By Lisa Dobruskin, M.D., F.A.C.S.
From diabetes to arthritis, being overweight or obese can increase your risk for a wide range of health complications.
But did you know that obesity is considered a chronic and complex disease in and of itself, and like other diseases, often requires medical treatment to stop its progression?
The Center for Bariatric Surgery & Metabolic Medicine at Penn Medicine Princeton Medical Center (PMC) offers patients with weight-related health concerns treatment options that range from comprehensive, medically supervised weight management to weight loss surgery.
A Significant Health Concern
Obesity is prevalent in the United States, affecting nearly 40 percent or 93.3 million American adults, according to the Centers for Disease Control and Prevention. In addition, millions more are considered overweight.
More than just a cosmetic issue, obesity is a significant health concern. People who have obesity compared to those with a normal or healthy weight are at increased risk for serious diseases and health conditions, including:
- High blood pressure
- High cholesterol
- Type 2 diabetes
- Heart disease
- Stroke
- Osteoarthritis
- Fatty liver disease
- Polycystic ovary syndrome (PCOS)
- Sleep apnea
- Some cancers (endometrial, breast, colon, kidney, gallbladder and liver)
- Mental health disorders (depression, anxiety)
Put another way, obesity is associated with many of the leading causes of death in the United States and around the world.
A Complex Disease
While obesity is a risk factor for developing other diseases, science has proven that it is a complex disease in and of itself.
Obesity stems from a variety of causes including genetics, diet, inactivity, hormone problems and certain medications. Additionally, studies have found that lack of quality sleep can contribute to being overweight or obese.
Further, being overweight or obese can cause hormonal and other chemical changes in your body that contribute to the disease and make it difficult to lose weight through diet and exercise alone.
Defining Obesity
Weight that is higher than what is considered a healthy weight for a given height is characterized as overweight or obese. Doctors typically use body mass index (BMI) as a screening tool for overweight or obesity. BMI is defined as weight in kilograms divided by height in meters squared.
A BMI that is between 18.5 and less than 25 is considered normal. A BMI between 25 and less than 30 falls within the overweight range, and a BMI over 30 is considered obese.
It is important to note that while BMI is a good indicator of body fat, it is not a diagnostic tool or an indication of a person’s overall health. It is one measure doctors take into consideration when evaluating a patient and their risk for disease.
Treating Obesity
By treating obesity, you are also in effect treating related health conditions. Consider that losing just 5 to 10 percent of your total body weight is likely to have health benefits, such as improvements in blood pressure, cholesterol and diabetes.
While diet and exercise are the first lines of treatment for obesity, they are often not enough for people to reach a healthy weight. Medication may also be recommended to promote weight loss, and in some instances, bariatric surgery is a safe and effective solution.
To be considered an ideal candidate for bariatric surgery, a patient must have a BMI of above 40 or a BMI of 35-39.9 and a disease caused by obesity, such as diabetes, high blood pressure or obstructive sleep apnea
Among the most common types of bariatric surgery are:
- Sleeve gastrectomy, a procedure in which the stomach is reduced to 25 to 30 percent of its original size. The procedure, which has become one of the most frequently chosen in recent years, also alters the hormones that affect hunger.
- Gastric bypass, which separates the stomach into two unequal compartments with a small portion of the stomach remaining usable for food consumption. During digestion, the food empties from the tiny stomach pouch into the upper intestine. In addition to restricting the amount of food you can eat, gastric bypass also limits the amount of calories that are absorbed.
The Center for Bariatric Surgery & Metabolic Medicine offers bariatric surgery using minimally invasive techniques, enabling patients to recover faster and reducing pain and scarring.
Tips for Maintaining a Healthy Weight
Whether you are trying to lose weight or maintain a healthy weight the following tips can help:
- Eat a high-protein, high-fiber diet while avoiding sugars and starches as much as possible. Because protein and fiber are more filling, they can help you eat less.
- Keep a food diary or use one of the many available nutrition apps to track what you eat, when you eat and how much you eat. Tracking brings awareness to what and how much you eat each day and enables you to identify patterns and areas where you can make modifications.
- Control your portion sizes. Even when eating high-protein, high-fiber foods, it’s still important to watch your portion sizes.
- Plan ahead when dining out. Before going to a restaurant, review the menu and decide what you are going to eat ahead of time. This helps guard against temptation and other distractions that occur when dining out. Also, ask your server to automatically box up half your meal, which will help prevent overeating.
- Drink water. The brain often confuses thirst with hunger. If you feel hungry soon after eating, a glass of water may be all you need.
- Commit to at least 30 minutes of exercise a day. It doesn’t have to be vigorous exercise – even 10 minutes of walking, three times a day, can make a difference.
If you are concerned about your weight, talk to your doctor about steps you can take to stay healthy, including consulting with a nutritionist.
To learn more about the Center for Bariatric Surgery & Metabolic Medicine at PMC or to find a physician affiliated with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Lisa Dobruskin, M.D., F.A.C.S., is a board certified surgeon, specializing in bariatric surgery, and a fellow of the American College of Surgeons. She is the Medical Director of the Center for Bariatric Surgery & Metabolic Medicine at Penn Medicine Princeton Medical Center.