What is obese class 1?

What Is Obesity?

Obesity is a complex condition that raises serious health risks and can contribute to a lower quality of life.

The definition of obesity is simple: It’s the state of having too much body fat.

But in reality, treating and managing obesity is anything but simple.

Obesity is a very complex disorder that isn’t just a cosmetic concern — being obese puts you at risk for a variety of diseases and health problems.

Excessive body fat is linked to:

  • Type 2 diabetes
  • High blood pressure
  • Heart disease
  • Stroke
  • Some types of cancer

Worldwide, the prevalence of obesity more than doubled between 1980 and 2014, according to the World Health Organization (WHO).

And the social and economic consequences of obesity — including higher healthcare costs, lost workplace productivity, and lower wages — are having profound effects throughout the United States and around the globe.

Obesity and BMI

Obesity is generally assessed using body mass index, or BMI.

BMI takes both a person’s height and weight into account and is expressed in units of kg/m2 (kilograms per meter squared).

BMI levels for adults are categorized as follows:

  • Normal weight: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Obese: 30 or greater

Obesity is further classified as:

  • Class I obesity: BMI = 30 to 34.9
  • Class II obesity: BMI = 35 to 39.9
  • Class III obesity: BMI 40 or higher

Morbid Obesity

Some health organizations also refer to people with a BMI of 40 or more as “morbidly obese.”

Morbid obesity may also be defined as being more than 100 pounds over your ideal weight, or having a BMI of 35 or more with an obesity-related condition such as high blood pressure or type 2 diabetes.

Being morbidly obese places people at much higher risk for health problems than being slightly overweight or obese.

BMI Calculators

There are many online tools that will calculate your BMI.

Adults can use this BMI calculator to determine their body mass index.

Children should use a different BMI calculator than adults. The Centers for Disease Control and Prevention (CDC) provides this BMI calculator for children ages 2 through 19.

Obesity and Pregnancy

Obesity can negatively affect fertility in both women and men.

In women, obesity is associated with anovulation (lack of ovulation, or release of eggs from the ovaries).

In men, obesity is associated with low semen quality, decreased libido, and erectile dysfunction.

For obese women who do conceive, obesity raises the risk of such pregnancy complications as:

  • Gestational diabetes
  • High blood pressure
  • Miscarriage
  • Preeclampsia (a serious complication of late pregnancy)
  • Abnormal labor, often leading to Cesarean section

Fetuses of overweight or obese women have a higher risk of:

  • Prematurity
  • Stillbirth
  • Congenital anomalies (birth defects)
  • Macrosomia (being overly large)
  • Childhood obesity

Losing weight before pregnancy and minimizing weight gain during pregnancy can help to lower these risks.

Obesity in Children

The World Health Organization calls childhood obesity “one of the most serious public health challenges of the 21st century.”

Obesity not only lowers a child’s quality of life during childhood, but overweight and obese children are likely to stay obese into adulthood and to develop obesity-related diseases such as type 2 diabetes and heart disease at a younger age.

While global childhood obesity rates are difficult to track with certainty, an estimated 43 million children under the age of 5 were overweight or obese in 2010.

Of those 43 million, 35 million lived in developing countries.

In the United States, data collected in the National Health and Nutrition Examination Survey (NHANES) show that childhood obesity rates have more than tripled over the past three decades:

  • In the 1970’s, 5 percent of U.S. children ages 2 to 19 were obese.
  • By 2008, nearly 17 percent of U.S. children ages 2 to 19 were obese.

The short-term health risks associated with obesity in children include:

  • Cardiovascular risk factors
  • Prediabetes
  • Bone and joint problems
  • Sleep apnea
  • Social stigmatization
  • Poor self-esteem

Long-term risks include those risks associated with obesity in adults.

Learn More About Obesity Causes

Learn More About Obesity Treatment

Learn More About Bariatric Surgery

Learn More About Obesity Complications

Learn More About Obesity in America

Learn More About BMI

Overweight and obese are labels for weight ranges. According to the Centers for Disease Control and Prevention, weights in these ranges are higher than what is generally considered healthy for a given height. Having a weight in one of these categories may increase your risk for certain diseases and health problems. The definitions of overweight and obese are different for adults than children.

