Obesity is defined as having an excessive amount of body fat. Obesity is
more than just a cosmetic concern, though. It increases your risk of
diseases and health problems such as heart disease, diabetes and high
blood pressure.
Being extremely obese means you are especially likely to have health problems related to your weight.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. You can usually lose weight through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
When you're obese, your overall quality of life may be lower, too. You may not be able to do things you'd normally enjoy as easily as you'd like. You may have trouble participating in family activities. You may avoid public places. You may even encounter discrimination.
Other weight-related issues that may affect your quality of life include:
Because BMI doesn't directly measure body fat, some people, such as muscular athletes, may have a BMI in the obese category even though they don't have excess body fat.
When to see a doctor
If you think you may be obese, and especially if you're concerned about weight-related health problems, see your doctor or health care provider. You and your doctor can evaluate your health risks and discuss your weight-loss options. Even modest weight loss can lessen or prevent problems related to obesity. Weight loss is usually possible through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits.
You can start feeling better and seeing improvements in your health by just introducing better eating and activity habits. The initial goal is a modest weight loss — 5 to 10 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9.1 kg) to start seeing benefits.
All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Other treatment tools include:
Reducing calories and eating healthier are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss of 1 or 2 pounds (1/2 to 1 kilogram) a week over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.
Dietary ways to overcome obesity include:
Increased physical activity or exercise also is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
To boost your activity level:
A behavior modification program can help you make lifestyle changes, lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity.
Behavior modification, sometimes called behavior therapy, can include:
Losing weight requires a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may help. Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don't make these other changes in your life, medication is unlikely to work.
Your doctor may recommend weight-loss medication if other methods of weight loss haven't worked for you and you meet one of the following criteria:
Weight-loss surgery
In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery offers the best chance of losing the most weight, but it can pose serious risks. Weight-loss surgery limits the amount of food you're able to comfortably eat or decreases the absorption of food and calories, or both.
Weight-loss surgery for obesity may be considered if:
Common weight-loss surgeries include:
Unfortunately, it's common to regain weight no matter what obesity treatment methods you try. But that doesn't mean your weight-loss efforts are futile.
One of the best ways to prevent regaining the weight you've lost is getting regular physical activity. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
You may always have to remain vigilant about your weight. Combining a healthier diet and more activity is the best way to lose weight and keep it off for the long term. If you take weight-loss medications, you'll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or eat foods laden with fat and calories.
Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.
Want to read more about obesity? Read from our source www.mayoclinic.com
Being extremely obese means you are especially likely to have health problems related to your weight.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. You can usually lose weight through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
Causes of Obesity
Although there are genetic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, including:- Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities.
- Unhealthy diet and eating habits. Having a diet that's high in calories, eating fast food, skipping breakfast, eating most of your calories at night, drinking high-calorie beverages and eating oversized portions all contribute to weight gain.
- Pregnancy. During pregnancy, a woman's weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
- Lack of sleep. Getting less than seven hours of sleep a night can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
- Certain medications. Some medications can lead to weight gain if you don't compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.
- Medical problems. Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, polycystic ovary syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.
Conditions that can place you at risk ( Contributing factor)
Obesity occurs when you eat and drink more calories than you burn through exercise and normal daily activities. Your body stores these extra calories as fat. Obesity usually results from a combination of causes and contributing factors, including:- Genetics. Your genes may affect the amount of body fat you store and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercise. Even when someone has a genetic predisposition, environmental factors ultimately make you gain more weight.
- Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you burn off through exercise and normal daily activities.
- Unhealthy diet and eating habits. Having a diet that's high in calories, eating fast food, skipping breakfast, consuming high-calorie drinks and eating oversized portions all contribute to weight gain.
- Family lifestyle. Obesity tends to run in families. That's not just because of genetics. Family members tend to have similar eating, lifestyle and activity habits. If one or both of your parents are obese, your risk of being obese is increased.
- Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to a weight gain of as much as several pounds a week for several months, which can result in obesity. In the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke. so quit.
- Pregnancy. During pregnancy a woman's weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
- Lack of sleep. Not getting enough sleep at night can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
- Certain medications. Some medications can lead to weight gain if you don't compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.
- Age. Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. This lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don't control what you eat as you age, you'll likely gain weight.
- Social and economic issues. Certain social and economic issues may be linked to obesity. You may not have safe areas to exercise, you may not have been taught healthy ways of cooking, or you may not have money to buy healthier foods. In addition, the people you spend time with may influence your weight — you're more likely to become obese if you have obese friends or relatives.
- Medical problems. Obesity can rarely be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, polycystic ovary syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.
