What you should know about morbid obesity

Obesity is an ever-growing health problem. As the number of overweight and obese Americans rises so does the number who are severely or morbidly obese. Morbid obesity is a serious health condition that results from an abnormally high body mass index.

A person with morbid obesity may have difficulty performing daily functions, such as walking and breathing, and is at increased risk for many serious health problems.

In theory, anyone can become morbidly obese. For someone to gain weight and become morbidly obese, they must consume more calories than their body can burn and use. The body stores the unnecessary calories as fat.

As more and more calories are consumed, the fat stores grow larger, leading to obesity or, as a worst case, morbid obesity.

Fast facts on morbid obesity:

  • The condition is characterized by having an extreme amount of excess body fat.
  • A doctor diagnoses it with a physical exam plus some basic questions.
  • For most people, morbid obesity is preventable and can be reversed.

What is morbid obesity?

Morbid obesity is when a person has extreme amounts of excess body fat and a body mass index or BMI greater than 35.

BMI is a scale that helps doctors and other medical professionals determine if a person is within a healthy weight range.

Some doctors also consider a person to be morbidly obese if their BMI is not over 35, but they are more than 100 pounds overweight.

BMI is broken down as follows:

  • Normal: 19.0–24.9
  • Overweight: 25.0–29.9
  • Obese stage 1: 30.0–34.9
  • Obese stage 2: 35.0–39.9
  • Morbidly obese stage 3: 40.0 or greater

When a person is morbidly obese, they are at greater risk of heart disease, certain illnesses, and conditions that directly affect their quality of life.

How does morbid obesity differ from obesity?

A person can be obese without being considered morbidly obese. A person who is obese has a BMI of 30 or above. An obese person has a greater chance of developing:

  • diabetes
  • stroke
  • heart disease
  • high blood pressure
  • arthritis
  • some cancers

Morbid obesity occurs when a person reaches a level of obesity that greatly increases the chances of developing one of these conditions.

These conditions are often referred to as comorbidities and are responsible for causing disabilities or even death.

Risk factors

While almost anyone can become morbidly obese, certain factors put a person more at risk than others. These include the following:

  • Genetic factors: Some research indicates that people with a family history of obesity or morbid obesity are more likely to become morbidly obese themselves.
  • Personal habits: The food a person chooses to eat and a person’s activity level affect whether or not they become overweight or obese.
  • Mental factors: Stress and anxiety can both cause someone to put on weight, as they can lead the body to produce more of the stress hormone cortisol. Cortisol leads to fat storage and weight gain.
  • Sleep habits: Lack of sleep can be another contributor to weight gain.
  • Being female: Many women have trouble losing pregnancy weight and are prone to gaining weight during menopause.
  • Certain medical problems: Some medical issues can cause obesity, including Cushing’s syndrome or Prader-Willi syndrome.
  • Some medications: Antidepressants and beta-blockers are just a few of the drugs that may cause weight gain.
  • Aging: As adults age, slowing metabolism and sedentary but busy lifestyles may make people more likely to gain weight.


The main symptom of morbid obesity is having a BMI of 35 or higher and obesity-related health problems, such as diabetes or hypertension. Other symptoms may include:

  • excess fat buildup around the body
  • being easily winded
  • difficulty walking
  • trouble breathing


Many Americans are obese. According to the Centers for Disease Control and Prevention (CDC), over one-third of the United States adult population is obese. Furthermore, the CDC identifies about 17 percent of all children in the U.S. as obese.

A doctor may want to know about the history of a person’s weight level, any weight loss efforts, and their eating and exercise habits. From there, a doctor will likely perform one or more tests.

To start, a doctor may measure someone’s BMI to determine if they are obese or morbidly obese.

Is BMI accurate?

BMI is not without its drawbacks. In fact, BMI is an estimate and not an exact measure of body fat.

People, particularly athletes, can throw off a BMI scale and fall into or out of the unhealthy ranges, depending on their sport. For example, bodybuilders may have very high body mass indexes while having low body fat.

Body fat percentage

A doctor may evaluate a person’s body fat percentage, as well as their BMI. This can be done with either a skin fold test, which uses bioelectrical impedance, or a water or air displacement device. All these tools are used to try to calculate the percentage of someone’s body that is fat.

Blood work

Finally, a doctor may want to order blood work to help rule out potentially fixable causes of excessive weight, such as side effects of medication. The blood work also checks for related health concerns that many people with morbid obesity can have.


When a person is morbidly obese, they have an increased risk of developing additional diseases and conditions. These related conditions can be debilitating or even deadly and include:

  • heart disease
  • abnormal blood lipid counts
  • type 2 diabetes
  • reproductive issues
  • osteoarthritis
  • obesity hypoventilation syndrome
  • stroke
  • sleep apnea
  • gallstones
  • certain cancers
  • metabolic syndrome

Treatment options

Fortunately, there are several treatment options for a person with morbid obesity to choose from to lose weight. Some of these options include:

  • diet and exercise
  • medication
  • surgery

Diet and exercise

It is not always easy for a person to lose weight from diet and exercise, and no single plan or program works for all people.

A person should discuss diet and exercise plans with their doctor or dietitian. Medical professionals can help set reasonable starting points and achievable goals. Also, being under a doctor’s care can help avoid problems from overexercising.

People who have morbid obesity may have difficulty exercising due to limited mobility. A doctor or physical therapist can suggest exercises that they can do safely.

Weight loss medication

Medications offer a less reliable means of losing weight than changes in diet. Once a person stops taking a medication, they will likely regain the weight unless significant changes to diet and exercise have been made.

There are several over-the-counter medications and supplements available. Often, doctors do not recommend these because their claims are not supported by research.


Surgery may be a final option for some people who have not had success with diet and exercise. A doctor will need to discuss what surgery option is best for an individual. Any surgery comes with risks, which should be factored into the decision to undergo a procedure.

There are two surgical options typically used. These are:

  • Gastric banding: This is where a ring is placed around the stomach, limiting the amount of food that can enter.
  • Gastric bypass: Where portions of the stomach are bypassed, giving a feeling of fullness.

If a person is successful at losing a significant amount of weight, they may also choose to have skin removal surgery, where surgeons remove excess skin from the body.


The best way to prevent obesity is through diet and exercise. A healthful diet combined with regular, moderately intense exercise is ideal.

A person should look to eat:

  • fresh, non-processed fruits
  • green, leafy vegetables
  • limited amounts of sugar
  • reduced number of calories
  • smaller, more frequent meals

A person may want to consider regularly doing some of the following exercises for 30 minutes, up to five times a week:

  • walking
  • running
  • jogging
  • jumping rope
  • riding a bike
  • swimming
  • rowing
  • yoga or other fitness classes


Left untreated, a person with morbid obesity can develop any number of more serious health conditions. These conditions can be limiting and potentially fatal.

When treated, morbid obesity can be reversed, and the chances of developing other medical conditions are greatly reduced. Diet and exercise are the most effective, long-term solutions to reversing morbid obesity.

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