Hyperadiposis
Hyperadiposis, also known as severe or extreme obesity, is characterized by having excess body fat that exceeds 200 percent of the standard body weight based on height and weight tables. This condition affects all anatomical systems and is often linked to a variety of serious health issues, including heart disease and diabetes. Factors contributing to hyperadiposis include a sedentary lifestyle, genetic predisposition, dietary habits, and emotional disorders. Common symptoms include shortness of breath, sleep disruptions, low back pain, and excessive sweating, among others. The accumulation of excess fat can lead to complications such as osteoarthritis and skin disorders.
Treatment options for hyperadiposis typically involve clinical programs that integrate supervised weight loss, behavioral modifications, and exercise. In some cases, surgical interventions like gastric bypass or stomach stapling may be recommended. The prevalence of severe obesity has more than doubled since 1900 in the United States, suggesting a significant shift in lifestyle and physical activity levels. Addressing hyperadiposis requires a comprehensive approach that recognizes both individual and societal factors. Understanding these dynamics is crucial for effective prevention and treatment strategies.
Hyperadiposis
ALSO KNOWN AS: Severe obesity; extreme obesity
ANATOMY OR SYSTEM AFFECTED: All
DEFINITION: Having excess body fat; exceeding 200 percent of standard body weight as defined on a height-weight table
CAUSES: Sedentary lifestyle, genetic predisposition, diet, emotional disorders
SYMPTOMS: Shortness of breath, difficulty breathing, sleep disruption, low back pain, osteoarthritis, skin disorders, excessive sweating, fluid accumulation in the ankles and feet
DURATION: Often chronic
TREATMENTS: Clinical programs combining supervised weight loss, behavior modification, and exercise; surgery if needed
Causes and Symptoms
Obesity results from consuming more calories than the body uses. Severe obesity accounts for less than 1 percent of all in the United States but is linked to a large number of deaths each year, many of them due to heart disease or diabetes. Genetics, socioeconomic status, and emotional disturbances may all contribute to severe obesity.
One leading theory proposes that body weight is regulated by a set point in the (a section of the brain), similar to a home's thermostat setting. A higher-than-normal would explain why some people are obese and why losing weight and maintaining weight loss are difficult for them. It is also well established that an increase in the size and/or number of fat cells adds to the amount of fat stored by the body. Those who become obese during early childhood may have up to five times as many fat cells as people of normal weight. Because the number of cells cannot be reduced, weight loss can come about only by decreasing the amount of fat stored in each cell.
Accumulation of excess fat below the and in the chest wall places pressure on the lungs, leading to shortness of breath and difficulty in breathing, even with minimal exertion. This may also seriously interfere with sleep. Low back pain and osteoarthritis, especially in the hips, knees, and ankles, may be seen, and skin disorders are common, owing to moisture retention in the folds of the fatty skin. Because of a low ratio of surface area to body weight in severe obesity, the body has a hard time getting rid of excess body heat, leading to excessive sweating and accumulation in the ankles and feet.
Fat tends to accumulate in the in males, and in the thighs and buttocks in females. Abdominal obesity in particular is linked with a high incidence of coronary artery disease, high blood pressure, adult onset diabetes, hyperlipidemia, and gallbladder disease. In addition, an increase in menstrual disorders and in breast, uterine, and ovarian cancer is seen in women. Men have higher rates of colorectal and prostate cancer.
Treatment and Therapy
Self-help and nonclinical weight loss programs rarely work in individuals with severe obesity. Clinical programs that combine supervised weight loss, behavior modification, and exercise have shown good results. Drugs such as amphetamines (ephedrine) have questionable value in cases of severe obesity. Total fasting produces a risk of ketonemia and electrolyte imbalances, leading to cardiac arrhythmias.
Surgery has become an increasingly popular form of treatment. Vertical banded gastroplasty (stomach stapling) and bypass are the most common procedures. Both produce satiety with small food intake and, if coupled with exercise, can result in weight losses approximating one-half of the excess weight (80 to 160 pounds). Jejunoileal bypass is also effective but produces a permanent syndrome that may lead to other metabolic problems. Liposuction, where a small incision is made and fatty deposits are suctioned out, produces only moderate results in the severely obese. Because of potential risks to blood vessels and nerves, only a small amount of fat can be removed from each location.
Leptin, the protein hormone product of the ob gene, has been suggested as a useful new treatment for severe obesity. However, only about 5 percent of obese individuals fail to produce leptin on their own, and in those individuals either daily injections of leptin or gene therapy to correct the chromosomal defect would be required. Neither is currently considered a practical solution.
Perspective and Prospects
Since 1900, the incidence of severe obesity in the United States has more than doubled, despite the fact that the average number of calories consumed per day has decreased by 10 percent. The most likely explanation is a decrease in physical activity among the population at large. While everyone needs to be of dietary intake and exercise needs, parents of young children in particular need to be careful not to use food as either reward or punishment, as the early years of development appear to be most crucial in setting the stage for later obesity.
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