What is BMI?

Obesity is the state of having excess total body fat and of being grossly overweight.

Whilst various metrics are used, BMI is most common. It can be used to grade or stratify the condition, with a higher BMI meaning a patient is more overweight or obese.

The BMI is calculated with mass (weight) in kg/ height in metres squared (m/h^2).

Classification BMI
Underweight <19
Ideal BMI 19-25
Overweight 25-30
Obese (Class I) >30
Severely Obese (Class II) >35
Morbidly Obese (Class III) >40
Super Obese (Class III) >50

BMI Calculator

Your BMI is

Scale of the problem

Obesity is quickly becoming Australia’s most prevalent modifiable risk factor for chronic disease. The Australian Institute of Health and Welfare states that 1 in 3 Australian adults were obese (BMI > 30 kg/m2) in 2017 – 18, increased from 1 in 5 in 1995. 74.5% of men and 59.% of women were overweight (BMI 25 kg/m2) or obese . The trend is also observed in children and adolescents and unfortunately, children with parents who are obese are much more likely to have unhealthy weights themselves.

Causes of Obesity.

Many factors contribute to society’s struggle with obesity. Some of these are affects on the entire population, whilst others are more personal. Calorie rich foods are easily available and quite often cheaper than more wholesome options. There is no longer a need to perform physically demanding activities for survival and in fact, many times work and play activities need minimal movement or activity. People are typically more stressed with less time for physical activities and often our sleep patterns are poor. Marketing campaigns encourage people to eat more and often make body image problems much worse.

At an individual level, there may be many complex issues playing together. People often make poor choices due to boredom, stress or to make them feel better in a difficult emotional situation. Often damaging behaviours or habits can lead to poor food choices, snacking or binge eating. Sometimes people aren’t clear on healthy portion sizes and develop habits of eating until feeling satisfied with ample helpings becoming larger.

In the simplest sense, the idea of energy in and energy out balance whether a body is burning energy storage or laying it down. In the same way, a simplistic view on weight loss is that a person simply needs to eat less and move more. There is some truth in these simplifications but the reality is much more complex. Weight loss in influenced by:

  • Hormonal,
  • Biochemical,
  • Microbial and
  • Circadian influences.

No two patients are the same and success comes from multiple successes. We strongly believe in the importance of multiple health professionals working with you to identify how these factors can be manipulated in your favour!

Health Effects

Increased BMI is associated with physical, psychological and functional problems. Most cancers are more prevalent and levels of inflammation are higher.

  • Preventable chronic diseases are more prevalent including type 2 diabetes, hypertension and high cholesterol. Combinations of these chronic disease lead to stroke, heart attack/ failure and early death. Sleep apnoea is intimately related to these problems.
  • Mood disorders (depression etc), anxiety and mental health problems are more common in obesity. Social isolation can often result.
  • Musculoskeletal disorders are particularly challenging. The heavier weight causes more wear and strain on joints and ligaments leading to pain and dysfunction. Apart from the physical functional impact from this, it also limits ability to remain active which perpetuates the problem with weight.
  • Observational studies have suggested that higher levels of body fat are associated with higher rates of cancers in the endometrium, oesophagus, stomach, liver, kidney, skin, brain, pancreas, colon, gallbladder, ovaries, thyroid and breast.

In addition to all of these terrible risks for the future, people who are obese face real challenges every day. Personal hygiene is often impacted and normal tasks become harder when you are obese, as movement is more difficult meaning they tire more quickly and find themselves short of breath. Public transport seats, telephone booths, and cars are often too small causing embarrassment and logistical challenges.

Mechanisms of Weight Loss…

Several options are available for losing weight:

  • Diet and calorie restriction,
  • Meal replacement shakes and soups (VLCD),
  • Appetite suppressants and malabsorptive medications, and
  • Bariatric surgery.

VLCD’s can be effective in starting weight loss, but most (80 – 90%) of people cant keep it off for the long term. This is mostly because our body has programmed compensatory processed trying to stop us losing weight. It’s kind of like a thermostat for fat stores leading to higher levels of hunger and less feelings of satisfaction. Often people become obsessed with high energy and sweet foods.

Bariatric surgery is the only approach proven to allow sustainable meaningful weight loss and resolution of obesity related diseases.

  • Improves obesity-related diseases and reduces risk of death (both from heart disease and all causes),
  • Gastric bypass works by reducing hunger, increasing satisfaction, changing food preferences and the amount of energy used in absorbing diet,
  • Gastric banding works through the reduction in hunger, possibly through stimulation of the vagal nerve, and
  • Sleeve gastrectomy shares some mechanisms from banding and some from bypass.

No procedure is a quick fix nor miracule cure. Weight is still difficult to lose and effort is needed in remaining active and controlling portion size. One must remain disciplined and sensible in food choices with the operation seen as a tool only (Not THE SOLUTION). A period of time is granted for more satisfaction and less hunger allowing people to regain control of their weight and health.

Meaningful and sustainable weight loss needs change in behaviours and habits. This is not easy and no-one can do it alone! Our weight management package includes sessions with a group of experts all bringing their own knowledge and experience together for your benefit, at all stages:

  • Initial assessment,
  • Post operative care,
  • Long term follow up including,
  • Back on track in the case of weight regain.

Weight regain is unfortunately quite common at around 3 to 5 years following surgery. Because of this we keep you linked in with our experts. More surgery is not the answer but we do have answers!

Learn more about weight regain

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