By J. M. Anderson, M.D. published in Style Magazine Feb. 2004

At six weeks from the New Year, how many people are still holding to the promise to make those lifestyle modifications required to become the “healthier” version of themselves?  If 2004 has already included another failed New Years resolution, I encourage you to sit down and ask yourself what it is that you are trying to achieve.  If you are trying to lose a certain amount of weight – how are you planning to get there and more importantly stay there?  Also, is your motivation vanity driven or is it a desire to achieve a better state of health by avoiding weight related diseases?  If it is the latter, do you know your body mass index (BMI), your cholesterol and triglyceride counts, and your blood pressure?  If you knew that your blood pressure and cholesterol were elevated, at least in part, because of being overweight, would that encourage you to continue dietary and exercise revisions.  This year, instead of focusing on the scale alone, make a point to target these other important variables that inclusively generate an overall profile of your health status. 

The prevalence of obesity is on the increase and as a result, mortality from the effects of obesity may ultimately exceed smoking related mortality.  The World Health Organization estimates that the number of obese adults increased by 50% (to 300 million) between 1985 and 2000.  Measured from a calculation incorporating your height and weight, your body mass index – BMI – is a number, which reflects whether you are at an ideal, overweight, or obese body weight.  In 1999, 61% of US adults were overweight (BMI between 25-29.9), and 27% were obese (BMI >30).  This represents a major increase from two decades ago when 46% of adults were overweight and 15% were obese.

In both men and women, obesity is associated with hypertension (high blood pressure), dyslipidemia (high total cholesterol and low HDL), and diabetes mellitus II (adult onset diabetes).  All of these are in turn high risk factors for coronary artery disease, stroke, and peripheral vascular disease.  In addition, obstructive sleep apnea, gallbladder disease, esophageal reflux, arthritis and certain malignancies (breast, colon, endometrial or uterine, prostate) are all more common among the obese population.

Specifically in women, there is a clear relationship with BMI and mortality.  In one study of 115,000 women followed for 16 years, women with a BMI in the overweight range (25 to 29) were nearly twice as likely to die (cause unspecified), when compared to a group with a consistent BMI of <19. Morbidly obese women (BMI >32) were four times as likely to die from cardiovascular disease and more than twice as likely to die from a malignancy when compared to women with ideal BMIs. 

As the incidence of obesity continues to climb in the US, physicians are faced with the challenge of how best to address and treat obese patients.  People need to be aware that obesity is more than just excess weight and carries with it risks for serious medical conditions that should also be the focus of the annual New Years Resolution.  To find out your BMI, blood pressure, cholesterol levels, and whether or not you have any other significant hurdles to becoming a healthier version of yourself, see your primary care physician on a regular and consistent basis.  Happy New Year and stay focused.