Obesity is one of the most serious public health problems of the 21st century. Health care expenditures for obese Americans accounted for 35 percent of all costs in 2006 or $303 billion, an increase from $167 billion in 2001 (Mr. Obama take note).

From 2001 to 2006, the number of obese Americans increased from 48 million to 59 million people, and the day I wrote this article, 45 percent of the patients I saw in my office were obese.

Obesity is a condition where excess body fat has accumulated to the extent that it adversely affects your health. A medical degree is not necessary to make the diagnosis, since most people recognize obesity on sight.

A good estimate of obesity is to calculate a number called body mass index (BMI). You obtain this number by measuring a person’s height and weight and applying a simple formula. I do it for every patient in my office practice.

A normal, healthy value for BMI is between 18.5 and 24.9. From 25 to 29.9, a person is considered to be overweight. Anything above 30 is obese, anything above 40 is considered morbidly obese and anything above 50 is super obese.

Many common diseases are strongly associated with obesity, particularly heart disease, Type 2 diabetes, breathing difficulties during sleep, certain types of cancer and osteoarthritis. It is estimated that obesity is the cause of 64 percent of the cases of Type 2 diabetes in men and 77 percent of the cases in women.

In addition to health risks, obesity is also a leading cause of death worldwide. A BMI of 30 to 35 reduces a person’s life expectancy by two to four years, and a BMI of more than 40 reduces life expectancy for men by 20 years and for women by five years.

A combination of excessive dietary calories (eating too much), lack of physical activity and genetic susceptibility cause obesity.

In the American society, the increased rates of obesity are thought to be a result of the easy accessibility to food and an increased reliance on cars and mechanized manufacturing. The alarming increase in childhood obesity correlates with increased time spent watching TV and playing video games, as well as a poor diet. American diets contain an increased percentage of processed, fatty foods and sugars, and less whole grains, fruits and vegetables.

The primary treatment for obesity is dieting and physical exercise. In my practice, I find most people have trouble doing both.

Diets may produce weight loss over the short term, but keeping weight off requires making exercise and a lower calorie diet a permanent part of your lifestyle. Long-term success rates are low (2 to 20 percent). Commercial diet programs like Jenny Craig, Weight-Watchers or Nutri-Systems can be useful to help achieve weight loss.

Also, exercise alone in sufficient quantity can produce weight loss. In one study, during 20 weeks of basic military training with no dietary restrictions, obese military recruits lost an average of 27.6 pounds.

If diet and exercise alone fail, people can try anti-obesity drugs to reduce appetite or inhibit fat absorption. The FDA has approved only two drugs for long-term use: Meridia (an appetite suppressant) and Orlistat (inhibits fat absorption). Doctors may prescribe other drugs on a short-term basis, usually three months or less.

For morbidly obese individuals, the last resort is Bariatric surgery, which reduces the ability to eat large quantities and absorb calories. These procedures have risks but can be very successful at producing significant and permanent weight reduction.

Obesity is an extremely common problem and a very serious health concern. It goes far beyond cosmetics. It is an excellent reason to visit your doctor and begin a discussion. Getting your weight under control will improve your appearance, your energy level and your health.

Dr. Wilbur practices at Safecare Medical Center’s Hollywood office, located at 4050 D Sheridan St., Hollywood, FL 33021.  For an appointment with Dr. Wilbur, please contact his office at 954-989-7441.