Obesity What Is Obesity? Obesity is an excess proportion of total body fat.

A person is considered obese when his or her weight is 20% or more above normal weight. The most common measure of obesity is the body mass index or BMI. A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30. "Morbid obesity" means that a person is either 50%-100% over normal weight, more than 100 pounds over normal weight, has a BMI of 40 or higher, or is sufficiently overweight to severely interfere with health or normal function. What Causes Obesity? Obesity occurs when a person consumes more calories than he or she burns. For many people this boils down to eating too much and exercising too little. But there are other factors that also play a role in obesity. These may include:

Age. As you get older, your body's ability to metabolize food slows down and you do not require as many calories to maintain your weight. This is why people note that they eat the same and do the same activities as they did when they were 20 years old, but at age 40, gain weight. Gender. Women tend to be more overweight than men. Men have a higher resting metabolic rate (meaning they burn more energy at rest) than women, so men require more calories to maintain their body weight. Additionally, when women become postmenopausal, their metabolic rate decreases. That is partly why many women gain weight after menopause. Genetics. Obesity (and thinness) tends to run in families. In a study of adults who were adopted as children, researchers found that participating adult weights were closer to their biological

parents' weights than their adoptive parents'. The environment provided by the adoptive family apparently had less influence on the development of obesity than the person's genetic makeup. In fact, if your biological mother is heavy as an adult, there is approximately a 75% chance that you will be heavy. If your biological mother is thin, there is also a 75% chance that you will be thin. Nevertheless, people who feel that their genes have doomed them to a lifetime of obesity should take heart. Many people genetically predisposed to obesity do not become obese or are able to lose weight and keep it off. Environmental factors. Although genes are an important factor in many cases of obesity, a person's environment also plays a significant role. Environmental factors include lifestyle behaviors such as what a person eats and how active he or she is. Physical activity. Active individuals require more calories than less active ones to maintain their weight. Additionally, physical activity tends to decrease appetite in obese individuals while increasing the body's ability to preferentially metabolize fat as an energy source. Much of the increase in obesity in the last 20 years is thought to have resulted from the decreased level of daily physical activity. Psychological factors. Psychological factors also influence eating habits and obesity. Many people eat in response to negative emotions such as boredom, sadness, or anger. People who have difficulty with weight management may be facing more emotional and psychological issues; about 30% of people who seek treatment for serious weight problems have difficulties with binge eating. During a binge-eating episode, people eat large amounts of food while feeling they can't control how much they are eating. Illness. Although not as common as many believe, there are some illnesses that can cause obesity. These include hormone problems such as hypothyroidism (poorly acting thyroid slows metabolism), depression, and some rare diseases of the brain that can lead to overeating.

Medication. Certain drugs, such as steroids and some antidepressants, may cause excessive weight gain.

Emotional Aspects of Obesity One of the most painful aspects of obesity may be the emotional suffering it causes. American society places great emphasis on physical appearance, often equating attractiveness with slimness or muscularity. In addition, many people wrongly stereotype obese people as gluttonous, lazy, or both. However, more and more evidence contradicts this assumption. Obese people often face prejudice or discrimination at work, at school, while looking for a job, and in social situations. Feelings of rejection, shame, or depression are common. When to Seek Help for Obesity You should call your doctor if you are having emotional or psychological issues related to your obesity, need help losing weight, or if you fall into either of the following categories.

If your BMI is 30 or greater, you're considered obese. You should talk to your doctor about losing weight since you are at high risk of having health problems. If you have an "apple shape" -- a so-called, "potbelly" or "spare tire" -- you carry more fat in and around your abdominal organs. Fat deposited primarily around your middle increases your risk of many of the serious conditions associated with obesity. Women's waist measurement should fall below 35 inches. Men's should be less than 40 inches. If you have a large waist circumference, talk to your doctor about how you can lose weight.

http://www.webmd.com/diet/guide/what-is-obesity

Psychological problems

In addition to the day-to-day problems of obesity, many people may also experience psychological problems (problems to do with mental health). These may include:

having low self-esteem, having a poor self-image (not liking how you look), having low confidence levels, feeling isolated in society, or having reduced mobility leading to a poor quality of life.

These can affect your relationships with family members and friends, and if they become severe, may lead to depression. http://www.nhs.uk/Conditions/Obesity/Pages/Obesitysymptoms.aspx

Symptoms associated with obesity can include:

Difficulty sleeping Snoring Sleep apnea Pain in your back or joints Excessive sweating Always feeling hot Rashes or infection in folds of your skin Feeling out of breath with minor exertion Daytime sleepiness or fatigue Depression

http://www.mayoclinic.com/health/obesity/DS00314/DSECTION=symp toms

Treatments for obesity (source: The Mayo Clinic)

Obesity treatments have two objectives: 1. To achieve a healthy weight. 2. To maintain that healthy weight. People who are obese are often discouraged because they think they have to lose a lot of weight before any benefits are experienced. This is not true. Any obese person who loses just five to ten per cent of their body weight will have significant improvement in health - this would mean between 12-25 pounds for an obese person who weighs 250 pounds. It is important for patients to realize that a small drop in weight is a good start and a great achievement. Experts have found that obese people who lose weight slowly and constantly, say one or two pounds each week, are more successful in keeping their weight down when they have reached their target weight. According to the Mayo Clinic, successful and permanent weight loss is best achieved as a result of increased physical activity, changing how and when you eat, and modifying your behavior. Some patients may be prescribed medication, while others might undergo weight-loss surgery.

