|
COPYRIGHT 2004 Jannetti Publications, Inc.
Obesity is a recognized epidemic in many regions around the world and billions of dollars are spent each year in attempting to combat this problem. However, before a discussion of the different conventional and alternative treatments for obesity can be initiated, it is first critical to determine whether or not a certain individual is actually overweight, obese, or has an excess of adipose tissue. Therefore, a review of the various popular and unpopular measurements of obesity is needed. A variety of measurements exist such as bioelectrical impedance, body mass index (BMI), crude weight, densitometry, dual energy x-ray absorptiometry (DEXA), lean body mass (LBM), skinfold thickness, and waist-to-hip ratio (WHR). All of these measurements contain inherent advantages and disadvantages, but many of these can still be used in a clinical setting. Health professionals should acquaint themselves with these different measurements in order to take the first step in bringing attention to and potentially treating a condition that affects virtually every medical discipline.
**********
Obesity is as an epidemic in the United States and other industrialized countries (National Heart, Lung, and Blood Institute [NHLBI], 1998). The overall prevalence of obesity (body mass index [BMI] of 30 or more) continues to increase at a dramatic pace. An increase in the obesity rate of 15% to 27% of Americans has occurred in just the past 20 years (Department of Health & Human Services, 2001). In addition, nearly 66% of Americans are overweight (BMI 25-29). Approximately 325,000 deaths and $39 to $52 billion in health care costs have been attributed to obesity annually (Flegal, Carroll, Ogden, & Johnson, 2002). Obese individuals have a greater risk of early mortality versus the nonobese, especially from cardiovascular disease (NHLBI, 1998; Singh & Lindstead, 1998; Solomon & Manson, 1997). For example, some studies have found as much as a seven-fold increase in coronary heart disease with a BMI of 35 or greater (Ellis, Elliott, Horrigan, Raymond, & Howell, 1996). Obesity is also associated with many co-morbid conditions such as dyslipidemia, heart disease, hypertension, type 2 diabetes, osteoarthritis, gallbladder disease, and a variety of cancers (Ellis et al, 1996; NHLBI, 1998; Quesenberry, Caan, & Jacobson, 1998). This list of co-morbid conditions seems to grow with each passing decade, and a brief summary of some of these conditions is listed in Table 1 (Moyad, 2002).
Multiple treatment strategies seem to be the general approach to managing obesity. Several of these strategies will be discussed in later manuscripts of this series including lifestyle changes, drug intervention, and surgery. Surveys have indicated that about one-third of U.S. adults are attempting to lose weight, and another third are trying to maintain weight, and in many cases these attempts are unsuccessful (Serdula et al., 1999). Therefore, for health professionals to enhance their knowledge about obesity and the issues surrounding this subject, it seemed important to provide a series of reviews that cover the various aspects of the obesity debate. In the first part of the series the various measurements that can and cannot be used in a clinical setting will be covered. Other parts of this series will not only cover conventional treatment options, but other methods of attempting weight loss such as the various fad diets the health professional has and will be dealing with in the future. Again, this series of articles should provide a strong foundation for health professionals who will continue to deal with these issues.
Defining Overweight And Obesity
Obesity is generally defined as an excess concentration of body fat or adipose tissue. Obesity and overweight are terms often used interchangeably, but they do not necessarily represent the same situation. Some individuals may be overweight but not obese, while obese individuals are overweight to a certain defined degree.
Adipose tissue or storage fat and lean tissue are two of the primary compartments of the human body. Adipose tissue is generally regarded as metabolically inactive in terms of energy and nutrient requirements, and its primary energy needs are for cargo transportation from one location to another. Adipose tissue consists mainly of storage fat, mostly in the form of triglyceride, which is one of the reasons that individuals who lose fat generally experience an adequate reduction in their serum values of triglycerides. On the other hand, when someone gains a significant amount of adipose tissue, especially in the abdominal area, his or her triglyceride level may increase. Again, adipose tissue is less metabolically active, but it does have a major role in hormone metabolism (for...
Read the full article for free courtesy of your local library.
|
Bookmark this article
Print this article
Link to this article
Email this article
Digg It!
Add to del.icio.us
RSS
