What Is Morbid Obesity? How To Treat Class III Obesity?

what is morbid obesity

Morbid obesity, now known as class III obesity, is a serious and complex health condition that leads to several chronic illnesses, side effects, and complications, and can decrease an individual’s quality of life. There are several treatment options available today that can help individuals lose weight, become healthier, and even reverse some associated illnesses.

What Is Morbid Obesity?

According to the World Health Organization (WHO), obesity is a condition where an individual’s percentage of body fat (PBF) is elevated to the point that it is negatively impacting their health and well-being.

Morbid obesity was declared a global epidemic by the WHO because of the alarmingly high percentage of the world’s population who suffer from the condition.

There is a universal scale that is used as a first-line indication of an individual’s level of body fat called a BMI scale. Within the BMI scale, there are ranges that form categories. As you can see from the chart below, an individual who has a BMI range of 40-49.9 would be considered morbidly obese or categorized as class III obesity. You can check your BMI quickly using our BMI calculator below.

  • Underweight: less than 18.5
  • Healthy weight: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Class I obesity: 30 to 34.9
  • Class II obesity: 35 to 39.9
  • Class III obesity: 40 to 49.9
  • Class IV obesity: 50+

Why Was The Name Morbid Obesity Changed To Class III Obesity?

Morbid obesity was first used to describe very overweight individuals in 1963. The term was used in a communication that was written by Dr. J. Payne to convince health insurance authorities to cover the cost of intestinal bypass surgery.

Morbidity is a medical term that is meant to describe an illness or disease. The word comorbidity is used by medical professionals to indicate an individual has more than one disease or illness. So the phrases morbidly obese or morbid obesity were used to accurately describe an individual whose body weight had reached the point of causing health issues.

Like many words today, the word morbid has been misused to the extent that most people do not know its proper meaning. Today when we hear that word we think of disturbing, unpleasant, or even gross which portrays a negative connotation.

When the word morbid is used with the word obesity it adds to the already misguided social stigma of the large group of people suffering from it. Obesity can have several origins and is not primarily due to a lack of willpower on an individual’s part.

The World Health Organization (WHO), researchers, and healthcare professionals now use the term class III obesity to categorize individuals whose BMI is 40+.

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Dr. Chris explains what obesity is and how to identify if a patient is obese. He discusses obesity-related health problems and what the IBI team can offer to patients who are obese.

How Is Class III Obesity Diagnosed?

Generally, individuals who meet the following criteria are determined to suffer from morbid obesity or class III obesity:

  • Have at least 100 pounds of excess weight compared against the healthy weight range for their height and gender;
  • Their BMI is 40 or above;
  • Their BMI is 35 or above and they suffer from one or more obesity-related health conditions, such as type 2 diabetes, or high blood pressure.

Diagnosing Class III Obesity With The BMI Chart

The BMI chart that is used today dates back to the 19th century and was developed by a mathematician to generally categorize a population. It was not originally intended to be used on an individual basis.

The standard BMI chart does not take the special circumstances of the following into consideration and can be inaccurate for:

  • Individuals with higher muscle mass;
  • Bodybuilders & professional athletes;
  • Seniors over 65;
  • Children.

Also, the standard BMI chart may be miscalculated for certain ethnic groups when calculating risks for health conditions.

Doctors and healthcare professionals use the BMI chart as an initial benchmark but also take other criteria into consideration before making a determination regarding a patient’s state of health.

Diagnosing Obesity Through Laboratory Tests

Your doctor may run a panel of tests to identify any health conditions that are attributed to weight gain or resulting from obesity. These tests may include:

  • Blood count;
  • Kidney function;
  • Metabolic panel (basic);
  • Liver;
  • Lipids;
  • HbA1C hemoglobin;
  • Thyroid (TSH) test;
  • Check Vitamin-D level;
  • Urinalysis;
  • CRP Protein;
  • Electrocardiogram (EKG);
  • Sleep study.

What Causes Class III Obesity?

Class 3 obesity can have many contributing factors but it primarily comes down to our bodies storing more fat than it burns. What causes each individual to burn or retain more calories than their body uses can be simple or complex. The most well-known causes of weight gain are:

  • Eating too much;
  • Eating unhealthy foods;
  • Lack of physical activity.

Other factors that can contribute to the predisposition of obesity are:

  • Genetics;
  • Imbalance in hormones;
  • Socio-economic or geographical;
  • Cultural differences;
  • Environment.

What Conditions or Illnesses Are Caused By Class III Obesity?

