a growing nation. In fact, according to the National
Institutes of Health, more than sixty percent of
Americans aged twenty years and older are
overweight, and one-quarter of American adults are
What does this mean for
the health of our nation? Nothing good. Obesity-related diseases are
"implicated" in more than a quarter million deaths every year. Below, Dr
Robert Kushner, Director of the Wellness Institute at Northwestern
Memorial Hospital, discusses the grave consequences of our growing
How serious is the
problem of obesity?
ROBERT KUSHNER, MD: It's the most serious problem we are facing today.
Next to cigarette smoking, overweight is the second leading cause of
preventable death in this country. It's estimated that 300,000 deaths
per year is attributable to our diet, physical inactivity and resulting
What are the current
statistics on overweight and obesity?
One in four is obese, and about one in three is considered overweight.
Combined, over 60% of adult Americans are now overweight or obese. That
means that the minority of this population is able to maintain a healthy
We're now hearing a
lot about children being obese. What is the number there?
It's about 1 in 10, or 10%. The troubling factor there is that children
are following in our oversized footsteps. An overweight or obese child
is more likely to be an obese adult. So we are looking at an epidemic
among our children as they become adults, and are likely to be more
obese than we are today.
Why has the number
of heavy people increased?
That's still debatable, and a lot of research is being done. But most of
us think that it's due to our society and culture. We really live in an
obesogenic society where food is plentiful, physical inactivity is
everywhere. Those two factors combined lead to gaining weight.
How is obesity
We currently define obesity by using a term called the
also known as the BMI. Everyone knows their cholesterol and everyone
knows their blood pressure. It's equally important that everyone knows
their BMI. It's a weight for height relationship that's fairly easily
calculated on tables. A BMI between 25 and 30 is defined as overweight.
A BMI of 30 or more is obese.
Roughly speaking, about
30 or more pounds overweight already defines one as obese.
Just 30 pounds?
Just 30 pounds. It doesn't take much to have the health complications
that are associated with obesity.
Talk about those
complications, the health effects of obesity.
Obesity is the major cause of type 2 diabetes in this country. Obesity
is the number one reason why diabetes is increasing in this country. It
is fueling that disease. In addition to diabetes, obesity is also linked
to increased risk of high cholesterol, high blood pressure,
gastroesophageal reflux disease, certain cancers, in addition to
psychological and emotional problems, as well as quality of life
changes. It eventually leads to earlier death.
What are the leading
causes of obesity?
The most significant factor really is our lifestyle. That's the only way
that we can understand why the numbers of obese patients or individuals
has risen so quickly. Again, that's the food that's everywhere and the
But genetics plays a
role as well. We currently think that genetics determines a
vulnerability to our environment, which then brings out the obesity.
There are other causes,
although less common. They include drug-induced obesity, such as people
on different corticosteroids or different hormonal agents. Those
medications can increase body weight, not to mention things like
antidepressants and other drugs used for mental health disorders.
Rarely is an underlying
medical condition a cause for obesity. That would be something like
Cushing's syndrome or different kinds of glandular problems. But they
are, once again, very uncommon.
What is the first
step in getting treatment for obesity? Where does a person go for help?
There are several places an individual can go for help. One is, and the
first that I would recommend, is to see his or her doctor. A doctor
should be an active partner to a patient who is trying to get control of
body weight. The doctor can also make sure that you don't have an
underlying problem that is either being caused by obesity or causing the
obesity itself. That needs to be ruled out right away.
Once you've done that,
you can either work with your doctor or work with a registered dietitian
or seek help with some of the commercial programs that are available,
which can be very helpful.