Question:  What is morbid obesity?

Morbid obesity is the end stage pathologic process resulting from excess fat storage in the body, resulting in multiple secondary disease processes.  This condition is distinctly different from the term “obesity” or “overweight” as it not only is associated with multiple diseases and shortened life, but in fact, represents a distinct disease process in and of itself, which will only respond to specific and radical intervention.  The natural history of morbid obesity leads to a multitude of diseases and ultimately, shortened life.

The Body Mass Index (BMI) is the index used by medical professionals to quantify the severity of obesity.  This is simply an index or number which is calculated by dividing one’s weight by ones height.  A BMI of 25 is considered normal, as this is the weight at which the human body is healthiest.  Multiple studies have shown that individual will live longest and healthiest with a BMI anywhere from 23 to 25. A BMI of 25 to 30 would be considered "overweight", and a BMI greater than 30, "obese".

Obesity becomes “morbid” when it reaches the point of significantly increasing the risk of one or more obesity related conditions (or co-morbidities) that result in either profound physical disability or early death.  As such, the disease of morbid obesity is defined as having a BMI greater than 40 or a BMI of 35 to 40 when associated with several specific co-morbidities such as diabetes, hypertension, heart disease, sleep apnea or life-limiting joint disease.  These criteria were set by the NIH  in 1991 and are universally used to qualify for surgical weight loss by weight loss surgeons and insurance carriers.

Currently, over half of Americans are considered overweight, with a third considered obese.  In 24 million adults, or 5% of the total population, are considered to have morbid obesity.  Notably, those with a BMI greater than 30 have tripled in the last 25 years, and those with a BMI greater than 40 have quadrupled.  Further, those with a BMI greater than 50 have quintupled.

Morbid obesity is a serious disease and should be treated as such.  It currently represents the most significant health threat to the United States in the foreseeable future.  It is a chronic multi-factorial process requiring aggressive, long-term treatment.