Ask a Health Care Professional – Obesity

By Wei-Ann Bay, M.D., Chief Medical Officer, Blue Cross and Blue Shield of New Mexico

Obesity is a serious chronic disease, and many have labeled it as an epidemic. The prevalence of obesity has greatly increased since the 1970s. While recent studies show the overall trend may be slowing a bit, the trend continues to increase for women 60 years and older. Obesity affects our nation’s overall health, cost of health care, economy and productivity. Obesity is also a risk factor for developing severe illness from COVID-19.

How is obesity defined?

Obesity is a condition in which a person has an unhealthy amount or distribution of body fat. Body mass index (BMI) is a measure of body fat based on height and weight. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems, but it is not diagnostic of the body fatness or health of an individual.

  • Normal is defined as a BMI of 18.5 kg/m2 to 24.9 kg/m2.
  • Overweight is defined as a BMI of 25 kg/m2 to 29.9 kg/m2.
  • Obesity is defined as a BMI of 30 kg/m2 to 39.9 kg/m2.
  • Severe obesity is defined as a BMI greater than or equal to 40 kg/m2.

An online calculator is available on the Centers for Disease Control and Prevention website; visit www.cdc.gov and search for adult BMI calculator. Next time you visit your health care provider, be sure to ask for your BMI.

How does obesity affect overall health?

Obesity can lead to the development of other chronic conditions. It is a risk factor for developing diabetes, hypertension, heart disease, stroke and some cancers. Studies have shown obesity may be linked to endometrial cancer, stomach cancer, liver cancer, esophageal cancer, colon cancer, and kidney cancer, just to name a few. Obesity can impair lung function to cause asthma-like symptoms and sleep apnea. Being just 10 pounds overweight puts an extra 15-50 pounds of pressure on the knee joints. This increases the risk for developing osteoarthritis, also known as wear-and-tear arthritis. More studies are beginning to show that excess fat triggers the release of inflammatory factors in the body, causing a state of constant inflammation. Constant low levels of inflammation have been suggested to explain how obesity might increase the risk of cancers, the development of cardiovascular disease and diabetes, and the progression of chronic diseases. Obesity also affects mental health, negatively impacting overall quality of life and increasing all-cause deaths.

How does obesity increase the risk for severe illness due to COVID-19?

Obesity is associated with worse outcomes from COVID-19. In fact, having obesity may triple the risk of hospitalization due to COVID-19 infection. Because obesity decreases lung function and lung capacity, having a respiratory illness such as COVID-19 can make breathing more difficult. There are also studies that show obesity can impair the functioning of the immune system. The COVID-19 shelter-in-place orders have resulted in many of us taking less steps per day, working longer hours sitting at our desks, being less socially active, and increased snacking and overeating. While the shelter-in-place orders were necessary during the pandemic, studies are showing these orders are linked to approximately 1.5 pounds of weight gain every month. The weight gain, often referred to as the “quarantine 19,” is a result of a change in lifestyle and reactions to a very stressful time. Weight loss during the pandemic has also been reported. It’s important to realize the unintended consequences and take steps to address them.

How can I get back on track and control my weight?

It’s never too late to get back on track. Set reachable goals and focus on lifestyle changes. Incorporating a daily routine that includes some form of exercise is a good first step. A brisk walk for 30 minutes can burn calories, increase metabolism and increase the body’s endorphin levels (the body’s natural pain and stress reliever). Depending on your physical condition, the addition of light weights to your routine helps to preserve muscle mass, increase metabolism and tone your body. At mealtimes, portion control, selecting food choices wisely and eating slowly are key to controlling weight. Finally, remember to consult with your health care provider about your plans for weight control. Your health care provider can determine if further evaluation is needed to ensure you can get back on track safely and have the best possible outcome.

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected]. BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.

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