Filed under: Weightloss (Obesity)
Obesity is defined as having an excessive amount of body fat. Obesity is more than just a cosmetic concern, though. It increases your risk of diseases and health problems such as heart disease, diabetes and high blood pressure.
Being extremely obese means you are especially likely to have health problems related to your weight.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. You can usually lose weight through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
Obesity is diagnosed when an individual's body mass index (BMI) is 30 or higher. Your body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.
|18.5 — 24.9||Normal|
|25.0 — 29.9||Overweight|
|30.0 and higher||Obese|
|40.0 and higher||Extreme obesity|
Because BMI doesn't directly measure body fat, some people, such as muscular athletes, may have a BMI in the obese category even though they don't have excess body fat.
When to see a doctor
If you think you may be obese, and especially if you're concerned about weight-related health problems, see your doctor or health care provider. You and your doctor can evaluate your health risks and discuss your weight-loss options. Even modest weight loss can lessen or prevent problems related to obesity. Weight loss is usually possible through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.
Although there are genetic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, including:
Obesity occurs when you eat and drink more calories than you burn through exercise and normal daily activities. Your body stores these extra calories as fat. Obesity usually results from a combination of causes and contributing factors, including:
Even if you have one or more of these risk factors, it doesn't mean that you're destined to become obese. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.
If you're obese, you're more likely to develop a number of potentially serious health problems, including:
Quality of life
When you're obese, your overall quality of life may be lower, too. You may not be able to do things you'd normally enjoy as easily as you'd like. You may have trouble participating in family activities. You may avoid public places. You may even encounter discrimination.
Other weight-related issues that may affect your quality of life include:
Talking to your doctor openly and honestly about your weight is one of the best things you can do for your health. You're likely to start by seeing your primary care doctor. In some cases, you may be referred to an obesity specialist — if one is available in your area. You may also be referred to a mental health provider, dietitian or nutrition specialist.
What you can do
Being an active participant in your care is important. One way to do this is by preparing for your appointment. Think about your needs and goals for treatment. Also, write down a list of questions to ask. These questions may include:
In addition to your prepared questions, don't hesitate to ask questions during your appointment.
What to expect from your doctor
During your appointment, your doctor or other health care provider is likely to ask you a number of questions about your eating, activity, mood and thoughts, and any symptoms you might have. You may be asked such questions as:
What you can do in the meantime
If you have several days or weeks before your scheduled appointment, you can start making some changes on your own to your eating and activity levels as you begin the journey to lose weight.
If your doctor believes you are overweight or obese, he or she will typically review your health history in detail, perform a physical exam and recommend some tests.
These exams and tests generally include:
Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you have. And this will shape what treatment options are right for you.
The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits.
You can start feeling better and seeing improvements in your health by just introducing better eating and activity habits. The initial goal is a modest weight loss — 5 to 10 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9.1 kg) to start seeing benefits.
All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Other treatment tools include:
Reducing calories and eating healthier are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss of 1 or 2 pounds (1/2 to 1 kilogram) a week over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.
Dietary ways to overcome obesity include:
Exercise and activity
Increased physical activity or exercise also is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
To boost your activity level:
A behavior modification program can help you make lifestyle changes, lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity.
Behavior modification, sometimes called behavior therapy, can include:
Prescription weight-loss medication
Losing weight requires a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may help. Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don't make these other changes in your life, medication is unlikely to work.
Your doctor may recommend weight-loss medication if:
Prescription weight-loss medications your doctor may prescribe include:
Orlistat (Xenical). Orlistat is a weight-loss medication that has been approved by the Food and Drug Administration (FDA) for long-term use in adults and children 12 and older. This medication blocks the digestion and absorption of fat in your stomach and intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is about 5 to 7 pounds (2.3 to 3.2 kilograms) more than you can get from diet and exercise after one or two years of taking the medication.
Side effects associated with orlistat include oily and frequent bowel movements, bowel urgency, and gas. These side effects can be minimized as you reduce fat in your diet. Because orlistat blocks absorption of some nutrients, take a multivitamin while taking orlistat to prevent nutritional deficiencies.
The FDA has also approved a reduced-strength version of orlistat (Alli) that's sold over-the-counter, without a prescription. Alli is not approved for children. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
Lorcaserin (Belviq). Lorcaserin is a long-term weight-loss drug approved by the FDA for adults. It works by affecting chemicals in your brain that help decrease your appetite and make you feel full, so you eat less. Your doctor will carefully monitor your weight loss while taking lorcaserin. If you don't lose about 5 percent of your total body weight within 12 weeks of taking lorcaserin, it's unlikely the drug will work for you and the medication should be stopped.
Side effects of lorcaserin include headaches, dizziness, fatigue, nausea, dry mouth and constipation. Rare but serious side effects include a chemical imbalance (serotonin syndrome), suicidal thoughts, psychiatric problems, and problems with memory or comprehension. Pregnant women shouldn't take lorcaserin.
Phentermine-topiramate (Qsymia). This weight-loss medication is a combination drug approved by the FDA for long-term use in adults. Qsymia combines phentermine, a weight-loss drug prescribed for short-term use, with topiramate, a medication that's used to control seizures. Your doctor will monitor your weight loss while taking the drug. If you don't lose at least 3 percent of your body weight within 12 weeks of starting treatment, your doctor may suggest either stopping use of Qsymia or increasing your dose, depending on your condition.
Side effects include increased heart rate, tingling of hands and feet, insomnia, dizziness, dry mouth and constipation. Serious but rare side effects include suicidal thoughts, problems with memory or comprehension, sleep disorders and changes to your vision. Pregnant women shouldn't take Qsymia. Qsymia increases the risk of birth defects.
You need close medical monitoring while taking a prescription weight-loss medication. Also, keep in mind that a weight-loss medication may not work for everyone. If the medication does work, its effects tend to level off after six months of use like any other method of weight loss. You may need to take a weight-loss medication indefinitely. When you stop taking a weight-loss medication, you're likely to regain much or all of the weight you lost.
In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery offers the best chance of losing the most weight, but it can pose serious risks. Weight-loss surgery limits the amount of food you're able to comfortably eat or decreases the absorption of food and calories, or both.
Weight-loss surgery for obesity may be considered if:
Weight-loss surgery can often help you lose as much as 50 percent or more of your excess body weight. But weight-loss surgery isn't a miracle obesity cure. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
Common weight-loss surgeries include:
Preventing weight regain after obesity treatment
Unfortunately, it's common to regain weight no matter what obesity treatment methods you try. But that doesn't mean your weight-loss efforts are futile.
One of the best ways to prevent regaining the weight you've lost is getting regular physical activity. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
You may always have to remain vigilant about your weight. Combining a healthier diet and more activity is the best way to lose weight and keep it off for the long term. If you take weight-loss medications, you'll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or eat foods laden with fat and calories.
Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.
Your effort to overcome obesity is more likely to be successful it you follow strategies at home in addition to your formal treatment plan. These can include:
Numerous dietary supplements that promise to help you shed weight quickly are available. But in almost all cases, the effectiveness and safety of these products are questionable. Talk to your doctor before taking any dietary supplements.
Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, don't have the same rigorous testing and labeling process as over-the-counter and prescription medications. Yet some of these substances, including products labeled as "natural," have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. Ingredients may not be standard, and they can cause unpredictable and harmful side effects. Dietary supplements can also cause dangerous interactions with prescription medications you take.
It's thought that acupuncture and hypnosis may complement other obesity treatments. Talk to your doctor if you're interested in adding acupuncture or hypnosis to your treatment.
Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts:
Whether you're at risk of becoming obese, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.
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