in 2018 42.4 of us adults were slated to have the disease of obesity of course this has continued to rise during the covet 19 pandemic obesity has emerged as the most prevalent chronic disease of our time hello my name is dr fatima cody stanford i'm an obesity medicine physician and scientist for children adolescents and adults at the massachusetts general hospital and the massachusetts general hospital weight center i'm the director of equity for the endocrine division in the department of medicine at mgh and i serve as the director of diversity for the nutrition obesity research center
here at harvard this is understanding obesity obesity is a disease characterized by different signaling in the brain that tells your body how much to eat and also how much to store there is a particular part of the brain that's really responsible for weight regulation and that part of the brain is called the hypothalamus it gets signals and tells your body what to do and how to store so if you've struggled with your weight and wondering why do i struggle with my weight compared to my mom my dad my spouse my children what is it about
me it's about how your brain signals and how that differs for someone else so how do we measure this disease of obesity we use something called bmi which stands for body mass index there are three classes of obesity mild moderate and severe a bmi of 30 to 34.9 being classified as someone having mild obesity a bmi of 35 to 39.9 someone with moderate obesity and those with bmis greater than or equal to 40 having the disease of severe obesity now i told you it's an indirect measure so bmi is not the end all be all
and when the bmi charts and tables were developed they were based upon metropolitan life insurance tables from the 1930s that didn't include racial and ethnic minorities like myself for example so i do want to say that we use that with the grain of salt in addition to looking at bmi we might measure waist circumference and we do look at this differently based upon gender so for females we measure waist circumference at the umbilicus which is a fancy word for belly button and we would use a tape measure and we would measure and if you are
35 inches or less we're in a healthy zone for men the same area measuring at the belly button and around the circumference and our goal is to have a waist circumference of 40 inches or less so what causes obesity is it just about how much you eat and how much you exercise absolutely not but for so many years we have supported this idea and this myth that it's all about calories in and calories out and i'm here to dispel that myth today it's so complex there are different factors that play a role in how the
body regulates weight some of the contributors to obesity include disordered eating age-related changes genetic and epigenetic factors smoking cessation sleep deficits the gut microbiota physical disabilities maternal and paternal obesity increased sedentary time these are just a few of the factors that contribute to individuals having the disease of obesity so some of the different factors that may be related to why you struggle with obesity are age related changes which happen in a woman's life there are three major time during a woman's life where we see major weight shifts when she gets her menstrual cycle as an
adolescent if she gets pregnant whether or not that carries to full term or not and at the time of menopause major weight shifts that we see there believe it or not trauma history of trauma causes an increase in stress which causes storage of fat tissue so that's another factor if you're eating away from home a lot that can cause major shifts in weight and weight status there are over 200 diseases related to obesity let's talk about a few of the diseases that are common that you would know about that are related to obesity diabetes high
blood pressure obstructive sleep apnea polycystic ovarian syndrome gastroesophageal reflux disease osteoarthritis hip pain that's associated with osteoarthritis can be associated with obesity we know of over 15 cancers related to having the disease of obesity that are triggered by having obesity so there are four potential treatment strategies for obesity lifestyle and behavioral device pharmacotherapy or medications and surgery lifestyle and behavioral therapy really looks at a few key factors diet diet quality physical activity the duration and quality of one's physical activity but it also gets into someone's mental health as it relates to their obesity so their
tendency to overeat secondary to emotional issues or stressors for example these are factors that fall under that big umbrella of lifestyle and behavioral therapy whether you're a child adolescent or adult we want to optimize diet quality we want to look at lean proteins whole grains fruits and vegetables as the premier makeup of one's diet there's a device that is approved by the fda that is actually capsules that one takes that expands a jelly-like substance in your abdomen other things to consider are things like medications for the treatment of obesity there are several medications that are
approved by the federal and drug administration for obesity these range from pills that one may take to injections that people may take on either a daily or a weekly basis for the treatment of obesity one thing to note with the treatment of obesity with medications is that the medication does need to be used long term as soon as we take away the medication any weight that you may have lost will return as soon as that agent is removed and then finally metabolic and bariatric surgery which is utilized for those that have moderate obesity which is
a bmi of 35 to 39.9 with an obesity related disease like obstructive sleep apnea type 2 diabetes or heart disease or those that have severe obesity what many people are unaware of is that metabolic and bariatric surgery leads to an 89 percent improvement in life expectancy within the course of five years 89 that is something that we have to acknowledge and 95 of patients report that their quality of life improves within just three to six months after surgery some of the many diseases that can resolve with metabolic and bariatric surgery include sleep apnea high cholesterol
asthma high blood pressure fatty liver disease metabolic syndrome reflux type 2 diabetes polycystic ovarian syndrome hirsutism and menstrual dysfunction if you or any of your family members have struggled with your weight please know that you are not alone we've already talked about the high prevalence of obesity the most prevalent chronic disease of our time and there is help out there there are those of us particularly in obesity medicine that are here to help you conquer and treat this disease that has often caused numerous other diseases recognize this is not your fault we are here and
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