Defining Obesity

To define what obesity means today, we can’t count on a dictionary. However, since obesity has become a growing national health problem in the U.S., it has perhaps never been more important that we have a working definition that we can all agree on.

In order to understand how someone is categorized as overweight or obese, the world’s health organizations have adopted the use of body mass index (BMI) to classify and communicate about body weight. BMI is a widely recognized weight-for-height index.

Unfortunately, this index does not quantify total body fat or convey information concerning regional distribution of fat — both of which are key to how obesity affects health. Nonetheless, BMI is an easily obtained measure that has been recommended for use in all age groups. Most clinical studies assessing the health effects of overweight and obesity rely on BMI.

Currently, the National Institutes of Health and the World Health Organization use the same measures of BMI for defining overweight. obese-3011213__340 (2)

  • If BMI is 25.0 to <30, it falls within the overweight range.
  • If BMI is 30.0 or higher, it falls within the obese range.

Since BMI describes body weight relative to height, it correlates strongly (in adults) with total body fat content. However, some very muscular people may have a high BMI without undue health risks.

Obesity is often from a combination of factors, based on both genetics and behavior. Accordingly, treating obesity usually requires more than just dietary changes.

Being overweight is a significant contributor to health problems. It increases the risk of developing a number of diseases including:

  • Type 2 diabetes
  • High blood pressure
  • Stroke
  • Heart attack
  • Congestive heart failure
  • Cancer (certain forms such as cancer of the prostate and cancer of the colon and rectum)
  • Gallstones and gall bladder disease
  • Gout and arthritis
  • Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back
  • Sleep apnea

Ideally, health-oriented definitions of overweight and obesity should be used that are based on the amount of excess body fat that puts an individual at a higher risk for health problems. Unfortunately, no such definition currently exists. Health risks associated with increasing weight are part of a continuum. People can have weight-associated health problems at BMIs lower than 25, and others can have no identifiable health problems at BMIs significantly greater than 25.

Easily determine your BMI with this free calculator:

If you’re interested in bariatric surgery, schedule an appointment with us. Our team of experts can find the right treatment for you.


What is Metabolic Syndrome

Nearly 35% of all U.S. adults and an astounding 50% of those 60 years of age or older are estimated to have a syndrome that makes them twice as likely to develop heart disease and 5 times as likely to develop diabetes as someone who doesn’t have this syndrome. The disorder is called metabolic syndrome, and it involves a group of 5 risk factors that increase the risks of developing several potentially deadly conditions.

What is metabolic syndrome?

It’s a group of risk factors that increases the likelihood of developing heart disease, diabetes, and stroke. The 5 risk factors are:

  • increased blood pressure
  • high blood sugar levels
  • excess fat around the waist
  • high triglyceride levels
  • low levels of good cholesterol, or HDL

Having one of these risk factors alone doesn’t mean one has metabolic syndrome. However, having just one does increase the chances of developing cardiovascular disease. Having three or more of these factors is considered as having metabolic syndrome.

What are the risk factors for metabolic syndrome?

The risk factors are related mostly to obesity. The two most important risk factors are defined by the National Heart, Lung, and Blood Institute as:

  • excess fat around the middle and upper parts of the body
  • insulin resistance, which makes it difficult for the body to use sugar

Other factors that can increase risk for metabolic syndrome include:

  • age
  • family history of metabolic syndrome
  • not getting enough exercise
  • women with polycystic ovary syndrome

What are the complications of metabolic syndrome?

Complications that can result from metabolic syndrome are often grave and chronic. Obesity concept in x-rayThey include:

  • hardening of the arteries
  • diabetes
  • heart attack
  • kidney disease
  • stroke
  • nonalcoholic fatty liver disease
  • peripheral artery disease
  • cardiovascular disease

If diabetes develops, additional health complications may result including:

  • eye damage
  • nerve damage
  • kidney disease
  • amputation of limbs

How is metabolic syndrome treated?

If you are diagnosed with metabolic syndrome, your doctor will probably recommend lifestyle changes that may include losing between 7-10% of your current weight and getting at least 30 minutes of moderate to intense exercise five to seven days a week. They may also suggest that you quit smoking.

