Chapter 175: Obesity

Obesity is a state of excess adipose tissue mass. About 70% of U.S. adults are categorized as overweight or obese, and the prevalence of obesity is increasing rapidly in most of the industrialized world. Children and adolescents also are becoming more obese, indicating that the current trends will accelerate over time. Obesity is associated with an increased risk of multiple health problems, including hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, nonalcoholic fatty liver disease, degenerative joint disease, and some malignancies.

Obesity should not be defined by body weight alone, as muscular individuals may be overweight by arbitrary standards without having increased adiposity. The most widely used method to classify weight status and risk of disease is the body mass index (BMI), which is equal to weight/height2 in kg/m2. At a similar BMI, women have more body fat than men. Furthermore, regional fat distribution may influence the risks associated with obesity. Central (primarily visceral) obesity (high ratio of the circumference of the waist to the circumference of the hips [waist-to-hip ratio], >0.9 in women and 1.0 in men) is independently associated with a higher risk for metabolic syndrome, diabetes mellitus, hyperandrogenism in women, and cardiovascular disease.

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