Obesity is an epidemic in the United States. The Merriam Webster Medical Dictionary defines obesity as “a condition that is characterized by an excessive accumulation and storage of fat in the body and that in an adult is typically indicated by a body mass index of 30 or greater.”
According to the World Health Organization, obesity is the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese. In addition, 44 percent of the diabetes burden, 23 percent of the ischemic heart disease burden and between 7 percent and 41 percent of certain cancer burdens are attributable to obesity.
Obesity rates have doubled among adults in the last 20 years and tripled among children in a generation. A recent report by the Robert Wood Johnson Foundation states that the evidence suggests that by the year 2040 roughly half of the adult population may be obese. Obesity and obesity-related illnesses cost an estimated 10 percent of annual medical spending in the U.S.
Recently, the American Medical Association (AMA) declared obesity a disease. So, what does this really mean? Various health and government agencies have weighed in and make arguments on either side. Those who think obesity should be classified as a disease say so because obesity impairs normal body function and can decrease life expectancy. It can increase the risk factors for other diseases such as diabetes, hypertension, some cancers and metabolic syndrome. Although some view obesity as a cosmetic problem, often one of carrying too much weight in the stomach and waist, it is in fact a very serious metabolic problem.
Adipose (fatty) tissue (usually around the waistline) is composed of cells (adipocytes) that secrete various substances into the blood stream, with negative health consequences. In particular, this tissue is a “factory” of chemicals that result in a lack of responsiveness to insulin. This insulin resistance increases the stimulus to eat and creates a “metabolic hunger” that results in more food cravings. This is all part of metabolic syndrome, which is a vicious cycle. Thus, fat begets more fat.
Metabolic syndrome is a serious health condition that affects about 35 percent of adults and places them at higher risk for cardiovascular disease, diabetes, stroke and diseases related to fatty build ups. The underlying causes of metabolic syndrome are obesity, lack of physical activity and likely genetic factors.
You can reduce your risks significantly by reducing your weight, increasing your physical activity, eating a heart-healthy diet rich in whole grains, fruits, vegetables and fish, and working with your health care provider to monitor and manage blood glucose, blood cholesterol and blood pressure.
Because metabolic syndrome is a cluster of factors, many of which must be determined with lab work, this condition is not one that an individual can assess without the help of a health care provider. However, if you have a large waist circumference and have been told that you have another condition like elevated triglycerides, high blood sugar or high blood pressure, you may want to discuss your combined risks with your healthcare provider.
Treating metabolic syndrome requires addressing several risk factors together. However, the good news is that obesity and the underlying health-related risks such as metabolic syndrome are reversible if treated with lifestyle changes.
Dr. Weinstock is Director, Cooper Heart Institute; Head, Division of Cardiovascular Disease; and Director, Clinical Cardiology, Associate Professor of Medicine at Cooper University Health Care.