Disease: Obesity

Overview

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.

Source: http://www.mayoclinic.com

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.

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0-34.9 Obese (Class I)
35.0-39.9 Obese (Class II)
40.0 and higher Extreme obesity (Class III)

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.

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 provider can evaluate your health risks and discuss your weight-loss options.

Source: http://www.mayoclinic.com

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.

Source: http://www.mayoclinic.com

Diagnosis

If your BMI is in the obese range, your health care provider will typically review your health history in detail, perform a physical exam and recommend some tests.

These exams and tests generally include:

  • Taking your health history. Your doctor may review your weight history, weight-loss efforts, exercise habits, eating patterns, what other conditions you've had, medications, stress levels and other issues about your health. Your doctor may also review your family's health history to see if you may be predisposed to certain conditions.
  • A general physical exam. This includes also measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.
  • Calculating your BMI. Your doctor will check your body mass index (BMI) to determine your level of obesity. This should be done at least once a year. Your BMI also helps determine your overall health risk and what treatment may be appropriate.
  • Measuring your waist circumference. Fat stored around your waist, sometimes called visceral fat or 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 (80 centimeters, or cm) and men with a waist measurement of more than 40 inches (102 cm) may have more health risks than do people with smaller waist measurements. Like the BMI measurement, your waist circumference should be checked at least once a year.
  • Checking for other health problems. If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure and diabetes.
  • Blood tests. What tests you have depend on your health, risk factors and any current symptoms you may be having. Tests may include a cholesterol test, liver function tests, a fasting glucose, a thyroid test and others. Your doctor may also recommend certain heart tests, such as an electrocardiogram.

Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you already have. And this will guide treatment decisions.

Source: http://www.mayoclinic.com

Complications

If you're obese, you're more likely to develop a number of potentially serious health problems, including:

  • High triglycerides and low high-density lipoprotein (HDL) cholesterol
  • Type 2 diabetes
  • High blood pressure
  • Metabolic syndrome — a combination of high blood sugar, high blood pressure, high triglycerides and low HDL cholesterol
  • Heart disease
  • Stroke
  • Cancer, including cancer of the uterus, cervix, endometrium, ovaries, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate
  • Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts
  • Gallbladder disease
  • Gynecological problems, such as infertility and irregular periods
  • Erectile dysfunction and sexual health issues
  • Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring
  • Osteoarthritis

Quality of life

When you're obese, your overall quality of life may be diminished. You may not be able to do things you used to do, such as participating in enjoyable activities. You may avoid public places. Obese people may even encounter discrimination.

Other weight-related issues that may affect your quality of life include:

  • Depression
  • Disability
  • Sexual problems
  • Shame and guilt
  • Social isolation
  • Lower work achievement

Source: http://www.mayoclinic.com

Prevention

Whether you're at risk of becoming obese, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly. You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
  • Follow a healthy eating plan. Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular meals a day with limited snacking. You can still enjoy small amounts of high-fat, high-calorie foods as an infrequent treat. Just be sure to choose foods that promote a healthy weight and good health most of the time.
  • Know and avoid the food traps that cause you to eat. Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you're feeling and how hungry you are. After a while, you should see patterns emerge. You can plan ahead and develop strategies for handling these types of situations and stay in control of your eating behaviors.
  • Monitor your weight regularly. People who weigh themselves at least once a week are more successful in keeping off excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gains before they become big problems.
  • Be consistent. Sticking to your healthy-weight plan during the week, on the weekends, and amidst vacation and holidays as much as possible increases your chances of long-term success.

Source: http://www.mayoclinic.com

Alternative medicine

Numerous dietary supplements that promise to help you shed weight quickly are available. The effectiveness, particularly the long-term effectiveness, and safety of these products are often questionable.

Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, don't have the same rigorous testing and labeling process as over-the-counter and prescription medications do.

