Overweight in Adults
(Obesity; Morbid Obesity)En Español (Spanish Version)More InDepth Information on This Condition
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: 25.0-29.9
- Obese: 30.0 or above
- Morbid obesity: 40
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 include physical activity and basic body 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 obesity include:
Risk factors include:
- Advancing age
- Working varied shifts
- Decreased activity
- Sedentary lifestyle—Getting too little exercise and spending too much time in front of a TV or computer
- Imbalance of excess calories versus decreased activity
- High level of fast food intake
- High alcohol consumption
- Eating until full and eating quickly
- Eating large portions of food
- Not getting enough sleep
- Increased weight
- Thickness around the midsection
- Obvious areas of fat deposits
Complications of Obesity
Obesity has been linked to health problems and quality of life issues such as:
- Decreased energy
- Heart disease
- Increased risk of blood clots
- Increased risk of stroke
- High cholesterol and high triglycerides in the blood
- High blood pressure
- Type 2 diabetes
- Liver disease
- Gastroesophageal reflux disease
- Joint problems, back pain
- Increased risk of certain cancers
- Increased risk of death from cancer
- Sleep apnea
- Poor self-image, depression
- Pregnancy complications, including high blood pressure , diabetes , complications during labor and deliver, malformations of the baby
- Early death
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
- Measuring waist-to-hip ratio
- Water-displacement tests
Your doctor may order blood tests to eliminate the possibility of other medical conditions.
Obesity is difficult to treat. Things that affect treatment are:
- Cultural factors
- Personal habits
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 eating healthy, 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:
Your doctor may recommend that you:
- Reduce carbohydrate and fat intake.
- Spread your calorie intake throughout the day rather than getting it all in a few large meals
The key to weight loss is reducing 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 for the long haul. A dietitian can help you with your total calorie intake goal. This is based on your:
- Current weight
- Weight loss goals
Portion size (or servings size) also plays an important role. Using special portion control plates may help you succeed.
Keep track of everything you eat and drink.
Ask your doctor about an exercise program. Even moderate-intensity exercise, like brisk walking, can help you lose weight.
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.
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 do seem to work for some people. Some studies also suggest that a partner or group may help you improve your eating habits and fitness.
Weight loss medicines, like orlistat (Xenical), may be prescribed. Orlistat interferes with the absorption of fat from the intestines. There are other medications available that may help with weight loss, but potential side effects need to be weighed carefully with potential benefits.
Medicines alone are not a viable option for losing weight and keeping it off. Some 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 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 who are having trouble losing weight by other means.
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Preventing obesity can be difficult. There are many factors influence your weight. General recommendations include:
- Talk to your doctor or a dietician about an appropriate number of calories to eat per day.
- Follow an appropriate exercise program.
- 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.
- Ask a dietitian for help planning a diet that will help you maintain a healthy weight or lose weight if necessary.
- Learn to eat smaller portions of food. Most Americans eat portions that are too large.
American Dietetic Association
The Obesity Society
Canada's Food Guide
Dietitians of Canada
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 August 28, 2012.
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 in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 16, 2012. Accessed August 28, 2012.
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.
Weight loss medication for obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 18, 2012. Accessed August 28, 2012.
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 meta2-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.
1/15/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta2-analysis. Am J Epidemiol . 2010;171(2):135-54.
1/29/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Kuk JL, Ardern CI. Influence of age on the association between various measures of obesity and all-cause mortality. J Am Geriatr Soc . 2009 Sep 15.
1/29/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Berkey CS, Rockett HR, Colditz GA. Weight gain in older adolescent females: the internet, sleep, coffee, and alcohol. J Pediatr . 2008;153(5):635-639.
2/19/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess . 2009;13:1-190, 215-357, iii-iv.
2/19/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : O'Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303(6):519-526.
10/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm . Published October 8, 2010. Accessed October 15, 2010.
12/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : US Food and Drug Administration. FDA: Tainted products marketed as dietary supplements potentially dangerous. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm236967.htm . Updated December 15, 2010. Accessed December 17, 2010.
Last reviewed September 2012 by Brian Randall, MD
Last updated Updated: 09/10/2012
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.
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