Definitions for Adults

Weight ranges for adults are defined using body mass index — a number calculated from a person’s height and weight. The easiest way to determine your BMI is to use an online BMI calculator. A calculator will give you both your BMI and the weight category your BMI falls within..

Weight Ranges for Adults

BMI Weight Category
Below 18.5 Underweight
18.5 to 24.9 Normal or healthy weight
25.0 to 29.9 Overweight
30.0 and above Obese

As with adults, BMI-for-age may be used as a screening tool, not as a diagnostic test. A health care provider needs more information to determine if excess body weight is a health problem. In addition to calculating BMI-for-age, a health care provider may ask about family health history, eating habits and the amount of physical activity your child gets. Additional assessments may help determine health risk, including skin fold thickness measurements and lab tests for cholesterol and blood sugar levels.

Overweight and Obese as Stereotypes

While the terms overweight and obese have precise definitions as noted above, these labels take on other meanings in our weight-obsessed society. Often, people who are considered to be overweight or obese are stereotyped, even enduring unfair treatment because of their weight. Larger children often are the target of weight-related bullying by other children and adults.

Overweight and obese are terms that refer only to a general estimate of an individual’s body weight. They do not in any way reflect on a person’s competence, self-discipline, drive or ability to lead a healthy lifestyle.

Morbid Obesity
In Episode 621, How Insensitive, Bobby Corso arrives at Seattle Grace-Mercy West Hospital in a… rental box truck. It takes several paramedics and firefighters to help him down onto a gurney because unfortunately, he has not walked in over a year. At nearly 700 lb, Bobby falls into the category of a rapidly rising health problem in the country today—morbid obesity.
Morbid obesity is a serious health condition in which excess body fat has accumulated to the extent that it interferes with basic physical functions such as breathing or walking. A person is diagnosed as morbidly obese when he or she has reached at least 100 lb over the ideal body weight or if they have a BMI of forty or higher (BMI stands for Body Mass Index, a measurement defined by the ratio of an individual’s height to his or her weight; normal BMI ranges from twenty to twenty-five). These patients stand at greater risk for serious illnesses that may reduce life expectancy such as diabetes, high blood pressure, sleep apnea, gastroesophageal reflux disease (GERD), gallstones, osteoarthritis, heart disease, cancer, and the list only continues.
What are some of the effects of these conditions?
– Obese people are resistant to insulin, which regulates blood sugar. This problem can induce illness such as Type 2 Diabetes.
– When the body carries around excess weight, the heart will not work correctly. The patient will develop hypertension (High blood pressure) which may lead to strokes, as well as damage the heart and kidneys.
– When additional weight is placed on joints such as the knees and hips, wear and tear ensues causing decreased mobility, back pain, and osteoarthritis of weight-bearing joints. However, in Bobby’s case of morbid obesity of approximately 700 lb, his ankle simply could not withstand the amount of weight, thus fracturing when he tried to walk.
– Fat deposits in the tongue and neck can block air passages, especially in patients who sleep on their backs, causing sleep apnea and respiratory problems. As a result, patients will lose sleep and suffer from daytime drowsiness and headaches.
– Excess weight will weaken and overload the valve at the top of the stomach, which then allows stomach acid to escape into the esophagus, causing GERD; this escape of acid has also been linked to esophageal cancer.
– Obesity can also lead to constant depression and emotional changes from failed diets, disapproval from family and friends, and remarks from strangers. Obese people also often struggle with fitting comfortably in public places, fearing discrimination from others.
– Obesity may wreak havoc on male and female hormone cycles, even causing infertility in some patients.
– A large, heavy abdomen relaxes pelvic muscles, weakening the valve on the urinary bladder. During a fit of coughing, sneezing, or laughing, an obese person may experience leakage and urinary stress incontinence.
– Menstrual irregularities often appear in women, presenting as irregular or absent periods with increased pain.
What can one do to pursue treatment for morbid obesity?
If a person struggles with morbid obesity, diet and exercise is the way to go, but an alternative solution would be to consult with a bariatric surgeon to determine whether or not the person may be a candidate for surgical treatment. They can perform a thorough work-up as well as help the patient submit a bariatric surgery insurance claim and provide weight loss financing options. Weight loss surgery addresses the issue at the source—it reduces the patient’s ability to overeat.
Gastric bypass surgery includes dividing the stomach into a large and smaller portion, thus creating a small-sized pouch or stomach (that can only hold about a cup of food). Next, the newer small pouch will be disconnected from the first part of the small intestine (the duodenum), reconnecting the stomach to a portion of intestine further down (the jejunum). Then, food will pass directly from the stomach into the jejunum, “bypassing” the duodenum, which leads to reduced absorption of calories. As a result, one experiences satiety much quicker, thereby helping to induce weight loss.
Now gastric banding surgery can be described as a restrictive procedure in which the surgeon uses one of a variety of techniques to actually reduce the size of the stomach. Therefore, when eating, a person will feel full faster, eat less, and lose weight.
Along with bariatric surgery, many obese patients choose to have their panniculus removed; the panniculus is the excess skin and fat in the lower stomach area that hangs below the belt line (often described as the “abdominal apron”). The extra fold or folds of skin and fat can affect hygiene, strain the back, and make physical activity quite difficult. Health conditions can ensue such as rashes, skin ulcers, and odor (such as the infection that Bobby developed).
People should strongly pursue treatment for morbid obesity, not only for the many physical health conditions one could easily develop, but also for the psychological and social effects as well. Some of obesity’s worst effects are emotional pain and suffering. Additionally, a common misconception of obesity is that these people are simply lazy and do not even try to lose weight; this perspective remains extremely damaging, leading to prejudice and discrimination in the job market, at schools, and in social situations.
For more information on obesity, please visit: http://www.cdc.gov/obesity/index.html

