Some Topics in Weight Loss are Special

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The statistics speak for themselves unfortunately.  The population is putting on weight at an alarming rate. Even more disturbing is the fact that U.S. citizens have obesity and extreme obesity rates that are accelerating also.  The following graphs for obesity rates for men and women clearly show the rising numbers.1


Figure 1: Obesity Rates for Women

Figure 2: Obesity Rates for Men

The increases in the number of people who are overweight, obese or extremely obese have led to the development of a number of surgical strategies and medications. Though it is always better to lose weight through diet and exercise, sometimes a person’s health is so jeopardized by their weight that quicker solutions are sought. Yet even if a doctor decides surgery or some form of diet pill is called for, you still have a responsibility to do everything you can to promote weight loss naturally and to keep it off.

In other words, surgery and pills are not the best solutions. Eating a balanced healthy diet and getting regular exercise are the ideal weight loss programs.

The terms overweight, obese and extremely obese are defined according to body mass index (BMI):

  • Overweight – BMI of 25 to < 30
  • Obese – BMI of 30 but < 40
  • Extremely obese – BMI over 40

BMI is essentially the ratio of a person’s height to his/her weight.

The alarming trends in weight gain among all adult groups have health officials emphasizing the need to paying attention to and take steps to reverse these trends. Reversing them is vital to the long-term health and financial prosperity of America, as much of the projected higher insurance and medical costs are due to the fact that more and more people are becoming overweight and obese.  This is because obesity tends to lead other health problems, including high blood pressure, heart disease, diabetes, and arthritis.

Extreme Obesity

Extreme obesity, which is also known as “morbid obesity,” describes adults who have a BMI of 40 or higher.  These are people who are at least approximately 100 pounds heavier than they should be.  A recent medical study indicates that the severity and prevalence of obesity is increasing in patients admitted to hospital intensive care units. Health care is infinitely more difficult for someone who is obese or extremely obese and a poor outcome is more likely.2

As of 2007-2008, approximately 5.7% of U.S.citizens over 20 years old were extremely obese.3  Extreme obesity is much more than just a statistic though. For many women and men, being extremely obese equates to poor health, low self-esteem and a general feeling that there is lack of societal acceptance. It’s difficult to sit in chairs, on airplanes or to participate in many of the activities others are enjoying like sports. Even walking can be chore for someone who is 100 pounds overweight.

Many doctors from previous generations used to think that extreme obesity was caused by hormonal abnormalities or other distinct conditions, but most doctors today believe that it is a combination of overeating and under-activity that is causing most people to gain this much weight this quickly.  Though there is plenty of evidence that hormones do cause some cases of extreme obesity, but it is lifestyle that seems to be playing a bigger role.

Many doctors believe that the biggest challenge in treating extremely obese people is giving them the hope to continue to try to lose weight, as many of them have tried desperately to lose weight. Extreme obesity is not good for health, nor is it a good precedent for a parent to set for the health of their children.


When virtually everything else fails, extremely obese people will often turn to bariatric surgery, which is also known as weight loss surgery, to help them shed the pounds that they cannot lose despite changes in diet and exercise habits.  Bariatric surgery includes such procedures as the gastric sleeve procedure, Lap-Band surgery, and gastric bypass surgery.

The gastric sleeve procedure involves the use of a laparoscopic tool that is inserted through small incisions in the body to provide a visual guide to the inner areas of the abdomen during the surgery. The stomach is then altered to form a thin sleave for food to travel through.

Lap-Band surgery involves placing a silicone rubber band around the top of the patient’s stomach which creates a tiny stomach pouch.  This causes the patient to feel full very quickly, cutting down on the amount of food and drink that is consumed.

Gastric bypass surgery involves stapling the smaller, upper part of the stomach, essentially separating it from the rest of the stomach.  This reduces the amount of food and drink that the patient consumes.  The small intestine is rerouted to connect to this smaller stomach pouch.


When people have a BMI of 27 and higher and are already dealing with obesity-related conditions, including high blood pressure or diabetes, doctors can prescribe prescription weight loss medications to try to help their patients get their body weight down to more healthy levels.

This is not the first choice of doctors, as they’d prefer to avoid medications if at all possible, but sometimes, diet and exercise are not enough for people to lose weight to improve their health and decrease their chances of obesity-related medical conditions, such as diabetes, high blood pressure, heart attacks, strokes, and more.  There are sometimes risks with prescription weight loss medications, and these types of medications are only supposed to be used over a short-term period of time, usually a period of a few weeks or months at most.

One common type of weight-loss medication is an “appetite suppressant.”  The most common type is “phentermine.”  This type of medication will help to suppress the patient’s appetite, causing him or her to eat less, and thereby intake fewer calories.  This should help the patient to lose more weight if he or she does the same amount of physical activity as he or she did before taking the appetite suppressant medication.

Another common type of weight-loss medication is a “fat absorption inhibitor.”  The only fat absorption inhibitor medication that is currently approved for use in theUnited States  is “Xenical.”  Xenical will block about 30% of dietary fat from being absorbed into the bloodstream.  Xenical is approved for longer-term use in extremely obese people, but because of it being relatively new to the medical field, its long-term effectiveness and safety have not been established beyond a two-year period.8

Obesity is a Serious Problem That Can Be Overcome With Effort and Help

Obesity is not a condition that discriminates. All groups are consistently increasing in rates of being overweight or obese.4 This is a national problem as much as it is a personal one.

It can be frustrating for those who are extremely obese who try their hardest to lose weight, but see minimal or no results.  Many lose all hope and think, “What’s the use?  I was just born to be obese and unhealthy – there’s nothing that I can do.”

All hope is not lost, however – with the proper mindset and approach, good support group (including family, friends, medical personnel, and counselors), continued effort (in terms of diet and exercise), and appropriate medical help (weight loss surgery, medications, or both), you can lose weight to help you become healthier, live longer, and enjoy life more with the ones you love.


1 Ogden, Cynthia L. and Margaret D. Carroll, Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960-1962 Through2007-2008. Retrieved from National Center for Health Statistics: www.cdc.gov/nchs/data/hestat/obesity_adult_07_08/obesity_adult_07_08.pdf.

2 Kiraly, Laszlo, M.D and Ryan T. Hurt, MD and Charles W. Van Way III, MD. (2011). The Outcomes of Obese Patients in Critical Care. Journal of Parenteral & Enteral Nutrition , v. 35, pp. 29s to 35s.

 3 Ibid.

4 Obesity Rates Continue to Climb in the United States. (2007, July 10). From the Johns Hopkins Bloomberg School of Public Health News Center: www.jhsph.edu/publichealthnews/press_releases/2007/wang_adult_obesity.html


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