a modest weight loss of 10 to 20 pounds can bring significant health improvements, such as lowering one's blood pressure and cholesterol levels.
How Is Obesity Linked to Heart Disease and Stroke?
Heart disease and stroke are the leading causes of death and disability for people in the U.S. Overweight people are more likely to have high blood pressure, a major risk factor for heart disease and stroke, than people who are not overweight. Very high blood levels of cholesterol can also lead to heart disease and often are linked to being overweight. Being overweight also contributes to angina (chest pain caused by decreased oxygen to the heart) and sudden death from heart disease or stroke without any signs or symptoms.
The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. Reducing your weight by 10% can decrease your chance of developing heart disease.
How Is Obesity Linked to Diabetes?
Type 2 diabetes reduces your body's ability to control blood sugar. It is a major cause of early death, heart disease, stroke, and blindness. Overweight people are twice as likely to develop type 2 diabetes compared to normal weight people. You can reduce your risk of developing type 2 diabetes by losing weight and exercising more. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. Increasing your physical activity may also allow you to reduce the amount of diabetes medication you need.
How Is Obesity and Cancer Linked?
Several types of cancer are associated with being overweight. In women, these include cancer of the uterus, gallbladder, cervix, ovary, breast, and colon. Overweight men are at higher risk for developing colorectal cancer and prostate cancer. For some types of cancer, such as colon or breast, it is not clear whether the increased risk is due to the extra weight or to a high-fat, high-calorie diet.
How Is Obesity Related to Gallbladder Disease?
Gallbladder disease and gallstones are more common if you are overweight. Your risk of disease increases as your weight increases. It is not clear how being overweight may cause gallbladder disease.
Ironically, weight loss itself, particularly rapid weight loss or loss of a large amount of weight, can actually increase your chances of developing gallstones. Modest, slow weight loss of about 1 pound a week is less likely to cause gallstones.
How Does Obesity Cause Osteoarthritis?
Osteoarthritis is a common joint condition that most often affects the joints in your knees, hips, and lower back. Carrying extra pounds increases the risk of osteoarthritis by placing extra pressure on these joints and wearing away the cartilage (tissue that cushions the joints) that normally protects them.
Weight loss can decrease stress on the knees, hips, and lower back and may improve the symptoms of osteoarthritis.
How Is Obesity Linked to Gout?
Gout is a disease that affects the joints that is caused by high levels of a substance called uric acid in the blood. The large amount of uric acid can form into solid or crystal-like masses that deposit in the joints. Gout is more common in overweight people and the risk of developing the disorder increases with higher body weights.
Over the short term, certain dietary changes may lead to an attack of gout in people who have high levels of uric acid or who have had gout before. If you have a history of gout, check with your doctor before trying to lose weight.
How Is Obesity Linked to Sleep Apnea?
Sleep apnea is a serious breathing condition that is associated with being overweight. Sleep apnea can cause a person to snore heavily and to stop breathing for short periods during sleep. Sleep apnea may cause daytime sleepiness and even heart failure. The risk for sleep apnea increases as body weight increases. Weight loss usually improves sleep apnea.
Is being a little overweight or obese really that bad?
Yes, according to a new study showing people who are even a little overweight face increased risk for many serious diseases, including diabetes, heart disease, colon cancer, high blood pressure, and gallstones.
"It's very important to take obesity seriously and intervene before people become overweight. The more your weight increases, the higher your risk will be," study author Alison E. Field, ScD, tells WebMD. "Even people at the upper end of the healthy weight range seem to be at increased risk for diabetes and hypertension." Field is an assistant professor of medicine at Harvard Medical School and at the Channing Laboratory at Brigham and Women's Hospital, both in Boston .
In this study, published in the July 9th issue of the Archives of Internal Medicine, researchers looked at data from large studies of more than 120,000 nurses and more than 50,000 male health professionals. They found the risk of several conditions increased as people became more overweight. In addition, as the degree of overweight increased, so did the risk of having more than one of these diseases.
"It's not surprising that more studies are coming out showing obesity is a major risk factor not only for heart disease but for other diseases as well," says Charles Famulare, MD. "Our standard for a healthy weight is going lower and lower." Famulare is an internist in the division of general medicine at Nassau University Medical Center in East Meadow , N.Y.
Health researchers use the body mass index (BMI) to describe how fat someone is. It's calculated by dividing your weight in kilograms by your height in meters, squared. A BMI of 25 to 29.9 means you're overweight, while 30 or above is considered obese.