About Obesity

Obesity is a biological, preventable and treatable disease. Obesity is not a condition, a character flaw, a consequence of poor will power, or anyone’s fault. Contributing factors to obesity include heredity and one’s environment. Obesity is defined as a body mass index (BMI) of 30 or more. The BMI is a ratio of weight to height that is not affected by age, gender, or race.

As a disease, obesity is at the core of many other chronic illnesses – type 2 diabetes, diseases of the heart and cardiovascular system, some types of cancer, depression, arthritis, disordered breathing, deconditioning and gastrointestinal disorders.

Obesity Symptoms

The greatest sign or symptom of obesity is a person’s body mass index (BMI). A lean person has a BMI of 18.5 or less. At a BMI of 25, a person is considered to be overweight. The higher the BMI, the higher the health risk. Obesity is further defined as follows:

BMI For Adults

BMI For Adults.
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There are a number of medical conditions that can be associated with obesity. Refer to the list below.


A disease characterized by a population of cells that grow and divide without respect to normal limits, invade and destroy adjacent tissues, and may spread to distant anatomic sites through a process called metastasis.

Breast Cancer Cancer of the glandular breast tissue.

Cervical Cancer Malignant cancer of the cervix.

Colon Cancer Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix.

Esophageal Cancer Malignancy of the esophagus.

Pancreatic Cancer Malignant tumor within the pancreatic gland.

Prostate Cancer A disease in which cancer develops in the prostate, a gland in the male reproductive system. It occurs when cells of the prostate mutate and begin to multiply out of control.

Renal cell carcinoma Renal cell carcinoma, also known as a gurnistical tumor, is the most common form of kidney cancer arising from the renal tubule.

Uterine Cancer Uterine cancer may refer to one of several different types of cancer which occur in the uterus. These include endometrial cancers, cervical cancer, and sarcomas of the myometrium, or muscular layer of the uterus.

Cataracts A cataract is an opacity that develops in the crystalline lens of the eye or in its envelope. Early on in the development of age-related cataract the power of the crystalline lens may be increased, causing near-sightedness (myopia), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors. Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated.

Coronary heart disease Coronary heart disease (CHD), also called CAD, ischaemic heart disease, or atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium (the muscle of the heart) with oxygen and nutrients. While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a “sudden” heart attack, finally arise.

Edema Edema (American English), oedema or œdema (British English), formerly known as dropsy or hydropsy, is the increase of interstitial fluid in any organ — swelling. Generally, the amount of interstitial fluid is in the balance of homeostasis. Increased secretion of fluid into the interstitium or impaired removal of this fluid may cause edema.

GERD Gastroesophageal Reflux Disease (GERD; or GORD when spelling œsophageal, the BrE form) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. This can be due to incompetence of the lower esophageal sphincter (LES), transient LES relaxation, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia.

