Obesity

Dr. Steven Reisman, a Cardiologist in New York City, Interviewed on Fox News about Obesity as a Disease.

July 16, 2013 by admin

Is obesity a disease

Dr. Steven Reisman, a New York City cardiologist, was recently interviewed on Fox Business News regarding the American Medical Association recently passing a resolution recognizing obesity as a disease. A disease, which is defined as an abnormal condition which interrupts normal bodily functions and is usually associated with symptoms and signs, may also include disorders and syndromes.

Obesity is generally defined as an elevated Body Mass Index (BMI). This is a formula utilizing both height and weight. A BMI over 30 is generally considered obese. One of the problems with using only the BMI is it may overestimate body fat in athletes and others with a muscular build, and may also underestimate body fat in older persons and those who have lost muscle mass. Another way of defining obesity is looking at “belly fat” by measuring the waist circumference. It is thought that a waist size greater than 35 inches for women and greater than 40 inches for men increases the risks that are associated with obesity and overweight individuals.

It is estimated that 1 in 3 Americans are obese. The complications of obesity include high cholesterol and elevated triglycerides, Type 2 Diabetes, high blood pressure or hypertension, metabolic syndrome, which is a combination of high blood sugar, high blood pressure, and high lipids, and also heart disease including heart attack and stroke. One study has shown that obesity can increase the risk of dying from heart attacks by 60% compared to non-obese individuals.

Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center, recommends early evaluation for obesity and also early evaluation for the complications of obesity including elevated blood sugar or type 2 Diabetes, high blood pressure, elevated lipids, and the possibility of risk for heart attack and stroke. This type of evaluation can be accomplished in a consultation with testing done at the New York Cardiac Diagnostic Center.

DR. STEVEN REISMAN, A CARDIOLOGIST IN NEW YORK CITY, DISCUSSES THE RELATIONSHIP BETWEEN PRE-DIABETES, TYPE 2 DIABETES AND METABOLIC SYNDROME

March 13, 2012 by admin

The prevalence of type 2 diabetes is increasing in the United States according to Dr. Steven Reisman, Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City. Pre-diabetes is usually defined as an elevation of fasting or post-prandial glucose levels. The American Diabetes Association has defined impaired fasting glucose as a level of 100 to 125 mg/dl. Also, an elevation in hemoglobin A1c or glycosylated hemoglobin (HbA1c) at a level of 5.7% to 6.4% may also represent pre-diabetes.

Metabolic Syndrome is related to pre-diabetes. Metabolic Syndrome is defined as any three of the following five components. These components include an elevated glucose level, abdominal obesity, elevated blood pressure, elevated triglycerides, and reduced high-density lipoprotein (HDL) cholesterol. Most individuals with metabolic syndrome have abdominal obesity. It is felt that insulin resistance may be mediating the metabolic risk factors of the metabolic syndrome. Most people with metabolic syndrome have insulin-resistance. It should be noted that the prevalence of pre-diabetes and metabolic syndrome overlap but not exactly. One can consider the metabolic syndrome as a pre-diabetic state. When comparing individuals without metabolic syndrome, those with this syndrome have an approximate 5-fold increase in diabetes risk. Once pre-diabetes is combined with metabolic syndrome, the risk is increased even more for diabetes.

The major adverse outcomes in individuals with pre-diabetes are macrovascular disease and type 2 diabetes, the leading contributors to microvascular disease. Macrovascular disease occurs both before and after the onset of diabetes, whereas microvascular disease occurs predominately several years after becoming diabetic. Metabolic Syndrome is a risk factor for macrovascular disease. Initial management is lifestyle intervention including weight reduction in obese subjects, reduced intake of dietary saturated and trans-fatty acids, cholesterol, and sodium along with increased physical activity.

According to Dr. Steven Reisman the Director of the New York Cardiac Diagnostic Center and a cardiologist in New York City these initial steps of lifestyle intervention in first line management should be emphasized to this group of individuals along with a thorough assessment of cardiovascular risk.

DR. STEVEN REISMAN A NEW YORK CITY CARDIOLOGIST, DISCUSSES THAT OBESITY ALONE INCREASES THE RISK OF A FATAL HEART ATTACK

March 3, 2011 by admin

A recent study has suggested that obesity alone can increase the risk of a fatal heart attack even excluding the effect of other risk factors such as hypertension and diabetes. Healthday (2/14 Mozes) has reported that obese men have a dramatically higher risk of dying from a heart attack. In the study of 6,000 middle age men followed for about 15 years, there was an increased risk of fatal heart attack independent of risk factors such as high blood pressure, diabetes, and high cholesterol.

Obese middle-aged men had a 60% increased risk of dying from a heart attack compared to non-obese middle age men after taking out the effect of these risk factors. This suggests that obesity itself may be causing the heart attack. One theory is that obesity may be related to inflammation as a factor in a fatal attack. In addition, obese individuals have larger hearts because of their increase in body size and their hearts may already be “stressed” prior to a heart attack.

Cardiology doctor Steven Reisman, Director of the New York Cardiac Diagnostic Center, states that our office advocates an aggressive approach about not only treating traditional risk factors but also obesity with nutrition counseling and also early diagnostic testing to detect heart disease prior to the development of a heart attack.

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Obesity

Is obesity a disease