Your doctor may prescribe medications to help reduce your risk of stroke and heart attack.

What is the outlook for patients with metabolic syndrome?

People who take their doctor’s advice and lose weight will reduce their chances of developing serious health problems such as heart attack or stroke. However, for many who are obese and haven’t been successful with diet changes and exercising, more intensive treatment like bariatric surgery might be needed.

If you live in the Las Vegas area and are considering bariatric surgery, schedule a consultation at VIPSurg. Our doctors and team of experts can help find the right treatment for you.


Health and the Holidays – How to Focus on Fun Not Food

Let’s face the facts here — most holidays are associated with certain foods. Our holiday gatherings usually revolve around an extravagant meal. Christmas at your house might not be the same without your aunt’s creamy corn casserole, but that doesn’t mean food has to be the main focus of the day. Instead, get into the other rituals a holiday brings.

Lead an Activity

We’re not suggesting you forgo or even minimize the importance of the holiday feast or traditional foods, but adding in some physical activity is something that’s good for the whole group. You can be creative, but here are some holiday themed activities to get everyone up and moving:

  • Caroling – who doesn’t love belting out a holiday tune? And what fun it is to hear people laughing outside (2)singing, open your door, and see a group of neighbors reveling in holiday spirit! Basically, this is a walk with plenty of stops for resting for those older or less fit among us.
  • Cut your own tree – Don’t buy a tree from a roadside lot where the trees have been drying out for weeks. Instead, visit a tree farm where you can cut your own. The tree will be fresher and often less expensive than they are at the lot. Also, you will burn calories (and fight some of the blood-sugar effects of the sweets you’ve been sneaking) by tromping around the grounds in search of the perfect tree. *Added bonus: Your family will have one more pleasant holiday memory to look back on of a lovely walk through a pine forest with loved ones.
  • Be inventive – nobody knows your family and friends better than you, right? Maybe a little friendly competition is in order. Perhaps your family enjoys a game of flag football or even musical chairs can get the heart pumping.

The point is — try to add some fun group activities that will get you and others moving.

Be Selective at the Table

Some of the more fattening or unhealthy choices on the table will be common foods that you could eat any time of the year. Opt instead for the holiday specialties if you want to “spend” your calories wisely.

  • Choose baked sweet potatoes over the cream and butter-laden mashed potatoes on the buffet.
  • Pour the gravy and sauces lightly. You may not be able to control what’s being served at a holiday meal, but you can make the turkey, roast beef, and even mashed potatoes and stuffing much healthier by skipping the sauce or gravy or ladling on just a small amount.
  • Indulge in only the most special holiday treats. Skip the store-bought baked goods, but do save some calories in your ‘budget’ to sample treats that are homemade and special to your family, such as your grandma’s special Yule log cake.

Teaching yourself what is worth indulging in and what to skip is much like budgeting your money: Do you want to blow it on mundane things that you can buy anywhere? Or do you want to spend it on a very special, one-of-a-kind souvenir? Don’t completely deprive yourself on festive days – your willpower will eventually be overwhelmed, and you’ll end up overeating.

All of us at VIP Surg wish you and yours a happy and healthy holiday season!




Is Obesity a Disease?

Whether or not obesity should be considered a disease is a matter of debate. In 2013, the American Medical Association, the nation’s largest group of physicians, voted to recognize obesity as a disease. The decision was controversial to say the least.

The decision was meant to improve access to weight loss treatment, reduce the stigma of obesity, and underscore the fact that obesity is not always a matter of self-control. Others argue that calling obesity a disease automatically categorizes a large portion of Americans as “sick,” when they may not be. Instead, critics say obesity should be considered a risk factor for many diseases, but not a disease in and of itself.

Experts on one side of the issue say obesity, like alcoholism, depression, and anxiety, is a disease. There are definite medical patterns: hormone imbalances, neurotransmitter deficiencies, and nutritional exhaustion that all contribute to obesity. Many patients that are obese have underlying medical issues that need to be addressed.

