Morbid Obesity: When Are You Medically Overweight?

Being overweight is defined as having more body fat than is ideal for good health. Body mass index (BMI) is a measuring tool to define whether a person is in the overweight category.

While overweight is defined as having a body mass of 25 kilograms per meters squared (kg/m 2 ), obesity begins at 30 kg/m 2 . Morbid obesity is indicated by a BMI of 40 kg/m 2 or higher.

It's important to remember BMI is not an exact measure of health—it simply indicates that a person might want to get tested for health issues usually associated with higher BMI.

This article discusses morbid obesity and BMI, the risks associated with morbid obesity, how to treat morbid obesity, and getting support for recovery.

Body mass index is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age.

Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.

Morbid Obesity, BMI, and Weight Risks

Being about 80 to 100 pounds over the reference body weight for your height could put you in the category of morbidly obese on the BMI chart. A high BMI might not mean you are unhealthy since BMI is only a screening tool to determine risks to screen for.

However, knowing your BMI category could be a way for you and your healthcare provider to gauge which tests might be necessary to monitor your health and what risks you might face. For example, people with morbid obesity aged 25 to 35 could be 12 times more likely to die prematurely when compared to their peers.

A BMI in the morbidly obese category, or a BMI of 40 kg/m 2 (88 pounds per foot squared) or higher, could increase the chances of the following health conditions:

• Shallow or restricted breathing (hypoventilation), asthma, or sleep apnea
• Diabetes
• Cardiovascular (heart and circulatory system) issues like high blood pressure, higher risk of heart attack, or coronary artery disease
• Persistent heartburn or gastroesophageal reflux disease (GERD)
• Gallbladder disease or fatty liver disease
• Urinary tract infections (UTIs) and fertility problems
• Joint, hip, and back pain
• Increased risk of cancer, including breast cancer, colon cancer, prostate cancer, and pancreatic cancer
• A decreased life expectancy by 10 to 15 years

Chart to Visualize Morbid Obesity Classification

Below is an example of a BMI chart, which can classify people's weight and, as a result, screen for health risks. However, BMI is not a direct indicator of health problems. To determine if your BMI is a concern, discuss your symptoms and necessary lab work with a healthcare provider.

You can check your BMI by entering your height in the Adult BMI Calculator provided by the Centers for Disease Control and Prevention (CDC).

Causes and Risk Factors

The causes of obesity are complex. An imbalance in the energy taken in and the energy expended can result in weight gain. Eating patterns, lack of physical activity, and not enough sleep play a role. These can be influenced by a person's environment and social and cultural factors. Sometimes, genetics, illnesses, and medications can be a factor.

Treating Morbid Obesity: Where Do You Start?

The first step toward treating morbid obesity is to speak to a healthcare provider on how to do so safely. For instance, starting a new exercise regime with a high BMI could put you at greater risk for injury, and meeting with a trainer or speaking to your healthcare provider could be advised.

The following are some ways to begin morbid obesity treatment.

Behavioral Changes

If weight loss seems overwhelming, it might help to begin by trying new behaviors, such as:

• Recording what you eat daily and using a calorie counter
• Drinking more water
• Avoiding temptations, like alcohol with dinner, which can make it more difficult to limit calories, or skipping a meal and overeating later
• Setting healthy and safe weight loss goals
• Taking small steps toward your health and focusing on one goal at a time
• Having realistic standards for appearance and weight
• Creating a support network via support groups, family, and friends
  

Modifying Diet

Dietary changes can be done in a variety of ways, including:

• Swapping processed foods, like packaged meals, for fresh ingredients, including fresh vegetables or fruits
• Limiting added sugars or unhealthy fats, like saturated fat
• Finding physical activities you know you'll enjoy enough to stick with
• If possible, making a goal to decrease calorie intake by 500 to 600 calories a day via exercise, diet, or both, which could result in weight loss of about 1 pound a week
• Learning how to read nutrition labels and how to determine portion sizes
• Determining your calorie deficit for the day, which can depend on exercise and weight loss goals
  

