Overweight in Adults

(Obesity; Morbid Obesity)

Definition    TOP

Being overweight or obese means your weight is above an ideal weight range. Excess weight creates an increase in the risk of serious diseases like heart disease, certain cancers, and diabetes.

One tool used to estimate weight range is called the body mass index (BMI). This scale determines weight ranges based on height. BMI levels in adults include:

  • Ideal weight range: 18.5-24.9
  • Overweight: 25-29.9
  • Obese: 30 or above
  • Morbid obesity: 40

Causes    TOP

Being overweight is caused by taking in more calories than we use. Calories are taken in through food. All activity in our bodies is fueled by calories. This includes physical activity and basic bodily functions. Excess weight gain occurs when this relationship is not kept in balance. If this imbalance happens regularly it will lead to obesity.

Factors that can influence the development of obesity include:

Risk Factors    TOP

Factors that may increase your chance of becoming overweight include:

  • Eating large portions of food
  • Sedentary lifestyle—Getting too little exercise and spending too much time in front of a television or computer
  • Eating until full and eating quickly
  • High level of fast food intake
  • Increased age
  • High alcohol consumption
  • Working varied shifts
  • Not getting enough sleep
  • Post-traumatic stress disorder in women

Symptoms    TOP

Symptoms may include:

  • Increased weight
  • Thickness around the midsection
  • Obvious areas of fat deposits

Complications of Excessive Weight Gain    TOP

Excessive weight gain has been linked to:

An increased risk of:

Decrease in quality of life associated with:

Being overweight can also affect pregnancy. Some complications include high blood pressure, diabetes, problems during labor and deliver, or malformations of the baby.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Obesity is diagnosed by visual exam and body measurements using:

  • Height and weight tables
  • Body mass index
  • Measuring body folds with a caliper
  • Measuring waist circumference
  • Water-displacement tests

Your bodily fluids may be tested. This can be done with blood tests.

Treatment    TOP

Obesity is difficult to treat. Things that affect treatment are:

  • Cultural factors
  • Personal habits
  • Lifestyle
  • Genetics

You and your doctor will talk about the best treatment plan for you. There are many different approaches to treating obesity based on lifestyle changes. You are more likely to successfully lose weight and keep it off by using a combination of strategies. These can include eating healthy, exercise, counseling, and/or medication. Plans for weight loss may include:

Diet

Your doctor may recommend that you spread your calorie intake throughout the day rather than getting it all in a few large meals. You may also need a special diet that will eliminate specific types of food.

Talk to your doctor or ask for a referral to a dietician. They can help you develop a plan that is best for you.

Calorie Intake

The key to weight loss is reducing the total number of calories that you eat. Following a specific kind of diet, like a low-carbohydrate diet, is not necessary. It is much more important to choose a low calorie diet that you can stick with long term.

A dietitian can help you with your total calorie intake goal. Calorie intake is based on your current weight and your weight loss goals.

Portion, or serving size, also plays an important role. Using special portion control plates may help you succeed.

Food Diary

Keep track of everything you eat and drink.

Exercise

Ask your doctor about an exercise program. Even moderate-intensity exercise, like brisk walking, can help you lose weight.

There are many easy ways to add extra activity into your daily routine. Take stairs instead of elevators. Park your car a little further away. Limit the amount of time you spend watching television and using the computer and substitute it with activity.

Behavior Therapy    TOP

Behavior therapy may help you understand:

  • When you tend to overeat
  • Why you tend to overeat
  • How to combat overeating habits

When combined with diet and exercise, therapy can help you with your weight reduction.

Weight Loss Programs    TOP

Weight loss programs may work for some people. Some studies also suggest that a partner or group may help you improve your eating habits and fitness.

Medications    TOP

Weight loss medications may be prescribed. Medication alone is not enough to lose weight and keep it off. Some medications have serious side effects. There are also risks associated with over-the-counter and herbal products. Talk to your doctor before taking any of these.

Bariatric Surgery    TOP

Bariatric surgery makes the stomach smaller. In some cases, it will also rearrange the digestive tract. The smaller stomach can only hold a tiny portion of food at a time. Examples of procedures include:

These procedures may be a good option for people who are severely obese who are having trouble losing weight by other means.

