You don’t have to look far to realize obesity is a common problem in the United States.
Its impact on the health of our nation continues to grow. In November 2013, the American Heart Association, American College of Cardiology and The Obesity Society released updated guidelines about managing overweight and obese American adults.
According to data from the National Center of Health Statistics, more than one-third of adults in the U.S. are obese. This represents more than 78 million American adults! While ethnic minorities face disparately high rates of obesity, the problem affects all groups. Of note, rates of obesity in men and women are about identical.
To be clear, obesity increases the risk of disease as well as the risk of death from all causes. According to the new guideline, among common health conditions associated with obesity are hypertension, elevated cholesterol, type 2 diabetes mellitus, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems and some cancers.
The new obesity management guideline summarizes the results of a systematic review of research evidence since 1998, when the National Heart, Lung and Blood Institute released the last guideline. It is the most comprehensive review of evidence supporting the benefits of obesity treatment currently available.
Obesity management generally falls into three categories: lifestyle measures, medication therapy and bariatric (weight loss) surgery.
Regarding medication therapy, the expert guideline panel did not review comprehensive evidence for weight loss drug therapy. However, expert opinion supported the use of approved weight-loss medication as an addition to lifestyle modification to achieve targeted weight loss and health goals.
Regarding the benefits of weight-loss surgery, there was strong evidence to support the potential health benefits of weight loss surgery for people with body mass index exceeding 40 or with BMI over 35 with weight-related health complications who had failed to achieve weight goals with lifestyle modification with or without medication treatment.
Yet, the bulk of the guideline focused on the importance of comprehensive lifestyle modification as the foundation for all effective weight-loss treatment.
Importantly, the guideline found strong evidence to support that even modest weight loss of 3 percent to 5 percent from lifestyle modification combining exercise with a healthful diet provided measurable health benefits – including reduction of death risk from all causes.
Annually, every adult should calculate BMI, a measure of weight for height. This can be accomplished by using any of a number of free online BMI calculators. Normal BMI for adults is 18 to 24. A BMI of 24 to 29 among adults indicates being overweight, while BMI over 30 indicates obesity.
For obese adults, a well-balanced, reduced-calorie diet is recommended. For women, a 1,200 to 1,500 daily caloric restriction is advised, while for men a 1,500 to 1,800 daily caloric restriction is advised.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.