Got Obesity?

You’ve probably heard or noticed that obesity rates are rising.  In fact, every year for the past several decades, more and more people are being diagnosed with obesity.  There are many theories about why more and more of us are developing obesity, but what exactly is obesity and how do you know if you have it?

Before we get into it, we need to be clear that shaming or judging someone for their body type is not just unhelpful, but it’s just plain wrong.  Just as we don’t shame someone for developing cancer or glaucoma, we should not allow ourselves to think badly of a person who happens to have developed obesity. Unfortunately, there is still a great deal of stigma against people with obesity.

How is Obesity Defined?

Obesity is a disease of excess and dysfunctional adipose (fat) tissue.  But it’s not just a matter of carrying too much fat on your body.  Adipose tissue is active, producing hormones and other molecules that affect the functioning of every body system.  Thus obesity is best thought of as a metabolic disease with far-reaching implications for health, longevity, and well-being. 

We all need some adipose tissue on our bodies, so how do we decide how much is too much?

There are actually several different ways to define obesity.  The most common way is by using body mass index (BMI), which is calculated using your height and weight.  You can use an online calculator to determine your BMI, and if it’s over 30, you have obesity.  

Now there are a few caveats to using BMI to diagnose obesity.  For example, we actually use a lower BMI threshold to diagnose obesity (usually 27.5) in people of Asian ethnicities, because they tend to develop some of the bad consequences of obesity at lower BMI thresholds.  And some people might have a BMI over 30 but not have the disease of obesity.  Think body-builders who have lots of muscle and so weigh a lot for their height.

Another way to define obesity is by measuring waist circumference.  In general, for non-Asian people in the US, a waist circumference over 40 inches for men or over 35 inches for women is considered in the range of obesity.  Even better than just a waist circumference is measuring a waist-to-hip ratio or a weight-to-height ratio.  For these, your waist circumference should be less than your hip circumference, and less than half your height.  

Yet another way to define obesity is by percentage of body fat.  If body fat percentage is over 25% for men or over 35% for women, this is sometimes considered obesity.  

Why Does it Matter?

You may be wondering why all these cutoffs matter.  And it’s a reasonable question.  After all, it’s not like any BMI under 30 means one thing and any BMI over 30 means something else.  We know that with increasing BMI, the risks of bad health consequences go up, so that if your BMI is 29 you have more risk than if your BMI is 24. So why do we say only a BMI over 30 indicates obesity?  

Although the cutoffs that define obesity may seem arbitrary, it’s important to have them in order to research treatments, to determine who might benefit. It’s also important for collecting data and tracking data over time, and for determining what treatments will be covered by insurance. For example, using BMI, some 40% of US adults are considered to have obesity, but using some of the other measures can increase the obesity rate to 70% or even higher.  

And the numbers that define obesity aren’t completely arbitrary, but are the numbers most strongly associated with increasing risk of health complications.  Some of the consequences of obesity include diabetes, high blood pressure, heart attacks and strokes, arthritis, sleep apnea, and nearly every type of cancer, to name just a few.  

And that’s why it should matter to you.  If you have obesity, or are anywhere close to the thresholds discussed above, you’re at higher risk of poor health. And that matters, because poor health will keep you from living the life you deserve.  Poor health can keep you from chasing your dreams and living as the man you’re meant to be, and nothing matters more than that.

How We Evaluate Obesity

At B1, we take a holistic view of health.  We measure height and weight, of course, but we also recommend our patients get a Dexa scan, which measures body fat, visceral fat, muscle mass, and bone health, giving us a more complete view of body composition.  We can follow these scans over time to track body recomposition.  We take the data from our physical exam and Dexa scan, along with lab results and tests of physical function, and we put it all together for our patients to give them insight into how their body is doing now and what to expect in the future.  And this assessment is all done in the light of each patient’s unique goals and values.  We believe each man is destined to grow and improve each day, and our mission is to help him on that journey to becoming the man he’s meant to be. 

Whether they have obesity or not, we help our patients get in better shape, so that they can function at their best and live their best lives.  We help them develop healthy habits first and foremost, and we use other treatments like nutraceuticals, medications, hormones, peptides, and procedures when appropriate.  Because every man deserves to be a man of great health.