Is Obesity Now Considered A Disease?

Depending on where you look, the definition of a ‘disease’ includes such phrases as a change from the normal state, a state of disorder, an abnormal or pathologic condition of the body, and being in dis-ease.  A disease can be brought about by personal factors, genetics, environmental influences, and lifestyle habits.  Common diseases include autoimmune conditions, hypertension, high cholesterol, diabetes, thyroid problems, cancer, endometriosis, ulcers, acne or more.  As of June 2013, the American Medical Association (AMA) has recognized obesity as a disease which could change the way insurance companies reimburse on prevention and treatment options for weight loss however those that oppose the AMA feel that obesity requires some personal responsibility as well.

According to the Centers for Disease Control and Prevention (CDC), almost 36% of Americans are in the obese category.  The classifications for ‘overweight’ and ‘obese’ are not perfect however the Body Mass Index (BMI) chart is most commonly used as it takes into account height and weight but not bone structure or lean muscle ratio.  A BMI between 18.5 and 24.9 is considered a normal, healthy weight.  Between 25 and 29.9 is in the overweight category and above 30 is officially classified as obese.  To give you an example, a 5’6” woman who weighs roughly between 160 and 185 pounds is considered overweight however if she weighs above 185 pounds then she is obese.  Another example would be a 5’4” woman who weighs between 145 and 175 pounds is considered overweight and if she were over 175 pounds she is considered obese. 

As many in the health field feel that abdominal obesity is more concerning as it means there is increased fat around the key abdominal organs, the waist circumference is gaining popularity when determining overweight, obesity and health risks.  Measure around your abdomen just above your hip bones (not necessarily your narrowest section) and women should be under 35 inches and men under 40 inches.  Higher numbers equals an increased girth which increases the risk for high blood sugar/pre-diabetes/diabetes, high cholesterol, high blood pressure and overall increased risk for cardiovascular disease. 

The overall concern is that excess weight can lead to long term consequences that could be preventable and there is an ongoing national push to get America healthier, reduce the number of obese and overweight adults and children, educate on proper nutrition, eliminate high sugar foods and drinks and encourage regular exercise.  Obesity is costing Americans millions of dollars as it can also cause an increased risk of cancer, joint pain, sleep problems, lethargy and more.  Please do not be a statistic – educate yourself and your family and start making healthy changes today!

References:

1.       Frellick, M.  AMA Considers Obesity A Disease.  Web.  23 June, 2013.

http://www.medscape.com/viewarticle/806566

2.        Centers for Disease Control and Prevention (CDC).  Adult Obesity Facts.  Web.  23 June, 2013.

http://www.cdc.gov/obesity/data/adult.html

3.       Centers for Disease Control and Prevention (CDC).  Defining Overweight and Obese.  Web.  23 June, 2013.

http://www.cdc.gov/obesity/adult/defining.html

4.       National Heart, Lung and Blood Institute.  According to Waist Circumference.  Web.  23 June, 2013. 

http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4142.htm

Do You Have PCOS?

Polycystic Ovarian Syndrome (PCOS) affects millions of women in the United States and causes a variety of fertility, hormone, skin, and ovarian problems.  In January 2013, a panel based on the Evidence Based Methodology Workshop at the National Institutes of Health suggested renaming and redefining the diagnostic criteria as they reported that PCOS should be determine by having 2 out of 3 criteria: excess androgens, ovulatory issues and multiple cysts in the ovaries.  This eliminates the requirement for ovarian cysts in absolute diagnosis as many people currently believe.

Typical symptoms of PCOS include: acne, excessive hair growth in places women typically do not want it, missed periods or irregular periods, not ovulating, weight gain especially around the middle, blood sugar and insulin problems, fertility problems, and ovarian cysts.  Androgens are a group of hormones such as DHEA, testosterone, androstenedione, and dihydrotestosterone that cause the skin and hair complaints.  Testing for PCOS can be difficult and as it is very multi-factorial .  First, evaluating for symptoms is important. Next, testing for androgens and looking for elevated levels.  Evaluating the menstrual cycle history looking to see if it is regular (roughly every 26 to 32 days) and if she ovulations. Testing for fasting blood sugar and insulin levels may indicate further consequences.  An ultrasound will visualize cysts on the ovary and discussing fertility challenges are important.

One of the issues the panel discussed was the difficulty in diagnosis as women will see different doctors or specialists for different issues.  A woman having trouble conceiving may see a fertility specialist while the woman with no menstrual cycle visits her gynecologist.  Acne and hair growth around the upper lip, chin, neck, nipples and abdomen may be evaluated by a dermatologist or aesthetician. If all symptoms are not accounted for, PCOS may be missed.  Also, women and their doctors may rule PCOS out if the ultrasound does not show multiple cysts on the ovaries yet she still has all the other symptoms.

Treatment for PCOS is important as long term sequelae can include diabetes mellitus, high blood pressure, high cholesterol, obesity, and a higher risk for cancer.  Seeking a healthcare provider who can evaluate all the symptoms, blood work and imaging then come up with a short and long term plan addressing all aspects is critical for health.  If the symptoms of PCOS sounds like you, do not hesitate to seek help as your health is important.

References:

1.       PCOS Diagnostic Criteria Clarified; Name Must Change.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/778066
2.       Increased Risk of Type 2 Diabetes with Polycystic Ovary Syndrome.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/767811