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Obesity


Definition:

Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle, bone, or water, as well as from having too much fat.

Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height.

Alternative Names:

Morbid obesity; Fat - obese

Treatment:

CHANGING YOUR LIFESTYLE

An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You will need a lot of support from family and friends.

When dieting, your main goal should be to learn new, healthy ways of eating and make them a part of your daily routine.

Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle.

Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about:

  • Healthy food choices
  • Healthy snacks
  • How to read nutrition labels
  • New ways to prepare food
  • Portion sizes
  • Sweetened drinks

Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again.

Learn new ways to manage stress, rather than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your health care provider.

MEDICATIONS AND HERBAL REMEDIES

You may see ads for supplements and herbal remedies that claim they will help you lose weight. Many of these claims are not true. Some of these supplements can have serious side effects. Talk to your health care provider before using them.

You can discuss weight loss drugs with your doctor. Most people lose between 5 and 10 pounds by taking these drugs. Most people also regain the weight when they stop taking the medicine, unless they have made lasting lifestyle changes.

SURGERY

Bariatric surgery can reduce the risk of disease in people with severe obesity. These risks include:

  • Arthritis
  • Diabetes
  • Heart disease
  • High blood pressure
  • Sleep apnea
  • Some cancers
  • Stroke

Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine.

Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if this is a good option for you.

Weight-loss surgeries include:

Support Groups:

Many people find it easier to follow a diet and exercise program if they join a group of people with similar problems.

 
Complications:

Obesity is a major health threat. The extra weight puts added stress on every part of your body and creates many risks to your health.

References:

Dale KS, McAuley KA, Taylor RW, Williams SM, Farmer VL, Hansen P, et al. Determining optimal approaches for weight maintenance: a randomized controlled trial. CMAJ. 2009;180:E39-E46.

Jensen MD. Obesity. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 227.

Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patietns with diabetes. N Engl J Med. 2012:Epub March 26.

Seagle HM, Strain GW, Makris A, Reeves RS; American Dietetic Association. Position of the American Dietetic Association: weight management. J Am Diet Assoc. 2009;109:330-346.

United States Department of Agriculture. Dietary Guidelines for Americans, 2010. Accessed April 21, 2012.

Wadden TA, Volger S, Sarwer DB, et al. A two year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365:1969-1979


Review Date: 5/12/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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