Page modified at: 23/11/2009
What is Obesity?
Obesity is a condition in which excess body fat has accumulated to such an extent that health may be negatively affected. It is commonly defined as a body mass index of 30 kg/m2 or higher. This distinguishes it from being overweight as defined by a BMI of 25 kg/m2 or higher.
Excessive bodyweight is associated with diseases such as cardiovascular disease, diabetes, obstructive sleep apnoea and certain types of cancer and osteoarthritis. It is associated with reduced life expectancy. In the US, obesity is the second-leading cause of preventable death after smoking
How common is obesity in Wales?
has compiled the prevalence rates of obesity from 2006-7 for the different regions of Britain.
Wales is one of the worst regions in Britain with about 1 in 10 people being obese!
| Prevalence of Obesity in Wales |
| Local Health Board Area | Percentage of people who are obese |
| Cardiff LHB | 7.4% |
| Swansea LHB | 8.0% |
| Ceredigion LHB | 8.2% |
| Monmouthshire LHB | 8.3% |
| Conwy LHB | 8.4% |
| Vale of Glamorgan LHB | 8.7% |
| Flintshire LHB | 8.7% |
| Gwynedd LHB | 9.0% |
| Bridgend LHB | 9.5% |
| Pembrokeshire LHB | 9.8% |
| Powys LHB | 9.8% |
| Newport LHB | 9.9% |
| Anglesey LHB | 9.9% |
| Carmarthenshire LHB | 10.0% |
| Denbighshire LHB | 10.1% |
| Merthyr Tydfil LHB | 10.6% |
| Wrexham LHB | 10.8% |
| Caerphilly LHB | 11.1% |
| Rhondda Cynon Taff LHB (Taff Ely & Rhondda) | 11.1% |
| Neath Port Talbot LHB | 11.9% |
| Blaenau Gwent LHB | 12.5% |
| Torfaen LHB | 13.9% |
Click on the map to see the OBESITY MAP for other parts of the UK
What is the Body Mass Index?
The Body Mass Index was defined by a Belgian statitician and sociologist Lambert Adolphe Jacques Quételet .
It is bases on body weight divided by to body height squared as follows:
BMI = Weight (kg) / (Height in cm x Height in cm)
There are various classifications of Body Mass Index but the following
is adapted from the WHO Definition and surgical literature.
| BMI kg/m2 | Classification WHO | Classification Surgical | | Under 18.5 | Under Weight | | | 18.5-24.9 | Normal Weight | | | 25.0-29.9 | Over Weight | | | 30.0-34.9 | Obesity - class I | | | 35.0-39.9 | Obesity Class II | | | 40.0-49.9 | Obesity Class III | Morbid Obesity | | Over 50.0 | Obesity Class III | Super Obesity | |
Graphic Illustration of bodies with increasing BMI
Where does my BMI put me?
Use this chart to plot your height and weight and see where your BMI lies
How does obesity affect mortality?
- Obesity is one of the leading causes of prevenatable death.
- A BMI of over 32 is associated with a doubling of risk of death
- Obesity on average reduces life expectancy by 6–7 years.
- Severe obesity ie BMIs >40 reduces life expectancy by 20 years for men and 5 years for women.
How does obesity affect health?
The mechanisms by which obesity affects health are related to:
- increased fat mass (osteoarthritis, obstructive sleep annoea)
- increased fat cells (diabetes, cancer, cardiovascular disease including high blood pressure, heart attacks and stroke, fatty liver disease)
- increased resistance to insulin (diabetes)
What are the options for treatment for obesity?
A combination of excessive calorie intake from the diet, lack of physical exercise and a genetic susceptibility is repsonsible for some people being overweight but some specific genetic conditions, medical conditions and psychiatric ilness may also be important. Primary treatment is therefore aimed at diet and exercis but other treatments may improve success. The American College of Physicians recommend the following approach:
- BMI over 30 - diet, exercise and other relevant behavioral interventions, and set a realistic goal for weight loss.
