Morbid Obesity

Morbid Obesity

Morbid obesity is a condition when there is too much fat in the body. As a result, sufferers have a body weight that is far from ideal. This condition causes the sufferer to experience limitations in carrying out daily activities.

The term morbid obesity refers to obesity that interferes with normal activities, such as breathing or walking. Morbid obesity has a higher body mass index (IMT) value compared to obesity , which is 40 (kg/m 2 ) or more.

Morbid obesity not only affects the physical form, but also has a high risk of causing other dangerous diseases, such as diabetes, high blood pressure (hypertension), sleep apnea , atherosclerosis , heart disease, and some types of cancer.

Causes of Morbid Obesity

In order to work optimally, the body needs energy in the form of calories that can be obtained from food. More calories will be used by the body when a person actively moves or exercises regularly. On the other hand, calories will be stored as fat if the body is not used for activity.

Morbid obesity is the impact of excess fat accumulated in the body. There are two main factors that cause fat to accumulate excessively, namely:

  • Lack of physical activity and sports so the body does not use calories effectively
  • Unhealthy and high-calorie eating patterns and menus, for example, often consuming fast food and high-sugar drinks

In addition to lack of physical activity and unhealthy eating patterns, morbid obesity can also be influenced by the following factors:

  • Congenital or genetic disorders, such as Prader-Willi syndrome or Cohen syndrome
  • Certain medical conditions, such as hypothyroidism, polycystic ovarian syndrome (PCOS), or  Cushing's syndrome
  • The use of certain drugs that can trigger weight gain, such as anticonvulsants, antidepressants,  antipsychotics , corticosteroids, and beta-blockers
  • Not resting enough leads to an increase in the hormone ghrelin which works to stimulate appetite
  • Heavy stress that triggers the production of the hormone cortisol so that blood sugar levels rise and are stored as fat
  • Increasing age triggers changes in hormones and the body's need for calories
  • Excessive weight gain during pregnancy
  • Unhealthy lifestyle or diet

Symptoms of Morbid Obesity

The difference between obesity and morbid obesity lies in the value  of the body mass index (IMT) . A person is said to be obese when they have a BMI of more than 30. Whereas in morbidly obese patients, the BMI value can reach 40 or more.

Patients with morbid obesity also generally experience symptoms in the form of:

  • Shortness of breath
  • Easy and sweaty a lot
  • Snoring while sleeping
  • Tired easily
  • It is difficult to do physical activity
  • Pain in the joints and back
  • Having skin problems, due to increased moisture in the skin folds
  • Feeling insecure or isolated in social circles

When should you go to the doctor?

Check with a doctor if you experience symptoms of morbid obesity, especially if the weight increases drastically, is difficult to lose, or causes limitations in physical activity and affects mental health.

Morbid obesity can reduce life expectancy by 3-10 years. Therefore, it is important to undergo examination and treatment to a doctor so that the risk of complications due to this condition can be reduced.

Diagnosis of Morbid Obesity

The doctor will ask questions related to the patient's health history and risk factors. The patient's physical condition will also be checked, including weight, height, blood pressure, and heart rhythm.

Next, the doctor will  calculate the patient 's body mass index . Body mass index is done by calculating the patient's height and weight. The calculation can be done manually or using a special calculator.

The body mass index formula is body weight (in kilograms or kg) divided by body height (in meters or m 2 ) squared. For example, if the patient's weight is 110 kg with a height of 170 cm, then the formula is:

110 : (1.7 x 1.7) = 38 (classified as morbid obesity)

Based on its value, the body mass index is divided into 4 categories in kg/m 2 units , namely:

  • Underweight: Less than 18.5
  • Normal: 18.5 to 22.9
  • Overweight: 23 to 24.9
  • Level 1 obesity: 25 to 29.9
  • Level 2 obesity: 30 to 37.4
  • Morbid obesity: 37.5 or more

The examination can be continued by  measuring the  patient 's waist circumference . The purpose is to assess the risk of complications, such as diabetes or  heart disease . A waist circumference of more than 80 cm in women and 90 cm in men indicates that the person is at high risk of suffering from other conditions.

