Q. I heard from a radio newscast that obesity is now considered a disease. Does categorizing obesity a disease have any significance?
A. Members of the American Medical Association (AMA) have indeed decided to classify obesity as a disease in their recent annual meeting in Chicago. This move by the AMA may help curb obesity among Americans because, in time, it could lead to improved coverage by health insurances and health maintenance organization for anti-obesity drugs, surgery and counseling. For Filipinos, however, this declaration by the AMA will probably have minimal impact.
Whether obesity is a disease or not has long been debated. The move by the AMA to declare it a disease will most likely not end the debate. In fact, up to now, experts do not even agree on the definition of the condition. The gauge that is presently applied to calculate body fat is the body mass index (BMI), a measure which many experts say is too simplistic and flawed. Incidentally, BMI is computed by dividing a person's weight (in kilograms) with the square of his/her height (in meters). Among Filipinos, one is considered obese if his BMI is 25 or higher. Particularly alarming is a BMI of 40 or above, people with this BMI value are considered morbidly obese.
Experts may not agree on whether to classify obesity as a disease or not, but they agree that obesity is now the single greatest contributor to chronic disease worldwide. The World Health Organization (WHO) statistics (2008) show that worldwide, more than 1.4 billion adults, 20 years old and older, are overweight. In the US, more than one-third (35.7 percent) of all adults are obese. In the Philippines, the figures are not that bad yet, but they are already alarming. A survey by the National Statistics Coordination Board (NSCB), which was also done in 2008, showed that 26.6 percent of Filipino adults are overweight, of whom 5.2 percent are obese.
Obesity is the biggest risk factor for type 2 diabetes mellitus. It likewise increases or aggravates hypertension and raises blood cholesterol levels, which are major predisposing factors to the development of heart attacks and strokes.
In overweight men, the occurrence of impotence and sterility is higher than average while in obese women, there is a higher than average incidence of menstrual disorders, infertility and complicated pregnancies. In both sexes, obesity increases the risk for gallbladder stones.
Obesity is likewise associated with cancers of the breast, uterus, cervix, ovary and gallbladder among women, and colon, rectum, prostate, pancreas and stomach among men.
Excess weight stresses the body's joints particularly the hips, knees and ankles; this results in or aggravates osteoarthritis. Excess weight is also a common cause of low back pain and is a predisposing factor to the development of varicose veins.
All told, experts estimate that, if untreated, obesity can increase ones risk of dying prematurely by up to two to three times.
The safest and most effective way to treat obesity is by combining diet and exercise.
In some cases, the use of drugs for a limited period can complement diet and exercise. The use of anti-obesity drugs should be time-bound and only as part of a comprehensive weight-reducing program that is supervised by a physician or a trained professional. By the way, two new anti-obesity drugs-Qsymia and Belviq-were introduced into the market last year.
In morbidly obese patients, surgical procedures designed to either limit the entry of food into the stomach or reduce the amount of nutrients that is absorbed by the small intestines are sometimes carried out. But theseprocedures are risky because they are major operations in a high-risk population.
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