Obesity and Overweight

Obesity means having an unhealthy amount of body fat. This puts your health in danger.

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What happens when a person is obese?

Obesity can raise your risk for certain health problems. These may include type 2 diabetes, high blood pressure, coronary artery disease (CAD), and stroke. If you have healthier habits or lose weight, you can lower your risk for these conditions.

What can happen when a person is obese?

How obesity affects your health depends on many things, including your age, your sex, where you carry your body fat, and how physically active you are.

Obesity raises your risk for many conditions, including:

  • Gallstones.
  • Type 2 diabetes.
  • High blood pressure.
  • High cholesterol and triglycerides.
  • Coronary artery disease (CAD).
  • Stroke.
  • Sleep apnea.
  • Arthritis.

In some people, fat builds up mostly around the stomach. (This is sometimes called apple-shaped.) Those people are at greater risk for type 2 diabetes, high blood pressure, high cholesterol, and coronary artery disease than people who are lean or people with fat around the hips (sometimes called pear-shaped).

If you have healthier habits or lose weight, you can lower your risk for these conditions.

Definition

Obesity

Obesity means having an unhealthy amount of body fat. This puts your health in danger.

Obesity puts you at greater risk for type 2 diabetes, heart disease, high blood pressure, arthritis, sleep apnea, some types of cancer, and stroke.

Treatment involves a long-term plan for making lifestyle changes. Medicine or surgery is sometimes used.

Diagnostics

How do you know if your weight is in the obesity range?

To know if your weight is in the obesity range, your doctor looks at your body mass index (BMI) and waist size.

BMI is a number that is calculated from your weight and your height. To figure out your BMI for yourself, you can use an online tool, such as http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm on the National Institutes of Health website.

If your BMI is 30.0 or higher, it falls within the obesity range. Keep in mind that BMI and waist size are only guides. They are not tools to determine your ideal body weight.

How is obesity diagnosed?

Doctors use a tool called BMI (body mass index) to see if your weight could be unhealthy. If your BMI is 30 or higher, your weight may be putting your health in danger.

Goal Settings

Obesity: What can you do to reach a healthy weight?

Focus on health, not diets. Diets are hard to stay on and don’t work in the long run. It is very hard to stay with a diet that includes lots of big changes in your eating habits.

Instead of a diet, focus on lifestyle changes that will improve your health and achieve the right balance of energy and calories. To lose weight, you need to burn more calories than you take in. You can do it by eating healthy foods in reasonable amounts and becoming more active, even a little bit every day. Making small changes over time can add up to a lot.

Make a plan for change. Many people have found that naming their reasons for change and staying focused on their plan can make a big difference. Work with your doctor to create a plan that is right for you.

  • Ask yourself: “What are my personal, most powerful reasons for wanting this change? What will my life look like when I’ve made the change?”
  • Set your long-term goal. Make it specific, such as “I will lose x pounds.”
  • Break your long-term goal into smaller, short-term goals. Make these small steps specific and within your reach, things you know you can do. These steps are what keep you going from day to day.

Talk with your doctor about other weight-loss options. If you have a BMI in a certain range and have not been able to lose weight with diet and exercise, medicine or surgery may be an option for you. Before your doctor will prescribe medicines or surgery, he or she will probably want you to be more active and follow your healthy eating plan for a period of time. These habits are key lifelong changes for managing your weight, with or without other medical treatment. And these changes can help you avoid weight-related health problems.

Overview

When you are overweight: Overview

If you’re overweight, your doctor may recommend that you make changes in your eating and exercise habits. Being overweight can lead to serious health problems, such as high blood pressure, heart disease, type 2 diabetes, and arthritis, or it can make these problems worse. Eating a healthy diet and being more active can help you reach and stay at a healthy weight.

You don’t have to make huge changes all at once. Start by making small changes in your eating and exercise habits. To lose weight, you need to burn more calories than you take in. You can do this by eating healthy foods in reasonable amounts and becoming more active every day.

Risk Factors

What puts you at risk for obesity?

If one of your parents is obese, you are more likely to be overweight too. Emotional concerns and the habits of your family and friends can also affect your weight.

How do your genes put you at risk of being overweight?

Genes determine what features (genetic traits) you inherit from your parents. They have an effect on how your body uses calories, how much energy you burn when you are at rest, and how your body tells you how much to eat. They also affect how fat is distributed in your body.

Self-care Treatment Options

How can you stay on your plan for change?

Be ready. Choose to start during a time when there are few events like holidays, social events, and high-stress periods. These events might trigger slip-ups.

Decide on your first few steps. Most people have more success when they make small changes, one step at a time. For example, you might switch a daily candy bar to a piece of fruit, walk 10 minutes more, or add more vegetables to a meal.

Line up your support people. Make sure you’re not going to be alone as you make this change. Connect with people who understand how important it is to you. Ask family members and friends for help in keeping with your plan. And think about who could make it harder for you, and how to handle them.

Try tracking. People who keep track of what they eat, feel, and do are better at losing weight. Try writing down things like:

  • What and how much you eat.
  • How you feel before and after each meal.
  • Details about each meal (like eating out or at home, eating alone, or with friends or family).
  • What you do to be active.

Look and plan. As you track, look for patterns that you may want to change. Take note of:

  • When you eat and whether you skip meals.
  • How often you eat out.
  • How many fruits and vegetables you eat.
  • When you eat beyond feeling full.
  • When and why you eat for reasons other than being hungry.

When you stray from your plan, don’t get upset. Figure out what made you slip up and how you can fix it.

