Is it OK to be fat?

The answer is absolutely no. No matter what spin the media and the apparel companies put, having a weight that is not appropriate for your body is simply unhealthy. The Center for Disease Control (CDC) came up with a controversial finding recently that it was OK to be slightly overweight but once they discovered their mistake, Director Julie Gerberding has been trying to clarify that we cannot afford to be overweight or obese. Recently she answered many questions related to the confusion that has been created.

CDC and other scientists have published several papers describing the association between obesity and death in the US. We can't get accurate estimates of the association because obesity is not listed on death records, so we have to use methods that rely on extrapolations. The studies that have been done have used different methods and different sources of information, and they've come to some different conclusions, and that has created a lot of confusion on the very definition of obesity.

Obesity, which is a risk factor for chronic diseases like diabetes, is typically calculated using the body mass index (BMI) -- dividing weight in kilograms by height in metres squared. A BMI of more than 30 is considered obese, more than 40 is very severe.

Obesity is a critically important health threat in both the United States and many other countries. In the US, where the problem appears to be the worst, two out of three people have a weight problem. Things are gradually getting worse in other countries. An estimated 10-20 percent of men and 10-25 percent of women in European countries are obese. Countries like China, where people have traditionally not been obese are now seeing signs of obesity, particularly among young people.

First of all, we know that over the last 20 years, the rate of obesity in this country has soared astronomically. The chart below (courtesy: CDC) depicts the current profile of obesity among adults in the United States, and, as you can see, there are some states where more than 25 percent of the population is obese.

Even more frightening than that is the fact that 16 percent of the children in the US are obese. That number has increased by at least two times over the last 20 years. Another chart (courtesy: CDC) shows how serious the crisis is.

People who are obese experience an increased rate of hypertension, diabetes, renal failure. They're at increased risk for cancers, including colon cancer, post-menopausal breast cancer, gall bladder cancer, and uterine cancer. People who are obese and overweight have an increased risk of arthritis and mobility problems. People have sleep disturbances and breathing problems. It was also recently found that obese people earn less than their healthy peers.

Another very scary fact for children -- Type II Diabetes, which used to be known as adult onset diabetes, is now increasingly being diagnosed and adding to the cardiovascular risk profile of children. The US has many children now who are not only overweight, but they also have high blood pressure, lipid abnormalities, and diabetes -- all of the factors that increase the risk among adults for cardiovascular disease and stroke.

We also know that obesity is linked to problems with child bearing, premature birth, learning disabilities, and other adverse outcomes for infants. And finally, the economic estimates of the impact of obesity are astronomical. Approximately $75 billion are attributed to obesity in 2003 in the US alone. There's a much higher rate of obesity among African Americans and among Hispanics in the United States. There's also a much higher proportion of people who are native Americans, who have problems with obesity. Treating obesity-related disorders costs as much or more than illnesses caused by aging, smoking and alcoholism. It accounts for 2 percent of the national health expenditure in France and Australia, more than 3 percent in Japan and Portugal and 4 percent in the Netherlands.

What does it mean for you?

While you may have heard contradictory information here and there, the bottom line is that there is simply no reason for you to have more weight than what you need for your height, age, and lifestyle. And you can do something about it. Apart from diet and exercise you can also seek help of plastic surgery to deal with your weight related problems.

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