Health Complications that Could Result from Obesity
If you're obese, you're more likely to develop a number of potentially serious health problems, including:- High cholesterol and triglycerides
- Type 2 diabetes
- High blood pressure
- Metabolic syndrome — a combination of high blood sugar, high blood pressure, high triglycerides and high cholesterol
- Heart disease
- Stroke
- Cancer, including cancer of the uterus, cervix, ovaries, breast, colon, rectum and prostate
- Sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts
- Depression
- Gallbladder disease
- Gynecologic problems, such as infertility and irregular periods
- Erectile dysfunction and sexual health issues, due to deposits of fat blocking or narrowing the arteries to the genitals
- Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring
- Osteoarthritis
- Skin problems, such as poor wound healing
When you're obese, your overall quality of life may be lower, too. You may not be able to do things you'd normally enjoy as easily as you'd like. You may have trouble participating in family activities. You may avoid public places. You may even encounter discrimination.
Other weight-related issues that may affect your quality of life include:
- Depression
- Disability
- Physical discomfort
- Sexual problems
- Shame
- Social isolation
Symptoms of Obesity
Obesity is diagnosed when an individual's body mass index (BMI) is 30 or higher. Your body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.BMI | Weight status |
---|---|
Below 18.5 | Underweight |
18.5 — 24.9 | Normal |
25.0 — 29.9 | Overweight |
30.0 and higher | Obese |
40.0 and higher | Extreme obesity |
Because BMI doesn't directly measure body fat, some people, such as muscular athletes, may have a BMI in the obese category even though they don't have excess body fat.
When to see a doctor
If you think you may be obese, and especially if you're concerned about weight-related health problems, see your doctor or health care provider. You and your doctor can evaluate your health risks and discuss your weight-loss options. Even modest weight loss can lessen or prevent problems related to obesity. Weight loss is usually possible through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
Treatment of Obesity
The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits.
You can start feeling better and seeing improvements in your health by just introducing better eating and activity habits. The initial goal is a modest weight loss — 5 to 10 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9.1 kg) to start seeing benefits.
All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Other treatment tools include:
- Dietary changes
- Exercise and activity
- Behavior change
- Prescription weight-loss medications
- Weight-loss surgery
Reducing calories and eating healthier are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss of 1 or 2 pounds (1/2 to 1 kilogram) a week over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.
Dietary ways to overcome obesity include:
- A low-calorie diet. The key to weight loss is reducing how many calories you take in. You and your health care providers can review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You and your doctor can decide how many calories you need to take in each day to lose weight, but a typical amount is 1,000 to 1,600 calories.
- Feeling full on less. The concept of energy density can help you satisfy your hunger with fewer calories. All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies, fats and processed foods, are high in energy density. This means that a small volume of that food has a large number of calories. In contrast, other foods, such as fruits and vegetables, have low energy density. These foods provide a larger portion size with a fewer number of calories. By eating larger portions of foods less packed with calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
- Adopting a healthy-eating plan. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein, such as beans, lentils and soy, and lean meats. Try to include fish twice a week. Limit salt and added sugar. Stick with low-fat dairy products. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as nuts and olive, canola and nut oils.
- Meal replacements. These plans suggest that you replace one or two meals with their products — such as low-calorie shakes or meal bars — and eat healthy snacks and a healthy, balanced third meal that's low in fat and calories. In the short term, this type of diet can help you lose weight. Keep in mind that these diets likely won't teach you how to change your overall lifestyle, though, so you may have to keep this up if you want to keep your weight off.
- Be wary of quick fixes. You may be tempted by fad diets that promise fast and easy weight loss. The reality, however, is that there are no magic foods or quick fixes. Fad diets may help in the short term, but the long-term results don't appear to be any better than other diets. Similarly, you may lose weight on a crash diet, but you're likely to regain it when you stop the diet. To lose weight — and keep it off — you have to adopt healthy-eating habits that you can maintain over time.
Increased physical activity or exercise also is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
To boost your activity level:
- Exercise. The American College of Sports Medicine recommends that people who are overweight or obese get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to lose a modest amount of weight. But to achieve significant weight loss, you may need to get as much as 250 to 300 minutes of exercise a week. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve. To make your own exercise goal more doable, break it up into several sessions throughout the day, doing just five or six minutes at a time.
- Increase your daily activity. Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Making simple changes throughout your day can add up to big benefits. Park farther from store entrances, rev up your household chores, garden, get up and move around periodically, and wear a pedometer to track how many steps you actually take over the course of a day.
A behavior modification program can help you make lifestyle changes, lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity.
Behavior modification, sometimes called behavior therapy, can include:
- Counseling. Therapy or interventions with trained mental health or other professionals can help you address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You can also learn how to monitor your diet and activity, understand eating triggers, and cope with food cravings. Counseling may be available by telephone, email or Internet-based programs if travel is difficult. Therapy can take place on both an individual and group basis.
- Support groups. You can find camaraderie and understanding in support groups where others share similar challenges with obesity. Check with your doctor, local hospitals or commercial weight-loss programs for support groups in your area, such as Weight Watchers.
Losing weight requires a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may help. Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don't make these other changes in your life, medication is unlikely to work.
