obesity

If you are struggling with overweight or obesity, you can find a decisive solution, a life changing experience through consulting with Dr. Berkes and getting involved in his Weight Management Program.

Obesity has become a serious public health problem. It is an epidemic. This is due to the fact that that there are as many as 58 million individuals who are overweight; 40 million obese and 3 million who are morbidly obese. There are as many as eight out of 10 individuals over 25 years of age, who are overweight. What all this mean is that you are not alone with you problem. Most Americans are struggling with it.

Why is this happening? Here are some of the reasons:

• 78% of American's not meeting basic activity level recommendations
• 25% of Americans are completely sedentary
• Positive calorie balance: daily ingestion of only 5% more calories than needed could result in the accumulation of approximately 13 lb of fatty tissue in 1 year. Ingestion of only 8 calories/day more than expended over 30 years could lead to an increase of 22 lbs in body weight.

Definition of obesity:  using body mass index calculation

• Normal weight = 18.5-24.9
• Overweight = 25-29.9
• Obesity = BMI of 30 or greater

Calculate Body Mass Index:

  BMI = weight (kg)/height (m)²
or
BMI = (weight (pounds)/height (inches)²) x 703

In summary: obesity results from imbalance between the calories consumed and the calories needed relative to our physical activity.

The consequences of obesity:

An estimated 300,000 deaths per year may be attributable to obesity. The risk of death rises with increasing weight. Even moderate weight excess (10 to 20 pounds for a person of average height) increases the risk of death, particularly among adults aged 30 to 64 years.

Individuals who are obese (BMI > 30)* have a 50 to 100% increased risk of premature death from all causes, compared to individuals with a healthy weight.

Obesity-Related Medical Conditions:

Some of the following complications, conditions, cancers and diseases are associated with obesity:

Cardiovascular Disease (CVD)
Obesity increases CVD risk due to its effect on blood lipid levels. Weight loss improves blood lipid levels by lowering triglycerides and LDL (“bad”) cholesterol and increasing HDL (“good”) cholesterol. Weight loss of 5% to 10% can reduce total blood cholesterol. The effects of obesity on cardiovascular health can begin in childhood, which increases the risk of developing CVD as an adult. Overweight and obesity increase the risk of illness and death associated with coronary heart disease. Obesity is a major risk factor for heart attack, and is now recognized as such by the

Diabetes (Type 2)
As many as 90% of individuals with Type 2 Diabetes are reported to be overweight or obese.

Obesity has been found to be the single largest influence on the prevalence of diabetes. Obesity complicates the management of Type 2 Diabetes by increasing insulin resistance and glucose intolerance, which makes drug treatment for Type 2 Diabetes less effective. A weight loss of as little as 5% can reduce high blood sugar.

Stroke
Elevated BMI is reported to increase the risk of ischemic stroke independent of other risk factors including age and systolic blood pressure. Abdominal obesity appears to predict the risk of stroke in men. Obesity and weight gain are risk factors for ischemic and total stroke in women.

Hypertension
Over 75% of hypertension cases are reported to be directly attributed to obesity. Weight or BMI in association with age is the strongest indicator of blood pressure in humans. The association between obesity and high blood pressure has been observed in virtually all societies, ages, ethnic groups, and in both genders. The risk of developing hypertension is five to six times greater in obese adult Americans, age 20 to 45, compared to non-obese individuals of the same age.

Liver Disease
Excess weight is reported to be an independent risk factor for the development of alcohol related liver diseases including cirrhosis and acute hepatitis. Obesity is the most common factor of nonalcoholic steatohepatitis, a major cause of progressive liver disease.

Gallbladder Disease
Obesity is an established predictor of gallbladder disease.
Obesity and rapid weight loss in obese persons are known risk factors for gallstones.
Gallstones are common among overweight and obese persons. Gallstones appear in persons with obesity at a rate of 30% versus 10% in non-obese.

Sleep Apnea
Obesity, particularly upper body obesity, is the most significant risk factor for obstructive sleep apnea. There is a 12 to 30-fold higher incidence of obstructive sleep apnea among morbidly obese patients compared to the general population. Among patients with obstructive sleep apnea, at least 60% to 70% are obese.

Osteoarthritis
Obesity is associated with the development of Osteoarthritis of the hand, hip, back and especially the knee. Modest weight loss of 10 to 15 pounds is likely to relieve symptoms and delay disease progression of knee OA.