Movement and Exercise

When starting an exercise program with a high BMI, it's recommended to start slowly, with shorter bouts of exercise, which could include:

• Parking your car farther from or walking a longer route to daily destinations
• Planning short, brisk walks, including a five-minute walk a couple of times a day
• Low-impact water aerobics
• Dancing or some other physical activity you enjoy

Other exercises that help with weight loss include:

• Running or cycling
• Weight lifting
• Group exercise classes
• Water aerobics
  

Some safety measures to incorporate when exercising could include:

• Watching for any difficulty breathing
• Using equipment correctly to maintain balance and prevent injury
• Modifying exercises if range of motion is limited

Prescription Medication

Weight loss medications can be prescribed by a healthcare provider or purchased over the counter (OTC). Prescription weight loss medications are meant for people with health problems because of their weight. The following are some prescribed weight loss medications:

• Adipex-P (phentermine): A stimulant that suppresses appetite
• Alli or Xenical (orlistat): Prevents fat from food from being absorbed, is also available without a prescription
• Topomax (topiramate): An anti-seizure medication that might help with binge eating
• Qsymia (phentermine and topiramate): A combination medication
• Contrave (naltrexone and bupropion): A combination of medications used to treat addiction and depression that might help with appetite and cravings
• Victoza or Saxenda (liraglutide): Injections that could lower appetite and help with cravings

Over-the-Counter Medication

Alli is an OTC version of orlistat that has been approved by the Food and Drug Administration (FDA).

While many OTC diet pills claim to help with weight loss, most are not approved by the FDA. It's advised to talk to your healthcare provider before taking any weight loss medication.

Weight loss pills usually claim to increase metabolism and suppress appetite. Most of these claims are not verified, and some can be unsafe. For instance, supplements could interfere with medications you're taking or cause high blood pressure or worsen heart problems.

Weight loss pills often contain one or more of the following:

Some OTC weight loss supplements are simply diuretics, meaning they cause water loss. This could cause dehydration and loss of minerals. Therefore, diuretics are not recommended as a weight loss tool.

Surgery

A BMI over 40 can make a person a candidate for bariatric surgery, A candidate for bariatric surgery might:

• Not be able to lose weight through lifestyle changes
• Have health issues related to weight

Whether bariatric surgery is a safe option for you also requires medical and psychological analysis beforehand.

"Bariatric surgery" is a general term for weight loss surgery. Some common bariatric surgery options are

• Gastric sleeve: About 80% of the stomach is removed to make it smaller.
• Roux-en-Y gastric bypass (RYGB): A small part of the stomach is sectioned off and connected to the lower intestine. This creates a small pouch that cannot absorb as much food as before.
• Adjustable gastric band (AGB, or lap band surgery): A band is placed on the stomach to limit how much a person can eat.

Weight Loss Goals for Morbid Obesity

Weight loss generally consists of these three goals:

• Short-term goal: Losing 5% to 10% of your body weight
• Interim goal: Maintaining weight loss
• Long-term goal: Maintaining new weight or more weight loss

According to the National Institutes of Health (NIH), it's recommended to:

• Lose 10% of your body fat first before losing 10% more of your new weight.
• Reduce calories moderately.
• Expect to lose 1 to 2 pounds a week.

Support and Commitment to Morbid Obesity Recovery

Morbid obesity treatment does not have to be a solo effort. In fact, getting help from support systems could be key to recovery.

Mental Health and Treating Morbid Obesity

Having obesity can be linked to mental health concerns, and working on mental health along with physical health can be key to maintaining recovery.

A person living with morbid obesity may have the following mental health difficulties:

• Being 5 times more likely to have experienced depression within the past year
• Eating for emotional reasons
• Binge eating disorder, which can sabotage weight loss efforts even after bariatric surgery
• Anxiety disorders, which are common among bariatric surgery patients, and some of this is social anxiety because of societal judgments
• Substance use disorder: About 10% of bariatric surgery patients could have a drug or alcohol problem, and it could be related to impulse control that affects eating.

