Obesity

Description

Obesity is condition of increased body weight (consisting of both lean and fat tissue) that leads to increased morbidity and mortality. Also defined as weight 20% greater than an individual's desirable weight as defined by the Metropolitan Life Insurance Company.

Android obesity (male pattern or abdominal obesity) is higher risk and gynoid obesity (female pattern or gluteal obesity) is lower risk for long-term health problems.

Causes

The cause of obesity is multifactorial. Rare genetic syndromes have been described. Idiopathic obesity is assumed to be due to an imbalance between food intake and energy expenditure (physical activity and metabolic rate).

Endocrine disorders can cause obesity. These would include: excess insulin (insulinoma), excess cortisol (Cushing's syndrome or corticosteroid drug use), hypothyroidism, and hypothalamic disorders. Adipose tissue proliferation in hyperadrenocorticism is due to corticosteroid excess and leads to increased gluconeogenesis and a correspondingly greater demand for insulin, which, in turn, stimulates lipogenesis. There are three known predictors of future weight gain: a low metabolic rate; a high RQ (respiratory quotient), indicating carbohydrate oxidation and the need to eat to replace carbohydrate; and insulin resistance.

Hormonal disorders may also cause obesity. According to the Òestrogen dominance theoryÓ android obesity is thought to be caused by excessive amounts of estrogen as compared to testosterone in men, or progesterone in women.

Risk factors for obesity include: Parental obesity; Pregnancy; Sedentary lifestyle; High fat diet; and Low socioeconomic status.

Conventional Labs

Lab tests are not needed for diagnosis. Thyroid function tests and cardiac risk factors (cholesterol, triglycerides, and glucose) are usually ordered.

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