Morbid Obesity

According to the United States National Institutes of Health (NIH), the term " morbid obesity" is defined as being 50–100 percent above one’s ideal body weight, or 100 pounds above one’s ideal body weight. A person with a BMI (body mass index) value of 40 or greater would also be considered morbidly obese. (As noted on the Bariatrics page, an adult who has a BMI of 30 or higher is considered merely "obese.") The term "morbid" is used here in the medical sense: relating to disease. Learn more about the causes of morbid obesity, the problems related to the condition, and how morbid obesity surgery can help obese patients lose weight.

Causes of Morbid Obesity

According to the Centers for Disease Control and Prevention (CDC), approximately 9 million adult Americans are morbidly obese. This is 4.7 percent of the U.S. population, up from 2.9 percent in 1994. The severity and prevalence of this problem make morbid obesity a very serious national health crisis.

Morbid obesity surgery is an increasingly common procedure used to treat individuals with morbid obesity. However, the varying causes of morbid obesity and the plethora of obesity problems further complicate the issue of whether obesity surgery is appropriate for a given individual.

The causes of obesity cannot be defined easily. An individual's transition from normal weight to overweight to obesity to morbid obesity usually involves an intake of food calories that is greater than the rate at which the individual is burning off those calories. However, there are many different reasons for this imbalance of calories in/calories out, and several factors are involved. The causes of obesity may include an individual's genetic makeup, metabolism, culture, environment, socioeconomic status, and behavior.

Genetic Factors

It is possible for an individual's genetic makeup to directly cause obesity; disorders such as Prader-Willi syndrome and Bardet-Biedl syndrome are examples. However, most cases of morbid obesity are not based solely on such a genetic cause. The term "genetic factors" might be more easily understood as "heredity." It has been observed that obesity often runs in families, with obesity being more common in some families than others. This would suggest genetic causes of obesity. However, a given family would also probably share a similar lifestyle and similar diet, which would contribute to the incidence (or absence) of obesity.

There does appear to be at least an association between heredity and obesity. In a well-known study regarding this issue, adults who were adopted as children were found to have body weights closer to those of their biological parents than their adoptive parents, suggesting that their genetic makeup had more influence on their body weight (and the incidence of obesity) compared to the environment in their adoptive family's home.

In another frequently cited study, it was noted that identical twins, even when raised apart from one another, had similar weights much more frequently than did fraternal twins. In other words, the identical twins (who shared DNA and genes) showed much more similar weight patterns than their non-DNA-sharing counterparts.

Environmental Factors

A person's environment (at home, work, school, at play, in the community, etc.) can have a significant impact on his or her risk of developing morbid obesity. His or her "environment" in this regard would be comprised of:

• The types of food that are available to the individual
• The quantity of food available
• The level of physical activity available or attainable
• The diet and exercise habits of the individual
• Diet and exercise habits of people in the individual's immediate environment

People may make health-related lifestyle decisions based on their environment. For example, someone may choose not to walk to many places because of the car-oriented layout of the surrounding community. Another individual might find the unhealthy lunch buffet at his/her office very difficult to resist. And of course, children do not have much control over their environment; their food choices are usually dictated by their parents.

Psychological Factors

A person's risk of developing morbid obesity is often heavily influenced by psychological factors. Boredom, depression, anxiety, stress, trauma (whether as an adult or child), and feelings of low self-esteem are examples of psychological factors that could result in an individual's overeating and under-exercising. Although the psychological aspect of morbid obesity can be difficult to overcome, it is not impossible. Merely identifying the psychological problems can help an individual greatly in his or her understanding of the basis of overeating.

Other Causes of Obesity

Illnesses can also lead to morbid obesity. Some of these include hypothyroidism, Cushing's syndrome, depression, and other neurological problems. The use of steroids and certain antidepressants can also lead to weight gain.

Obesity Problems and Health Risks

Obesity is now the second leading cause of death in the United States. It is also associated with an increased risk of developing or worsening more than 30 serious health conditions or diseases. Obesity impairs a person's mobility, making physical activity more difficult, compounding the problem and further increasing the risk of developing or worsening some of these conditions. Here is an abbreviated list of conditions which are affected by obesity:

• Coronary heart disease
• Stroke
• High blood pressure
• Fatty liver disease
• Osteoarthritis
• Gout, a disease affecting the joints
• Diabetes
• Gallbladder disease
• Respiratory problems, including sleep apnea
• Cancer
• Reproductive and gynecological problems in women

Obesity problems can afflict men and women, adults, teenagers, and children. There are gender- and age-related differences in the types and incidence of obesity problems, but every person who is suffering from morbid obesity has the same problem — determining the best way to safely attain normal weight.

Psychological and Social Effects of Morbid Obesity

While morbid obesity certainly takes a physical toll on the body, it also takes a psychological toll. Some of obesity's worst effects are emotional pain and suffering. Society does not look kindly upon those who are very overweight, and many people do not understand obesity's complex causes and effects. Additionally, there is the common misconception that all obese people are simply lazy, which is absolutely not true. Nevertheless, this misconception leads to prejudices and discrimination in the job market, at schools, and in social situations. These prejudices often cause obese people to feel rejection, shame, and depression.

Morbid Obesity Surgery

According to the American Obesity Association, the most effective treatment for morbid obesity is obesity surgery. The risks of the various types of morbid obesity surgery are thought to be outweighed by the benefits of achieving significant weight loss when other weight loss efforts have failed.

There are three categories of obesity surgery: restrictive surgery, malabsorptive surgery, and combined restrictive and malabsorptive surgery. In restrictive obesity surgery, bands or staples are used to restrict the amount of food that a person can comfortably ingest by making the stomach smaller. A stomach "pouch" is created. Malabsorptive surgery makes the small intestine smaller, changes where it connects to the stomach, or both. These changes limit the amount of food that is absorbed; thus the surgery is called "malabsorptive." Combined restrictive and malabsorptive surgery is comprised of a restrictive obesity surgery (making a stomach pouch) and a bypass (the malabsorptive surgery), in which part of the small intestine is bypassed. The small intestine is where most of the body's digestion and absorption of food take place.

Morbid obesity surgery may be performed in an "open" procedure, with a major incision made, or with laparoscopy (using a long, narrow tube with a light and camera at the end, inserted through a small incision).

Morbid obesity surgery is a serious choice for an obese person, one not to make lightly or in an emotional moment. However, chronic obesity problems have made life an unhealthy and unpleasant journey for many people, and morbid obesity surgery has greatly improved the health and lives of thousands of patients. The various types of obesity surgery each have a distinct set of possible complications that should be taken into account. Consulting with an experienced and qualified obesity surgeon to determine whether you are an appropriate candidate for obesity surgery is a recommended preliminary step.

Locate an Obesity Surgeon to Discuss Your Options

If you are suffering from morbid obesity or obesity-related problems and you think that morbid obesity surgery might be the appropriate course to take, it's advisable to talk about your concerns and your medical history with an obesity surgeon. You can find an experienced and compassionate obesity surgeon in your area with DocShop.