Obesity An Epidemic

Obesity is emerging as a health epidemic around the world.  According to the US Centre for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups.  

An estimated 97 million adults in the United States are overweight or obese.  That figure represents more than 50% of the American adult population. Of this group, 11 million adults suffer from severe obesity.  The American Obesity Association reports that obese individuals have a 50-100% increased risk of death as compared to normal weight individuals, with 300,000 to 587,000 deaths each year. This substantial increase in health risks has made obesity the second leading cause of preventable death in the United States.

In Australia, Monash Obesity and Diabetes Institute published in August 2013 the following results***:

  • 14 million Australians are overweight or obese.
  • More than 5 million Australians are obese (BMI ≥ 30 kg/m). 
  • If weight gain continues at current levels, by 2025, close to 80% of all Australian adults and a third of all children will be overweight or obese. 
  • Obesity has overtaken smoking as the leading cause of premature death and illness in Australia. 
  • Obesity has become the single biggest threat to public health in Australia.
  • On the basis of present trends we can predict that by the time they reach the age of 20 our kids will have a shorter life expectancy than earlier generations simply because of obesity.
  • Aboriginal and Torres Strait Islander Australians are 1.9 times as likely as non-indigenous Australians to be obese.

Secondary Complications

  • More than 900,000 Australians suffer from diabetes.
  • Aboriginal and Torres Strait Islander Australians have the fourth highest rate of Type 2 diabetes (non-insulin dependent diabetes mellitus, or NIDDM) in the world and are 1.9 times as likely as non-indigenous Australians to be obese.
  • Australians reporting heart, stroke and vascular diseases aged 15 years and over were much more likely to be classified as overweight or obese than those without heart stroke and vascular disease (65% compared with 51%).
  • Health disorders in children like type 2 diabetes, high blood pressure, asthma, hypertension and sleep apnea can be directly attributed to childhood obesity.
  • Cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) account for approximately quarter of the burden of disease in Australia, and just under two-thirds of all deaths. These three diseases often occur together and share risk factors, such as physical inactivity, overweight and obesity and high blood pressure.

Causes of Obesity

Obesity could be a combination of the following:

  • The genes you inherited from your parents
  • How well your body turns food into energy
  • Your eating and exercising habits
  • Your surroundings
  • Psychological factors

Consequences of Obesity

If you are obese, severely obese, or morbidly obese, you may experience medical conditions like:

  • Shorter Life Expectancy
  • Compared to people of normal weight, obese people have a 50% to 100% increased risk of dying prematurely
  • Diabetes (type 1 and type 2)
  • Joint problems (e.g., arthritis)
  • High blood pressure
  • Heart disease
  • Gallbladder problems
  • Certain types of cancer (breast, uterine, colon)
  • Digestive disorders (e.g., gastroesophageal reflux disease, or GORD)
  • Breathing difficulties (e.g., sleep apnoea, asthma)
  • Psychological problems such as depression
  • Problems with fertility and pregnancy
  • Urinary Incontinence

Risks to psychological and social well-being

  • Negative self-image
  • Social isolation
  • Discrimination

Difficulties with day-to-day living

  • Normal tasks become harder when you are obese, as movement is more difficult
  • You tend to tire more quickly and you find yourself short of breath
  • Public transport and airline seats, cars may be too small for you
  • You may find it difficult to maintain personal hygiene

Treatment Options

Non-Surgical Treatment

Dieting, exercise, and medication have long been regarded as the conventional methods to achieve weight loss.  Sometimes, these efforts are successful in the short term.  However, for people who are morbidly obese, the results rarely last.  For many, this can translate into what’s called the “yo-yo syndrome,” where patients continually gain and lose weight with the possibility of serious psychological and health consequences.  Recent research reveals that conventional methods of weight loss generally fail to produce permanent weight loss.  Several studies have shown that patients on diets, exercise programs, or medication are able to lose approximately 10% of their body weight but tend to regain two-thirds of it within one year, and almost all of it within five years**.   Another study found that less than 5% of patients in weight loss programs were able to maintain their reduced weight after five years*.

Surgical Treatment

Over the years, weight loss surgery has proven to be a successful method for the treatment of morbid obesity#.  Surgical options have continued to evolve and is pleased to be able to offer patients the following options.

 

** American Association of Clinical Endocrinologists (AACE) / American College of Endocrinology (ACE) Statement on the Prevention, Diagnosis, and Treatment of Obesity (1998 Revision). AACE/ACE Obesity Task Force. Endocr Pract. 1998; Vol. 4 No. 5: 297-330.

* Kramer FM et al. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes 1989; 13:123-136.

# SAGES/ASBS Guidelines for Laparoscopic and Conventional Surgical Treatment of Morbid Obesity. American Society for Bariatric Surgery. www.asbs.org/html/guidelines.html

*** MODI- Obesity in Australia – Monash Obesity and Diabetes Institute 6 August 2013