Super ObeseSuper Obese: A 200 Kilo Problem According to an article in The Age, nearly half a million Australians now qualify as "super obese". Not just obese or morbidly obese, they have outgrown these traditional categories, with some weighing in at more than 200 kilograms, like The Biggest Loser contender Shannon Bourke. What is Obesity? One of the indicators of our health is our BMI or Body Mass Index. BMI is used to measure the amount of body fat in an adult man or woman. It is calculated by dividing a person's weight in kilograms by the square of their height in metres. According to the Department of Heart Lung and Blood Institute (NHLBI) in the United States, a healthy BMI is between 18.5 and 24.9. An index of 30 is classified obese. 40 is morbidly obese, and more than 50 is super obese. So a person who weighs 52 kg and is 1.62 metres tall has a BMI of 19.8, which is considered a healthy BMI. A person who weighs 214 kilos and is 1.82 metres tall has a BMI of 65, putting him or her in the super obese category. Obesity and Weight Loss In assessing a person's obesity risk, medical experts take into account the BMI, waist circumference and risk factors, such as whether the person has:
NHLBI guidelines recommend weight loss as the solution for those who are obese or who are overweight with two or more risk factors. Even a small weight loss can help to lower the risk of diseases commonly associated with obesity. Obesity Trends Obesity specialist John Dixon says there has been a fivefold increase in the extreme obesity category, and that this is the group that is most at risk because they have multiple issues, physical as well as psychological. Surgeon Dr Harry Frydenberg notes that besides being extremely overweight, individuals who are super obese also suffer from chronic conditions such as diabetes, sleep apnoea, depression and serious cardiac or respiratory problems. This makes bariatric surgery, including lap-banding, a highly risky option because of the anaesthesia requirement. Is the super obese problem an environmental epidemic? Associate Professor Tim Gill from the Boden Institute of Obesity at the University of Sydney thinks so. He says people don't choose to be obese. The trend towards obesity is a result of lifestyle changes and the modern environment: life is more fast-paced and pressurizing; people sit in front of computer screens all day long and have very little exercise; there are vending machines everywhere; commercially sold foods contain too much fat. There are many studies that have found a connection between obesity and one's education level and socio-economic status. The more educated and financially stable a person is, the healthier he is likely to be in body and mind. Poverty (including knowledge poverty) makes it harder for a super obese individual to understand the need for a healthy balanced diet and exercise and to persevere long enough to make a difference. As Associate Professor Gill puts it, "the more overweight you are the less easy it is for you to take those steps to prevent further weight gain". Weight Loss Solutions for the Super Obese One strategy that has been mooted is lap-banding or laparoscopic gastric banding, a relatively new stomach-reducing procedure in which bands are wrapped around the stomach to shrink it. The surgery merely reduces the stomach size. It does not address underlying issues that may have made it difficult for the super obese individual to lose weight, such as psychological or psychiatric issues or lack of nutritional education. Furthermore, Sarah McMahon noted in an article on OnlineOpinion that studies have warned of numerous post-surgery health complications from lap-banding, such as:
The lap-banding procedure is appropriate under medical advice, but should not be taken as a quick-fix solution by persons who have not thoroughly considered the alternatives. Healthy weight loss over a sustained period of time through correct eating and exercise may take a longer time to show results, but it is non-invasive and does not carry the medical risks that lap-banding can pose. If the underlying problem is psychological in nature, then that problem has to be addressed and appropriately treated. In some cases it can be a self-esteem issue. You don't like yourself, so you eat to self-medicate and to make sure no one else likes you either, which becomes a vicious cycle. In fact, one gentleman attributed his success at healthy weight loss to diet, exercise - and a lot of soul searching.
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