University Health System Blog

Dr. Aditi Singh answers the question: “Can you be overweight because of a slow metabolism?”

Yes, but this is rare.

Obesity is a chronic disease that is increasing in prevalence in children and adults in the U.S. In the last two to three decades, the prevalence of becoming overweight or obese has been increasing. There are various factors that effect body weight, including metabolism, diet and physical activity.

Metabolism is the process by which the body converts what you eat to energy for the body to utilize (“food into fuel”). This energy is vital for the body to function. The amount of calories your body needs for basic functions, such as breathing and sleeping, is your basal metabolic rate.

Your basal metabolic rate is influenced by your age, which slows down as you get older. It’s influenced by gender, with males having a higher rate than females. It is also influenced by the proportion of your lean body mass, for example, your metabolic rate tends to be higher if you have more muscle mass.

Certain medications can also be responsible. Genetic factors also play a role in obesity. There are also medical conditions that may contribute to obesity, including Cushing’s syndrome and hypothyroidism, which slows metabolic activity.

However, compared to lifestyle factors, these are rare. Most cases of obesity are related to sedentary lifestyle and increased caloric intake. A sedentary lifestyle lowers your energy expenditure, thus promoting weight gain. Unhealthy habits such as sleep deprivation and frequent fast-food consumption are also associated with weight gain.

Effective measures to keep energy expenditure up are activity, low-calories meals and healthy habits.

Dr. Aditi Singh is an assistant professor of medicine at the University of Nevada School of Medicine in Las Vegas. She is board certified by the American Board of Internal Medicine.

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Dr. Kami Larsen answers the question: “I’ve heard fruit juice is bad for kids because it contributes to obesity. But it’s a good source of vitamins. What should I do?”

The amount of fruit juice consumed by children is definitely a contributing factor in our battle against childhood obesity. While in some cases it may be a good source of vitamins, typically the carbohydrate (sugar) content is far too high.

If parents want to ensure their children get vitamins in the diet, they should be focused on whole fruits and vegetables, not solely on juice.

In moderation (four to six ounces per day), juice can be acceptable, even helpful.

Parents should check the label to look at vitamin content and go for those that offer the most bang for the buck. Simply pumping 32 ounces a day of apple juice into a child is typically just giving them empty calories.

Kami Larsen, M.D. is a pediatrician at University Health System in Las Vegas, Nevada. Dr. Larsen is assistant professor of pediatrics at the University of Nevada School of Medicine and medical director of Kids Healthcare Clinic.

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Dr. Shawn Tsuda answers the question: “Laparoscopic gastric bypass versus the laparoscopic adjustable gastric band: Is one or the other better for long term weight loss results?”

The number of weight loss procedures performed over the past ten years has increased by more than a ten-fold in the U.S., exceeding 200,000 operations in 2006. The laparoscopic Roux-en-Y gastric bypass, which provides both restriction and malabsorption of food intake, is still considered the gold standard operation for long-term weight loss.

However, the laparoscopic adjustable gastric band, which uses one of two FDA approved devices for primary restriction of food into the gastrointestinal tract, is the second most commonly performed procedure and is quickly gaining in popularity. There is an abundance of data that supports both the gastric bypass and laparoscopic adjustable gastric band as safe (but not risk-free) procedures with sustainable weight loss and a positive impact on obesity-related diseases such as diabetes mellitus, hypertension and obstructive sleep apnea. (Learn more about weight loss surgery procedures from the U.S. National Library of Medicine).

The amount of weight loss that can be expected on average for the gastric bypass ranges between 60 and 80 percent of excess weight loss, or loss of weight beyond a calculated ideal body weight. The laparoscopic adjustable gastric band has a wider spectrum of success, ranging between 30 and 70 percent of excess weight loss.

Both operations are endorsed by most professional medical societies as acceptable treatments for the severely obese. The choice of operation depends on the patient’s preference, along with his or her surgeon’s counseling on any specific contraindications to either of the operations. An informed decision is essential to undergoing any weight loss procedure.

Shawn Tsuda, M.D. is vice chief for bariatric surgery at the University of Nevada School of Medicine, in Las Vegas, Nevada. Dr. Tsuda completed his fellowship training in minimally invasive and bariatric surgery at Harvard Medical School. He is board certified in general surgery.

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Dr. James Lau answers the question: “What’s the difference between being overweight and obesity?”

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. Both terms mean that your weight is greater than what’s considered healthy.

Obesity most often occurs over time when you eat more calories than you burn or use. The balance between calories-in and calories-out differs for everyone. Genetics, overeating, eating high fat foods and being physically inactive are factors that can make you obese.

It’s important to note that obesity is not just a cosmetic concern. Obesity and carrying excess body fat places you at greater risk of developing high blood pressure, diabetes, stroke, arthritis, certain cancers, and other serious health problems. Losing even five to ten percent of your weight if you’re obese can help delay or prevent some of these diseases.

If your body hasn’t responded to diet and exercise, you may be a good candidate for weight loss surgery, or bariatric surgery, such as the gastric bypass or the lap band using laparoscopic techniques. It’s important to get the facts about your choices if you believe you’re a good candidate for weight loss surgery.

The University of Nevada School of Medicine and University Medical Center sponsors free seminars in Las Vegas on bariatric surgery that Dr. Shawn Tsuda and I personally conduct. These free seminars are usually held once or twice a month at the School of Medicine. For a complete schedule, and for more information, please contact Robin Morello at 702-671-5150.

James Lau, M.D. is an assistant professor and chief of the bariatric surgery division at the University of Nevada School of Medicine Department of Surgery. Dr. Lau is board certified in general surgery and completed fellowship training in bariatric and minimally invasive surgery at Stanford University. He specializes in weight loss surgery.

Have a question? University Health System doctors answer select questions from readers like you.