In 2010, 36 states had obesity rates of 25 percent or higher, and 12 of those had obesity rates of 30 percent or higher. Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems.
WHAT DOES IT ACTUALLY MEAN TO BE OVERWEIGHT OR OBESE?
At their most basic, the words “overweight” and “obesity” are ways to describe having too much body fat.
The most commonly used measure of weight status today is the body mass index, or BMI.
BMI uses a simple calculation based on the ratio of someone’s height and weight (BMI = kg/m2). Decades of research have shown that BMI provides a good estimate of “fatness” and also correlates well with important health outcomes like heart disease, diabetes, cancer, and overall mortality.
HEALTHY BMI RANGES FOR ADULTS
What’s considered a healthy BMI?
For adult men and women, a BMI between 18.5 and 24.9 is considered healthy.
Overweight is defined as a BMI between 25.0 and 29.9; and a BMI of 30 or higher is considered obese. Obesity has been linked to a number of health complications, some of which are life-threatening:
- Type 2 Diabetes
- Heart Disease
- High Blood Pressure
- Certain Cancers (Breast, Colon, and Endometrial)
- Liver and Gallbladder Disease
- High Cholesterol
- Sleep Apnea and Other Breathing Problems.
Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren’t enough.
SET REALISTIC GOALS
Setting realistic weight-loss goals is an important first step to losing weight.
- Try to lose 5 to 10 percent of your current weight over 6 months. This will lower your risk for coronary heart disease (CHD) and other conditions.
- The best way to lose weight is slowly. A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. It also will give you the time to make new, healthy lifestyle changes.
- If you’ve lost 10 percent of your body weight, have kept it off for 6 months, and are still overweight or obese, you may want to consider further weight loss.
Lifestyle changes can help you and your family achieves longterm weightloss success. Example of lifestyle changes include:
- Focusing on balancing energy IN (calories from food and drinks) with energy OUT (physical activity)
- Following a healthy eating plan
- Learning how to adopt healthy lifestyle habits Over time, these changes will become part of your everyday life.
Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day. All patients with a BMI greater than 25 who would benefit. For individuals with a body mass index (BMI) >30 kg/m2 or a BMI of 27 to 29.9 kg/m2 with comorbidities, who have failed to achieve weight loss goals through diet and exercise alone, we suggest pharmacologic therapy be added to diet and exercise (from weight loss should receive counseling on diet, exercise, and goals for weight management. For patients with a BMI ≥40 kg/m2 who have failed to lose weight with diet, exercise, and drug therapy, we suggest bariatric surgery. However recently FDA approved gastric balloon for the treatment of obesity. This type of weight loss treatment can help you lose weight without invasive surgery. One type of gastric balloon is known as OrberaTM. During the procedure a soft balloon is inserted into your stomach through your mouth, using an endoscope (a thin, flexible telescope)
The FDA say the new dual balloon device offers a non-surgical option that can be quickly implanted, is non-permanent and can be easily removed.
The device comprises two balloons that are inserted into the stomach and inflated without the need for surgery. The device is meant to be a temporary measure and should be removed after 6 months. Removal is also via a non-surgical procedure.
“… Likely works by occupying space in the stomach, which may trigger feelings of fullness, or by other mechanisms that are not yet understood.”
The Dual Balloon does not alter the anatomy of the stomach. To help achieve and maintain weight loss, patients implanted with the Dual Balloon are advised to follow a medically supervised diet and exercise plan both while the device is in place and then for 6 months after it is removed.
The device is inserted during an outpatient visit. The procedure lasts no more than half an hour and is performed while the patient is under mild sedation.
A trained physician inserts the deflated balloons using an endoscope. This is a tube with a camera on the end that goes into the mouth, down the throat and into the stomach. The camera allows the physician to guide the placement of the deflated balloons.
Once in the stomach, the physician inflates the balloons by filling them with a sterile salt solution and then releases them and removes the endoscope.
The device is for obese adults whose body mass index (BMI) lies in the range 30-40 kg/m2. It is intended for patients who have not been able to lose weight through diet and exercise alone and is limited to those with one or more obesity-related conditions such as high blood pressure, high cholesterol and diabetes.
Trial participants lost 14 lbs on average For the approval, the FDA reviewed a clinical trial of 326 obese patients aged from 22 to 60 whose BMI was in the range 30-40 kg/m2 and who had at least one obesity-related condition.
The trial randomly assigned the patients to either have the Dual Balloon inserted, or to undergo an identical “dummy” endoscopic procedure but where the device was not fitted.
The results showed that at the end of 6 months, when the device was removed, the 187 patients who were fitted with the Dual Balloon on average lost 14.3 lbs (6.5 kg), equivalent to 6.8% of their body weight.
In contrast, the control group on average lost 7.2 lbs (3.3 kg, 3.3% of their body weight).
And 6 months after the device was removed, the group that had it fitted managed to keep off an average of 9.9 lbs (4.5 kg) of the 14.3 lbs they lost.
The insertion procedure may have side effects. These include muscle pain, nausea and headache. In rare instances, this may also lead to severe allergic reaction, tearing of the esophagus, infection, breathing problems and heart attack. Once the Dual Balloon is inserted, patients may also experience nausea, vomiting, feelings of indigestion, abdominal pain and stomach ulcers.
Patients who have had bariatric or other kinds of gastrointestinal surgery should not be fitted with the device, and neither should patients diagnosed with inflammatory intestinal or bowel disease, who have symptoms of delayed gastric emptying or active H. pylori infection, or who have a large hiatal hernia. Pregnant women and patients taking aspirin every day should also avoid it, the FDA advises.
By Srinivas Seela, MD
Srinivas Seela, MD moved to Orlando, Florida after finishing his fellowship in Gastroenterology at Yale University School of Medicine, one of the finest programs in the country. During his training he spent a significant amount of time in basic and clinical research, and has published articles in Gastroenterology literature. His interests include advanced and therapeutic endoscopic procedures, colorectal cancer screening, Gastro Esophageal Reflux Disease (GERD), metabolic and other liver disorders.
Dr. Seela is board certified in both Internal Medicine and Gastroenterology. He is a member of the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), the American Association for the Study of Liver Diseases (AASLD), and Crohn’s Colitis Foundation (CCF).
In addition to being an Assistant Professor at the University of Central Florida School of Medicine, he is also a teaching attending physician at both the Florida Hospital Internal Medicine Residency and Family Practice Residence (MD and DO) programs. Dr. Srinivas Seela is a gastroenterologist at Digestive and Liver Center of Florida.
Contact information 407-384-7388.