by Robert T. Marema, MD FACS
all men, weight loss isn't a matter of looking better, it's associated
with real health problems. Some of the problems associated with obesity
include sleep apnea, high blood pressure, diabetes, asthma, high cholesterol,
abnormal triglycerides, coronary artery disease, shortness of breath,
reflux, fatty liver disease, increased risks of cancer including colon
and prostate, and increased rates of early death.
Obesity affects about 75% of men 40 years or older in the United States.
Obesity is classified as a BMI (body mass index) of greater than 30. BMI
is a calculation that uses both one's height and weight. In this era
of the epidemic of obesity, the BMI is as valuable of a tool for assessing
one's medical risk as is a blood pressure reading. Please see the
BMI chart below to estimate your own BMI
In a large study using GE Certricity Electronic medical Record, over 2.8
million patients were evaluated for health and disease. The study found
that males are more likely than females to have diabetes, hypertension,
and hyperlipidemia. It also found that the incidence for these diseases
increases as the males BMI and and/or age increases. According to the
database, obesity is severely underreported and thus undertreated. Only
10% of patients with a BMI of 30-35 were reported , and only 57% were
reported as obese at the seriously dangerous BMI of 50 or greater! This
means that only a small percentage of people are informed of the risk
that their weight poses to their health!
Specifically to men, prostate health is of concern in obesity. It has been
demonstrated that obesity is a huge risk factor for development of prostate
cancer. Even more concerning is a new study that finds that the early
prostate cancer cell markers tests are incorrect in obese men due to their
low levels of testosterone. So, early detection is not common, but rather
it is being discovered late and in advanced stages.
Low testosterone and high estrogen is one of the hormone imbalances related
to obesity. Low testosterone produces symptoms such as decreased libido,
erectile dysfunction, low energy, trouble concentrating, decreased muscle
and bone density, increased fat storage, depression, and insomnia.
My recommendation to men of all ages is to know your BMI, and work with
your healthcare providers to keep your BMI in a range of 19-29. This keeps
you in the lower risk category of severe health issues related to your weight.
If you find that you are unable to reduce your BMI below 35 or gain control
of your diabetes, then bariatric surgery should be considered. Dr. Oz
has reported that bariatric surgery is one of the most effective and underutilized
treatments in America today.