Definition ^
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 ^
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:
- Genetics
- Biologic factors—the amount and activity of certain chemicals in the body
- Medications, such as corticosteroids, antidepressants, or antipsychotics
- Underactive thyroid
- Cushing's disease
- Polycystic ovary syndrome
Risk Factors ^
This condition is more common in older adults.
Factors that may increase your chance of becoming overweight include:
- Personal history of obesity as a child
- Family history of obesity
- 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
- High alcohol consumption
- Working varied shifts
- Not getting enough sleep
- Post-traumatic stress disorder in women
Symptoms ^
Symptoms may include:
- Increased weight
- Thickness around the midsection
- Obvious areas of fat deposits
Complications of Excessive Weight Gain ^
Excessive weight gain has been linked to:
An increased risk of:
- Early death
- Heart disease and stroke
- Type 2 diabetes
- High blood pressure
- High cholesterol and high triglycerides in the blood
- Gastroesophageal reflux disease (GERD)
- Increased risk of certain cancers, such as liver, kidney, thyroid, colon, and rectal
- Death from cancer
- Blood clots
- Gout
- Liver disease
- Gallstones
- Pancreatitis
- Cataracts
Decrease in quality of life associated with:
- Decreased energy
- Sleep apnea
- Joint problems, back pain
- Poor self-image, depression
- Infertility
Being overweight can also affect pregnancy. Some complications include:
- High blood pressure—preeclampsia
- Gestational diabetes
- Depression during your pregnancy
- Depression after your baby is born—postpartum depression
You may also experience problems during labor and deliver, have a baby with a high birth weight, or have a baby with birth defects.
Diagnosis ^
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 ^
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 dietitian. A dietitian 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.
Improve Sleep
Making small adjustments to your routine will help improve sleep:
- Get on a regular sleep schedule. Go to bed and get up around the same time every day, even on your days off.
- Reduce noise, temperature, and light in the bedroom.
- Avoid caffeine, nicotine, and alcohol before bed.
- Eat a light dinner and avoid heavy evening meals.
- Create a relaxing routine before bed, such as taking a warm bath or reading a book.
Sleep apnea interferes with sleep and can create serious health complications. If you snore loudly or stop breathing during the night (noticed by a bed partner), talk to your doctor about getting a sleep test. Sleep apnea is treatable and it will improve your overall health.
Behavior Therapy
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
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
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
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:
- Gastric bypass
- Laparoscopic gastric banding
- Gastric stapling
These procedures may be a good option for people who are severely obese who are having trouble losing weight by other means.
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Balloon Procedure
A non-surgical temporary balloon device has been approved to promote weight loss. The device is inserted into the stomach through the mouth. It occupies space in the stomach and triggers a feeling of fullness. The device is removed 6 months after insertion. Talk to your doctor for more information about this procedure.
Prevention ^
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:
Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org
The Obesity Society
http://www.obesity.org
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Last reviewed February 2016 by Kim Carmichael, MD Last Updated: 2/17/2016
