Obesity (patient information)

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Obesity
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
Obesity On the Web
Ongoing Trials at Clinical Trials.gov
Images of Obesity
Videos on Obesity
FDA on Obesity
CDC on Obesity
Obesity in the news
Blogs on Obesity
Directions to Hospitals Treating Obesity
Risk calculators and risk factors for Obesity

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle, bone, or water, as well as from having too much fat.

Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height.

What causes Obesity ?

Taking in more calories than you burn can lead to obesity because the body stores unused calories as fat. Obesity can be caused by:

• Eating more food than your body can use
• Drinking too much alcohol
• Not getting enough exercise

Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost.

Other factors that affect weight include:

• The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat.
• We are surrounded by things that make it easy to overeat and hard to stay active:
  • Many people do not have time to plan and make healthy meals.
  • More people today work desk jobs compared to more active jobs in the past.
  • People with less free time have less time to exercise.

The term "eating disorder" means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time.

Sometimes, medical problems or treatments cause weight gain, including:

• Underactive thyroid gland hypothyroidism
• Medicines such as birth control pills, antidepressants, and antipsychotics

Other things that can cause weight gain are:

• Quitting smoking. Most people who quit smoking gain 4 - 10 pounds in the first 6 months after quitting. Some people gain as much as 25 - 30 pounds.
• Stress, anxiety, feeling sad, or not sleeping well
• For women:
  • Menopause -- women may gain 12-15 pounds during menopause
  • Not losing the weight they gained during pregnancy

Diagnosis

The two most common ways to measure health risks from obesity are:

• Body mass index (BMI)
• Waist circumference (waist measurement in inches)

BMI is measured using height and weight. Health care provider can use BMI to estimate body fat.

Waist measurement is another way to estimate body fat. Extra weight around your middle or stomach area increases your risk for type 2 diabetes, heart disease, and stroke. People with "apple-shaped" bodies (meaning their waist is bigger than their hips) also have an increased risk for these diseases.

Skin fold measurements may be taken to check your body fat percentage.

Blood tests may be done to look for thyroid or hormone problems that could lead to weight gain.

Treatment options

Lifestyle Changes

An active lifestyle and regular exercise, along with healthy eating, is the best way to lose weight. Even modest weight loss can improve health. Support from family and friends is required.

When dieting, main goal should be to learn new, healthy ways of eating and make them a part of daily routine.

Many people find it hard to change their eating habits and behaviors, they need to be motivated to make lifestyle changes. Make the behavior change part of life over the long term.

Working with health care provider and dietitian to set realistic, safe daily calorie counts helps in loosing weight while staying healthy. Dietitian can teach about:

• Healthy food choices
• Healthy snacks
• Sweetened drinks
• Portion sizes
• How to read the nutrition labels
• New ways to prepare food

Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again.

Learn new ways to manage stress, rather than snacking. Examples may be meditation, yoga, or exercise. If depressed or stressed a lot, talking to health care provider helps.

Medications and Herbal Remedies

You may see ads for supplements and herbal remedies] that claim they will help you lose weight. Many of these claims are not true, and some of these supplements can have serious side effects. Talk to your health care provider before using them.

Several prescription weight loss drugs are available. Most people lose between 5 and 10 pounds by taking these drugs. Most people also regain the weight when they stop taking the medicine, unless they have made lasting lifestyle changes, such as exercising and cutting unhealthy foods from their diet.

Surgery

Bariatric surgery can reduce the risk of disease in people with severe obesity. These risks include:

• Arthritis
• Diabetes
• Heart disease
• High blood pressure
• Sleep apnea
• Some cancers
• Stroke

Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine.

Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after the surgery. Talk to your doctor to learn if this is a good option for you.

The two most common weight-loss surgeries are:

• Laparoscopic gastric banding
• Gastric bypass surgery

You may have complications from these surgeries. One problem some people have is throwing up if they eat more than their new small stomach can hold.

Where to find medical care for Obesity ?

Directions to Hospitals Treating Obesity

Possible complications

Obesity is a major health threat. The extra weight puts added stress on every part of your body. People with obesity are at risk for these health problems:

• Bone and joint problems -- extra weight puts strain on the bones and joints. This can lead to osteoarthritis, a disease that causes joint pain and stiffness.
• Gallstones and liver problems
• Heart attack from coronary heart disease, congestive heart failure, and stroke
• High blood cholesterol and triglycerides (dyslipidemia or high blood fats)
• High blood pressure (hypertension)
• High blood sugar (glucose) or diabetes
• Stopping breathing during sleep (sleep apnea). This can cause daytime fatigue or sleepiness, poor attention, and problems at work.