Yet some of these substances, including products labeled as "natural," have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. Ingredients may not be standard, and they can cause unpredictable and harmful side effects. Dietary supplements also can cause dangerous interactions with prescription medications you take. Talk to your doctor before taking any dietary supplements.

Mind-body therapies — such as acupuncture, mindfulness meditation and yoga — may complement other obesity treatments. However, these therapies generally haven't been well-studied in the treatment of weight loss. Talk to your doctor if you're interested in adding a mind-body therapy to your treatment.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Your effort to overcome obesity is more likely to be successful if you follow strategies at home in addition to your formal treatment plan. These can include:

  • Learning about your condition. Education about obesity can help you learn more about why you became obese and what you can do about it. You may feel more empowered to take control and stick to your treatment plan. Read reputable self-help books and consider talking about them with your doctor or therapist.
  • Setting realistic goals. When you have to lose a significant amount of weight, you may set goals that are unrealistic, such as trying to lose too much too fast. Don't set yourself up for failure. Set daily or weekly goals for exercise and weight loss. Make small changes in your diet instead of attempting drastic changes that you're not likely to stick with for the long haul.
  • Sticking to your treatment plan. Changing a lifestyle you may have lived with for many years can be difficult. Be honest with your doctor, therapist or other health care providers if you find your activity or eating goals slipping. You can work together to come up with new ideas or new approaches.
  • Enlisting support. Get your family and friends on board with your weight-loss goals. Surround yourself with people who will support you and help you, not sabotage your efforts. Make sure they understand how important weight loss is to your health. You might also want to join a weight-loss support group.
  • Keeping a record. Keep a food and activity log. This record can help you remain accountable for your eating and exercise habits. You can discover behavior that may be holding you back and, conversely, what works well for you. You can also use your log to track other important health parameters such as blood pressure and cholesterol levels and overall fitness.
  • Identifying and avoiding food triggers. Distract yourself from your desire to eat with something positive, such as calling a friend. Practice saying no to unhealthy foods and big portions. Eat when you're actually hungry — not simply when the clock says it's time to eat.
  • Taking your medications as directed. If you take weight-loss medications or medications to treat obesity-related conditions, such as high blood pressure or diabetes, take them exactly as prescribed. If you have a problem sticking with your medication regimen or have unpleasant side effects, talk to your doctor.

Source: http://www.mayoclinic.com

Coping and support

Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts:

  • Journal. Write in a journal to express pain, anger, fear or other emotions.
  • Connect. Don't become isolated. Try to participate in regular activities and get together with family or friends periodically.
  • Join. Join a support group so that you can connect with others facing similar challenges.
  • Focus. Stay focused on your goals. Overcoming obesity is an ongoing process. Stay motivated by keeping your goals in mind. Remind yourself that you're responsible for managing your condition and working toward your goals.
  • Relax. Learn relaxation and stress management. Learning to recognize stress and developing stress management and relaxation skills can help you gain control of unhealthy eating habits.

Source: http://www.mayoclinic.com

Risk factors

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.
  • Family lifestyle. Obesity tends to run in families. If one or both of your parents are obese, your risk of being obese is increased. That's not just because of genetics. Family members tend to share similar eating and activity habits.
  • 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 through exercise and routine daily activities. Having medical problems, such as arthritis, can lead to decreased activity, which contributes to weight gain.
  • Unhealthy diet. A diet that's high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.
  • Medical problems. In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in 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.
  • Social and economic issues. Research has linked social and economic factors to obesity. Avoiding obesity is difficult if you don't have safe areas to exercise. Similarly, 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.
  • 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 consciously control what you eat and become more physically active as you age, you'll likely gain weight.
  • 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.
  • Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain that the person becomes obese. In the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke.
  • Lack of sleep. Not getting enough sleep or getting too much sleep 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.

Even if you have one or more of these risk factors, it doesn't mean that you're destined to become obese. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Source: http://www.mayoclinic.com

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