Complications of obesity can cause symptoms such as chest pain
or shortness of breath from heart disease, knee or hip pain,
or abdominal pain from gallstones.
When To Call Your Doctor
• If you are obese and
unable to change your eating and exercise habits to lose weight,
see a doctor or nutritionist.
What Is It?
Obesity is conventionally defined as an excess of
stored fat resulting in a body weight that is 20 percent or
what is accepted as ideal for a person’s height and body
type. Though not itself a disease, obesity is a serious health
risk. Mortality rates and the incidence of high blood pressure,
coronary heart disease, and diabetes mellitus are substantially
higher in obese adults, especially in those whose excessive
fat is stored in the abdomen rather than in the hips. Excess
increases the risk of gallbladder disease and may cause or
aggravate arthritis by placing greater stress on the back,
hips, and knees.
Certain types of cancer may also be more common in overweight
people. In addition, obesity is often accompanied by poor self-image,
psychological distress, and diminished quality of life. Losing
weight and keeping it off, however, is extraordinarily difficult.
Obesity results from an imbalance between caloric intake and
energy expenditure, usually due to habitually excessive food
intake and/or limited physical activity. Some people may gain
weight because they have lower basal metabolic rates: they
burn fewer calories to maintain body functions, such as breathing,
heart contractions, and digestion.
environmental, and psychological factors all play
a role in obesity.
Establish healthy eating habits; maintain a nutritious, low-fat,
• Exercise regularly
and stay as active as possible.
Obesity is formally defined by a body mass index (BMI) greater
than 30; overweight is defined by a BMI between 25 and
30. The BMI is calculated by dividing your weight in pounds
by your height
in inches squared, and then multiplying by 705.
• Another approach compares
a patient’s weight to an ideal
weight for their height and body type.
tests are obtained to detect common complications of obesity,
such as high blood levels of glucose and triglycerides.
• Waist circumference is measured; a circumference greater than
40 inches in men or 35 inches in women indicates abdominal
How To Treat It
Your doctor or nutritionist may advise a diet of no less than
1,200 calories a day, made up of nutritious, low-fat,
low-calorie foods (fruits, vegetables, whole grains, lean meat
or fish, and
low-fat dairy products).
• Crash diets,
fasting, and appetite suppressants (which may produce short-term
weight loss, but rarely sustained weight loss)
should be avoided.
• Engaging in regular, vigorous
aerobic exercise, such as running, biking, or swimming—or
even walking or gardening—for
at least 30 minutes a day four days a week is helpful.
• Modest weight loss may
be achieved with the prescription weight-loss drugs sibutramine
(Meridia) or orlistat (Xenical). The
drugs should be combined with dietary and lifestyle measures.
• For grossly obese patients,
doctors may advise a very low-calorie liquid diet (800 to 900
calories a day) with close medical
• In rare cases when obesity
can be life-threatening, doctors may resort to extraordinary
including surgery to
staple the stomach and reduce its size, or cutting or suctioning
fat (liposuction). The long-term success of liposuction
is questionable, and severe complications are possible.
or counseling may help to confront underlying psychological
and emotional reasons for overeating. Support groups
are often helpful.
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