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Obesity is a multi-faceted and complex medical condition, characterized by a person being grossly fat or overweight. One can be overweight without being obese—some people weigh more than the average for their height because of muscles, bone, or water weight. But if you have too much fat, it can endanger your health and put you at serious risk of health conditions such as heart disease, diabetes, and high blood pressure.
According to the National Health and Nutrition Examination Survey, more than 2 out of every 3 adults—and 1 out of every 3 children—are overweight, and more than half of these overweight people are obese.
The main tool used to measure body fat—and can hence tell whether one is overweight or obese—is the body mass index (BMI). You can calculate your body mass index by dividing your weight in kilograms (1 kg ≈ 2.2 lb) by your height in meters squared (1 m ≈ 3.28 ft; 1 m2 ≈ 10.76 ft2). You can find out your BMI online by entering your height and weight into the BMI calculator provided by the Centers for Disease Control and Prevention.
A typical healthy person has a BMI of 18.5 to 24.9. A BMI of 25 or greater is considered overweight, and a BMI of 30 or greater is likely to be obese.
BMI is not a perfect measurement. Some people may have a BMI in the overweight or obese category, even if they don’t have a lot of body fat. Very muscular people are one example, and some people may have a high weight because of bone mass, excess water, or a stocky build. But for most people, BMI is a reasonable place to start when you want to know if you have a healthy weight.
Fortunately, if you are overweight or obese, even a little weight loss can help you improve your health and prevent some of the health problems that obesity may cause. Losing weight isn’t easy. It can take time and effort to get rid of excess pounds and keep them off. But losing weight can make a permanent difference in your overall health
Ultimately, body weight is the result of genetics, metabolism, environment, behavior, and culture. But the most common causes of obesity and weight problems are overeating and physical inactivity. The essential equation remains: if you eat more calories than you use in a day, then you will gain weight, as your body stores those extra calories as fat. If the number of calories you eat in a day is about the same as the number of calories you use, your weight should stay more or less the same. And if you use more calories than you take in, then you will likely lose weight.
Put a different way, obesity is caused by taking in more energy (calories) than your body uses. All living things need energy. Your body gets this energy from the foods you eat. Your body uses energy all the time, but it uses more energy when you’re moving than it does when you’re sitting still.
So if your weight has been constant for a long time and then starts increasing, it may mean that you’re eating more calories, or that you’re exercising less, or it could be caused by something else that changes the way your body uses energy, such as:
Not everyone has the same risk of obesity. Some factors that can make you likely to be overweight or obese include:
When you visit your doctor about a weight problem, your doctor will check your height and weight, and calculate your BMI. Your doctor will also ask you questions about your eating and exercise habits, what you think might be causing or contributing to your excess weight, and how much weight you hope to lose. Other questions may focus on:
Your doctor will also perform a physical exam to check vital signs such as your heart rate and blood pressure. Measuring the circumference around your waist can tell your doctor some information about how much your weight is likely to affect your overall health. Fat stored around your waist, sometimes referred to as abdominal fat, may further increase your risk of diseases such as diabetes and heart disease. Women with a waist measurement (circumference) of more than 35 inches and men with a waist measurement of more than 40 inches may have more health risks than those with smaller waist measurements.
In all likelihood, your doctor will also order blood tests to check for health problems associated with overweight and obesity. Some of the lab tests your doctor may request include:
Your doctor may also want to check your heart function with an electrocardiogram or other tests.
The information from this exam and tests will help your doctor get a sense of your weight and your overall health, to understand how much weight you need to lose and what the best approach will be to get you to that goal.
If you find yourself gaining weight, you may want to talk to your doctor about whether your weight is in the healthy range, and whether you need to change your eating and exercise habits to keep yourself in shape. Some indicators that you may be gaining weight include:
Indicators that you may be overweight or obese include:
Being overweight can lead to a number of serious health problems, including:
Being moderately obese (BMI 30-35) can shorten your lifespan by 3 years. Morbid obesity (BMI 40-50) can shorten your life by 10 years. At the high end, extreme obesity (BMI > 55) may shorten lifespan by as much as 14 years.
The good news is that losing just 15 to 20 pounds and keeping it off can reduce your risk of diabetes, heart failure, and other serious complications by 10% to 25%.
Losing weight isn’t easy. It can take a lot of willpower to stay on track, and no one else can do it for you. So what are some things you can do to help you keep yourself moving forward? Here are a few tips:
The U.S. Preventive Services Task Force recommends that doctors screen all adults and children aged 6 and over for obesity, and offer counseling and weight loss assistance for any patients with a BMI of 30 or higher. If you don’t know whether you have a weight problem, you can ask your doctor to check your BMI and screen you for weight-related health issues.
You can screen yourself for overweight and obesity using an online BMI calculator provided by the U.S. Centers for Disease Control and Prevention.
