By
Mitchell R. Weisberg, M.D., M.P. 
Forward
Over the next several posts, I am going to update a document I first wrote in October 2006. My primary mission is to expose my readers, whether healthcare providers or laypersons, to the current state of the medical solutions for Obesity. Whenever I discuss the current medical approach to any aspect of the human condition, I replace the common phrase “state of the art”, with “state of our ignorance”. I want my readers to realize as I do, that nearly as soon as I understand and apply the current state of the medical science it becomes outdated if not completely obsolete, which is exactly as I want it to be. With everything I have ever learned about human health and medicine, there is one thing about which I will always be certain; we can always be doing better than what we are now. With that as my only disclaimer, I hope you find this update informative and useful.
Obesity the disease
If I had only one hour to save the world, I would spend fifty-five minutes defining the problem, and only five minutes finding the solution. Albert Einstein
Disease – Definition
A disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.
Obesity- Definition
Obesity, as defined by the BMI (Body Mass Index) is useful for estimating the incidence of the Disease Obesity within a Population and is a risk factor for acquiring other diseases, but the BMI by itself is not a disease.
Obesity the disease is defined in a given individual by the comorbid health conditions that are, partly or wholly, the result of excess body weight (described below). While the likelihood that a given individual will acquire one or several comorbid health conditions correlates with his or her BMI, comorbidities can occur independently from the BMI. So, a given individual may have a relatively normal or modestly elevated BMI yet have many comorbid health conditions while another individual can have an extremely elevated BMI and no comorbidities. Thus, there are multiple individual factors other than BMI that play causal roles in the disease state called Obesity. The comorbid conditions of Obesity can be
Physical Comorbidities
Pulmonary Disease
Metabolic Comorbidities
Cancer
Breast
Uterine
Cervical
Colon
Esophagus
Pancreatic
Kidney
Prostate
Cataracts
Cerebrovascular Accident (CVA, Stroke)
Fatty Liver Disease
Gallbladder Disease (Cholecystitis)
Gout
Gynecological Abnormalities
Abnormal Menses
Infertility
Hypertension
Pancreatitis
So, while a medical evaluation of Obesity may begin with calculating a patient’s Body Mass Index, it certainly does not end there. To properly treat Obesity, one must first properly diagnose obesity, and this cannot be accomplished with a scale or a mirror. To know whether they are obese (as defined here), most Americans need a thorough history and physical examination by a competent healthcare professional. Only then can they seek solutions, medical or otherwise.
In the posts that will follow, I will show how the definition of Obesity, as I laid it out here, serves as a guide in the medical evaluation (history, physical examination and ancillary testing) and ultimately the medical treatment of Obesity.
End Post
Mitchell R. Weisberg, MD, MP
Internist-Psychopharmacologist-Corporate Wellness Consultant
Founder-CEO and Personal Physician at,
Optimal Performance MD LLC
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