On the other hand, with more than one third of the American population presently classified as obese, it is clear that there are many causes for excessive fat accumulation like genetic issues, too little exercise/physical activity, too much food, inappropriate food selection, eating while watching television, etc. In many cases, obesity is the result of a specific lifestyle which can typically be reversed (at least in the short term) by adopting a different lifestyle.

Obesity increases the risk of developing a number of serious health conditions, including:

  • Coronary heart disease
  • High blood pressure
  • Stroke
  • Type 2 diabetes
  • Cancer
  • Sleep apnea
  • Gallstones
  • Osteoarthritis
  • Infertility or irregular periods

The Center for Disease Control (CDC) says people should aim to make long-term changes, such as eating healthy on a regular basis, and boosting daily physical activity. Even small amounts of weight loss — such as 5% to 10% of your total body weight – can have health benefits.

For some, obesity as a disease invalidates the importance of discipline, proper nutrition, and exercise and enables individuals with obesity to escape responsibility. For others, obesity as a disease is a bridge to additional research, coordination of effective treatment, and increased resources for weight loss.

Ultimately, obesity is a complex entity that can have many causes; some are endocrine (like thyroid malfunction or hyperfunctioning of the adrenal gland or Cushing’s syndrome), but often the condition is from a combination of inactivity and overeating. For others, there are genetic factors that produce a tendency to be overweight even with the consumption of what would be for most people an appropriate number of calories. Whether the causes are hormonal, genetic, or reside in the brain is often difficult to determine.

If you’re in the Las Vegas area and looking for treatment for obesity and the life-threatening conditions that often accompany it, schedule an appointment with VIP Surg. Our experts can help you find the right treatment for your unique situation.

Gastric Bypass for a Longer Life

According to research by the Geisinger Health System, one of the largest health service organizations in the U.S., patients with severe obesity who have gastric bypass surgery reduce their risk of dying from obesity and other diseases by 48% up to 10 years after surgery, compared to similar patients who do not undergo the procedure. This is significant considering that the American Society for Metabolic and Bariatric Surgery estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.

Researchers from the Geisinger Health System followed nearly 2,700 patients who had gastric bypass at the system’s nationally accredited bariatric surgery center between 2004 and 2014. Mortality benefits began to emerge within two years after surgery and were significant within four years. The biggest reduction in risk occurred in patients 60 years or older at the time of surgery and in patients who had diabetes before surgery.

“The long-term survival benefits these older patients and those with diabetes experience likely relate to improvements in long-term metabolic and cardiovascular health, among other risk factors,” said Michelle R. Lent, Ph.D., a Geisinger Obesity Institute researcher. “While this study did not evaluate specific-cause mortality, as expected, we did find significant improvements or remission in diabetes and high blood pressure.”

In the study, more than 60 percent of patients with diabetes before surgery experienced diabetes remission about five years after surgery. Previous studies have shown death from heart disease and even certain cancers are lower in gastric bypass patients than patients with severe obesity who do not have the operation.

People with obesity and severe obesity have higher rates of heart disease, diabetes, some cancers, arthritis, sleep apnea, high blood pressure and dozens of other diseases and conditions. Studies have shown individuals with a BMI greater than 30 have a 50 to 100 percent greater risk of premature death compared to healthy weight individuals.Live Longer

If you live in the Las Vegas area and are interested in learning what bariatric surgery can do for you, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts can help you choose the best treatment for your unique situation.


Obesity: The Disease that Keeps on Growing

A number of studies have shown that individuals who are obese are often stereotyped as “lazy” or “lacking in willpower.” However, obesity is no longer considered a cosmetic issue that is caused by overeating and a lack of self-control. The World Health Organization (W.H.O.), along with National and International medical and scientific societies, now recognize obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

In the United States, epidemiological data from a study that measured the actual body size of thousands of Americans, showed that 34 percent of adults more than 20 years old are affected by obesity and 68 percent are overweight (2007-2008 data). Obesity affected 10 percent of children between two and five years of age, 2 percent of those between 6 to 11 years old, and 18 percent of adolescents.

