Hensrud Donald D, Klein Samuel
Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Mayo Clin Proc. 2006 Oct;81(10 Suppl):S5-10. doi: 10.1016/s0025-6196(11)61175-0.
The prevalence of obesity has markedly increased in the past few decades, and this disorder is responsible for more health care expenditures than any other medical condition. The greater the body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters), the greater the risk of comorbidities, including diabetes mellitus, hypertension, obstructive sleep apnea, many cancers, dyslipidemia, cardiovascular disease, and overall mortality. Class III (extreme) obesity, defined as a BMI of 40 kg/m2 or greater, has also increased such that it now affects almost 1 in 20 Americans. The prevalence of extreme obesity is greater among women than among men and greater among blacks than among non-Hispanic whites or Hispanics. The effect of extreme obesity on mortality is greater among young than among older adults, greater among men than among women, and greater among whites than among blacks. The current permissive environment that promotes increased dietary energy intake and decreased energy expenditure through reduced daily physical activity coupled with genetic susceptibility is an important pathogenic factor. The number of bariatric surgical procedures performed annually is relatively small but increasing.
在过去几十年中，肥胖症的患病率显著上升，这种疾病导致的医疗保健支出比任何其他疾病都多。体重指数（BMI）（计算方法为体重千克数除以身高米数的平方）越高，患合并症的风险就越大，这些合并症包括糖尿病、高血压、阻塞性睡眠呼吸暂停、多种癌症、血脂异常、心血管疾病以及总体死亡率。III类（重度）肥胖定义为BMI达到40kg/m²或更高，其患病率也有所上升，现在几乎每20个美国人中就有1人受其影响。极端肥胖在女性中的患病率高于男性，在黑人中的患病率高于非西班牙裔白人或西班牙裔。极端肥胖对死亡率的影响在年轻人中比在老年人中更大，在男性中比在女性中更大，在白人中比在黑人中更大。当前这种通过减少日常身体活动促进饮食能量摄入增加和能量消耗减少的宽松环境，再加上遗传易感性，是一个重要的致病因素。每年进行的减肥手术数量相对较少，但在不断增加。
