FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

WEIGHT LOSS DRUGS ONLY APPROPRIATE FOR "MORBID OBESITY"

Question: I have seen ads on television for a new medicine for those of us who are definitely overweight. I'm concerned about using a medicine to help with my weight problem because of the heart problems other popular weight loss drugs caused, but I sure could use some type of help. What do you think?

Answer: Being overweight is almost always a behavioral problem. That is, we become overweight by eating more food each day than the body uses up. The body saves that little extra food energy by storing it as fat. This overeating occurs for a wide variety of reasons, but the most common are eating just because it is meal time, eating as a response to stress, or eating as a response to boredom. The consequence of food consumption in excess of use, when done for several days, can be measured on the bathroom scales. Several weeks or months of consistent excess results in weight above the ideal range -- a condition we physicians call obesity.

Individuals whose weight is up to 120 percent of ideal (see chart below) don't experience serious health consequences because of their extra padding. Unfortunately, this is not true for those 34 percent of adults in this country who are even heavier.

Those who have weight between 120 and 140 percent of their ideal are classified as mildly obese. This condition has an associated increased risk of high blood pressure, diabetes mellitus and other serious conditions. Those who are between 140 to 200 percent above their ideal weight are classified as having moderate obesity. They are at greater risk of having the same serious problems as persons with mild obesity, along with the likelihood of developing arthritis in the feet, ankles, knees and hips. This is a consequence of supporting all the extra weight.

People who are twice their ideal body weight, or more, are at great risk of dying from conditions that are a direct consequence of their weight. Heart attacks, strokes, diabetes mellitus and heart failure are the most common of these. The seriousness of this severe affliction is obvious from the medical term that describes it -- morbid obesity. The imminent risks of this condition make it appropriate to consider treatments that would be inappropriate for those who just need to lose a few pounds. The appetite suppressant drugs that you have seen advertised on television can play a helpful role here, in addition to the obvious benefits of diet and counseling. In some cases surgery to reduce the size of the stomach is also undertaken.

If you are more than 120 percent of your ideal weight, talk to your doctor to determine what treatments, besides learning to eat an appropriate diet, are best for you. To help you decide if you should seek professional help, I've reproduced a chart of "acceptable weights" for adults as defined by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. Please note that the higher rates in the ranges generally apply to men, who tend to have more muscle and bone; the lower weights more often apply to women, who have less muscle and bone.

Acceptable Weights for Adults

Height		Weight		Height		Weight
5'0"		97-128		5'8'		125-164 
5'1"		101-132	5'9"		129-169
5'2"		104-137	5'10"		132-174
5'3"		107-141	5'11"		136-179
5'4"		111-146	6'0"		140-184
5'5"		114-150	6'1"		144-189
5'6"		118-155	6'2"		148-195
5'7"		121-160	6'3"		152-200

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.