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What is Obesity?

The biggest myth in America is that weight is about your appearance. - Robin Blackstone, 2007
Obesity in the United States has increased dramatically since the 1950s, with more than two thirds of the U.S. population overweight or obese. There are now an estimated 11 million people in the U.S. considered to be 'morbidly obese,' meaning they are 100 pounds or more over their healthy weight. Morbid obesity is a disease characterized by accumulation of fat, strong resistance to dietary management, greatly increased risk of health problems, and a shortened life span.

However, even people who are 50-100 pounds or more overweight are putting their health at risk. According to the National Institutes of Health, an increase of 20 percent or more above your 'healthy' or 'ideal' body weight is the point where excess weight becomes a health risk. 

What Causes Obesity?
Many people think obesity is simply a result of overeating. Although this is true for people with certain eating disorders or glandular abnormalities, it's not that simple. Ongoing research shows that obesity is a complex combination of hereditary (genetic) and environmental factors that, once established, is almost impossible to control by dieting. The disease is also considered chronic and worsens with time, which means that it requires lifelong control and treatment.Unfortunately, medical weight loss programs – diet, exercise, drugs, and behavior modification – fail in at least 95% of morbidly obese patients no matter how much they want to lose weight or how hard they try. And even patients who are 50-100 pounds overweight may be unable to shed pounds and improve their health without some form of medical intervention.Hereditary and environmental factors also play a role in obesity. Clearly, lifestyle can foster obesity in people whose body stores fat efficiently. In the United States, the convenience fast food, large portions, little or no structure in meal planning, high-fat, high-calorie snacks and sugar-laden sodas, and a lack of proper exercise magnify the hereditary factors that underlie obesity.

Obesity-Related Diseases
Eventually, being obese damages your body and shortens your lifespan. The most common and the serious obesity-related diseases are:

• Type 2 Diabetes Mellitus - About 95% of patients with type 2 diabetes are overweight. Obesity can cause the body to develop a resistance to insulin, which results in high blood sugar levels. Over time, too much sugar in the blood seriously harms various tissues of the body, including the nervous and circulatory systems. High Cholesterol - 'High cholesterol' is shorthand for the medical term 'hypercholesterolemia,' a common abnormality of lipid (fat) metabolism. When the blood contains too much low-density cholesterol and other lipids, these substances begin to stick to and build up on artery walls, restricting blood flow through the arteries. This disease is more commonly known as hardening of the arteries or 'atherosclerosis.' Its presence increases the risk of hypertension, coronary heart disease – which can result in a heart attack or stroke. Heart Disease and High Blood Pressure - In obese people, the heart is forced to work much harder than it was designed to. Over time, this stress can damage the heart and the kidneys. When such damage is accompanied by high blood pressure (hypertension), heart attack, stroke or congestive heart failure can result. Osteoarthritis or Degenerative Arthritis-  Excess weight on weight-bearing joints, especially the hips, knees, ankles, and feet, eventually leads to joint damage and inflammation, accompanied by pain and loss of mobility. In obese people, this disease can also affect the spine. Cancer - Obesity increases the risk of uterine and breast cancer in women and prostate cancer in men. In both sexes, the presence of any type of cancer increases the risk of mortality. Sleep Apnea - In some people, the body stores excess fat in the tongue and neck. During sleep, these tissues relax and obstruct the air passage, making it difficult to breathe. This is especially true for those who sleep on their back. Because these people never achieve a deep, restful sleep, they often awake feeling tired and are low on energy all day long. Heartburn and Acid Indigestion- Referred to by doctors as 'gastro esophageal reflux,' heartburn and acid indigestion occur when gastric acid flows backward into the esophagus or food pipe through the valve at the top of the stomach. Habitual overeating weakens this valve. This condition can cause extreme discomfort, and if left untreated, gastro esophageal reflux increases the risk of esophageal cancer. Psychological Depression - Depression is common in people who are morbidly obese. Feelings of extreme sadness or emptiness, an inability to take pleasure in any activity, insomnia, constant fatigue, feelings of worthlessness or unnecessary guilt, and inability to concentrate only add to the difficulty of coping with physical problems. Urinary Stress Incontinence - A large abdomen and weak abdominal muscles can weaken the urinary bladder enough to allow urine to leak from it during coughing, sneezing and laughing. Embarrassing and difficult to live with, this disease adds to the social and psychological damage caused by morbid obesity.

• Venous Stasis in the Legs - Heart or kidney disease caused by excess weight can keep the veins in the legs from functioning properly, making it difficult for the blood in the legs to return to the heart. As a result, the legs and ankles often become swollen and sometimes ulcers can develop on the legs.

Social and Psychological Effects
Obesity also has significant social, psychological and even economic effects. Almost everything in life is more difficult for the obese – shopping for clothes, driving a car, traveling on a plane, going to the theater, employment, job advancement, obtaining medical insurance, family relationships, and just difficulty with relationships in general. However unfair and in some cases illegal, social and economic difficulties are very real and can be very devastating.

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