Idiopathic intracranial hypertension Idiopathic intracranial hypertension (IIH), sometimes called benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (ICP) in the absence of a tumor or other intracranuial pathology.

Liver and biliary tree

Cirrhosis Cirrhosis of the liver is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. Cirrhosis is most commonly caused by alcoholism and hepatitis C, but has many other possible causes.

Cholelithiasis, Cholecystitis Cholecystitis is inflammation of the gall bladder. It is commonly due to impaction (sticking) of a gallstone within the neck of the gall bladder, leading to thickening of bile, bile stasis, and infection by gut organisms. Cholecystitis may be a cause of right upper quadrant pain. The pain may actually manifest in the right flank or scapular region at first. In severe cases, the gall bladder can rupture and form an abscess or it may lead to a life-threatening infection of the liver called ascending cholangitis. In other cases, it may lead to a stable inflammatory state termed chronic cholecystitis.

Steatohepatitis Steatohepatitis is a type of liver disease, characterized by inflammation of the liver with concurrent fat accumulation in the liver (“steato” meaning fat, “hepatitis” meaning inflammation of the liver). Classically seen in alcoholics, steatohepatitis also is frequently found in people with diabetes and obesity. When not associated with excessive alcohol intake, it’s referred to as “non-alcoholic steatohepatitis,” or NASH. Steatohepatitis of either etiology may progress to cirrhosis, and NASH is now believed to be a frequent cause of unexplained cirrhosis (at least in Western societies). Recent studies suggest that diet, exercise, and especially antiglycemic drugs may alter the course of the disease.

Steatosis In cellular pathology, steatosis (also called fatty change) is the process describing the abnormal retention of lipids within a cell. It reflects an impairment of the normal processes of synthesis and breakdown of triglyceride fat. Excess lipid accumulates in vesicles that displace the cytoplasm. When the vesicles are large enough to distort the nucleus, the condition is known as macrovesicular steatosis, otherwise the condition is known as microvesicular steatosis. While not particularly detrimental to the cell in mild cases, large accumulations can disrupt cell constituents, and in severe cases the cell may even burst.

Phlebitis An inflammation of a vein, usually in the legs.

Polycystic Ovarian Syndrome Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects approximately 1 in 10 women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The principal features are lack of regular ovulation and excessive amounts or effects of androgenic (masculinizing) hormones. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance,

Psychiatric Disease

Depression Clinical depression or major depressive disorder is a state of intense sadness, melancholia or despair, that has advanced to the point of being disruptive to an individual’s social functioning and/or activities of daily living.

Pulmonary Disease Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airway disease (COAD), is a group of diseases characterized by limitation of airflow in the airway that is not fully reversible. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other disorders. It occurs most often due to tobacco smoking, but can be due to other airborne irritants such as coal dust, asbestos or solvents, as well as preserved meats containing nitrites.

Hypoventilation Syndrome Congenital Central Hypoventilation Syndrome or primary alveolar hypoventilation, is a respiratory disorder that is fatal if untreated. Persons afflicted with Ondine’s Curse classically suffer from respiratory arrest during sleep.

Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is not only much more frequent than Central Sleep Apnea, it is a common condition in many parts of the world. Approximately 1 in 5 American adults has at least mild OSA. Since the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of the throat, the human airway is composed of walls of soft tissue which can collapse, it is easy to understand why breathing can be obstructed during sleep – particularly in the obese. Although many individuals experience episodes of obstructive sleep apnea at some point in life, a much smaller percentage of people are afflicted with chronic severe obstructive sleep apnea.

Severe Pancreatitis Pancreatitis is defined as inflammation of the pancreas.

Sexual Dysfunction

Abnormal Menses – Infertility Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention.

Hypogonadism Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). The gonads have two functions: to produce hormones (testosterone, estradiol, antimullerian hormone, progesterone, inhibin B, activin) and to produce gametes (eggs or sperm). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature menopause) in adults. Defective egg or sperm development results in infertility.

Skin Disease

Acanthosis Acanthosis is increased thickness of the prickle cell layer of the skin.