Class III obesity is associated with a plethora of serious health conditions, including:

  • Type 2 diabetes – excess fat can cause insulin resistance. The risk of experiencing type 2 diabetes increases incrementally for each single point increase on the BMI scale.
  • Heart disease – prolonged obesity affects the heart’s ability to function and facilitates heart disease.
  • Metabolic syndrome – a combination of three or more conditions such as high blood pressure, elevated blood sugar levels, and high cholesterol.
  • High blood pressure – hypertension is 3.5 times more likely to develop in obese individuals making them more at risk for heart disease.
  • Atherosclerosis – obesity can lead to the accelerated buildup of plaque in the arteries.
  • Sleep apnea – fat deposits in the upper respiratory tract can cause the breathing airway to narrow causing momentary breathing blockage during sleep.
  • Cancer: – obesity can increase an individual’s risk of developing 13 different types of cancer.
  • Obesity hypoventilation syndrome (OHS) – this breathing disorder that causes an imbalance of carbon dioxide to oxygen levels in the blood can cause serious health issues and can be life-threatening.
  • Osteoarthritis – obesity creates stress and pressure on joints that the body is not capable of bearing for long periods of time.
  • Depression -adults suffering from obesity have greater instances of depression.

What Happens If Morbid Obesity Is Left Untreated?

Morbid obesity can cause a myriad of serious health conditions but even more disturbing is that Class III obesity can shorten an individual’s life expectancy by 14 years.

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How Is Morbid Obesity Treated?

Treating class III obesity varies by the individual. Since there are many root causes of obesity, treatments differ so they can address these individually. Usually, treating an individual that is suffering from class III obesity involves multiple components including:

  • Drastic lifestyle changes including a healthy diet, increased physical activity, getting an adequate amount of sleep, and stress management all contribute to weight loss and weight management;
  • Multiple therapies including behavioral & psychological can assist weight loss patients with some of the root causes of obesity and provide support as they navigate through weight loss surgery or maintain a healthy weight;
  • Medications – sometimes, medications can be effective in helping to treat obesity. These medications can help decrease the appetite and the feeling of being hungry or can block the intestines from absorbing fat.;
  • Education;
  • Support groups;
  • Bariatric surgery.

Bariatric Surgery To Treat Class III Obesity

Individuals who are suffering from class III obesity have a very low chance of attaining a healthy body weight without medical intervention. There are several surgical options that may be viable options to help an obese individual lose weight. A consultation with a bariatric surgeon can help determine if you are a candidate for weight loss surgery and which choice would be best for you.

  • Lap Band Surgery – a silicone band is placed on the upper part of the patient’s stomach and is inflated to adjust its size and position. The band helps control the amount of food the person can eat at one time.
  • Gastric Sleeve Surgery (VSG) – the surgeon cuts away a portion of the patient’s stomach, shaping the rest into a pouch. This makes the stomach about 75% smaller. reduces the amount of food they can consume.
  • Gastric Bypass – there are two ways that gastric bypass surgery helps a patient lose weight. The first is similar to the gastric sleeve in that the stomach is permanently made smaller. The second is that in addition to reducing the stomach size, one portion of the digestive system is altered. The surgeon re-routes part of the small intestine which inhibits the body from absorbing all calories the individual eats.
  • Duodenal Switch – patients that undergo duodenal switch surgery lose the most significant amount of weight. Like gastric bypass surgery, the stomach is made smaller and the digestive system is rerouted. However, during duodenal switch surgery, alterations are made to two sections of the digestive system.

What Treatment Is Available For Obesity Type IV (BMI Over 50)?

Sometimes, patients with very high BMI numbers can not undergo a surgical procedure due to health risks. In cases such as these, doctors often use a multi-step approach. They perform one non-invasive, low-risk procedure to help the individual lose some initial weight and then use another procedure or perform surgery to help them effectively lose more.

Treatments that may be used for super obese individuals include:

  • Gastric Balloon System – a gastric balloon is a non-surgical procedure that reduces the amount of space in a patient’s stomach to prevent them from overeating. Some gastric balloons work using just one balloon and others use multiple balloons. The balloons are inserted into the stomach through a simple procedure or through the patient swallowing a tablet-like capsule. The doctor can then control the amount of space the balloon takes up by inflating or deflating the balloon(s).
  • Endoscopic Sleeve Gastroplasty (ESG) – ESG is similar to a gastric sleeve in the way it works but is non-surgical and can be reversed in most cases. The patient’s stomach is altered using sutures making it smaller and pouch-like in shape. The procedure is performed through the patient’s throat so it does not require any incisions. The procedure is much shorter than surgery, does not require a hospital stay, and has a short recovery time.
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Alicia tells her heartbreaking story of what motivated her to get additional help with her weight. She had bariatric surgery many years ago and her weight was coming back. She sought a gastric sleeve revision to help her on her weight loss journey.

Type III obesity is a serious and potentially life-threatening condition. The good news is that it can be treated through a combination of weight loss surgery, therapy, and ongoing support. The even better news is that many individuals who have undergone weight loss surgery have eliminated or greatly reduced obesity-related health issues such as type 2 diabetes.

If you are suffering from obesity or class III obesity, please contact IBI Healthcare Institute. We are here to help you reclaim your health and your quality of life. Set up a consultation with one of our caring experts today and learn more about how we can create a custom plan to help you attain your weight loss goal.

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