Doctors can also perform a series of tests below to detect other diseases:

  • Blood test
  • Kidney function test
  • Thyroid hormone test
  • Electrocardiography

Treatment of Morbid Obesity

Patients with morbid obesity generally make several independent attempts to lose weight, but only a few of them succeed. Therefore, the handling of morbid obesity needs to be done based on the advice of the doctor.

The treatment of morbid obesity aims to reduce the patient's weight. The treatment method can be diet, physical therapy, drugs, or surgery, depending on the patient's condition. Here is the explanation:


Avoid diets that claim to lose weight quickly. In addition to being unsafe, rapid weight loss does not last long and can quickly gain back.

The main key to losing weight is to limit calorie intake. The way is to regulate eating patterns, avoid fast food , and consume low-calorie and high-fiber foods.


Regular moderate intensity exercise can increase calorie burning. Examples of moderate-intensity sports that can be done include fast walking, cycling, swimming, and gymnastics. You can do it 30 minutes a day, 5 days a week.


The use of drugs to overcome morbid obesity should be accompanied by a healthy diet and routine exercise. It is important to remember that drug use must be accompanied by direct supervision from a doctor.

Some of the drugs used to lose weight are:

  • Orlistat
  • Phentermine
  • Liraglutide
  • Bupropion


If dietary arrangements, routine exercise, and drug use are not effective, the doctor will perform an operative procedure. The operation method will be adapted to the patient's condition and the purpose of the operation itself.

The following are the operative methods used to deal with morbid obesity:

  • Gastric bypass surgery
    This procedure is performed by reducing the size of the stomach and directly connecting it to the small intestine. The purpose is to reduce the absorption of calories by the body.
  • Gastric banding surgery
    In this operation, the doctor will tie a special tape to the upper part of the stomach. This is intended so that the food that enters the body is limited so that the patient quickly feels full.
  • Gastric sleeve
    In this operation, the doctor will lift part of the stomach so that the size of the stomach becomes smaller.

Complications of Morbid Obesity

Morbid obesity can increase the risk of developing other diseases, especially if not treated correctly. Some of the complications due to morbid obesity include:

  • Type 2 diabetes
  • Metabolic syndrome
  • High cholesterol levels
  • Diseases of the heart and blood vessels, such as high blood pressure (hypertension), atherosclerosis, heart attack, and stroke
  • Respiratory disorders, such as sleep apnea , asthma, or obesity hypoventilation syndrome (OHS)
  • Cancer, such as colon cancer, liver cancer, or breast cancer
  • Osteoarthritis
  • Urinary incontinence
  • Gallstones
  • Gastric acid reflux disease ( GERD )
  • Infertility or fertility disorders
  • Erectile dysfunction
  • Worsening of symptoms of COVID-19

Morbid obesity can also affect quality of life and disrupt psychological conditions. This can happen due to  body shaming , as well as limitations in following an activity.

Psychological disorders experienced by patients with morbid obesity can be in the form of:

  • Problems in sex life
  • Isolated by environment
  • Shame and guilt
  • Decreasing the quality of work
  • Depression

Prevention of Morbid Obesity

A person who has risk factors for morbid obesity is recommended to be more careful and routinely monitor their weight. If necessary, consult a doctor regarding efforts to prevent morbid obesity.

How to prevent morbid obesity is not too different from handling it. Some efforts that can be made to prevent this condition are:

  • Increase physical activity
  • Exercising with moderate intensity for 150-300 minutes per week, for example jogging or swimming
  • Maintain calorie intake and increase the consumption  of high fiber foods , such as vegetables and fruits
  • Reduce the intake of foods and drinks that are high in sugar and fat
  • Weigh the body once every 1 week
  • Doing relaxation to lower stress levels
  • Adequate ideal sleep time

In addition to the efforts above, make notes about the menu and meal times, as well as the number of calories in the food that has been consumed. That way, you can organize a strategy to avoid the habit of overeating.

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