A healthy weight is what you naturally weigh when you consistently eat a nutritious diet and balance the calories you eat with physical activity. Obesity results from the excessive accumulation of fat that exceeds the body’s skeletal and physical standards. Morbid obesity is a chronic disease, meaning that its symptoms build slowly over an extended period of time. It is typically defined as being 100 pounds or more over ideal body weight or having a body mass index (BMI) of 40 or higher.
Causes of Morbid Obesity
There are many complex reasons for morbid obesity. Despite conventional wisdom, it is not simply a result of overeating. Studies have shown that dieting and exercise programs have a limited ability to provide effective, long-term relief for morbid obesity. In many cases, there is a significant, underlying cause of morbid obesity, including, but not limited to:
- Genetics – Studies show our genes play an important role in our tendency to gain excess weight. Just as some genes determine eye color or height, others affect our appetite, our ability to feel full or satisfied, our metabolism, our fat-storing ability, and even our natural activity levels.
- Environment – If you have a genetic predisposition toward obesity, then the modern American lifestyle and environment may make controlling weight more difficult. Fast food, long days sitting at a desk, and suburban neighborhoods that require cars all magnify hereditary factors such as metabolism and efficient fat storage.
- Metabolism – Researchers talk about the “set point” theory, a sort of thermostat in the brain that makes people resistant to either weight gain or loss. Try overriding the set point by drastically cutting calories, and your brain responds by lowering metabolism and slowing activity. You then gain back any weight you lost.
- Medical conditions – Certain conditions, such as hypothyroidism, as well as eating disorders, can also cause weight gain. That's why it's important to work with your doctor to make sure you do not have a condition that should be treated with medication and counseling.
Obesity-Related Health Conditions (Co-morbidities)
Whether alone or in combination, the following health conditions are commonly associated with morbid obesity:
- Type 2 Diabetes – Obese people develop a resistance to insulin, which regulates blood sugar levels. Over time, the resulting high blood sugar can cause serious damage to the body.
- High blood pressure and heart disease – Excess body weight strains the ability of the heart to function properly. Resulting hypertension (high blood pressure) can cause strokes, as well as heart and kidney damage.
- Osteoarthritis – Additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.
- Sleep apnea and respiratory problems – Fat deposits in the tongue and neck can cause intermittent obstruction of the air passage. Because the obstruction is increased when sleeping on your back, you may find yourself waking frequently to reposition yourself. The resulting loss of sleep often results in daytime drowsiness and headaches.
- Gastroesophageal reflux and heartburn – Stomach acid seldom causes any problem when it stays in the stomach. When acid escapes into the esophagus through a weak or overloaded valve at the top of the stomach, the result is called gastroesophageal reflux. “Heartburn” and acid indigestion are common symptoms.
- Depression – Seriously overweight people face such emotional challenges as repeated failure with dieting, disapproval from family and friends, and even sneers from strangers. They often experience discrimination at work, cannot fit comfortably in theater seats, or ride in a bus or plane.
- Infertility – Morbidly obese women have a diminished ability to get pregnant. Those who do get pregnant have a higher risk of miscarriage.
- Menstrual irregularities – Morbidly obese women often experience disruptions of the menstrual cycle, abnormal menstrual flow and increased pain associated with the menstrual cycle.
- Urinary stress incontinence – A large, heavy abdomen and relaxation of the pelvic muscles, often associated with childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing or laughing.
Controlling excess weight is something people must work at their entire lives. All current medical interventions – including weight loss surgery – should not be considered medical cures.