Throughout the last 3 decades, the prevalence of obesity has been increasing at an alarming rate. Since 1985, the Center for Disease Control (CDC) has supported an ongoing study, conducted on a yearly basis by state health departments, to examine changes in obesity prevalence state-to-state, and has found the following:

  • In 1990, the obesity prevalence for most of the states was 10 percent or less.
  • By 1995, more than half the states had a prevalence of 15 percent.
  • By 2000, nearly half the states had a prevalence of 20 percent or higher.
  • Five years later (2005), all but three states had a prevalence greater than 20 percent and nearly a third had a prevalence of 25 percent or more.
  • By 2010, the data show that most of U.S. states had a prevalence of 25 percent and many had a prevalence of 30 percent or higher.

Obesity is considered a multifactorial disease with a strong genetic component. Acting upon a genetic background are a number of hormonal, metabolic, psychological, cultural and behavioral factors that promote fat accumulation and weight gain.

Many other conditions associated with obesity contribute to the progression of the AdobeStock_69574863 (2).jpgdisease. Obesity reduces mobility and the number of calories that would be burned in the performance of activity. Weight gain may also cause psychological or emotional distress which, in turn, produces hormonal changes that may cause further weight gain by stimulating appetite and by increasing fat uptake into fat storage depots.

Sleep duration is reduced by weight gain due to a number of conditions that impair sleep quality such as pain, sleep apnea and other breathing problems, a need to urinate more frequently, use of certain medications, and altered regulation of body temperature. Shortened sleep duration, in turn, produces certain hormones that both stimulate appetite and increase the uptake of fat into fat storage depots.

Weight gain also contributes to the development of other diseases such as hypertension, diabetes, heart disease, osteoarthritis and depression, and these conditions are often treated with medications that contribute to even further weight gain. In all of these ways and more, obesity ’begets’ obesity, trapping the individual in a vicious weight gain cycle.

Multiple factors acting upon a genetic background cause weight gain and obesity. Conditions associated with weight gain and biological changes in the body that occur as a result of weight gain contribute to progression of the disease, often trapping the individual in a vicious weight gain cycle. Obesity is a complex disease influenced by several issues, including genetic, physiological, environmental, and behavioral.

If you live in the Las Vegas area and are concerned about your weight, schedule an appointment with Dr. Shawn Tsuda to learn more about how to improve your weight and health.


Tips for Staying on Track with Health Goals during the Holidays

Between all of the special foods, doing our best to put others before ourselves, and the hustle and bustle of the holidays, we can easily go off track in regards to our health and fitness goals. Consider the following to help during the rest of this holiday season.

  • Nobody’s perfect.
    With all the shopping needs and other time obligations, you are bound to miss a workout here and there, and that is okay. We don’t expect perfection with other areas of our life, and exercise is no different. Just make sure you get the next one!
  • Commit to two or three of your favorite holiday treats.
    List your favorites, and you are more likely to stick to those.
  • Plan ahead and create time.
    Instead of dwelling on the obstacles faced during the holiday season and what you can’t do, focus on what you can do, and find solutions to help keep you on track. Just as you would plan your time spent with your family, plan to incorporate your exercise as well. Even exercising as little as ten minutes sporadically throughout the day has been shown to be better than no exercise at all.
  • Be realistic.
    Keep in mind that having a realistic view about your situation and abilities is key to overcoming any pressure that you may be putting on yourself during this busy time of year. Be honest and know your limitations.
  • Make exercise a family affair.
    Quality time with family during the holiday season is often spent with too much food and too much sitting around. Exercise tends to take a backseat to yearly family traditions. Instead of taking a complete break during the holidays, reinvent some of those traditions and make exercise more of a family affair. Maybe go for a family walk around the neighborhood and look at the holiday decorations, suggest a game of backyard football or even a holiday-themed dance party.

You might not be able to stick to your holiday plan 100%. However, celebrating small victories can help you stay inspired and get you back on track to your routine for the new year as soon as possible! Dr. Tsuda and his team wish you a very Happy New Year full of health and fitness. Schedule an appointment to learn how we can help.

Digital scales with female feet on them and sign"no!" surrounded by Christmas decorations and glass of vermouth. Shows how alcohol and unhealthy lifestyle during xmas holidays effect our body.