I have a number of patients who are either overweight or obese and although this is always of concern to me because of the  potential for diabetes, hypertension and dyslipidemia, I am most concerned about my obese younger patients.

We note the BMI (body mass index) on all our patients. This is a very simple chart that has the height in inches along the vertical axis and the weight along the horizontal. By simply measuring the person’s height and weight, it’s a simple step to finding the BMI.

A BMI between 25 and 29 is considered overweight and a BMI 30 or more is obese. Furthermore, there is a distinction between obese and extreme obesity which is a BMI of 40 or more.

So it was with particular sadness that I met a teenager whose BMI was greater than the chart measures (a BMI over 54). He was already showing signs of diseases we would expect to see in middle-aged adults: hypertension and elevated cholesterol.  Needless to say, he suffered from depression.

He has a long psychological road ahead of  him and almost certainly a medically complicated future. At this stage, simply eating less is not likely to produce the desired outcome because of the complex metabolic reactions that conspire to keep him from losing weight.

Research in the causes and treatment of obesity is compelling but still a long way from practical application. Given the enormous financial burden this puts on our health care, (let alone the psychological burden endured by individual), we need to develop public policy that promotes nutritional education in high-risk groups, brings back physical education in schools, bans the sale of fast-foods and soft drinks in schools and supports a tax on the sale of foods that we know contribute to this epidemic.

I believe we can reverse this epidemic in the same way that we have decreased the number of people who smoke cigarettes by banning television advertisements and the sale of cigarettes to minors as well as a well orchestrated educational media blitz.

We can’t afford to let this epidemic go unchecked.

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