Obesity

Obesity is a complex disorder involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. 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. Dietary changes, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss surgery are additional options for treating obesity.

Symptoms

Obesity is diagnosed when your 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.

For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obese category even though they don’t have excess body fat. Ask your doctor if your BMI is a problem.

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Causes

Although there are genetic, behavioral 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 can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing’s syndrome, and other diseases and conditions. However, these disorders are rare and, in general, the principal causes of obesity are:

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: Weight gain is inevitable if you regularly eat more calories than you burn. And most Americans’ diets are too high in calories and are full of fast food and high-calorie beverages.

Treatments:

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 dietitian, behavior counselor or an obesity specialist to help you understand and make changes in your eating and activity habits.

The initial treatment goal is usually a modest weight loss 3 to 5 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 6 to 10 pounds (2.7 to 4.5 kg) for your health to begin to improve. However, the more weight you lose, the greater the 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
  • Dietary changes

Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss 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.

To boost your activity level:

Exercise: People who are overweight or obese need to get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to maintain the loss of a modest amount of weight. To achieve more-significant weight loss, you may need to exercise 300 minutes or more a week. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve.

Keep moving: 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.

Weight-loss surgery:

In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories or both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks.

Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that haven’t worked and:

You have extreme obesity (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

Common weight-loss surgeries include:

Gastric bypass surgery: 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.

Biliopancreatic diversion with duodenal switch: This procedure begins with the surgeon removing a large part of the stomach. The surgeon leaves the valve that releases food to the small intestine and the first part of the small intestine (duodenum). Then the surgeon closes off the middle section of the intestine and attaches the last part directly to the duodenum. The separated section of the intestine is reattached to the end of the intestine to allow bile and digestive juices to flow into this part of the intestine.

Gastric sleeve: In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It’s a less complicated surgery than gastric bypass or biliopancreatic diversion with duodenal switch.