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Department of Surgery
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 Obesity

Columbia University Center for Metabolic and Weight Loss Surgery
About Obesity

According to a December 1998 article in the Journal of the American Medical Association, 59.4% of American men and 50.7% of American women meet the criteria for overweight and nearly 5% of all Americans meet the criteria for morbid obesity. This problem is associated with the development of life-threatening complications such as hypertension, diabetes, and coronary artery disease. Morbid obesity is generally defined as being 100 pounds or 100% above ideal body weight according to the Metropolitan Life Insurance Company height and weight tables.


Causes of Obesity

The exact causes of morbid obesity are not understood, but there are, most likely, many factors involved. In obese people, the set point of stored energy is too high. This altered set point may result from a low metabolism with low energy expenditure, excessive caloric intake or a combination of both. Some scientific data indicate that 80% of obesity may be inherited, strongly indicating a genetic cause. The most probable contributing factors to obesity are genetic, psychological, environmental, social and cultural influences. Severe obesity is absolutely not caused by a lack of self control. Because of the multi-faceted nature of this disorder, there is no single quick fix of the problem nor is there a single way to achieve permanent weight loss for every individual. That is why a comprehensive approach to the problem is absolutely necessary.


Know the Health Risks of Obesity

A variety of medical problems are associated with being obese. The risks associated with medically severe obesity are greater than the risks associated with its surgical treatments.

  • Diabetes

    Non insulin-dependent diabetes is highly associated with obesity. A weight gain of 11 to 18 pounds increases a person's risk of developing type 2 diabetes to twice that of individuals who have not gained weight. After weight loss, up to 80% of patients find they no longer have symptoms or require diabetes medication. Obese patients who are not diabetic will significantly reduce their risk of developing diabetes with weight loss.
  • Heart Disease

    There is an increased risk for heart disease, such as heart attack, congestive heart failure, angina or chest pain, sudden death and abnormal heart rhythms.
  • Hypertension

    Hypertension is also a risk factor of obesity. Losing weight is one of the primary recommendations for individuals with high blood pressure.
  • Infertility and complications of pregnancy

    Many severely overweight women are infertile because their fatty tissue alters normal estrogen hormone levels. This causes the ovaries not to release eggs. Weight loss can significantly increase one's chances of becoming pregnant.

    Obesity during pregnancy is associated with increased risk of death in both the baby and the mother and increases in maternal blood pressure by 10 times. Women who are obese during pregnancy are more likely to have gestational diabetes and problems with labor and delivery.
  • Sleep Apnea

    Sleep apnea (gaps in breathing during sleep) is a very common and serious complication of obesity. It can become so serious that heart and lung damage or sudden death can result.
  • Cancer

    Obesity is associated with an increased risk for certain types of cancer: uterine, colon, gall bladder, prostate, kidney and breast cancer.
  • Arthritis

    For every 2-pound increase in weight, the risk of developing arthritis is increased by 9 to 13%.
  • Other important health risks

    Gastroesophageal reflux or severe heartburn, urinary incontinence, venous problems of the legs, lower back pain, and disability from degenerative arthritis and disk disease have also been linked to being severely overweight. Other problems, including joint pain and hypoventilation, or shortness of breath, are significantly improved or reversed by weight loss.
  • Decreased Life Span

    Individuals with medically severe obesity have a decreased life span. A recent study in the Annals of Internal Medicine (Jan. 2003) concluded that obesity and overweight are associated with large decreases in life expectancy and increases in early death.
    • Forty year old female nonsmokers lost 7.1 years of life because of obesity
    • Forty year old male nonsmokers lost 5.8 years because of obesity
    • Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal weight nonsmokers.

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