How can you care for yourself when you are overweight?

  • Improve your eating habits. You’ll be more successful if you work on changing one eating habit at a time. All foods, if eaten in moderation, can be part of healthy eating. Remember to:
    • Eat a variety of foods from each food group. Include grains, vegetables, fruits, dairy, and protein foods.
    • Limit foods high in fat, sugar, and calories.
    • Eat slowly. And don’t do anything else, such as watch TV, while you are eating.
    • Pay attention to portion sizes. Put your food on a smaller plate.
    • Plan your meals ahead of time. You’ll be less likely to grab something that’s not as healthy.
  • Get active. Regular activity can help you feel better, have more energy, and burn more calories. If you haven’t been active, start slowly. Start with at least 30 minutes of moderate activity on most days of the week. Then gradually increase the amount of activity. Try for 60 or 90 minutes a day, at least 5 days a week. There are a lot of ways to fit activity into your life. You can:
    • Walk or bike to the store. Or walk with a friend, or walk the dog.
    • Mow the lawn, rake leaves, shovel snow, or do some gardening.
    • Use the stairs instead of the elevator, at least for a few floors.
  • Change your thinking. Your thoughts have a lot to do with how you feel and what you do. When you’re trying to reach a healthy weight, changing how you think about certain things may help. Here are some ideas:
    • Don’t compare yourself to others. Healthy bodies come in all shapes and sizes.
    • Pay attention to how hungry or full you feel. When you eat, be aware of why you’re eating and how much you’re eating.
    • Focus on improving your health instead of dieting. Dieting almost never works over the long term.
  • Ask your doctor about other health professionals who can help you reach a healthy weight.
    • A dietitian can help you make healthy changes in your diet.
    • An exercise specialist or personal trainer can help you develop a safe and effective exercise program.
    • A counselor or psychiatrist can help you cope with issues such as depression, anxiety, or family problems that can make it hard to focus on reaching a healthy weight.
  • Get support from your family, your doctor, your friends, a support group—and support yourself.

Treatment Options

How is obesity treated?

The best way to lose weight is to eat less and move more. Little steps mean a lot. Losing just 10% of your body weight can make a difference in your health.

You'll have the most success if you make a long-term plan with your doctor. Your first goal will likely be to improve your health, not to reach an ideal weight.

Some people take medicines or have surgery to help them lose weight. Your doctor may also suggest counseling. If you use food to cope with depression, loneliness, anxiety, or boredom, you can learn new skills to deal with those feelings.

You might want to try weight-loss medicines or have weight-loss surgery if:

  • You do not lose weight after you have tried healthy eating and more activity for 6 months.
  • You keep gaining weight.
  • You have lost weight several times only to regain it.
  • Your doctor is concerned about a health problem related to obesity, such as heart disease or diabetes.

Lifestyle changes

Most people have more success when they make small changes, one step at a time. For example, you might eat an extra piece of fruit or add more vegetables to your meals.

One of the best ways to increase your activity is by walking.

Medicines

Medicine may help you lose a small amount of weight. But without permanent changes in eating and exercise habits, most people gain weight again after they stop taking the medicine.

Surgery

After surgery, you will need to make big, lifelong changes in how you eat, including smaller portions and different foods.

Obesity: Can you take medicines or have surgery to lose weight?

If you have a BMI in a certain range and have not been able to lose weight with diet and exercise, medicine or surgery may be an option for you.

If you have a BMI of at least 30.0 (or a BMI of at least 27.0 and another health problem related to your weight), ask your doctor about weight-loss medicines. They work by making you feel less hungry, making you feel full more quickly, or changing how you digest fat. Medicines are used along with diet changes and more physical activity to help you make lasting changes.

If you have a BMI of 40.0 or more (or a BMI of 35.0 or more and another health problem related to your weight), your doctor may talk with you about surgery. Weight-loss surgery has risks, and you will need to work with your doctor to compare the risk of having obesity with the risks of surgery.

With any option you choose, you will still need to eat a healthy diet and get regular exercise.

What Causes It

What causes obesity?

Obesity is complex. You gain weight when you take in more calories than you burn off. But other things can affect your weight. These things include:

What and how you eat.
Eating unhealthy foods and overeating are easy in our culture today. Many things influence eating behavior, including emotions, habits, and access to food.
How active you are.
Modern conveniences—such as elevators, cars, and the remote control for the television—cut activity out of our lives. Being active helps you stay fit. When you're fit, you burn more calories, even when you're resting.
Your genetic makeup.
Your genetic makeup has a very big effect on your weight. It affects:
  • The rate at which your body uses energy (calories) when at rest, called your basal metabolic rate. Some people are born with higher basic metabolic rates than others. They naturally burn more calories than other people.
    • Regular physical activity can raise your metabolic rate.
    • Very low-calorie diets will lower your metabolic rate. A lower metabolic rate makes it easier to gain weight, because you don't burn calories as fast.
  • Your body signals, such as your appetite and feeling hungry or full.
  • Your fat distribution. You can't change where your body stores fat. Typically, men store fat in the belly (abdomen) while women store more in the hips and thighs. As women age, more fat is stored in the abdomen.
Medicines or health problems.
Some conditions and medicines may also cause weight gain. Examples include having Cushing's syndrome or hypothyroidism and taking certain antidepressants or corticosteroids.

What It Is

What is obesity?

Obesity means having an unhealthy amount of body fat. This puts your health in danger. It can lead to other health problems, such as type 2 diabetes and high blood pressure.

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