The Obesity Epidemic

According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity in adults in the 2017-2018 National Health and Nutrition Examination Survey was 42.4% with no significant differences between men and woman or by age group.¹ The prevalence for both obesity and severe obesity was highest in non-Hispanic Black adults compared with other race-and Hispanic-origin groups. The etiology of obesity is multifactorial including genetic, psychosocial, behavioral, and environmental factors. Obesity is a chronic disease requiring a lifetime of prevention, treatment, and maintenance.

Overweight is determined by calculating the body mass index (BMI, defined as the weight in kilograms divided by height in meters squared). Overweight is defined as a BMI of 25 to 29.9 kg/m2, obesity as a BMI of >30 kg/m2.

Useful Tools

• BMI Calculator
• Basal Metabolic Rate(calories needed to maintain current weight)

Many large epidemiologic studies have shown a relationship between all causes and cardiovascular mortality with increasing BMI.^2,3 Obesity in adulthood is also associated with a striking reduction in life expectancy for both men and women. Obesity is an independent risk factor for the development of several chronic diseases including diabetes, hypertension, dyslipidemia, gout, heart disease, stroke, dementia, GERD, osteoarthritis, cancer, kidney disease, urinary incontinence, and depression. Other reports have found higher disability and health care expenditures for patients who are overweight and obese.

Approaches to Weight Loss

Changing the way patients approach weight loss can help them be more successful in the long-term. Most people who are trying to lose weight only focus on the goal of weight loss. However, setting the right goals and focusing on lifestyle changes such as following a healthy eating plan, watching portion sizes, being physically active, decreasing sedentary time, reducing stress, and getting enough sleep are much more effective.

The combination of a reduced-calorie diet and increased physical activity is recommended, because it produces weight loss that also may result in decreases in abdominal fat and increases in strength and cardiorespiratory fitness.⁴ The initial goal of weight-loss therapy should be to reduce body weight by 5%-10% from baseline as this can have significant impact on health parameters.⁴ With success, and if warranted, further weight loss can be attempted.