Obesity is typically measured in terms of a person’s body mass index (BMI) which is found by taking your weight in kilograms and dividing this by the square of your height in meters.
An individual with a BMI in excess of 30 is considered to be obese and a person with a BMI of more than 40 is said to be severely or morbidly obese. In other words, a 1.6 meter tall man weighing 115 kilograms would have a BMI of 45 and would be morbidly, or life-threateningly, obese.
This however is something of a simplistic view of morbid obesity because it is quite possible for an individual to be suffering from life-threatening obesity and to have a BMI below, and in some cases well below, 40.
So we need to find a better definition.
Obesity can be considered life-threatening when your weight causes health problems which are a direct result of your being overweight and where such health problems are likely to lead to a marked deterioration in your general health, shorten your life expectancy and severely affect your lifestyle. Such health conditions are referred to as co-morbidities and are many and varied. Some of the more commonly seen co-morbidities include:
- Atherosclerotic Cardiovascular Disease (ASCVD). ASCVD is a condition in which fat is deposited within the walls of the blood vessels and can lead to coronary artery disease and congestive heart failure. Commonly referred to as “hardening of the arteries” this represents a major cause of death in the United States today.
- Type 2 (or Adult-Onset) Diabetes. Type 2 diabetes is seen normally in middle aged and elderly patients and, if you are excessively overweight, you increase your chances of contracting type 2 diabetes forty fold. Type 2 diabetes is again a leading cause of death in the United States.
- High Blood Pressure. High blood pressure, or hypertension, is very common in obese individuals and can lead to the early development of cardiovascular disease, as well as to kidney disease.
- Obstructive Sleep Apnea. As the muscles relax during sleep the weight of the excess tissue around the throat in obese individuals collapses the throat passage and breathing stops. The body reacts by “jolting” you into breathing again but, as time goes by and weight continues to increase there is a growing incidence of death resulting from sleep apnea.
- Liver Disease. Fat deposited in the tissue of the liver can lead to chronic inflammation of the liver, cirrhosis and, eventually, to liver failure.
- Gall-Bladder Disease. Gallstones (frequently composed of crystallized cholesterol) can lead to obstruction of the ducts from the liver, jaundice and inflammation of the pancreas.
In this short article it is only possible to list some of the conditions commonly seen as a result of obesity and this list should not be taken as exhaustive.
In cases however where these conditions, and others, are present morbid obesity surgery will often be considered.
Weight loss surgery has been around for many years now and advances in technology, improved surgical techniques (such as advances in robotic surgery) and simple experience have led to the development of several surgical techniques which are now considered to be relatively low risk and which display fewer complications that earlier forms of surgery.
As our medical knowledge and technology improves we will not only see further advances in such things as robotic surgery, but we will also a lowering of the risks of obesity surgery.