Skin tags Skins tags are small benign tumors that form primarily in areas where the skin forms creases, such as the neck, armpits and groin. They may also occur on the face, usually on the eyelids. They range in size from rice to golf ball size, although larger ones have been seen. Skin tags are harmless, although they are sometimes irritated by clothing or jewelry and can interfere with shaving and other routine grooming. Why and how skin tags form is not entirely known, but there are correlations with age and obesity.

Stroke Stroke (or cerebrovascular accident or CVA) is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. This phenomenon can be caused by thrombosis, embolism, or hemorrhage (haemorrhage).

Urinary Incontinence Urinary incontinence is an unintentional loss of urine control. Those with this condition are not able to hold urine in the bladder due to loss of voluntary control over the urinary sphincters, resulting in the involuntary passage of urine. It is often temporary and almost always results from an underlying medical condition.

Venostatsis The trapping of blood in an extremity by compression of veins, a method sometimes employed for reducing the amount of blood being returned to the heart.


Healthy eating combined with an active lifestyle is the best way to prevent obesity. This means eating more fresh fruits and vegetables, and whole grains. It also means finding physical activities that you enjoy. Note that “diet” and “exercise” are not needed. Rather, good nutrition and physical activity throughout the day, every day, work best.

The key word for healthy eating is moderation. And it’s important to know portion sizes. A convenient way to balance your nutrition properly is to fill half of your plate with fruits and vegetables. In the other two quarters, put a source of protein and a carbohydrate. In addition, try using a salad plate rather than a full-size dinner plate.

Here are some other examples of portion equivalents:

  • 3 oz. of lean meat = a deck of cards
  • 1 oz. of cheese = 4 stacked dice
  • 1 medium apple = a tennis ball
  • 1 cup of pasta or rice = a clenched fist
  • 1 serving of pie = 1/8 of the pie

Be sure to eat three well-balanced meals every day, with breakfast being the biggest. Skipping meals actually lowers your metabolism because your body thinks you’re trying to starve it.

Developing a healthy lifestyle is something you and your family can and should do together. Prepare favorite recipes using more healthful ingredients. Try fruits and vegetables you’ve never eaten before. Follow some of the physical activities that you and your family enjoy. Ask for more healthy eating ideas the next time you see your endocrinologist or personal physician. Remember, each meal is an opportunity to eat better and each day is an opportunity to be more physically active.


Developing a healthier lifestyle will be part of any treatment program for overweight, obesity, and for any long-term complications from the conditions. Success is based on meeting three treatment goals:

  • You do not gain any more weight – we are happy.
  • You lose 1 percent of your body weight per year – we are happier.
  • You lose 5 to 10 percent of your body weight in 6-12 months – we are happiest!

Consider that losing 1 percent of your body weight can reduce your risk of developing complications, such as Type 2 diabetes, by 11 percent.

Improving your lifestyle, focusing on better nutrition and increasing physical activity alone is appropriate if your BMI is 25 to 29 and you have no complications from the excess weight (co-morbidities). Nutrition and increased physical activity should always be a part of your management because they improve cardiovascular conditioning and lower cardiovascular risk.

Medications, in addition to improving lifestyle, are indicated for a BMI of 27 or more, with two or more complications from obesity. Medications are also indicated if your BMI is 30 or more, regardless of whether complications are present or not.

In addition to improving lifestyle and using medications, surgery is indicated for a BMI of 35 or more, with two or more complications from obesity. Surgery is also indicated for a BMI of 40 or more regardless of whether complications are present or not.

The table below is a useful guideline for these interventions.



Risk of complications

Very low











Physical Activity






Behavioral Management














What You Need to Know These are some numbers for you to track as you take charge of your health:

  • BMI
  • Weight
  • Minutes spent engaged in physical activity/day
  • Daily servings of fruits/vegetables, proteins, and carbohydrates
  • Nutritional content of what you eat (read all food labels)
  • Step count (get a pedometer, or step counter)

Additional Resources Academy of Nutrition and Dietetics – www.eatright.org Centers for Disease Control and Prevention – www.cdc.gov and click on the “Healthy Living” link Action for Healthy Kids – www.actionforhealthykids.org America on the Move – www.americaonthemove.com