- If these goals are not achieved, drug therpay can be offered. The patient needs to be informed of the possibility of side effects and the unavailability of long-term safety and efficacy data.
- BMI over 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated.
What is Reductil (Sibutramine) and how does it work?
Reductil capsules contain the active ingredient sibutramine hydrochloride monohydrate, which is a type of anti-obesity medicine. It works by affecting neurotransmitters in the brain. Neurotransmitters are natural body chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. They are released from nerve cells as a message is transmitted. Once the message has been transmitted, the nerve cells then reabsorb the neurotransmitter.
Sibutramine prevents two of these neurotransmitters, noradrenaline and serotonin, from being reabsorbed back into the nerve cells. Noradrenaline and serotonin are responsible for moderating mood and various other processes in the brain. It is thought that sibutramine helps people to lose weight by increasing the amount of noradrenaline and serotonin free to act in the brain. This enhances the feeling of fulfillment from eating, and so makes you feel satisfied after eating less food. You will need to continue with an appropriate diet and exercise programme while taking this medicine, so that you are able to maintain your new weight after you have stopped treatment.
When is Reductil used?
Reductil is only licensed to aid weight loss in people with a body mass index (BMI) of 30 or higher, and people with a BMI of 27 or higher who also have other obesity related risk factors, such as type II diabetes or high cholesterol.
It is only prescribed to people in these categories who have had difficulty achieving or maintaining weight loss of more than five per cent of their body weight over three months, using conventional weight loss programmes alone (eg diet and exercise).
Who cannot take Reductil?
Reductil is not suitable for people with the following:
- Under 18 or over 65 years of age
- Obesity caused by a medical condition
- Severely reduced renal or liver function or over active thyroid gland
- Uncontrolled high blood pressure
- History of coronary artery disease, heart failure, increased heart rate, arrhytmia or poor peripheral circulation
- History of stroke or small temporary ischaemic attacks
- Closed angle glaucoma
- Tumour of the adrenal gland (phaeochromocytoma)
- Urinary retention in men caused by an enlarged proatste gland
- Psychiatric illness including Gilles de la Tourette's syndrome
- History of anorexia or bulimia nervosa
- History of drug, alcohol or medication dependence or abuse
- People on antidepressant, antipsychotic or appetite suppressant medicines, or tryptophan to aid sleep
- Pregnancy and breast feeding
- Rare hereditary problems of galactose intolerance. (Reductil capsules contain lactose).
How will I know if can I get Reductil?
If you meet the criteria for medical treatment and there are no medical reasons not to prescribe it you can arrange a consultation to discuss Redcutil as part of a programme of weight loss for obesity.
We will enquire about your background medical history, family history and drug history (including alcohol and smoking).
Your height will be measured and you will be weighed to determine your BMI. Your blood pressure and pulse will be checked.
Blood tests will be taken to check the following: - Renal Function, Liver Function, Thyroid Function, Cholesterol and Triglycerides.
The doctor will then discuss the pros and cons of treatment but you will not be prescribed the medication until your blood test results are back and checked.
| Height | Weight | Blood Pressure | Pulse | Blood Test | | 
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How will I be monitored when I am on Reductil?
Your weight should be monitored while you are taking this medicine. If you are not responding adequately to this medicine, ie if you have not lost at least five per cent of your body weight within three months, or if you put on more than 3kg at any stage after previously losing weight, you will need to stop taking this medicine. Patients should consult a doctor if they experience shortness of breath, chest pain or ankle swelling while taking this medicine or any mood changes, depression, or distressing thoughts or feelings.
Routine Monitoring consists of: Weight, blood pressure and pulse every 2 weeks for first 3 months, every month for next 3 months, then every 3 months for the next 6 months. Treatment should not exceed 12 months.
| Weight | Blood Pressure | Pulse | |
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