Being overweight or obese means your weight is above an ideal weight range. Excess weight creates increased risk of heart disease, certain cancers, and other serious illnesses like diabetes. One tool used to estimate ideal and overweight ranges is called the body mass index (BMI). This scale determines weight ranges based on height. BMI levels include:
- Ideal weight range: 18.5-24.9
- Overweight: 25.0-29.9
- Obese: 30.0 or above
- Morbid obesity: 40 or above (35 and above with current health condition like diabetes or high blood pressure)
There are slightly different categories for teens and children.
Calories are taken in through food. They are used through physical activity and basic body functions. Excess weight gain occurs when this relationship is not kept in balance. High caloric intake and low usage will cause weight gain. If this happens regularly it will lead to obesity.
Factors that can influence obesity are:
- Genetics
- Biologic factors (eg, amount and activity of certain chemicals in the body)
- Medications (eg, corticosteroids, antidepressants, and antipsychotics)
- Underactive thyroid
- Cushing's disease
- Polycystic ovary syndrome
- Froehlich's syndrome
- Prader-Willi syndrome
- Laurence-Moon-Biedl syndrome
Risk factors include:
- Advancing age
- Working varied shifts
- Decreased activity
- Sedentary lifestyle—Getting too little exercise and spending too much time in front of a TV or computer can contribute to obesity in children and adults.
- Imbalance of excess calories versus decreased activity
- High level of fast food intake
- High alcohol consumption
- Eating foods with a high glycemic index such as refined carbohydrates (eg, instant mashed potatoes, baked white potatoes, instant rice)
- Eating until full and eating quickly
Symptoms include:
- Increased weight
- Thickness around the midsection
- Obvious areas of fat deposits
- Decreased energy
- Heart disease
- Increased risk of blood clots
- Increased risk of stroke
- Increased levels of cholesterol and triglycerides in the blood
- High blood pressure
- Pregnancy complications, including high blood pressure , diabetes , complications during labor and deliver, malformations of the baby
- Type 2 diabetes
- Liver disease
- Pancreatitis
- Gastroesophageal reflux disease
- Gallstones
- Cataracts
- Worsening arthritis symptoms
- Joint problems
- Increased risk of certain cancers, such as esophageal, colon, rectal, gallbladder, pancreas, kidney, multiple myeloma, non-Hodgkins Lymphoma
- Increased risk of death from cancer
- Gout
- Infertility
- Sleep apnea
- Poor self-image, depression
- Urinary incontinence
Being overweight or obese is late adolescence has been shown to increase the risk of mortality in adulthood. Researchers have also found that adults who have a high waist circumference or a high waist-to-hip ratio have an increased risk of death. Whether you are a teen or an adult, losing weight now will lower your risk of serious complications later.
Obesity is diagnosed by visual exam and body measurements using:
- Height and weight tables
- Body mass index
- Measuring body folds with a caliper
- Measuring waist-to-hip ratio
- Water-displacement tests
To rule out other medical conditions that may cause excess body weight, your doctor may order:
- Blood tests
Obesity is difficult to treat. Things that affect treatment are:
- Cultural factors
- Personal habits
- Lifestyle
- Genetics
There are many different approaches to treating obesity. You are more likely to successfully lose weight and keep it off by using a combination of strategies, like diet, exercise, counseling, and/or medication. Talk to your doctor or ask for a referral to a dietician . They can help you develop a plan that is best for you. Plans for weight loss may include:
Your doctor may recommend that you:
- Reduce saturated and trans fats
- Limit the amount of refined carbohydrates that you eat
- Keep fat intake under 35% of total calories eaten daily
According to a recent study, the key to weight loss is in reducing the amount of calories that you consume, rather than following a specific kind of diet (like a low-carb diet). It is much more important to choose a low calorie diet you can stick with for the long haul. A dietitian can help you with your total calorie intake goal. This is based on your:
- Current weight
- Weight loss goals
Portion size also plays an important role. Using special portion control plates may help you succeed.
Keep track of everything you eat and drink.
Ask your doctor about an exercise program.
Add bits of activity through your day. Take stairs instead of elevators. Park a little further away. Limit the amount of time you spend watching television and using the computer. This is particularly important for children.
Behavior therapy may help you understand:
- When you tend to overeat
- Why you tend to overeat
- How to combat overeating habits
Weight loss programs do seem to work for some people. Some studies also suggest that a partner or group may help you improve your diet and fitness.
Weight loss medications include:
- Sibutramine (Meridia) —suppresses appetite
- Orlistat (Xenical) —interferes with the absorption of fat from the intestines
Medications alone are not a viable option for losing weight and keeping it off. Some have led to serious side effects. Do not use over-the-counter or herbal remedies without talking to your doctor.
The problem of obesity, of course, is not restricted to adults. There is evidence that the same changes in diet, exercise, and other behaviors can help children and teens lose weight. For example, kids may find success by participating in group therapy that focuses on diet and behavior changes.
When added to lifestyle changes, medications (eg, sibutramine, orlistat) have also been shown to help obese children and adolescents lose weight, though careful monitoring for potential adverse effects is required.
Surgical procedures reduce the size of the stomach. It will also rearrange the digestive tract. The smaller stomach can only hold a tiny portion of food at a time. Operations include:
- Gastric bypass
- Laparoscopic gastric banding
These procedures can have serious complications. They are only an option for people who are dangerously overweight.
© 2009 Nucleus Medical Art, Inc.
Preventing obesity can be difficult. There are many factors influence your weight. General recommendations include:
- Talk to your doctor or a dietician about an appropriate number of calories to eat per day.
- Eat a diet with no more than 35% of daily calories from fat.
- Follow an appropriate exercise program.
- Limit the amount of time you spend doing sedentary activities. This includes watching TV or using the computer.
- Talk to your doctor or an exercise professional about working activity into your daily life.
- Ask a dietitian for help planning a diet that will help you maintain a healthy weight or lose weight if necessary.
- Learn to eat smaller portions of food. Most Americans eat portions that are too large.
Last reviewed November 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.