Obesity Is a Serious Health Problem

By Joseph Afram, MD

Obesity surgery offers thousands a new lease on life. To understand the impact the surgery has on improving health, quality of life and longevity, one needs to recognize the severity of the obesity problem in the U.S.

Prevalence

An estimated 127 million U.S. adults are overweight or obese, compared with 800,000 to 900,000 Americans affected with HIV (about 300,000 with AIDS), 9 million with cancer, 16 million with diabetes, and 26 million with heart disease. Obesity has increased 61% in 10 years (1991-2000) in virtually all ethnic, racial, and socioeconomic populations, both genders, and in all age groups.

Mortality

Poor diet and sedentary lifestyle, contributing factors of obesity, are responsible for between 300,000 and 587,000 deaths per year, making it the second leading cause of preventable death after smoking. The rate of death and illness from obesity increases in proportion to excess weight. Death rates are two-fold for both men and women who are 50% above average weight. If they are diabetic, the death rate is five-fold for men and eight-fold for women.

Disability

Obesity is associated with about 30 diseases or conditions, many of which are incapacitating. Obesity is a chronic condition that can worsen other medical conditions or disabilities including hypertension, hypertrophic cardiomyopathy, hyperlipidemia, diabetes, cholelithiasis, obstructive sleep apnea, hypoventilation, degenerative arthritis and psychosocial impairments. Severe obesity often produces musculoskeletal, cardiovascular, peripheral vascular and pulmonary complications that preclude gainful employment.

Economic and Social Costs

The cost attributable to obesity is approximately $100 billion. A 1998 study estimated the direct medical costs at $51.64 billion. The real costs are likely significantly higher, since data is based on information gathered before obesity came to the forefront of our consciousness and was thus underreported.

The Burden of Obesity

The implications of obesity extend far beyond the decrease in health-related quality of life, which includes functional disability due to bodily pain. Persons with obesity are also subject to tremendous discrimination and stigma in our society. The American public, eager to deal with their weight problems, often turn to tabloid announcements of miracle cures, quick fixes and magic bullets spending billions of dollars on ineffective methods.

Obesity Surgery

Surgical treatment of obesity is considered medically necessary because it is the only proven method of achieving long term weight control for the morbidly obese. It is not a cosmetic procedure. Bariatric surgery involves reducing the size of the gastric reservoir that results in dramatic changes in eating behavior, which in turn reduces caloric intake to promote weight loss. Success of surgical treatment involves setting realistic goals, the best possible use of well designed and tested operations, and comprehensive follow-up care.
The number of people who have had bariatric surgery is increasing rapidly, jumping from about 16,000 operations in 1992 to an estimated 170,000 in 2005. Medicare recently endorsed three types of stomach-shrinking surgery, recognizing the procedures can offer safe and effective ways to treat obesity. Since private insurers often follow Medicares lead, this recent approval may lead to more extensive coverage making this life saving and life improving procedure available to more Americans.