Breast Cancer
Postmenopausal women with obesity have a higher risk of developing breast cancer. In addition, weight gain after menopause may also increase breast cancer risk. Women who gain nearly 45 pounds or more after age 18 are twice as likely to develop breast cancer after menopause than those who remain weight stable. High BMI has been associated with a decreased risk of breast cancer before menopause. However, a recent study found an increased risk of the most lethal form of breast cancer, called inflammatory breast cancer (IBC), in women with BMI as low as 26.7 regardless of menopausal status. Premenopausal women diagnosed with breast cancer who are overweight appear to have a shorter life span than women with lower BMI. The risk of breast cancer in men is also increased by obesity.

Colorectal Cancer
High BMI, high calorie intake, and low physical activity are independent risk factors of colorectal cancer.

Endometrial Cancer (EC)
Women with obesity have three to four times the risk of EC than women with lower BMI.
Women with obesity and diabetes are reported to have a 3-fold increase in risk for EC above the risk of obesity alone. Body size is a risk factor for EC regardless of where fat is distributed in the body.

Renal Cell Cancer
Consistent evidence has been found to associate obesity with renal cell cancer, especially in women. Excess weight was reported in one study to account for 21% of renal cell cancer cases.

Daytime Sleepiness
People with obesity frequently complain of daytime sleepiness and fatigue, two probable causes of mass transportation accidents. Severe obesity has been associated with increased daytime sleepiness even in the absence of sleep apnea or other breathing disorders.

End Stage Renal Disease (ESRD)
Obesity may be a direct or indirect factor in the initiation or progression of renal disease, as suggested in preliminary data.

Impaired Immune Response
Obesity has been found to decrease the body’s resistance to harmful organisms.
A decrease in the activity of scavenger cells, that destroy bacteria and foreign organisms in the body, has been observed in patients with obesity.

Impaired Respiratory Function
Obesity is associated with impairment in respiratory function. Obesity has been found to increase respiratory resistance, which in turn may cause breathlessness. Decreases in lung volume with increasing obesity have been reported.

Low Back Pain
Obesity may play a part in aggravating a simple low back problem, and contribute to a long-lasting or recurring condition. Women who are overweight or have a large waist size are reported to be particularly at risk for low back pain.

Pancreatitis
Obesity is a predictive factor of outcome in acute pancreatitis. Obese patients with acute pancreatitis are reported to develop significantly more complications, including respiratory failure, than non-obese. Patients with severe pancreatitis have been found to have a higher body-fat percentage and larger waist size than patients with mild pancreatitis.

Urinary Stress Incontinence
Obesity is a well-documented risk factor for urinary stress incontinence, involuntary urine loss, as well as urge incontinence and urgency among women. Obesity is reported to be a strong risk factor for several urinary symptoms after pregnancy and delivery, continuing as much as 6 to 18

Obesity in numbers:

1. 80% of type II diabetes related to obesity
2. 70% of Cardiovascular disease related to obesity
3. 42% breast and colon cancer diagnosed among obese individuals
4. 30% of gall bladder surgery related to obesity
5. 26% of obese people having high blood pressure

Where are most of the calories coming from?

1. Sweets and desserts, soft drinks and alcoholic beverages: 25%
2. Salty snacks and fruit-flavored drinks: 5%
3. Total energy from nutrient-poor foods = 30 percent of the total calorie intake.

Contributing factors to obesity:

• Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status.
• Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions.
• Hormonal causes: Hypothyroidism, Growth hormone deficiency, Estrogen and/or Progesterone deficiency (i.e. Menopause), Testosterone deficiency, adrenal disease, polycystic ovarian syndrome, diabetes
• Drugs: steroids and some anti depressants
• Depression
• Stress

Treatment of obesity:

Treat underlying hormonal abnormalities (Menopause, Andropause in men, Thyroid disorders, Adrenal disease etc.)

Discontinue undesirable medications if possible

Available treatments:

• Dietary Therapy
• Physical Activity
• Behavior Therapy
• Drug Treatment
• Surgery
• Dietary Supplements and Liposuction

After a thorough evaluation and diagnostic work up, Dr. Berkes and you will design a plan most suitable to your individual needs. If you are battling a weight problem, we can help you with through our weight management program. Call our office today for your appointment with Dr. Berkes.