Obesity

Definition

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might tip the balance include your genetic makeup, overeating, eating high-fat foods and not being physically active.

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass index" (BMI). BMI is used because, for most people, it correlates with their amount of body fat.

Children grow at different rates, so it isn't always easy to know when a child is obese or overweight.

For children and teens, BMI ranges above a normal weight have different labels (at risk of overweight and overweight). Additionally, BMI ranges for children and teens are defined so that they take into account normal differences in body fat between boys and girls and differences in body fat at various ages.

Ask your doctor to measure your child's height and weight to determine if he or she is in a healthy range.

 

Statistics

When you look at the age-wise breakup, obesity statistics have an interesting tale to tell. 29% of men and 28% of women are obese in the age group 15-25. This number triples in the older age group of 45-60. This means that the threat of obesity increases with age. Another survey showed that people who were obese in their twenties were almost always obese throughout their lives.
There are many overweight and obese people all around. Here is some overweight statistics:


• 64 percent of people are overweight in the US
• 48 percent of people in Europe are overweight
• 27 percent of Americans are classified as obese
• Obesity is responsible for 325,000 deaths every year
• Obesity cost an estimated $ 75 billion in 2003 because of its long and expensive treatment
• 750 million worldwide are overweight, out of which 300 million are obese

 

What causes obesity?

Obesity occurs when a person consumes more calories from food than he or she burns. Our bodies need calories to sustain life and be physically active, but to maintain weight we need to balance the energy we eat with the energy we use. When a person eats more calories than he or she burns, the energy balance is tipped toward weight gain and obesity. This imbalance between calories-in and calories-out may differ from one person to another. Genetic, environmental, and other factors may all play a part.

Genetic Factors

Obesity tends to run in families, suggesting a genetic cause. However, families also share diet and lifestyle habits that may contribute to obesity. Separating genetic from other influences on obesity is often difficult. Even so, science does show a link between obesity and heredity.

Environmental and Social Factors

Environment strongly influences obesity. Environment includes lifestyle behaviors such as what a person eats and his or her level of physical activity. Too often people eat out, consume large meals and high-fat foods, and put taste and convenience ahead of nutrition. Also, most people ido not get enough physical activity.

Environment also includes the world around us. Today, more people drive long distances to work instead of walking, live in neighborhoods without sidewalks, tend to eat out or get “take out” instead of cooking, or have vending machines with high-calorie, high-fat snacks at their workplace. Our environment often does not support healthy habits.

In addition, social factors including poverty and a lower level of education have been linked to obesity. One reason for this may be that high-calorie processed foods cost less and are easier to find and prepare than healthier foods, such as fresh vegetables and fruits. Other reasons may include inadequate access to safe recreation places or the cost of gym memberships, limiting opportunities for physical activity. However, the link between low socioeconomic status and obesity has not been conclusively established, and recent research shows that obesity is also increasing among high-income groups.

Cultural Factors

An individual’s cultural background may also play a role in his or her weight. For instance, foods specific to certain cultures that are prepared with a lot of fat or salt may hamper one’s weight-loss efforts. Similarly, family gatherings offering large amounts of food may make it difficult to pay attention to proper portion control and serving sizes.

Although you cannot change your genetic makeup, you can work on changing your eating habits, levels of physical activity, and other environmental factors.

Other Causes of Obesity

Some illnesses may lead to or are associated with weight gain or obesity. These include:

  • Hypothyroidism, a condition in which the thyroid gland fails to produce enough thyroid hormone. It often results in lowered metabolic rate and loss of vigor.
  • Cushing’s syndrome, a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs.
  • Polycystic ovary syndrome, a condition characterized by high levels of androgens (male hormone), irregular or missed menstrual cycles, and in some cases, multiple small cysts in the ovaries. Cysts are fluid-filled sacs.

A doctor can tell whether there are underlying medical conditions that are causing weight gain or making weight loss difficult.

Lack of sleep may also contribute to obesity. Recent studies suggest that people with sleep problems may gain weight over time. On the other hand, obesity may contribute to sleep problems due to medical conditions such as sleep apnea, where a person briefly stops breathing at multiple times during the night.

Certain drugs such as steroids, some antidepressants, and some medications for psychiatric conditions or seizure disorders may cause weight gain. These drugs may slow the rate at which the body burns calories, stimulate appetite, or cause the body to hold on to extra water. Be sure your doctor knows all the medications you are taking (including over-the-counter medications and dietary supplements). He or she may recommend a different medication that has less effect on weight gain.

 

What are the consequences of obesity?

Health Risks

Obesity is more than a cosmetic problem. Many serious medical conditions have been linked to obesity, including type 2 diabetes, heart disease, high blood pressure, and stroke. Obesity is also linked to higher rates of certain types of cancer. Men who are considered obese are more likely than nonobese men to develop cancer of the colon, rectum, or prostate. Women who are considered obese are more likely than nonobese women to develop cancer of the gallbladder, uterus, cervix, or ovaries. Esophageal cancer has also been associated with obesity.

Other diseases and health problems linked to obesity include:

  • Gallbladder disease and gallstones.
  • Fatty liver disease (also called nonalcoholic steatohepatitis or NASH).
  • Gastroesophageal reflux, or what is sometimes called GERD. This problem occurs when the lower esophageal sphincter does not close properly and stomach contents leak back—or reflux—into the esophagus.
  • Osteoarthritis, a disease in which the joints deteriorate. This is possibly the result of excess weight on the joints.
  • Gout, another disease affecting the joints.
  • Pulmonary (breathing) problems, including sleep apnea, which causes a person to stop breathing for a short time during sleep.
  • Reproductive problems in women, including menstrual irregularities and infertility.

Health care professionals generally agree that the more obese a person is, the more likely he or she is to develop health problems.

Psychological and Social Effects

Emotional suffering may be one of the most painful parts of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages may make people considered overweight feel unattractive.

Many people think that individuals who are considered obese are gluttonous, lazy, or both. This is not true. As a result, people who are considered obese often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection, shame, or depression may occur.

 

Treatments

DIET

A combination of dieting and exercise (when you stick to it) appears to work better than either one alone. Sticking to a weight reduction program is difficult and requires a lot of support from family and friends.

When dieting, your main goal should be to learn new, healthy ways of eating and make them a part of your everyday routine. Work with your doctor and nutritionist to set realistic, safe daily calorie counts that assure both weight loss and good nutrition. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your nutritionist can teach you about healthy food choices, appropriate portion sizes, and new ways to prepare food.

EXERCISE

Exercise is a major mood lifter, a great way to burn energy, and a way to strengthen your bones. Exercise can also help you manage high blood pressure, heart disease, or diabetes.

Avoid a sedentary lifestyle by increasing your activity level.

Perform aerobic exercise for at least 30 minutes a day, three times a week.

Increase your physical activity by walking, rather than driving.

Climb stairs instead of using an elevator or escalator.

Always talk to your health care provider before starting an exercise program.

MEDICATIONS AND HERBAL REMEDIES

There are many over-the-counter diet products. Most do not work and some can be dangerous. Before using one of these products, talk to your health care provider.

Several prescription weight loss drugs are available. Such medicines include subutramine (Meridia) and orlistat (Xenical). Ask your health care provider if these are right for you.

SURGERY

Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise. However, these surgeries are not a "quick fix" for obesity. You must still 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 -- the surgeon places a band around the upper part of your stomach, creating a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food.
  • Gastric bypass surgery -- helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you will not be able to eat as much as before, and your body will not absorb all the calories and other nutrients from the food you eat.

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