Obesity

Definition

Obesity is defined as a condition in which a person has accumulated so

much adipose (fatty) tissue that his or her health is impaired. It is also

defined by a person

BMI is an indirect measurement of body fat. To calculate an adult

in English measurements, multiply a person

703.1, and divide that number by the person

A personwith a BMI above 25 is considered overweight; a BMI over 30 is considered

obese; and a BMI above 40 is considered morbid obesity. In terms of

waistmeasurement, women with a waistline greater than 35 inches (88.9 centimeters)

and men with a waistline greater than 40 inches (101.6 centimeters)

are considered obese.

Some doctors think that obesity itself should be defined as a disease,

while others maintain that it should be considered more broadly as an

unhealthy condition that increases a person

diseases.

’s body mass index (BMI) or waist measurement. The’s BMI’s weight in pounds by’s height in inches squared.’s risk of diabetes and other

Description

Obesity is a condition that develops when a person takes in more food calories

than his or her body burns up in the course of one

The body turns those excess calories into fat. Overweight refers to an

excess of body weight compared to set standards. The extra weight may

come from muscle, bone, fat, or body water. Obesity refers specifically

to having an abnormally high proportion of body fat. Thus it is possible

for an athlete to be overweight without being obese if his or her extra

weight consists of muscle rather than fat tissue.

Obesity is a concern to doctors because it is associated with a number of

diseases and disorders that can shorten a person

lower one

include:

’s life expectancy as well as’s quality of life. Some of these diseases and other health problems

•

Type 2 (adult-onset) diabetes

•

High blood cholesterol levels

•

Heart disease

•

Stroke

•

High blood pressure

•

Osteoarthritis

•

Sleep apnea

•

Gallbladder disease

•

Complications of pregnancy

•

Depression

•

Increased risk of breast, colorectal, or kidney cancer•

Demographics

Obesity is a growing health problem in all countries in the developed

world. The World Health Organization (WHO) estimated in 2005 that

10 percent of the world

with another 760 million overweight. In the United States, about twothirds

of adults are overweight compared to the ideal weight for their sex,

age, and height; one-third of American adults are obese. The proportion

of obese adults in the general American population has more than

doubled since 1960. Obesity costs the United States about $100 billion

each year, $52 billion for direct health care costs and $33 billion for

weight-loss products or programs.

Obesity is equally likely to affect men and women. There are, however,

racial and ethnic differences within the American population.

Groups that have a higher than average risk of obesity include the Pima

Indians of Arizona and several other Native American tribes; Hispanics;

African Americans; and Pacific Islanders.

Obesity is often associated with eating disorders in adults; about

30 percent of obese adults have a history of bulimia or binge eating.

’s population, or 400 million people, were obese,

Causes and Symptoms

Obesity is thought to be the end result of a combination of factors rather

than having a single cause. Although obesity can be briefly described as an

imbalance between food energy taken in and energy used up in exercise,

eating and exercise are intertwined with other factors in complicated ways.

•

of the variations in human body size. Genetic factors affect

how efficiently a person

the excess fat is stored. People whose fat is stored around the

abdomen have a higher risk of health problems than those whose

extra weight is carried on the hips.

Genetic factors. Researchers think that these account for 40–70 percent’s body burns food and where on the body

•

foods is likely to adopt their eating habits.

Family environment. A person whose parents eat a lot of highcalorie

•

their calorie requirements drop; thus people who may not have been

obese as young adults may become obese as they grow older.

Age. People’s bodies lose muscle tissue and gain fat as they age, and

•

their calorie requirements for maintaining their body weight are

higher than women

the same height and weight to gain weight if they consume the

same number of calories as the men.

•

the thyroid gland, or depression are at increased risk of obesity.

Medical conditions. People with Cushing’s syndrome, disorders of

•

drugs, antiseizure medications, or antidepressants may gain weight

on these drugs.

Medication side effects. People who must take corticosteroid

•

when they are sad, angry, bored, or upset.

Emotional factors. Some people use food to soothe their feelings

•

because food tastes better after they quit. In addition, the nicotine

in tobacco raises the rate at which the body burns calories, so the

former smoker

Quitting smoking. People who quit smoking often gain weight’s body needs fewer calories to maintain its weight.

•

after each pregnancy; over time, these weight gains can lead

to obesity.

