What is obesity? Are you a candidate for weight loss surgery?

About a third of Americans are obese and another third are overweight. In Canada, 1 in 4 Canadians were obese in 2011-2012, or about 6.3 million people; the proportion has grown 17.5% since 2003. Mexico’s obesity prevalence is not that distant to these countries with 32.4% obese and 38.8% overweight.

The prevalence of obesity has been increasing over the last four decades affecting men and women of all ages, races, and ethnic groups. Obesity is a major risk factor for numerous diseases and it is a major cause of disability and mortality, it influences quality of life and accounts for huge expense to the health care system.


What is obesity?

Recent studies indicate that those with an elevated percentage of body fat are at an increased risk of developing cardiometabolic disease despite having a normal BMI. Therefore, the determination of adiposity by methods more accurate than BMI could have favorable public health implications in the diagnosis of obesity. People with excess belly fat are at an increased risk, even if they look thin on the outside. Body mass index (BMI) does not take into account central adiposity, which has been associated with increased disease risk. People with a normal BMI with a high body fat can fall into a condition called NORMAL WEIGHT OBESITY (NWO).  

The gold standard definition of obesity is considered to be an excess of body fat (BF) and clinicians and epidemiologists usually rely on body mass index (BMI) as a means of defining the presence of adiposity or obesity. However, a significant limitation of using BMI is its failure to differentiate between an elevated body fat mass and sustained or increased lean mass, especially in patients with a BMI below 30.  Obesity is defined as having an excessive amount of body fat — not as weighing too much! Yes. You may have a normal BMI while your body fat percentage is high enough to increase health risks.

At OCC, we measure BMI and BF as mutually exclusive variables to classify obesity due to the prevalence of metabolic syndrome and its components in iniduals with normal body weight (NWO) with an excess of body fat.

If your body fat percentage is above the following cut-off points depending on your BMI, gender, and age, you are a candidate for weight loss surgery!


Diagnosis for NORMAL WEIGHT OBESITY evidenced by body fat percentage

Body fat percentage is obtained by bio impedance with cut off points as follows:

Gender Age Body Fat
Female 20-39 >33%
Female 40-59 >34%
Female >60 >36%
Male 20-39 >20%
Male 40-59 >22%
Male >60 >25%

To sum up, if you happen to be a TOFI (Thin in the Outside but Fat on the Inside), surgery is justified as your risks associated with obesity are determined by body fat and not your dress size!

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OCC’s epidemiologist is closely monitoring the COVID-19 status and is actively issuing updates as they are available. The Centers for Disease Control and the World Health Organization are the most trusted sources online.  While the CDC has announced new mask protocols for vaccinated individuals, there will be no changes for our office protocols for patients, guests, and staff members as the announcement does not apply to hospitals or medical facilities. Masks are still a requirement for all patients, guests and staff at our facility.

As we reinitiate weight loss surgery, we are constantly adapting and installing new and updated safety measures.

Weight loss surgery is medically necessary.

Bariatric Surgery and the clash of two pandemics.   

Major metabolic and bariatric surgery Societies and colleges globally are now calling for the safe resumption of bariatric and metabolic surgery before the COVID-19 pandemic is declared over. 

The sooner bariatric surgery can be safely performed, the quicker obesity, type 2 diabetes, and other diseases can be reduced or resolved as they are not only chronic they are also progressive.  Obesity is also linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis, and at least 13 different types of cancer.

A recent statement from the ASMBS says “Before COVID-19 began, it was clear that patients with obesity were ‘safer through surgery.’ In the era of COVID-19, ‘safer through surgery’ for patients with obesity may prove to be even more important than before.” Obesity and Metabolic syndrome have been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients.

See here for full COVID-19 update. 

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