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Regional Center Staff
This Months Featured Article
August

Measuring Obesity and Health Risk

The numbers are shocking – it is currently estimated that two out of three American adults are overweight or obese. In the last 40 years, the obesity rate for adults has doubled. Approximately 15% of children are now overweight. The obesity rate for children has tripled in the last 25 years. Further, studies indicate that obesity is more common among persons with mental retardation than with the general population, especially with women.

Obesity has serious health consequences. The Centers for Disease Control and Prevention recently concluded that obesity has overtaken tobacco as the leading cause of preventable deaths in this country. Obesity is a major risk factor for hypertension, cardiovascular disease, diabetes mellitus and some cancers in men and women. Obesity is also associated with many other health problems.

Definitions of Overweight and Obesity

The Body Mass Index (BMI) is a now a commonly used tool for defining a person’s weight status. The BMI is a newer measure of weight status used instead of a height-weight table that portrays “ideal weight”. The BMI is a mathematical calculation based upon multiplying a person’s weight in pounds by 703 and then dividing by the person’s height in inches squared. (Automatic calculators for BMI are readily available through internet sites; one such site is http://www.nhlbisupport.com/bmi/bmicalc.htm.)

A person’s BMI may also be determined by the following table:

While the BMI does not measure body fat, it generally correlates well with the degree of obesity. For example, a person 5’6” tall weighing 130 pounds has a BMI of 21, which is considered a healthy weight. A person 5’6” tall weighing 190 pounds has a BMI of 31 and would be considered obese. There are limitations with BMI as it may overestimate body fat in a person who is very muscular yet underestimate it in a person who has lost muscle mass.

Clinical judgment must be used when interpreting a BMI score but the following classifications for BMI scores are commonly used by health professionals:

Underweight
BMI less than 18.5
Healthy weight
BMI 18.5 to 24.9
Overweight
BMI 25 to 29.9
Obesity (Class 1)
BMI 30 to 34.9
Obesity (Class 2)
BMI 35 to 39.9
Extreme Obesity (Class 3)
BMI greater than 40

Assessing Health Risk

Several measures are often used to evaluate a person’s weight status with respect to overall health risk. In addition to the measure of BMI, another measure is a person’s waist circumference. Excess abdominal fat is considered a risk factor for disease. Men have an increased risk for disease if their waist circumference is greater than 40 inches. Women have an increased risk if their waist circumference is greater than 35 inches. The waist circumference is most useful in persons who have BMI scores categorized as normal or overweight.

When assessing overall health risk for a person who is overweight or obese, the presence of other conditions or risk factors should be considered. These other risk factors include:

  • high blood pressure (hypertension)
  • high LDL-cholesterol
  • low HDL-cholesterol
  • high triglycerides
  • high blood glucose
  • family history of premature heart disease
  • physical inactivity
  • cigarette smoking

The table below summarizes the health risk associated with a person’s BMI score and depends upon the presence of other conditions.

BMI Category
Health Risk
Health Risk with Presence of Other Conditions*
< 25
Minimal
Low
25 - <27
Low
Moderate
27 - <30
Moderate
High
30 - <35
High
Very High
35 - <40
Very High
Extremely High
>40
Extremely High
Extremely High
 

*Other conditions (or co-morbidities) include hypertension, cardiovascular disease, type II diabetes, high LDL-cholesterol, low HDL-cholesterol, high triglycerides, sleep apnea, osteoarthritis, and infertility.

 

Weight loss should be considered for people who are obese, for those who are overweight and have one or more risk factors, as well as for people who simply carry more weight than needed for overall health. Studies have shown that even a small weight loss of only 10 percent of current body weight improves health and decreases the risk of obesity-related health problems and diseases.

Service Coordinators should ensure that an appropriate assessment is obtained for consumers who may be overweight or obese. Such an assessment should include a consideration of the presence or absence of other health problems and risk factors as noted above. Clinical professionals should participate with the consumer in the planning process to develop an appropriate treatment plan and weight loss strategies as may be indicated.

For information regarding specific health risks and related conditions of obesity, see the article for Clinical Professionals at this site.

 

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