If you are not currently overweight, healthy eating and exercise habits can help keep you at a healthy weight and prevent overweight, obesity, and related health problems. And the sooner you start, the better. If you have children, then setting a good example and encouraging your children to maintain a healthy lifestyle can help prevent weight issues in the future. Some things you can do to help maintain a healthy weight for yourself and your children include:
Keep track of your weight, your waist measurement, and your BMI, and track your kids’ growth as well.
The first step in weight loss treatment is usually lifestyle changes. Changing the way you eat and getting up to move more often will help you lose weight and get yourself in shape. The general idea is to make sure that the number of calories you use in a day is just a little bit more than the number of calories you consume, so that your body will start to feed off your excess body fat to replace the calories it isn’t getting through food.
There is no one right way to change your eating habits; different approaches work for different people. Some approaches that may help include:
Watch out for fad diets that offer a quick fix. If you want to keep the weight off for the long term, then you need to find a long-term plan that works for you.
Developing an exercise regimen is also a very helpful step in losing weight. Aim to get at least 150 minutes of moderate exercise per week–or half an hour of exercise, five days a week. If you can’t find a half hour at one time, it’s OK to break it into smaller blocks throughout the day. It also helps to find ways to increase the amount you move throughout the day, such as taking the stairs instead of the elevator, or walking to places you would normally drive.
If it’s hard for you to stick with your weight loss program, you may benefit from behavior modification techniques to help you change. These may include:
If you are still struggling to lose weight without success despite diet, exercise, and other strategies, then there are medicines to help you lose weight. Your doctor may prescribe medical treatments for weight loss if your BMI is 30 or higher, or if you have weight-related complications and a BMI above 27.
Keep in mind, though, that medical weight loss treatments are intended for use alongside lifestyle changes, not to take their place. If you don’t stay active and keep watching what you eat, then weight loss medicines aren’t likely to help as much. And when you stop taking a weight loss medicine, you may regain much of the weight you lost. Prescription medicines for weight loss include:
If other treatments don’t help you, weight loss surgery may help you lose up to a third of your excess body weight, but you will still need to watch what you eat if you want to keep the weight off. Surgery may be an option, if:
There are several types of weight loss surgeries. Some of the most common surgical treatments for weight loss include:
Alternative and complementary treatments, by definition, aren’t as well studied as conventional medicine—and they generally aren’t as well regulated either, so you should be cautious about using alternative treatment, and always tell your doctor about any alternative treatments you use, as they may have dangerous side effects, or they might interact with your other treatments. Herbal treatments that have been tried for weight loss include:
At present there isn’t enough evidence to say for sure whether acai and bitter orange are safe or effective. Green tea appears to be safe, but studies have shown only minor, non-significant improvement in weight loss, if any at all.
Ephedra for weight loss has been banned in the United States, because it causes risk of heart disease or stroke, which can far outweigh the short-term weight loss benefits.
Research suggests that mind-body techniques such as yoga and meditation may be helpful as part of a larger program. Other techniques, including hypnosis and acupuncture, do not seem effective according to the most current studies, although large, well-controlled studies have not yet been performed.
Keeping weight off after you’ve lost it can be as hard as or harder than losing the weight in the first place. Many people do suffer relapses and regain some or all of the weight they lost. However, others do manage to keep it off. Some people, including many doctors, will say that 95% percent of people who lose weight will gain it all back–but that figure is based in a small study that’s over 50 years old. More recent estimates suggest that the 95% figure is accurate for crash diets and weight loss fads, but not for all people who make a concerted effort to lose weight. Overall, more than a third of people who lose weight can keep it off for at least 3 years.
Things you can do to help you lose weight and keep off the weight you’ve lost include:
If you think you may have a weight problem, tell your doctor—especially if you’re concerned about weight-related health problems, such as diabetes, sleep apnea, or high cholesterol.
Your primary care doctor can help you with a weight loss plan or refer you to a bariatric physician, or weight loss specialist. As well, you can search online database provided by the American Society of Bariatric Physicians.
When you go to see your doctor, it’s good to have a list of the questions you’d like to have answered. Take a moment to write down some of the things you want to know. Your questions for your doctor might include some of these:
Other useful resources to help you learn about weight loss and take charge of your treatment can be found at:
The Obesity Society is “the leading scientific society dedicated to the study of obesity. Since 1982, The Obesity Society has been committed to encouraging research on the causes and treatment of obesity, and to keeping the medical community and public informed of new advances.”
The Obesity Action Coalition (OAC) is a “non-profit organization dedicated to giving a voice to the individual affected by the disease of obesity and helping individuals along their journey toward better health through education, advocacy and support.”
The American Society of Bariatric Physicians offers a searchable directory of doctors who specialize in weight loss.
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