In this study, researchers found that even people with a healthy weight were at increased risk. A woman with a BMI between 22 and 24.9 has double the risk for diabetes, compared to a woman in the 18.5 to 21.9 BMI range. She also has a 40% increased risk for gallstones and high blood pressure, and a 30% increased risk for high cholesterol and colon cancer.
To translate these BMI numbers into practical terms, in the past a woman 5 feet 3 inches tall was considered to be at the upper limit for healthy weight at about 138 pounds. Now, researchers are saying she'd be even healthier if she could get down to 122 pounds.
Losing weight is difficult, and keeping it off is even more difficult. That means it's important to catch weight gain and stop it right when it first begins, Field says. "We need to shift from the concept of an intense, short-term diet towards moderate changes you can stick with long term. In addition, we need to emphasize the importance of at least not gaining weight as you grow older. If you can just maintain your current weight, or achieve a small loss, that will have a huge impact on your health risks.
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Disclaimer THE LAP-BAND SYSTEM INDICATIONS, CONTRAINDICATIONS, AND COMPLICATIONS. The LAP-BAND System is not right for everyone. You and your surgeon should work together to decide if this is the right treatment for you. Here are some of the things your surgeon will consider. The LAP-BAND System may be right for you if:
If your BMI is less than 40, the LAP-BAND System may not be right for you. On the other hand, your surgeon may consider it if you have health problems that are related to obesity. Your surgeon may also have other criteria he or she uses. Ask him or her to discuss the criteria with you. CONTRAINDICATIONS The LAP-BAND System is not right for you if:
Some surgeons say patients with a “sweet tooth” will not do well with the LAP-BAND System. If you eat a lot of sweet foods, your surgeon may decide not to do the procedure. The same is true if you often drink milkshakes or other high-calorie liquids. Your motivation is key Your surgeon will not do the operation unless he or she knows you understand the problems your excess weight is causing. Also, your surgeon will make sure you know you have responsibilities. These include new eating patterns and a new lifestyle. If you are ready to take an active part in reducing your weight, your surgeon will consider the treatment. First, though, your surgeon will want to make sure you know about the advantages, disadvantages, and risks involved. RISKS, COMPLICATIONS, AND ADVERSE EVENTS YOU NEED TO KNOW ABOUT All surgical procedures have risks. When you decide on a procedure, you should know what the risks are. Talk with your surgeon in detail about all the risks and complications that might arise. Then you will have the information you need to make a decision. What are the general risks? Using the LAP-BAND System includes the same risks that come with all major surgeries. There are also added risks in any operation for patients who are seriously overweight. You should know that death is one of the risks. It can occur any time during the operation. It can also occur as a result of the operation. Death can occur despite all the precautions that are taken. There is a risk of gastric perforation (a tear in the stomach wall) during or after the procedure that might lead to the need for another surgery. In the U.S. clinical study this happened in 1% of the patients. There were no deaths during or immediately after surgery in the U.S. study. Your age can increase your risk from surgery. So can excess weight. Certain diseases, whether they were caused by obesity or not, can increase your risk from surgery. There are also risks that come with the medications and the methods used in the surgical procedure. You also have risks that come from how your body responds to any foreign object implanted in it. Published results from past surgeries, however, do show that LAP-BAND System surgery may have fewer risks than other surgical treatments for obesity. Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomachband outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function) occured in 11% of patients, the long-term effects of which are currently unknown. Constipation, diarrhea and dysphagia (difficulty swallowing) occurred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications. Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel ovements), abnormal stools, constipation, flatulence 7 (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, prickly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gallstones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you don’t understand. Is there a chance the device will need to be removed? The LAP-BAND System is a long-term implant, but it may have to be removed or replaced at any time. For instance, the device may need to be removed to manage any adverse reactions you might have. The device may also need to be removed, repositioned or replaced if you aren’t losing as much weight as you and your doctor feel you should be losing. What are the specific risks and possible complications? Talk to your doctor about all of the following risks and complications:
Laparoscopic surgery has its own set of possible problems. They include:
Laparoscopic surgery is not always possible. The surgeon may need to switch to an “open” method due to some of the reasons mentioned here. This happened in about 5% of the cases in the U.S. Clinical Study. There are also problems that can occur that are directly related to the LAP- BAND System. They include: The band can spontaneously deflate because of leakage. That leakage can come from the band, the access port, or the tubing that connects them. In these cases its necessary to remove the band or the port ,having the band with no function until we put a new reservoir so it can continue functioning.
