Table of Contents
WHAT IS OBESITY?
Obesity is a condition characterized by a body weight that is far beyond the optimum or ideal weight due to the storage of extra body fat. The patient’s age, gender, genetics, and cultural background could all influence these standards.
A body mass index exceeding 30 is considered as obesity, and a BMI surpassing 40 is labeled as severe obesity or morbid obesity. Following are the BMI values for each respective category:
| Normal weight | 19-24.9 |
| Overweight | 25-29.9 |
| Obesity level I | 30-34.9 |
| Obesity level II | 35-39.9 |
| Obesity level III | ≥ 40 |
People identified through the ICD-10 code for morbid obesity satisfy the following conditions:
⦁ They weigh more than 100 pounds more than what the BMI considers to be “healthy weight” for their height and gender;
⦁ Their body mass index is 40 or higher;
⦁ They have a BMI of 35 or higher and have one or more major health problems as a result of their weight. (severe sleep apnea, type 2 diabetes, excessive blood pressure, etc.)
HOW COMMON IS OBESITY IN THE UNITED STATES?
According to the 2018 National Health and Nutrition Examination data (NHANES), at that time, 31% of adults were categorized as overweight (1 in 3 adults). Almost 44% of adults were considered obese, and 10% of American adults were classified as morbidly obese.
The obesity epidemic has hit both adults and children, and more than 16% of children from ages 2 to 19 were classified as overweight, 19% were considered obese, and over 6% fell into the morbidly obese category.
The statistics related to obesity have grown each year, so the numbers for 2022 are actually higher.
WHAT IS AN ICD-10 CODE?
An ICD-10 code, short for the International Classification of Diseases, is a globally recognized system of diagnostic codes regularly updated by the National Center for Health Statistics. These codes serve the purpose of providing highly specific descriptions for diseases or medical conditions. Established in 2015 to align with HIPAA regulations, these codes are mandatory for use by covered entities such as payers, clearinghouses, and healthcare professionals.
WHY WERE ICD-10 CODES FOR MORBID OBESITY AND OTHER CONDITIONS DEVELOPED?
The development of ICD-10 codes, including those for morbid obesity, aimed to offer a standardized terminology compatible with clinical practices. Unlike its predecessor, ICD-9-CM, which had 13,000 codes, the ICD-10 system boasts over 68,000 codes. This expanded set allows for a more detailed representation of the quality of care, facilitating better communication about issues and the monitoring of treatment outcomes.
ICD-10 CODES FOR OBESITY
Moreover, ICD-10 codes play a crucial role in providing anonymous information and detail, which, when coupled with clinical algorithms, contributes to decision-making and research endeavors. Specific to obesity, there are distinct ICD-10 codes available for children aged birth to 19 and adults aged 20 and above. You can access the ICD-10 database to find these codes along with their respective descriptions.
The primary code used to classify individuals with overweight and obesity is E66, falling under the category of Endocrine, nutritional, and metabolic diseases as listed by the World Health Organization (WHO). This code serves as a general classification, and to provide further details about the degree of obesity, a numeric code is added to E66. For instance:
- E66 Overweight and obesity
- E66.0 Obesity due to excess calories;
- E66.01 Morbid (severe) obesity due to excess calories;
- E66.09 Other obesity due to excess calories;
- E66.1 Drug-induced obesity;
- E66.2 Morbid (severe) obesity with alveolar hypoventilation;
- E66.3 Overweight;
- E66.8 Other obesity;
- E66.9 Obesity, unspecified.
Additionally, a Z68 code is incorporated to indicate the patient’s body mass index (BMI). For example, E66.01.Z68.42 signifies severe obesity due to excess calories with a BMI in the range of 45 to 49.9. The complete list of BMI codes can be found on the ICD data website.
Treatment for Overweight & Obesity
In terms of treatment for overweight and obesity, healthcare professionals typically focus on guiding individuals through lifestyle changes to promote safe weight loss and long-term weight maintenance. In some cases, weight-loss medicines or surgery may be recommended.
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How much weight should I lose?
If you’re aiming to lose weight, collaborating with a healthcare professional can help you establish a realistic weight-loss goal and timeframe. For instance, shedding 5% of your body weight over 6 months could be an initial target. If you weigh 200 pounds, this equates to losing 10 pounds.
The positive impact of weight loss extends to reducing the risk of health problems associated with overweight and obesity. If you’re already contending with weight-related health issues like high blood pressure or diabetes, shedding excess weight can contribute to improvements in your overall health.