Dietary changes The Mayo Clinic advises obese people to reduce their total daily calorie intake and to consume more fruits, vegetables and whole grains. It is important that your diet is varied - you still need to feed yourself, and should continue to enjoy the tastes of different foods. The consumption of sugar, certain refined carbohydrates and some fats should be reduced significantly. Ideally, you should work with your doctor, a dietician, and/or a wellknown weight-loss program.

Trying to lose weight quickly by crash-dieting carries the following risks:

You may develop health problems You will probably experience vitamin deficiencies You chances of failure are significantly higher

People who are seriously obese may be prescribed a very low calorie liquid diet. These must be done with a health care professional.

Physical activity The more you move your body the more calories you burn. To lose a kilogram of fat you need to burn 8,000 calories (1 pound of fat = 3,500 calories). Walking briskly is a good way to start increasing your physical activity if you are obese. Combining increased physical activity with a good diet will significantly increase your chances of losing weight successfully and permanently! Try to find activities which you can fit into your daily routine. Anything that becomes part of your daily life, weaved into your existing lifestyle, is more likely to become a long-term habit. If you use an elevator, try getting off one or two floors before your destination and walking the rest. You could try the same when driving your car or taking any form of public transport - get off earlier and walk that bit more. If any of your regular shops are within walking distance, try leaving your car at home. Several surveys indicated that the majority of urban car trips outside the rush hours are less than a mile long - we can all walk a mile, and should! If you are very obese, are unfit, or have some health problems, make sure you check with a health care professional before increasing your physical activity.

Prescription medications for losing weight Prescription medications should really only be considered as a last resort. If the patient finds it extremely hard to shed the pounds, or if his obesity has reached such a point as to significantly undermine his health, then prescription drugs may become an option. According to the Mayo Clinic prescription medications should only be considered if:

Other strategies to lose weight have failed The patient's BMI is over 27 and he also has diabetes, hypertension, or sleep apnea. The patient's BMI is over 30

There are two approved drugs a physician may consider, Sibutramine (Meridia in USA/Canada, Reductil in Europe and much of the world) or Orlistat (Xenical). Bear in mind that as soon as you stop taking these drugs the overweight problem generally comes back - they have to be taken indefinitely. Some patients may not respond to these drugs, while others may find their beneficial effects may lessen somewhat after a few months.

Health risks associated with obesity

Bone and cartilage degeneration (Osteoarthritis) Obesity is an important risk factor for osteoarthritis in most joints, especially at the knee joint (the most important site for osteoarthritis). Obesity confers a nine times increased risk in knee joint osteoarthritis in women. Osteoarthritis risk is also linked to obesity for other joints. A recent study indicated that obesity is a strong determinant of thumb base osteoarthritis in both sexes. Data suggest that metabolic and mechanical factors mediate the effects of obesity on joints (University of Bristol). Coronary heart disease Obesity carries a penalty of an associated adverse cardiovascular risk profile. Largely as a consequence of this, it is associated with an excess occurrence of cardiovascular disease morbidity and mortality. (Department of Preventive Medicine, University of Tennessee) Gallbladder disease Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is then delivered into the bile causing it to become supersaturated. Some evidence suggests that specific dietary factors (saturated fats and refined sugars) are the primary culprit in these cases (University of Maryland Medical Center) High blood pressure (Hypertension) There are multiple reasons why obesity causes hypertension, but it seems that excess adipose (fat) tissue secretes substances that are acted on by the kidneys, resulting in hypertension. Moreover, with obesity there are generally higher amounts of insulin produced. Excess insulin elevates blood pressure. (Weight.com) High total cholesterol, high levels of triglycerides (Dyslipidemia) The primary dyslipidemia related to obesity is characterized by increased triglycerides, decreased HDL levels, and abnormal LDL composition. (Howard BV, Ruotolo G, Robbins DC.)

Respiratory problems Obesity can also cause respiratory problems. Breathing is difficult as the lungs are decreased in size and the chest wall becomes very heavy and difficult to lift. (Medical College of Wisconsin) Several cancers In 2002, approximately 41,000 new cases of cancer in the USA were thought to be due to obesity. In other words, about 3.2% of all new cancers are linked to obesity (Polednak AP. Trends in incidence rates for obesity-associated cancers in the U.S. Cancer Detection and Prevention 2003; 27(6):415-421) Sleep apnea Obesity has been found to be linked to sleep apnea. Also, weight reduction has been associated with comparable reductions in the severity of sleep apnea. (NHLBI) Stroke Rising obesity rates have been linked to more strokes among women aged 35 to 54. (Medical News Today - "Stroke Increase And Obesity Linked Among Middle-Aged Women") Type 2 diabetes One of the strongest risk factors for type 2 diabetes is obesity, and this is also one of the most modifiable as it can be partially controlled through diet and exercise. (Medical News Today "Researchers Verify Link Between Type 2 Diabetes And Diet" )

http://www.medicalnewstoday.com/info/obesity/