CHAPTER 41 OBESITY
Obesity is the most common nutritional problem, affecting almost one third of the population.
Approximately 13% of Americans have a body mass index (BMI) greater than 35 kg/m .
Obesity is the second leading cause of preventable disease in the United States, after smoking.
The cause of obesity involves significant genetic/biologic susceptibility factors that are highly
influenced by environmental and psychosocial factors.
The degree to which a patient is classified as underweight, healthy (normal) weight, overweight,
or obese is assessed by using a BMI chart.
Individuals with fat located primarily in the abdominal area (apple-shaped body) are at a greater
risk for obesity-related complications than those whose fat is primarily located in the upper legs
Complications or risk factors related to obesity include the following:
o Cardiovascular disease in both men and women
o Severe obesity may be associated with sleep apnea and obesity/hypoventilation
o Type 2 diabetes mellitus; as many as 80% of patients with type 2 diabetes are obese
o Osteoarthritis, probably because of the trauma to the weight-bearing joints and gout
o Gastroesophageal reflux disease (GERD), gallstones, and nonalcoholic steatohepatitis
o Breast, endometrial, ovarian, and cervical cancer is increased in obese women
When patients who are obese have surgery, they are likely to suffer from other comorbidities,
including diabetes, altered cardiorespiratory function, abnormal metabolic function, hemostasis,
and atherosclerosis that place them at risk for complications related to surgery.
Measurements used with the obese person may include skinfold thickness, height, weight, and
The overall goals for the obese patient include the following: o Modifying eating patterns
o Participating in a regular physical activity program