Weight-loss medicines
Losing weight can be a challenging journey, and when lifestyle changes alone are insufficient, healthcare professionals may prescribe medications to address overweight and obesity. Some medications are also effective in maintaining weight loss. The U.S. Food and Drug Administration (FDA) has approved six drugs for long-term use:
- Bupropion-naltrexone (Contrave)
- Liraglutide (Saxenda)
- Orlistat (Xenical, Alli)
- Phentermine-topiramate (Qsymia)
- Semaglutide (Wegovy)
- Setmelanotide (Imcivree)
These prescription weight-loss drugs primarily work by reducing hunger or inducing a feeling of fullness, with orlistat being an exception as it affects the body’s fat absorption. Common mild side effects include nausea, constipation, and diarrhea, which may diminish over time. It’s crucial to discuss treatment options, potential benefits, and risks with your healthcare provider.
However, these medications can be costly and may not always be covered by insurance, so it’s advisable to check your coverage. While some people may regain weight after discontinuing these drugs, adopting healthy lifestyle habits can help manage weight gain.
Weight-loss surgery
In cases where medications are not effective, weight-loss surgery, also known as metabolic and bariatric surgery, may be recommended. This option is considered for individuals with a body mass index (BMI) of 35 or higher, or those with lower BMI and obesity-related health issues like type 2 diabetes or sleep apnea. The three main types of weight-loss surgeries are:
- Gastric Bypass: This procedure involves creating a small pouch at the top of the stomach, connecting it directly to the small intestine, restricting portion size, and limiting food absorption.
- Gastric Banding: An adjustable silicone band is placed around the upper stomach, allowing for alterations in the amount of food the stomach can hold by adjusting the tightness of the band.
- Sleeve Gastrectomy: This restrictive procedure entails removing a significant portion of the stomach, limiting the amount of food one can consume.
Weight-loss devices
For those who haven’t achieved desired weight loss through other means, weight-loss devices may be considered. Three FDA-regulated devices include:
- Gastric Band: Placed around the top part of the stomach, limiting available space for food.
- Gastric Balloon Systems: Inflatable balloons occupy space in the stomach, delaying gastric emptying.
- Endoscopic Suturing Devices: These devices, inserted down the throat to the stomach, place permanent sutures to reduce stomach volume.
As these devices have recently gained FDA approval, long-term risks and benefits are still being studied.
Obesity and PCOS
Obesity frequently occurs in women with PCOS, intensifying the symptoms and complications of the condition. Excess weight, especially around the abdomen, can aggravate insulin resistance and hormonal imbalances, making PCOS management more challenging. Combating obesity through a nutritious diet and consistent exercise is essential for alleviating symptoms and enhancing overall health in women with PCOS. Maintaining a healthy weight can significantly lessen PCOS symptoms and decrease the risk of associated health issues like type 2 diabetes and heart disease
Conclusion
In conclusion, addressing overweight and obesity involves a multifaceted approach, ranging from lifestyle changes and medications to surgical interventions and innovative devices. The array of available weight-loss drugs, approved by the FDA, provides options for individuals struggling with excess weight. However, it’s essential to consider potential side effects, discuss choices with healthcare professionals, and complement medication with sustained healthy habits.
For those requiring more intensive interventions, weight-loss surgeries such as gastric bypass, gastric banding, and sleeve gastrectomy offer effective strategies, particularly for those with associated health concerns. Additionally, emerging weight-loss devices, though promising, warrant careful consideration due to their recent FDA approval.
Ultimately, achieving and maintaining a healthy weight is a personalized journey, and collaboration with healthcare providers can guide individuals toward the most suitable and sustainable solutions for their unique needs. Whether through lifestyle adjustments, medications, surgery, or innovative devices, the goal remains fostering overall well-being and minimizing the health risks associated with overweight and obesity.
Ive been working out for past 6 years and feel quite fit and healthy. However according to BMI i fall into overweight category, is it concerning?? Should i consult someone?? Are there any other tests I might consider getting checked??
Even with improved exercise and healthier eating habits, weight loss may not be reflected in BMI changes. This is because while you lose fat, you may also be building muscle, which BMI doesn’t consider. Therefore, if the scale doesn’t show a decrease, your BMI might not change, even though you’re reducing risks associated with obesity-related health issues like heart disease and diabetes.
Also BMI is a useful tool for assessing general weight categories, but it has limitations, especially for individuals with high muscle mass. Since you’ve been working out for six years and feel fit and healthy, it’s likely that your increased muscle mass is influencing your BMI, categorizing you as overweight. Instead of relying solely on BMI, consider other health indicators and tests, such as body fat percentage, waist circumference, and overall fitness assessments. Consulting with a healthcare professional or a fitness expert can provide a more comprehensive understanding of your health and fitness.