Pregnancy. Most women retain 4 to 6 pounds (1.8 to 2.7 kilograms)

Diagnosis

The diagnosis of obesity in adults may be based on the CDC body mass

index tables, or it may be based on other measurements. One common

test involves measuring the thickness of the skin fold over the triceps

muscle on the upper arm, although this measurement may not be accurate

unless performed by a trained technician. Another test involves measuring

the person

just below the belly button.

’s waist circumference at its widest point, usually at or

Treatment

Treatment of obesity is usually more complicated than simply placing

people on a calorie-restricted diet or telling them to get more exercise.

The doctor must take into account other health conditions that may

affect the patients, their medications, occupation, and other lifestyle factors.

For example, a person who lives alone can control food purchases or

daily workouts more easily than someone who has to take the eating

habits and time schedules of other family members into consideration.

Similarly, someone with osteoarthritis may need to find forms of exercise

that will not damage sore joints. In some cases the doctor and patient can

work out a diet and exercise plan with the help of a registered dietitian or

physical therapist, so that the patient can eat a nutritious diet that

includes one

likes as well. One of the keys to sticking with a weight-loss program is

satisfaction; people who feel deprived of the foods they like or bored

by their physical exercise program are likely to quit.

It helps to remember that losing even a small amount of weight can be

beneficial. Some doctors call this approach the

is, losing just 10 percent of one

disease and diabetes. If the person is able to keep that 10 percent weight

loss for six months or longer, he or she can consider losing more weight.

People who have been unable to lose weight by a combination of

exercise and food intake, or who are morbidly obese, may be treated by

medications or weight-loss surgery. The two major medications that have

been approved by the Food and Drug Administration (FDA) for weight

loss are Meridia, which works by making the person feel full more

quickly during a meal, and Xenical, which works by lowering the amount

of fat that the body absorbs from the intestines. Both drugs have side

effects, and weight loss tends to be modest, about 13 pounds (5.9 kilograms)

in a year.

Weight-loss surgery, known as bariatric surgery, is usually limited to

people with a BMI over 40 or those with a BMI over 35 combined with

type 2 diabetes, sleep apnea, or heart disease. There are two basic types of

surgery for weight loss, restrictive and malabsorptive. Restrictive procedures

work by closing off part of the stomach so that the person cannot

eat as much without feeling full. In malabsorptive procedures, the surgeon

creates a bypass around the part of the small intestine where most of the

calories in the food are absorbed. This type of surgery lowers the amount

of calories that the body absorbs as well as lowering the patient

intake. Bariatric surgery is not for everyone; it can produce serious complications

that include bloating, nausea, and diarrhea. In addition, the

patient will need to see the doctor periodically for the rest of his or her life.

’s favorite foods and find a form of exercise that he or she“10 percent solution”—that’s excess weight can lower the risk of heart’s food

Prognosis

According to the Centers for Disease Control and Prevention (CDC), obese

adults have a 10

compared to people whose weight is normal or only slightly overweight.

Obesity shortens a person

and accounts for 112,000 excess deaths each year in the United States compared

to people of normal weight. Men with a BMI over 40 have their life

expectancy shortened by twenty years, and women by five years.

Prevention

Preventing weight gain or maintaining weight loss can be difficult in a

society where inexpensive high-calorie snacks make it easy to overeat and

television or video games make it easy to avoid physical activity. The following

tips, however, can help a person stay committed to a weight-loss

or weight-maintenance program:

•

swimming, or other forms of moderate exercise.

Make time each day—thirty to sixty minutes—for fast walking,

•

foods rather than sweets or snacks that are high in fat.

Build a daily menu around fruits, vegetables, and whole-grain

•

One way to spot these patterns is to keep a food diary.

Learn to recognize the situations or triggers that lead to overeating.

•

related to overeating.

If necessary, get help for depression or other psychological problems

•

Keep track of weight and waist size on a regular basis.

The Future

It is likely that obesity will increase in the future, not just in the United

States but worldwide. The World Health Organization (WHO) reported

in 2006 that the only part of the world where obesity is still unusual is

sub-Saharan Africa. Obesity is rising in all age groups, including the

elderly, as well as in almost all countries.

Since the discovery in 1994 of leptin, a hormone that regulates the

brain

studying it in hopes of learning more about the biological factors that

influence appetite and food intake in humans. Other researchers are

looking at the emotional and social factors that encourage people to

overeat, and to test the effectiveness of psychotherapy as well as medications

in weight-loss programs.

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