Managing obesity begins with assessment of issue
Tuesday, November 28, 2006
TODAY, WE GET to do a little arithmetic. There has been a great deal of publicity about the epidemic of obesity, even in elders, in the United States and, increasingly, in many other nations. One of the leading scientific journals in the world, the British Medical Journal has a series of excellent articles on the subject. They cover the extent of the problem, how to assess it and how it can be managed, both medically and surgically.
Obesity is best defined by measuring either a body mass index or a waist circumference. To calculate your BMI, simply ask your doctor for your weight and your height. Working with your doctor, take your height (in meters) and multiple it by itself. Then, take your weight (in kilograms) and divide it by the number you obtained by the first multiplication process. For example, if you are 5 feet 10 inches tall, you are about 1.78 meters in height. Multiplying 1.78 times 1.78 equals about 3.17. If your weight is 154 pounds, this is about 70 kilograms. So your BMI is 70 divided by 3.17 or approximately 22.1.
The World Health Organization has classified a BMI of 25 to 29.9 as overweight and 30 to 39.9 as obese. Values equal to or greater than 40 reflect morbid obesity. People of the height and weight used in the example have a healthy BMI.
Another way to assess obesity is to measure waist circumference. If your BMI or waist circumference is significantly increased, you should discuss this with your doctor. The risks of diabetes, hypertension and all its consequences -- including strokes, as well as coronary artery disease and heart failure -- are increased under those circumstances. Osteoarthritis and difficulty walking often are aggravated if an elder is significantly overweight.
If overweight, there are many ways to begin to lose weight. Talk with your doctor about various changes in your behavior that might help. Reminders on the refrigerator door, decreasing the size of portions, keeping a diary of what was eaten each week and appropriate exercise may all be helpful. As pointed out in one of the articles, even reducing the periods of inactivity rather than doing more exercise may be helpful. There are surgical procedures available for the management of extreme obesity. Generally, they are considered only after attempts to lose weight have been tried and have failed. Surgery is most often considered when an individual has a BMI of at least 35 and perhaps early signs of one of the complications of obesity.
It is especially important to remember that the risk of developing diabetes and hypertension, for example, decline with just a modest reduction in weight in obese persons. Even the risk of some cancers may decline with weight reduction. If overweight, work with your doctor and make a change.
Managing Obesity
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