Obstruction of the stoma can be caused by
There have been some reports that the esophagus has stretched or dilated in some patients. This could be caused by
Patients who have a weaker esophagus may be more likely to have this problem. A weaker esophagus is one that is not good at pushing food through. Tell your surgeon if you have difficulty swallowing. Then your surgeon can evaluate this. Weight loss with the LAP-BAND System is typically slower and more gradual than with some other weight-loss surgeries. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat. Infection is possible. Also, the band can erode into the stomach. This can happen right after surgery or years later, although this rarely happens. Complications can cause reduced weight loss. They can also cause weight gain. Other complications can result that require more surgery to remove, reposition, or replace the band. Some patients have more nausea and vomiting than others. You should see your physician at once if vomiting persists. Rapid weight loss may lead to symptoms of:
It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity. If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery. If you have existing problems, such as diabetes, a large hiatal hernia (part of the stomach in the chest cavity), Barrett’s esophagus (severe, chronic inflammation of the lower esophagus), or emotional or psychological problems, you may have more complications. Your surgeon will consider how bad your symptoms are, and if you are a good candidate for the LAP-BAND System surgery. You also have more risk of complications if you’ve had surgery before in the same area. If the procedure is not done laparoscopically by an experienced surgeon, you may have more risk of complications. Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution. You can develop gallstones after a rapid weight loss. This can make it necessary to remove your gallbladder. There have been no reports of autoimmune disease with the use of the LAP-BAND System. Autoimmune diseases and connective tissue disorders, though, have been reported after long-term implantation of other silicone devices. These problems can include systemic lupus erythematosus and scleroderma. At this time, there is no conclusive clinical evidence that supports a relationship between connective-tissue disorders and silicone implants. Long-term studies to further evaluate this possibility are still being done. You should know, though, that if autoimmune symptoms develop after the band is in place, you may need treatment. The band may also need to be removed. Talk with your surgeon about this possibility. Also, if you have symptoms of autoimmune disease now, the LAP-BAND System may not be right for you. Removing the band If the LAP-BAND System has been placed laparoscopically, it may be possible to remove it the same way. This is an advantage of the LAP-BAND System. However, an “open” procedure may be necessary to remove a band. In the U.S. Clinical Study, 60% of the bands that were removed were done laparoscopically. Surgeons report that after the band is removed, the stomach returns to essentially a normal state. At this time, there are no known reasons to suggest that the band should be replaced or removed at some point unless a complication occurs or you do not lose weight. It is difficult, though, to say whether the band will stay in place for the rest of your life. It may need to be removed or replaced at some point. Removing the device requires a surgical procedure. That procedure will have all the related risks and possible complications that come with surgery. The risk of some complications, such as erosions and infection, increase with any added procedure. Once this is explained and analyzed, the patient signs in agreement that he/she has been informed about the complications and risks including the morbidity and mortality that can occur when the gastric band is used, and he/she agrees that this surgical group integrated by
Are not responsible of the expenses from the aforementioned complications that can happen in or after surgery , and also of hospital expenses, following surgeries , accessories of the gastric band, fees from other medical specialists and hospitals, medicine, use of therapy, land or air transportation or board and lodging and any other expense that can happen from any early or late complication as a consequence of the placing of the gastric band. PATIENT’S SIGNATURE
Treatment
Learn more about our Lap Band treatment
Whats the BMI It's a term the medical community uses to determine how overweight a person is. Individuals with a BMI over 40 may qualify for bariatric surgery. Those with a BMI of 35-40 may also qualify, if they have a life-threatening comorbid condition such as sleep apnea, diabetes and others. To find your BMI, fill out the form below: At Mexico Extreme Makeover, we've helped many people achieve their weight-loss goals. Now, we want to help you. But first we must determine together if you're a qualified candidate. Any surgery is a serious step. So, we only want to take it together if it's the right step for you. Because of our experience, we have very well defined guidelines which are based on those recommended by the National Institutes of Health to help determine if you're a candidate for bariatric surgery. You may qualify for the gastric band implant treatment if: Your BMI is between 35 and 40 and you have one or more of the following obesity-related conditions: Or, if: You are 100 pounds or 100% over you ideal weight, or have a Body Mass Index (BMI) of 40 or greater and you have one or more of the following obesity-related conditions:
And if: You've repeatedly tried unsuccesfully to lose excess weight with diets, exercise, or weight-loss drugs. If you meet these three criteria, contact us with our online form, by e-mail you can answer our medical history questionnaire or you can call to us available 24 hours a day, 7 days a week. You can also apply online for financing. If you qualify for bariatric surgery, you can benefit from our commitment to comprehensive treatment and care. If you're considering bariatric surgery, there's no other place that has the experience, expertise, and care that you'll find at Mexico Extreme Makeover. This highly experienced medical team promises to put our entire focus on you, the patient. We are committed to assist with your long-term success.
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