Structured Weight Loss Programs With Exercise Help Obese Lose A Lot Of Weight

People who are obese or severely obese can lose a considerable amount of weight if they receive a structured one-year weight loss program combined with physical activity, according to two reports published in the Journal of the American Medical Association (JAMA). A person is considered as obese when their Body Mass Index (BMI) is 30 or above. A BMI of between 20 and 25 is seen as ideal, while between 25 and 29.9 is overweight.
The authors explain that obesity rates in the USA have been rising steadily for the last thirty years – it has become one of the major public health problems of this century, particularly among African-American females.
According to the one of the reports, 68% of adults in the USA have a BMI of 25 or more, meaning that over two-thirds of the country’s adult population is either overweight or obese. Being overweight or obese significantly increases the risk of developing diabetes and hypertension (high blood pressure).
Bret H. Goodpaster, Ph.D., the University of Pittsburgh School of Medicine and team assessed a lifestyle intervention study which included a combination of structured diet and physical activity. The 1-year study involved 130 severely obese adult participants. None of them had diabetes. They were randomly selected into two groups and were monitored for weight loss for 12 months.

  • Group 1 – the combined diet and physical activity group. During the whole twelve-month period their program consisted of a structured diet plus physical activity.
  • Group 2 – delayed physical activity group. This group had the same program as the one above, however, their physical activity did not begin until six months into the program.

The investigators wrote:
To facilitate dietary compliance and improve weight loss, liquid and pre-packaged meal replacements were provided at no cost for all but one meal per day during months one through three and for only one meal replacement per day during months four through six of the intervention.
Physical activity – each individual was given a pedometer, a device which measures how many steps you take. They were asked to try to walk 10,000+ steps daily. They also had to do a 60-minute brisk walk each day. There were some small financial incentives for those who managed to do this.
The lifestyle intervention included group, individual and telephone sessions.
The authors wrote:
Of 130 participants randomized, 101 (78 percent) completed the 12-month follow-up assessments.
The Diet and Physical Activity Group (Group 1) lost 24 pounds during the first six months, compared to 18 pounds loss in the other group (Group 2). At the end of the 12-month period Group 1 lost an average of 27 pounds, compared to 22 pounds in Group 2.
The researchers added and then concluded:
Waist circumference, visceral abdominal fat, hepatic (liver) fat content, blood pressure and insulin resistance were all reduced in both groups.
In conclusion, intensive lifestyle interventions using a behavior-based approach can result in clinically significant and meaningful weight loss and improvements in cardiometabolic risk factors in severely obese persons. It is also clear that physical activity should be incorporated early in any dietary restriction approach to induce weight loss and to reduce hepatic steatosis and abdominal fat. Our data make a strong case that serious consideration should be given by health care systems to incorporating more intensive lifestyle interventions similar to those used in our study. Additional studies are clearly needed to determine long-term efficacy and cost-effectiveness of such approaches.
Donna H. Ryan, M.D. and Robert Kushner M.D., M.S. wrote in an accompanying Editorial:
“Class II obesity (body mass index of more than 35) and class III obesity (BMI of 40 or more) is a prevalent condition that adversely affects health,” according to Donna H. Ryan, M.D. of Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, and Robert Kushner, M.D., M.S., of Northwestern University Feinberg School of Medicine, Chicago, in an accompanying editorial.
Severe obesity is a prevalent public health problem, disproportionately affecting women and minorities. There is still much to learn about the mechanisms underlying differing risk and treatment outcomes between populations. Optimal treatment approaches for class II and class III obesity are underexplored, while payment approaches for interventions known to work have yet to be adopted.
They concluded:
Additional rigorous research, such as the clinical trial by Goodpaster et al, are needed to unravel the causes, identify prevention strategies, and develop the best treatments for obesity.
“Effects of Diet and Physical Activity Interventions on Weight Loss and Cardiometabolic Risk Factors in Severely Obese Adults – A Randomized Trial”
Bret H. Goodpaster, PhD; James P. DeLany, PhD; Amy D. Otto, PhD; Lewis Kuller, MD; Jerry Vockley, MD, PhD; Jeannette E. South-Paul, MD; Stephen B. Thomas, PhD; Jolene Brown, MD; Kathleen McTigue, MD, MS, MPH; Kazanna C. Hames, MS; Wei Lang, PhD; John M. Jakicic, PhD
JAMA. Published online October 9, 2010. doi:10.1001/jama.2010.1505
Written by Christian Nordqvist

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