Definition of Obesity and Indications for Surgery
Obesity is an excess of body fat that frequently results in a significant impairment of health. It is a chronic, lifelong, genetically related, life-threatening disease of excessive fat storage. Obesity results when the size or number of fat cells in a person’s body increases. A normal-sized person has 30 to 35 billion fat cells. When a person gains weight, these fat cells first increase in size and later in number. One pound of body fat represents about 3,500 calories. The prevalence of overweight and obesity in the United States make obesity a leading public health problem that can have medical, social, psychological, and economic consequences. Obesity is growing at an exponential rate: It is estimated that there are more than 150,000 bariatric operations performed each year in the United States.
Although “overweight” technically refers to an excess of body weight and “obesity” to an excess of fat, these two words can be defined operationally in terms of body mass index. The body mass index (BMI) is the most practical way to evaluate the degree of obesity, although it does not take into account the different ratios of adipose to lean tissue. Visceral fat (or central obesity) has a much stronger correlation with certain diseases, such as cardiovascular disease, than the BMI alone. The absolute waist circumference (>102 cm in men and >88 cm in women) or waist-hip ratio (> 0.9 for men and > 0.85 for women) are both used as measures of central obesity.
KeywordsBody Mass Index Obstructive Sleep Apnea Bariatric Surgery Morbid Obesity Stress Urinary Incontinence
Unable to display preview. Download preview PDF.
- Cowan GSM Jr, Hiler ML, Buffington CK. Criteria for selection of patients for bariatric surgery. In: Deitel M, Cowan GSM Jr, eds. Update: surgery for the morbidly obese patient. Toronto: FD Communications, 2000:161–170Google Scholar
- Gastrointestinal surgery for severe obesity. Proceedings of a National Institutes of Health Consensus Development Conference. March 25–27, 1991, Bethesda, MD. Am J Clin Nutr 1992;55:487S–619SGoogle Scholar
- Health Implications of Obesity. NIH Consensus Development Conference Statement. Ann Intern Med 1985;103:1073–1077Google Scholar
- World Health Organization. WHO technical report series 894: Obesity: preventing and managing the global epidemic. A Report of a WHO Consultation. Geneva, 2000Google Scholar