Your doctor may recommend weight-loss medication if other methods of weight loss haven't worked for you and you meet one of the following criteria:
- Other methods of weight loss haven't worked for you
- Your body mass index (BMI) is 30 or greater
- Your body mass index (BMI) is greater than 27 and you also have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea
-
Orlistat (Xenical). Orlistat is a weight-loss
medication that has been approved by the Food and Drug Administration
(FDA) for long-term use in adults and children 12 and older. This
medication blocks the digestion and absorption of fat in your stomach
and intestines. Unabsorbed fat is eliminated in the stool. Average
weight loss with orlistat is about 5 to 7 pounds (2.3 to 3.2 kilograms)
more than you can get from diet and exercise after one or two years of
taking the medication.
Side effects associated with orlistat include oily and frequent bowel movements, bowel urgency, and gas. These side effects can be minimized as you reduce fat in your diet. Because orlistat blocks absorption of some nutrients, take a multivitamin while taking orlistat to prevent nutritional deficiencies.
The FDA has also approved a reduced-strength version of orlistat (Alli) that's sold over-the-counter, without a prescription. Alli is not approved for children. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
-
Lorcaserin (Belviq). Lorcaserin is a long-term
weight-loss drug approved by the FDA for adults in 2012. It works by
affecting chemicals in your brain that help decrease your appetite and
make you feel full, so you eat less. Your doctor will carefully monitor
your weight loss while taking lorcaserin. If you don't lose about 5
percent of your total body weight within 12 weeks of taking lorcaserin,
it's unlikely the drug will work for you and the medication should be
stopped.
Side effects of lorcaserin include headaches, dizziness, fatigue, nausea, dry mouth and constipation. Rare but serious side effects include a chemical imbalance (serotonin syndrome), suicidal thoughts, psychiatric problems, and problems with memory or comprehension. Pregnant women shouldn't take lorcaserin.
-
Phentermine-topiramate (Qsymia). This weight-loss
medication is a combination drug approved by the FDA for long-term use
in adults. Qsymia combines phentermine, a weight-loss drug prescribed
for short-term use, with topiramate, a medication that's used to control
seizures. Your doctor will monitor your weight loss while taking the
drug. If you don't lose at least 3 percent of your body weight within 12
weeks of starting treatment, your doctor may suggest either stopping
use of Qsymia or increasing your dose, depending on your condition.
Side effects include increased heart rate, tingling of hands and feet, insomnia, dizziness, dry mouth and constipation. Serious but rare side effects include suicidal thoughts, problems with memory or comprehension, sleep disorders and changes to your vision. Pregnant women shouldn't take Qsymia. Qsymia increases the risk of birth defects.
- Phentermine (Adipex-P, Suprenza). Phentermine is a weight-loss medication for short-term use (three months) in adults. Using weight-loss medications short-term doesn't usually lead to long-term weight loss. While some health care providers prescribe phentermine for long-term use, few studies have evaluated its safety and weight-loss results long term.
Weight-loss surgery
In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery offers the best chance of losing the most weight, but it can pose serious risks. Weight-loss surgery limits the amount of food you're able to comfortably eat or decreases the absorption of food and calories, or both.
Weight-loss surgery for obesity may be considered if:
- You have extreme obesity, with a body mass index (BMI) of 40 or higher
- Your BMI is 35 to 39.9, and you also have a serious weight-related health problem, such as diabetes or high blood pressure
- You're committed to making the lifestyle changes that are necessary for surgery to work
Common weight-loss surgeries include:
- Gastric bypass surgery. This is the favored weight-loss surgery in the United States because it has shown relatively good long-term results. In gastric bypass (Roux-en-Y gastric bypass), the surgeon creates a small pouch at the top of your stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of your stomach.
- Laparoscopic adjustable gastric banding (LAGB). In this procedure, your stomach is separated into two pouches with an inflatable band. Pulling the band tight, like a belt, the surgeon creates a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently. LAGB is popular because it is less invasive, generally causes slow, steady weight loss and the band can be adjusted if needed. However, as with other procedures, this won't work without changes in your behavior. Results are usually not as good as with other procedures. The LAP-BAND gastric banding device has also been approved for use in people who have a BMI of 30 to 34 and have an additional health condition related to their obesity.
- Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. There are ongoing studies evaluating this procedure.
- Biliopancreatic diversion with duodenal switch. In this procedure, most of your stomach is surgically removed. This weight-loss surgery offers sustained weight loss, but it poses a greater risk of malnutrition and vitamin deficiencies, and you require close monitoring for health problems. It's generally used for people who have a body mass index of 50 or more.
Unfortunately, it's common to regain weight no matter what obesity treatment methods you try. But that doesn't mean your weight-loss efforts are futile.
One of the best ways to prevent regaining the weight you've lost is getting regular physical activity. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
You may always have to remain vigilant about your weight. Combining a healthier diet and more activity is the best way to lose weight and keep it off for the long term. If you take weight-loss medications, you'll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or eat foods laden with fat and calories.
Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.
Want to read more about obesity? Read from our source www.mayoclinic.com
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