There are several ways to find support when recovering from morbid obesity, including:

• Support groups: These could be online or in-person groups via organizations like the Obesity Action Coalition (OAC) or group therapy.
• Commercial plans: Weight loss programs like Weight Watchers or fitness groups through a local gym could help you achieve your goals.
• Family and friends: Enlist family and/or friends to help you via support like exercising together or helping with maintaining a healthier diet.
• Professional groups: Your weight loss could include a team of professionals that might include a nutritionist, physical therapist, counselor, and primary physician.

Summary

Morbid obesity is defined as having a BMI of 40 or higher. Morbid obesity is associated with a host of health conditions, including heart problems, breathing difficulty, joint pain, mental health concerns, increased likelihood of cancer, and a decrease of 10 to 15 years in life expectancy.

Treating morbid obesity can start with behavioral changes like avoiding temptations or eating fewer processed foods. Dietary changes for weight loss might include reducing calories or a macronutrient, like carbohydrates.

Exercising for morbid obesity treatment can start small with actions like parking farther from destinations to increase steps or water aerobics.

Morbid obesity can also be treated via prescription medications, which might include appetite suppressants or medications like orlistat, which prevents fat absorption. Alli is the over-the-counter version of orlistat. Those diagnosed with morbid obesity might also be qualified for bariatric surgery.

When planning weight loss, losing 10% of your body fat at a time, or 1 to 2 pounds a week, is generally advised.

Support for weight loss can be found online or in person via group therapy, volunteer-run support groups, or weight loss programs like Weight Watchers.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. World Health Organization. Obesity.
2. Centers for Disease Control and Prevention. About adult BMI.
3. UPMC. Defining obesity.
4. National Heart, Lung, and Blood Institute. Obesity and overweight causes and risk factors.
5. Centers for Disease Control and Prevention. Causes of obesity.
6. UCSF Health. Obesity treatments.
7. Centers for Disease Control and Prevention. Losing weight: getting started.
8. MedlinePlus. Binge eating disorder.
9. Adams S, Wijk E. Effects of acute alcohol consumption on food intake and pictorial Stroop response to high-calorie food cues. Alcohol and Alcoholism. 2021;56(3):275-283. doi:10.1093/alcalc/agaa063
10. NHS Inform. Obesity.
11. MedlinePlus. 10 ways to cut 500 calories a day.
12. University of Utah Health. Weight loss medications (anti-obesity medications.
13. National Institutes for Health. Dietary supplements for weight loss.
14. MyHealth.Alberta.ca. Non-prescription products for weight loss.
15. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts of weight-loss surgery.
16. American Society for Metabolic & Bariatric Surgery. Bariatric surgery procedures.
17. National Institutes for Health. Goals of weight management/treatment.
18. Sarwer DB, Polonsky HM. The psychosocial burden of obesity. Endocrinol Metab Clin North Am. 2016;45(3):677-688.
19. UC San Diego Health. Obesity treatment overview.
20. Obesity Action Coalition. Education and support.

By Neha Kashyap
Kashyap is a New York-based health journalist with a bachelor's degree in print journalism from the University of Southern California.

• Meet Our Medical Expert Board
• About Us
• Editorial Process
• Diversity Pledge
• Privacy Policy
• In the News
• Advertise
• Terms of Service
• Careers
• Contact
• EU Privacy

Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

We Care About Your Privacy

We and our 100 partners store and/or access information on a device, such as unique IDs in cookies to process personal data. You may accept or manage your choices by clicking below, including your right to object where legitimate interest is used, or at any time in the privacy policy page. These choices will be signaled to our partners and will not affect browsing data.

We and our partners process data to provide:

Store and/or access information on a device. Use limited data to select advertising. Create profiles for personalised advertising. Use profiles to select personalised advertising. Create profiles to personalise content. Use profiles to select personalised content. Measure advertising performance. Measure content performance. Understand audiences through statistics or combinations of data from different sources. Develop and improve services. Use limited data to select content. List of Partners (vendors)