In this day of excessive political correctness, we are constantly being encouraged to accept people ‘as they are.’ That is all well and good when it comes to race, creed, color, etc., but it is not when it comes to ones health and wellbeing. Obesity is probably the best example.
I have probably heard every excuse in the book with respect to why a patient is considerably overweight: Big bones, genetics, over-active glands, my breasts are too big to exercise, my knees or back or feet or whatever hurt too much to exercise, I am happy with my weight (really a lie rather than an excuse) or I’m just too lazy. Once you figure out what your excuse is, you give yourself a reason to quit trying. To quote the late great distance runner Steve Prefontaine, “To give anything less than your best is to sacrifice the gift.” You do not want it for your family or friends, then why is it OK for you? It is simply not acceptable.
Diet and Exercise
If not being able to exercise is your excuse, they why is not every paraplegic and quadriplegic morbidly obese? You can eat more calories in a minute that you can work off even with vigorous exercise in two hours. The key to weight control is diet, diet, diet, diet, diet and then exercise. I mean diet as in what your consumption consists of, not some ridiculous new fad program that promises fast massive weight loss and is unhealthy from the start. A rigid exercise program is great for those who are healthy enough and have both the time and motivation to do so; especially for those who use exercise as their kick-starter and motivation. But failure to be able to or get motivated to exercise is NOT a reason to be fat.
Calculating your body mass index, or BMI, is simple. Simply divide your weight in pounds by the square of your height in inches and multiply that by 703. For example if you are 5’ 10” and weight 185 pounds, your BMI is 703 x 185/ (70 x 70) = 26.54. Normal weight is a BMI of 20-25, overweight is >25-<30, obese is >30 -<35, morbidly obese is >35-<40 and severely obese is >40. Although BMI is not a perfect system and does not take into account build or gender, it has tremendous correlation with complications related to surgery as well as medical conditions associated with obesity.
Medical Conditions Related to Obesity
No one wants to sit here and read all of the medical conditions associated with being significantly overweight. You have heard them all before and you really don’t want to have any of them. High blood pressure, heard disease, congestive heart failure, stroke, diabetes, kidney failure, peripheral vascular disease, etc., etc., etc. Yes, you can take some expensive medications to help compensate, but it is much better and cheaper to correct. Many patients who have been on high blood pressure and diabetes medications for years are able to get off of them completely by simply losing weight. And, it is not a matter of if you are going to get one or more of these conditions, it is simply a matter of when.
Increased Complications of Surgery
Not only do I want my patients to get the best results from surgery, I want them to be as safe as possible and have the lowest risk of complications. The risk of bleeding, infection, wound healing problems, pneumonia, anesthesia problems, blood clots, pulmonary emboli and other serious complications all go up with a higher BMI. This is one of the many reasons why you need to get your BMI down to a reasonable number before cosmetic surgery.