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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Obesity facts
• What is obesity?
• How common is obesity?
• What are the health risks associated with obesity?
• What causes obesity?
• What are other factors associated with obesity?
• How is body fat measured?
• What about weight-for-height tables?
• What is the body mass index (BMI)?
• Does it matter where body fat is located?
• What can be done about obesity?
• What is the role of physical activity and exercise in obesity?
• What is the role of diet in the treatment of obesity?
• What is the role of medication in the treatment of obesity?
• What about herbal fen/phen?
• What about meal substitutes, artificial sweeteners, and OTC products?
• What is the role of surgery in the treatment of obesity?
• How can patients choose a safe and successful weight-loss program?
• Patient Comments: Obesity - Effective Treatments
• Find a local Internist in your town
• Obesity (Weight Loss) Index

Concern is directed not only at how much fat a person has but also where that fat is located on the body. The pattern of body fat distribution tends to differ in men and women.

In general, women collect fat in their hips and buttocks, giving their figures a "pear" shape. Men, on the other hand, usually collect fat around the belly, giving them more of an "apple" shape. (This is not a hard and fast rule; some men are pear-shaped and some women become apple-shaped, particularly after menopause.)

Apple-shaped people whose fat is concentrated mostly in the abdomen are more likely to develop many of the health problems associated with obesity. They are at increased health risk because of their fat distribution. While obesity of any kind is a health risk, it is better to be a pear than an apple.

In order to sort the types of fruit, doctors have developed a simple way to determine whether someone is an apple or a pear. The measurement is called waist-to-hip ratio. To find out a person's waist-to-hip ratio

• measure the waist at its narrowest point, and then measure the hips at the widest point;
• divide the waist measurement by the hip measurement. For example, a woman with a 35-inch waist and 46-inch hips would have a waist-to-hip ratio of 0.76 (35 divided by 46 = 0.76).

Women with waist-to-hip ratios of more than 0.8 and men with waist-to-hip ratios of more than 1.0 are "apples."

Another rough way of estimating the amount of a person's abdominal fat is by measuring the waist circumference. Men with a waist circumference of 40 inches or greater and women with a waist circumference of 35 inches or greater are considered to have increased health risks related to obesity.