severe obesity


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severe obesity

Obesity in which a person has a BMI of 35 to 40 kg/m2.

obesity

(o-be'sit-e, -bes' ) [ obese]
A body mass index of > 30 kg/m.2, an unhealthy accumulation of body fat. In adults, damaging effects of excess weight are seen when the body mass index exceeds 25 kg/m2. A person 5'7? tall and weighing more than 191 lb would be obese by this standard. Synonym: adiposis; adiposity; corpulence; liposis. See: body mass index for table; weight

Obesity is the most common metabolic/nutritional disease in the U.S., with more than 65% of the adult population being overweight. Obesity is more common in women, minorities, and the poor. The obese have an increased risk of developing diabetes mellitus, hypertension, heart disease, stroke, fatal cancers, and other illnesses. Obese people may also suffer psychologically and socially.

Etiology

Obesity is the end result of an imbalance between food eaten and energy expended, but the underlying causes are more complex. Genetic, hormonal, and neurological influences all contribute to weight gain and loss. In addition, some medications (such as tricyclic antidepressants, insulin, and sulfonylurea agents) may cause patients to gain weight.

Treatment

Attempts to lose weight are often unsuccessful, but mild caloric restriction, an increase in physical activity, and supportive therapies all have a role. Medications to enhance weight loss can sometimes produce weight losses of several kilograms. However, some weight loss agents (such as amphetamines or amphetamine-like agents) have unacceptable side effects (such as cardiac valvular injuries with fenfluramine/phentermine, addiction with other anorexiants). Surgical remedies (bariatric surgery) are available for some patients and can result in sustained weight loss, but such surgery involves significant morbidity and a 1% to 2% risk of death in the perioperative period.

Diet

Caloric intake should be less than maintenance requirements, but all essential nutrients must be included in any weight-loss regimen. Severe caloric restriction is unhealthy and should be avoided unless undertaken under strict supervision. For many patients of average size and activity, consumption of 1200 to 1600 calories a day will result in gradual loss of weight. Most fad diets provide temporary results at best.

Exercise

Dietary changes should be accompanied by a complementary program of regular exercise. Exercise improves adherence to weight loss diets and consumes stored fat. For many people 35 minutes of low-level exercise performed daily (either in one long workout session or in several shorter intermittent sessions) will aid weight loss and improve other cardiovascular risk factors. Exercise programs may be hazardous for some patients; professional supervision may be recommended for some people who start an exercise program, e.g., people with a history of heart or lung disease, arthritis, or diabetes mellitus.

Patient care

The U.S. Preventive Services Task Force and other promoters of public health recommend that clinicians screen all adults for obesity and offer incentive behavioral counseling to obese adults. Patients who are overweight should be screened for conditions worsened by obesity, e.g., hypertension, diabetes mellitus, and hyperlipidemia. Health care professionals can aid patients in making permanent life-style changes by discussing diet and exercise, being familiar with various eating plans, and by providing patients with a list of local weight loss centers. The patient's feelings about weight and body image should be explored to understand the individual's motivations. People who diet and exercise for health reasons tend to be the most successful. Family support is also important.

abdominal obesity

Android obesity.

acquired obesity

Obesity that results primarily from environmental rather than genetic causes. It can be most clearly identified in identical twins one of whom is of normal weight and the other markedly overweight

adult-onset obesity

Obesity first appearing in the adult years.
Synonym: Recent obesity

android obesity

Obesity in which fat is located largely in the waist and abdomen. It is associated with an increased risk of heart disease, hypertension, and diabetes. People with android obesity are often described as having an apple-shaped body. Synonym: abdominal obesity

developmental obesity

Juvenile obesity

endogenous obesity

Obesity associated with some metabolic or endocrine abnormality.

exogenous obesity

Obesity due to an excessive intake of food.

gluteal-femoral obesity

Obesity in which fat deposits are located primarily below the waist in the hips and thighs. The health risks of gluteal-femoral fat appear to be less than those associated with abdominal obesity.
Synonym: gynecoid obesity

gynecoid obesity

Gluteal-femoral obesity.

hypothalamic obesity

Obesity resulting from dysfunction of the hypothalamus, esp. the appetite-regulating center.

juvenile obesity

Obesity that occurs before adulthood. It is associated with an increased risk of obesity in adulthood. Synonym: developmental obesity

Patient care

About one third of American children and 15% of teenagers are overweight or obese. A variety of factors contributes to childhood obesity, including learned patterns of behavior, genetics, a decreased emphasis on physical activity and exercise, and access to inexpensive, calorically dense fast foods (typically rich in fats and sugars but limited in fiber, vitamins, minerals, and other essential nutrients). School nurses, pediatricians, and other health care professionals who provide care to children should help educate children about healthy food choices and portion sizes and the need to increase activity and decrease caloric intake. Parents should be taught to avoid overfeeding infants and to familiarize themselves with nutritional needs and optimum growth rates. The overweight child should be assisted in keeping a record of what, where, and when he/she eats to help identify situations that lead to overeating. Unhealthy weight loss behaviors, such as fad diets or purging, are discouraged. Children and teens benefit from weight loss support programs. Snacks should consist of foods such as raw vegetables rather than cookies, candies, or sugary drinks. Families that exercise together (as by walking, hiking, biking, swimming) provide children with interest in, knowledge of, and practice in activities that help to maintain desired weight levels.

morbid obesity

1. Having a body mass index > 40. Approx. 5% of Americans 20 years and older are morbidly obese.
2. 2. Having a BMI > 95 or 99% of the population (expert opinion varies).
Synonym: severe obesity

recent obesity

Adult-onset obesity.

severe obesity

Morbid obesity.
References in periodicals archive ?
I am to record that the injury or disease causing the death of Barry Eaves is one of coronary heart disease, diabetes and hypertension, and severe obesity.
They found that the prevalence of severe obesity tripled (from 0.
Dr Nicholas Finer, Consultant Endocrinologist, at UCL Hospitals NHS Foundation Trust and member of NICE advisory board for bariatric surgery, commented: "I very much welcome Diabetes UK's acceptance of the potential for surgical treatment of severe obesity to have an important role in diabetes management.
Those who are obese have a BMI of 30 or more, and severe obesity is indicated by a BMI of 40 or more.
Severe obesity may or may not increase risk of injury, but seasoned occupational medicine doctors and nurses are convinced it vastly complicates recovery after injury.
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By some estimates, more than 32,000 surgeries designed to correct severe obesity are expected to take place in the United States this year.
New equipment at Birmingham Children's Hospital will enable medics to monitor heart rate, calorie burning and body weight composition in brain tumour victims who often suffer from severe obesity as a result of their condition.
People with Prader-Willi syndrome, a genetic disorder that causes constant hunger and severe obesity, have unusually high concentrations of a hormone called ghrelin, which has been linked to hunger pangs.
Severe obesity is one of the major risk factors for type 2 diabetes.
The first operation that was widely used for severe obesity was the intestinal bypass.
Dietz also noted that the obese child who becomes an obese adult will have more severe obesity than that of adults whose obesity began in adulthood.

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