Bariatrics is the study and treatment of obesity and those diseases associated with obesity. Diet, exercise, behavior modification, lifestyle changes, institutional and home medical equipment, medications and, in some cases, surgery are the tools used by bariatric physicians to help patients manage obesity1.
Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. The amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits. Body fat distribution can be estimated by skinfold measures, waist-to-hip circumference ratios, or techniques such as ultrasound, computed tomography, or magnetic resonance imaging2.
Body Mass Index or BMI is a tool for indicating weight status in adults, representing weight levels associated with the lowest overall risk to health. It is a measure of weight for height. For adults over 20 years old, BMI falls into one of these categories3:
BMI
Below 18.5 = Underweight
18.5 - 24.9 = Normal
25.0 - 29.9 = Overweight
30.0 and above = Obese
BMI Calculator4
BodyMass Index can be calculated using pounds and inches with this equation:
BMI = [(Weight in Pounds) ÷ (Height in Inches) x (Height in Inches)] x 703
For example, a person who weighs 220 pounds and is 6 feet 3 inches tall has a BMI of 27.5.
[220 ÷ (75 x 75)] x 703 = 27.5
The BMI ranges are based on the effect body weight has on disease and death. As BMI increases, the risk for some diseases also increases. Some common conditions related to overweight and obesity include3:
Cardiovascular disease
High blood pressure
Osteoarthritis
Premature death
Some cancers
Diabetes
BMI is just one of many factors related to developing a chronic disease (such as heart disease, cancer or diabetes). Other factors that may be important to look at when assessing your risk for chronic disease include5:
Diet
Physical activity
Waist circumference
Blood pressure
Blood sugar level
Cholesterol level
Family history of disease
Obesity and obesity-related diseases are some of the nation's leading causes of preventable death. Smoking is the number one cause of preventable death in America. Currently, 64 percent of U.S. adults are either overweight (BMI of 25 or greater) or obese (BMI of 30 or greater). The increase in obesity over the past 30 years has been fueled by environmental, social, economic, and behavioral factors, acting on a background of genetic susceptibility6.
* Patients should always consult a physician before starting any exercise program. So what are some things that a person can do to help improve their quality of life if they are overweight or obese?
Even if a person is large, they can still be physically active! Here are some tips7:
Start slowly. The body needs time to get used to a new activity. The goal at first may not be to lose weight, but to prevent further weight gain.
Warm up. Warm-ups get the body ready for action. Warm-ups include shrugging the shoulders, tapping the toes, swinging the arms or marching in place.
Cool down. One should slow down little by little. After walking fast, one should walk slowly or stretch for a few minutes to cool down. Cooling down may protect the heart, relax the muscles, and prevent injury.
Set goals. One should set short-term and long-term goals. A short-term goal may be to walk for five minutes at least three days for one week. It may not seem like a lot, but any activity is better than none.
Get support. One should get a family member or friend to join in the physical activity for support.
Track progress. Keep a journal of physical activity. It may not feel like progress is being made but looking back at the starting point brings a pleasant surprise.
Have fun! Try different activities to find the most enjoyable ones.
Weight-bearing activities, such as walking, involve lifting or pushing one's own body weight.
Non-weight-bearing activities, such as swimming and water workouts, put less stress on joints because one does not lift or push one's own weight. Feet or joint pain while standing may indicate that non-weight-bearing activities may be best for the individual.
Lifestyle activities, such as gardening, do not have to be planned. Other examples are: putting away the remote and getting up to change the channel, sitting in a rocking chair and pushing off with your feet, or taking the stairs instead of the elevator.
Physical activity does not have to be hard or boring to be beneficial. Anything that gets a person moving around, even for only a few minutes a day, is a healthy start. Chances are, your health care provider will be pleased with any decision to start an activity program.
Myth: BMI Measures Body Fat
Two people can have the same BMI, but a different percent body fat. A bodybuilder with a large muscle mass and a low percent body fat may have the same BMI as a person who has more body fat, because BMI is calculated using body weight and height only.
This a good reminder that BMI is only one piece of a person's health profile. It is important to talk with a doctor about other measures and risk factors. (e.g. waist circumference, smoking, physical activity level, and diet.)
Myth: BMI is a Diagnostic Tool
BMI alone is not diagnostic. It is one of many risk factors for disease and death. As a person's BMI increases, the risk for many diseases increases as well.
Provided with permission by Dr. Kevin Huffman, D.O., President, American Bariatric Consultants.
CDC Nutrition and Physical Activity
Available at: http://www.cdc.gov/nccdphp/dnpa/obesity/defining.htm.
Accessed August 31, 2004.
CDC Nutrition and Physical Activity
Available at: http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-adult.htm.
Accessed June 6, 2004.
Body Mass Index Formula
Available at: http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-adult-formula.htm.
Accessed August 30th, 2004.
CDC Nutrition and Physical Activity
Available at: http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-means.htm.
Accessed June 6, 2004.
NIH Obesity Research Task Force Strategic Plan for NIH Obesity Research.
Available at: http://www.obesityresearch.nih.gov/News/background.htm.
Accessed August 30, 2004.
Based upon the article Active at Any Size, NIH Publication No. 04 - 4352, May 2004.
Available at: http://www.niddk.nih.gov/health/nutrit/activeatanysize/active.html.
