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Overweight in Adults

(Obesity; Morbid Obesity)

by Rosalyn Carson-DeWitt, MD

Definition

Overweight is a body weight that is above an ideal range. Extra weight can increase in the risk of some serious health problems. This includes heart disease, certain cancers, and diabetes.

One tool used to check weight range is the body mass index (BMI). This scale creates 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

Overweight is caused by taking in more calories than are used. Calories are taken in through food. Physical activity and basic body functions use calories. If more calories are eaten than used, then weight gain will happen.

Factors that can influence the development of obesity include:

Genetics and family history
Environment
Behaviors
Race, ethnicity, and culture

Risk Factors

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
Medications, such as corticosteroids, antidepressants, or antipsychotics
Medical conditions such as

Symptoms

Symptoms may include:

Increased weight
Thickness around the midsection
Obvious areas of fat deposits

Complications of Excessive Weight Gain

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 several cancers such as , kidney, breast, colon, rectal, ovarian, and uterine
Death from cancer
Blood clots
Gout
Liver disease, including liver cancer
Gallstones and gallbladder cancer
Pancreatitis and pancreatic cancer
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
Difficulty during labor and delivery
High birth weight baby
Birth defects in baby

Diagnosis

You will be asked about your symptoms and health 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

Treatment

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

Cultural factors
Personal habits
Lifestyle
Genetics

There are many different options to treating obesity. A mix of treatments may be most successful. It should include changes in diet, activity, counseling, or medicine.

You may need to try different diets before you see results. Diets can be designed by:

Registered dietitians—talk to your doctor about a referral
Hospitals
Internet- or commercial-based organizations such as Weight Watchers or Atkins

Diet

Different steps may help you. This may include avoiding certain types of foods. In general, the focus will be on increasing:

Proteins
Fruits and vegetables
Whole grains

At the same time reduce:

Saturated fats
Refined carbohydrates—white breads, pasta, or rice
Processed foods

Your and your doctor will find a plan that works best for you.

Calorie Intake

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

Portion, or serving size, also plays an important role. Learning how to read nutrition labels may help you succeed.

Food Diary

Keep track of everything you eat and drink. There are several tracking apps that can be used on your phone or tablet. It makes tracking much easier.

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 day. Take stairs instead of elevators. Park your car a little further away. Limit the amount of time you spend watching television. Decrease computer time and substitute it with activity.

There are many tools to help you track and measure your activity. This includes counting the number of steps throughout the day. Many of these tools can connect to apps on your phone or tablets.

Improve Sleep

Poor sleep can increase your risk of weight gain. Fatigue may also make you want to eat more and move less. 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. Continue 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. Try taking a warm bath or reading a book.

Sleep apnea interferes with sleep. If you snore loudly or stop breathing during the night, 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. A partner or group may also help you improve your eating habits and fitness.

Medicine

Weight loss medicine may be prescribed. Medicine alone is not enough to lose weight and keep it off. Some medicine can have serious side effects. There are also risks associated with over the counter medicine 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:

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

Gastric Bypass

Balloon Procedure

This option uses a balloon type tool. This balloon fills up the stomach creating a feeling of fullness. The device is inserted into the mouth and passed to the stomach. The device is removed 6 months after it is placed. Talk to your doctor for more information about this procedure.

Prevention

Losing weight can be difficult. It is best to avoid weight gain. To reduce your chances of getting overweight:

Keep track of your weight.
Talk to your doctor or a dietitian about your daily calorie needs.
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
https://www.eatright.org

Obesity Society
http://www.obesity.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

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

References:

Body mass index (BMI calculator). American Heart Association website. Available at:
...(Click grey area to select URL)
Updated July 12, 2016. Accessed March 23, 2018.

Complications of obesity. EBSCO DynaMed website. Available at: http://www.dynamed... . Updated January 19, 2018. Accessed March 23, 2018.

Diets for weight loss. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated January 22, 2018. Accessed March 23, 2018.

Dietary guidelines for Americans 2015-2020. US Department of Health and Human Services website. Available at: https://health.gov/dietaryguidelines/2015/guidelines. Accessed March 23, 2018.

Obesity. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/obesity. Updated December 2016. Accessed March 23, 2018.

Obesity, bias, and stigmatization. Obesity Society website. Available at:
...(Click grey area to select URL)
Accessed March 23, 2018.

Obesity in adults. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T115009/Obesity-in-adults . Updated January 19, 2018. Accessed March 23, 2018.

Physical activity for weight loss. EBSCO DynaMed website. Available at: http://www.dynamed... . Updated January 18, 2018. Accessed March 23, 2018.

Understanding adult overweight & obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity. Accessed March 23, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD
Last Updated: 3/23/2018

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