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1
in 50 Americans Morbidly Obese
Americans are not just getting fatter,
they are ballooning to extremely obese proportions at an alarming
rate.
The number of extremely obese American
adults those who are at least 100 pounds overweight
has quadrupled since the 1980s to about 4 million. That works
out to about 1 in every 50 adults.
Extreme obesity once was thought
to be a rare, distinct condition whose prevalence remained relatively
steady over time. The new study contradicts that thinking and
suggests that it is at least partly due to the same kinds of behavior
overeating and under-activity that have contributed
to the epidemic number of Americans with less severe weight problems.
In fact, the findings by a RAND
Corp. researcher show that the number of extremely obese adults
has surged twice as fast as the number of less severely obese
adults.
On the scale of obesity, "as the
whole population shifts to the right, the extreme categories grow
the fastest," said RAND economist Roland Sturm. He added: "These
people have the highest health care costs."
Sturm said health problems associated
with obesity including diabetes, heart disease, high blood
pressure and arthritis probably affect the extremely obese
disproportionately and at young ages.
Sturm analyzed annual telephone
surveys conducted nationwide by the Centers for Disease Control
and Prevention. His report covers surveys from 1986 through 2000.
The findings appear in Monday's Archives of Internal Medicine.
In 1986, 1 in 200 adults reported
height and weight measurements reflecting extreme obesity, or
a body-mass index of at least 40. By 2000 that had jumped to 1
in 50, Sturm found.
The prevalence of the most extreme
obesity people with a BMI of at least 50 grew fivefold
from 1 in 2,000 to 1 in 400, Sturm said.
By contrast, ordinary obesity
a BMI of 30 to 35 doubled, from about 1 in 10 to 1 in 5,
based on the same surveys.
Body-mass index is a ratio of height
to weight.
Americans tend to understate their
weight, and a recent study based on actual measurements found
an obesity rate of nearly 1 in 3, or almost 59 million people.
Sturm said his findings probably understate the problem for the
same reason.
The average man with a BMI of 40
in Sturm's study was 5-foot-10 and 300 pounds, while the average
woman was 5-foot-4 and 250 pounds.
Dr. Mary Vernon, a trustee of the
American Society of Bariatric Physicians, said the study reflects
what doctors who specialize in treating obesity are seeing in
their offices. Vernon said the number of her patients weighing
300 to 350 pounds or so has doubled in the past several years.
She said thinking has evolved from
a generation ago, when many doctors believed extreme obesity was
due to hormonal abnormalities or other distinct conditions.
Now many believe it is a combination
of lifestyle factors and genetics, as well as a propensity for
some people's bodies to be hyper-efficient at storing calories.
This tendency would benefit people in societies where starvation
is rampant but is a huge problem in developed countries where
food is plentiful and lifestyles are increasingly sedentary, Vernon
said.
Vernon said the biggest challenge
in treating severely obese people, who typically have tried mightily
to lose weight, "is giving them enough hope that it's worth trying
again."
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On the Net:
Archives of Internal Medicine:
http://www.archinternmed.com
American Society of Bariatric Physicians:
http://www.asbp.org
Reference
Source 102
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