Morbid obesity refers to individuals who are 50 - 100% above their ideal body weight.

The best way to measure how healthy someone’s weight is in relation to their height is to calculate their Body Mass Index (BMI).

It is calculated by taking their weight in kilograms divided by their height in metres squared (Weight (Kg) / Height (m2)).

Clinically, body weight and thus the extent of obesity is classified by using the BMI. The following table shows the internationally accepted criteria for BMI:

BMI	Weight classification
< 20	Underweight
20 - 25	Ideal BMI
25 - 29.9	Overweight
30 - 34.4	Obese
35 - 39.9	Severe obesity
40 - 49.9	Morbid obesity
> 50	Super obesity

The level of obesity correlates with differing levels of health risk:

BMI range	Weight class	Health risk
BMI 20-25	Normal weight	Normal
BMI 25-30	Overweight	Moderate health risk
BMI 30+	Clinically obese	High health risk
BMI 40+	Morbidly obese	Very high health risk
BMI 50+	Super obese	Extremely high health risk

Health risks associated with obesity

Greatly increased risk	Moderately increased risk	Slightly increased risk
Type 2 diabetes	Heart disease	Some cancers
Gallbladder disease	Hypertension	Reproductive abnormalities
Insulin resistance	Osteoarthritis	Polycystic Ovary Syndrome
Breathlessness	Gout	Impaired fertility
Sleep apnoea	Several of the common cancers	Low back pain
High cholesterol		Anaesthetic complications

(Department of Health 2006)
Another way to calculate being overweight is by your waist measurement. Risks increase with a waist measurement of over 40 inches (102cm) in men and over 35 inches (88cm) in women.

Assessment of the health risks associated with overweight and obesity in adults should be based on BMI and waist circumference as follows:

BMI classification	Waist circumference
	Low	High	Very high
Overweight	No increased risk	Increased risk	High risk
Obesity I	Increased risk	High risk	Very high risk

For men, waist circumference of less than 94 cm is low, 94–102 cm is high and more than 102 cm is very high.

For women, waist circumference of less than 80 cm is low, 80–88 cm is high and more than 88 cm is very high.

Once a person reaches the level of morbid obesity, the weight causes quicker and more extensive damage to the body

Essentially obesity is caused when the number of calories consumed through eating is greater than the calories used in physical activity. The excess energy is stored by the body in the form of fat.

Morbid obesity is a complex medical disorder, however, and there are a number of other contributing factors:

• Genetics can be a key factor in understanding obesity and its causes. It has been proven that the chance of having morbid obesity is increased if other people in your family have the condition.
• It has also been suggested that psychological and environmental factors can influence weight gain. Psychological factors influence the way people eat, as well as what they eat. A number of people eat in response to certain emotions such as boredom, sadness, or anger.
• Environmental factors could include someone’s lifestyle behaviours, for example the way in which they cook food, the type of job they have and also whether they incorporate exercise within their day-to-day life.
• Another significant cause of obesity is an inability to understand what it is to be 'full'. Most people are aware when they are full through eating because their stomach tells their brain it is full and to stop. However in some individuals there is a flaw in this process. By not identifying when the stomach is full, some individuals continue to consume more food. If they also carry out limited physical activity then this results in weight gain.

Consequences of morbid obesity
Severe and morbid obesity are hugely detrimental to overall health and wellbeing. As well the risk to general health, it can also lead to premature death.

Obesity is a 21st century epidemic. It has grown by 400% in the last 25 years and it is on trend to surpass smoking as the biggest killer in the UK. It costs the NHS >£4bn per year and is responsible for 18m sick days per year having a massive impact on the economy nationally as well as on the morbidity and mortality rates of the UK population.

Obesity is associated with a number of illnesses - it is thought that at least 45 health problems are directly related to a raised BMI. Several disease processes can arise directly as a result of morbid obesity (known as co-morbidities):

• You are 6 x more likely to develop gall bladder disease
• You are 5.6 x more likely to have a raised blood pressure
• Diabetes is 3.8 x more common in people who have a BMI >30
• Osteoarthritis is twice as likely
• Infertility, back problems and sleep disturbances are also common
• Life expectancy is shortened by <9years
• Common cancers are more likely

To get more information or to book a free no obligation consultation with our experts at one of our UK weight loss surgery centres call us on 0800 849 4050 or fill in our enquiry form here.

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