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Overweight(Obesity; Morbid Obesity)DefinitionBeing overweight or obese means your weight is above an ideal weight range. Excess weight creates increased risk of heart disease, certain cancers, and other serious illnesses like diabetes. One tool used to estimate ideal and overweight ranges is called the body mass index (BMI). This scale determines weight ranges based on height. BMI levels include:
CausesCalories are taken in through food. They are used through physical activity and basic body functions. Excess weight gain occurs when this relationship is not kept in balance. High caloric intake and low usage will cause weight gain. If this happens regularly it will lead to obesity. Factors that can influence obesity are:
Risk FactorsRisk factors include:
SymptomsSymptoms include:
Complications of Untreated Obesity
Being overweight or obese is late adolescence has been shown to increase the risk of mortality in adulthood. Researchers have also found that adults who have a high waist circumference or a high waist-to-hip ratio have an increased risk of death. Whether you are a teen or an adult, losing weight now will lower your risk of serious complications later. DiagnosisObesity is diagnosed by visual exam and body measurements using:
To rule out other medical conditions that may cause excess body weight, your doctor may order:
TreatmentObesity is difficult to treat. Things that affect treatment are:
There are many different approaches to treating obesity. You are more likely to successfully lose weight and keep it off by using a combination of strategies, like diet, exercise, counseling, and/or medication. Talk to your doctor or ask for a referral to a dietician . They can help you develop a plan that is best for you. Plans for weight loss may include: DietYour doctor may recommend that you:
Calorie IntakeAccording to a recent study, the key to weight loss is in reducing the amount of calories that you consume, rather than following a specific kind of diet (like a low-carb diet). It is much more important to choose a low calorie diet you can stick with for the long haul. A dietitian can help you with your total calorie intake goal. This is based on your:
Portion size also plays an important role. Using special portion control plates may help you succeed. Food DiaryKeep track of everything you eat and drink. ExerciseAsk your doctor about an exercise program. Add bits of activity through your day. Take stairs instead of elevators. Park a little further away. Limit the amount of time you spend watching television and using the computer. This is particularly important for children. Behavior TherapyBehavior therapy may help you understand:
Weight Loss ProgramsWeight loss programs do seem to work for some people. Some studies also suggest that a partner or group may help you improve your diet and fitness. MedicationsWeight loss medications include:
Medications alone are not a viable option for losing weight and keeping it off. Some have led to serious side effects. Do not use over-the-counter or herbal remedies without talking to your doctor. Treatment for Children and TeensThe problem of obesity, of course, is not restricted to adults. There is evidence that the same changes in diet, exercise, and other behaviors can help children and teens lose weight. For example, kids may find success by participating in group therapy that focuses on diet and behavior changes. When added to lifestyle changes, medications (eg, sibutramine, orlistat) have also been shown to help obese children and adolescents lose weight, though careful monitoring for potential adverse effects is required. Bariatric SurgerySurgical procedures reduce the size of the stomach. It will also rearrange the digestive tract. The smaller stomach can only hold a tiny portion of food at a time. Operations include:
These procedures can have serious complications. They are only an option for people who are dangerously overweight.
Gastric Bypass © 2009 Nucleus Medical Art, Inc. PreventionPreventing obesity can be difficult. There are many factors influence your weight. General recommendations include:
RESOURCES: American Dietetic Association The Obesity Society CANADIAN RESOURCES: Canada's Food Guide Dietitians of Canada References: Cecil R, Goldman L, Bennett J. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Co; 2000. Dietary guidelines for Americans. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.health.gov/dietaryguidelines/dga2005/document/default.htm . Accessed June 8, 2008. Glycemic index—a new way of looking at carbs. Canadian Diabetes Association website. Available at: http://www.diabetes.ca/Section_About/glycemic.asp . Updated June 2005. Accessed January 23, 2008. Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders, 2008. Goroll AH, Mulley AG, Mulley AG Jr. Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000. Kronenberg HM, Melmed S, Polonsy KS, Larsen PR. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier, 2008. Obesity. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed July 29, 2008. Obesity, bias, and stigmatization. The Obesity Society website. Available at: http://www.obesity.org/information/weight_bias.asp . Accessed June 8, 2008. Thompson WG, Cook DA, Clark MM, Bardia A, Levine JA. Treatment of obesity. Mayo Clin Proc . 2007;82:93-101. 8/21/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 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 DynaMed's Systematic Literature Surveillance : 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 DynaMed's Systematic Literature Surveillance : 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 DynaMed's Systematic Literature Surveillance : 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 DynaMed's Systematic Literature Surveillance : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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 http://www.ebscohost.com/dynamed/what.php : 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. Last reviewed November 2009 by Rosalyn Carson-DeWitt, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © 2009 EBSCO Publishing All rights reserved.
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