Gastric Bypass

Copyright © Nucleus Medical Media, Inc.

Prevention    TOP

Controlling your weight can be difficult. To reduce your chance of getting overweight, take these steps:

  • Talk to your doctor or a dietitian about an appropriate number of calories to eat per day that will help you maintain a healthy weight or lose weight if necessary.
  • Learn to eat smaller portions of food.
  • Limit the amount of time you spend doing sedentary activities. This includes watching TV or using the computer.
  • Talk to your doctor or an exercise professional about working activity into your daily life.

RESOURCES:

Academy of Nutrition and Dietetics
http://www.eatright.org
The Obesity Society
http://www.obesity.org

CANADIAN RESOURCES:

Dietitians of Canada
http://www.dietitians.ca

References:

Body mass index (BMI calculator). American Heart Association website. Available at:
...(Click grey area to select URL)
Updated August 22, 2013. Accessed February 27, 2014.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at:
...(Click grey area to select URL)
Accessed February 27, 2014.
Obesity in adults. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated January 22, 2014. Accessed February 27, 2014.
Obesity, bias, and stigmatization. The Obesity Society website. Available at:
...(Click grey area to select URL)
Accessed February 27, 2014.
Thompson WG, Cook DA, Clark MM, Bardia A, Levine JA. Treatment of obesity. Mayo Clin Proc. 2007;82:93-101.
Weight loss medications for obesity in adults. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
. Updated February 19, 2014. Accessed February 27, 2014.
8/21/2007 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Pedersen SD, Kang J, Kline GA. Portion control plate for weight loss in obese patients with type 2 diabetes mellitus: a controlled clinical trial. Arch Intern Med. 2007;167:1277-1283.
7/22/2008 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229-241.
9/30/2008 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Samuels-Kalow ME, Funai EF, Buhimschi C, et al. Pre-pregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am J Obstet Gynecol. 2007;197:490.e1-6. Epub 2007 Aug 21.
12/2/2008 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Maruyama K, Ohira T, Maeda K, et al. The joint impact on being overweight of self reported behaviours of eating quickly and eating until full: cross sectional survey. BMJ. 2008;337.
12/2/2008 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105-2120.
2/5/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.
4/14/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859-873.
4/16/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Neovius M, Sundström J, Rasmussen F. Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ. 2009 Feb 24;338:b496.
5/11/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Luttikhuis HO, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;(1):CD001872.
7/6/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47:573-582. Epub 2008 Jan 16.
9/25/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Garipağaoğlu M, Sahip Y, Darendeliler F, Akdikmen O, Kopuz S, Sut N. Family-based group treatment versus individual treatment in the management of childhood obesity: randomized, prospective clinical trial. Eur J Pediatr. 2009;168:1091-1099.
10/16/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7:352-356.
11/10/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Laurson KR, Eisenmann JC, Welk GJ, Wickel EE, Gentile Da, Walsh DA. Combined influence of physical activity and screen time recommendations on childhood overweight. J Pediatr. 2008;153(2):209-214.
1/15/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171(2):135-54.
1/29/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Kuk JL, Ardern CI. Influence of age on the association between various measures of obesity and all-cause mortality. J Am Geriatr Soc. 2009 Sep 15.
1/29/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Berkey CS, Rockett HR, Colditz GA. Weight gain in older adolescent females: the internet, sleep, coffee, and alcohol. J Pediatr. 2008;153(5):635-639.
2/19/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1-190, 215-357, iii-iv.
2/19/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
O'Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303(6):519-526.
10/15/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Published October 8, 2010. Accessed February 27, 2014.
12/17/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
: US Food and Drug Administration. FDA: Tainted products marketed as dietary supplements potentially dangerous. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm236967.htm. Updated December 15, 2010. Accessed February 27, 2014.
11/25/2013 DynaMed's Systematic Literature Surveillance.
...(Click grey area to select URL)
Kubzansky L, Bordelois P, et al. The weight of traumatic stress: A prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiatry; 2013 Nov 20.
Last reviewed February 2014 by Kim Carmichael, MD
Last Updated: 2/27/2014