Morbid obesity is characterized by a body mass index (BMI) equal to or greater than 40 kg/m². This form of obesity is also known as grade 3 obesity.
BMI is not an accurate tool for diagnosing obesity and, therefore, the doctor and nutritionist must carry out a complete assessment, using other body measurements, such as waist circumference and other diagnostic tests.
Read too: Obesity: what it is, degrees, types, causes, consequences and treatment
This type of obesity increases a person’s risk of developing some health problems, such as diabetes, hypertension and heart disease, and it is important that a doctor is consulted so that the diagnosis can be confirmed and the most appropriate treatment can be initiated.
Main symptoms
There are no specific symptoms of morbid obesity, and it is mainly characterized by a BMI equal to or greater than 40 kg/m², as well as excessive fat accumulation.
However, some people with morbid obesity may experience body pain, especially in the back, legs, knees and shoulders, as well as difficulty exerting effort and walking due to excess weight and lack of physical fitness. Additionally, there may be shortness of breath due to the pressure caused by excessive weight on the lungs, and dark spots on the skin, especially the neck and armpits.
How to confirm
The diagnosis of morbid obesity is made by a doctor or nutritionist. According to the World Health Organization (WHO), morbid obesity is confirmed when the BMI is equal to or greater than 40 kg/m².
However, calculating the BMI is not considered the most accurate way to confirm the diagnosis, as the formula does not take body composition into account, and it is important that the professional also considers the measurement of abdominal and arm circumference, in addition to evaluating the skin folds, such as the triceps and biceps, for example.
In addition, the health professional may also request laboratory tests, such as blood count, lipid profile, liver function tests, glucose and hormone levels, to check if there is any condition that may be related to weight gain and / or to assess whether the person is at risk of having any complications associated with being overweight.
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Main causes
The cause of obesity is an association of several factors, which include:
- Cultural factorsin which the environment encourages the consumption of foods with high caloric value due to the large amount of carbohydrates, mainly simple sugars;
- Sedentary lifestyleas the lack of exercise does not stimulate fat burning and facilitates the accumulation of fat;
- Emotional disorderswhich encourage binge eating;
- Genetic predispositionbecause when parents are obese it is common for the child to have a greater tendency to have it;
- Hormonal changeswhich is the least common cause, associated with some diseases, such as polycystic ovary syndrome, Cushing’s syndrome or hypothyroidism, for example;
- Use of some medications, such as steroids and some antidepressants.
Furthermore, obesity may also be associated with some genetic changes, such as Prader Willi syndrome, Bardet-Biedl syndrome, hereditary osteodystrophy, fragile X syndrome and Cohen syndrome, but these conditions are rarer.
Risks of morbid obesity
Morbid obesity increases the risk of developing some diseases, such as:
- Cardiovascular diseasessuch as atherosclerosis, heart attack or stroke, due to increased blood pressure, increased cholesterol and triglycerides;
- Dermatitis and fungal infectiondue to the accumulation of sweat in the folds of the body;
- type diabetes 2, due to excess fat stored in the body, which can favor insulin resistance and, consequently, the development of diabetes;
- Sleep apneawhich is a disorder in which breathing stops momentarily due to obstruction of the airways, causing snoring, hot flashes during sleep and excessive drowsiness during the day;
- Fatty liver and gallstone formation due to a diet rich in fats and ultra-processed foods;
- Sexual impotence and infertilitydue to hormonal changes and difficulty in blood circulation;
- Deep vein thrombosiswhich occurs due to changes in vessels and blood circulation due to a sedentary lifestyle.
Furthermore, people with morbid obesity have a high risk of having anxiety and depression due to dissatisfaction with body image and binge eating.
How the treatment is carried out
The treatment of morbid obesity must be individualized, as it needs to be well adapted to the health status and associated diseases. Therefore, the ideal is to undergo a consultation with an endocrinologist, who will carry out a detailed assessment and identify the most effective forms of treatment for each case.
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The main forms of treatment generally indicated are:
1. Changes in diet
It is important to consult a specialized nutritionist so that a nutritional plan adapted to the person’s needs can be indicated.
Therefore, it is recommended to give preference to the consumption of fresh foods, such as vegetables and fruits, lean meats and foods rich in fiber, such as seeds, legumes and whole grains. Furthermore, the consumption of processed and ultra-processed foods rich in fats and sugars should be reduced.
2. Practice physical activity
Practicing physical activity is important to promote weight loss and excess fat accumulated in the body, as well as stimulating the increase in muscle mass. Ideally, a physical education professional will recommend an exercise plan adapted to the person’s needs.
However, the general recommendation is to perform moderate-intensity physical activity 3 times a week for 30 to 60 minutes, preferably aerobic exercises.
3. Therapy
In some cases, depending on the cause associated with morbid obesity, the doctor may recommend therapy with a psychologist, especially if the person also presents symptoms of anxiety, stress and/or depression.
4. Medications
In cases where changing your lifestyle is not enough, your doctor may recommend the use of some medications to help facilitate weight loss. However, it is important to follow your doctor’s instructions regarding the use of medications, as they can cause unwanted side effects.
Furthermore, self-medication is not recommended, not only because of the side effects, but it may also be contraindicated in some health conditions.
5. Surgery
Bariatric surgeries, or stomach reduction surgeries, are valid treatment alternatives for morbid obesity, but in general they are only advised in cases where after 2 years of medical and nutritional treatment there is no significant weight loss, or when there is a risk of life due to being overweight. Find out more about surgeries and how weight loss surgeries work.
In addition to a healthy diet, successful treatment also involves the practice of physical activity and psychological support to maintain motivation in the face of difficulty in losing weight.
Childhood morbid obesity
Childhood obesity is characterized by excess weight among babies and children up to 12 years of age, when their body weight exceeds the average weight corresponding to their age by 15%. This excess weight increases the child’s risk of developing serious health problems, such as diabetes, high blood pressure, difficulty breathing, sleep disorders, high cholesterol or liver problems, for example.
The treatment of childhood obesity also involves changing eating habits and encouraging the practice of physical activity, with guidance from a nutritionist being recommended, so that dietary adjustments can be calculated according to the amount of weight that needs to be lost and the needs of each child. Check out the ways to help overweight children lose weight.
