Overweight in Adults

(Obesity; Morbid Obesity)

by Rosalyn Carson-DeWitt, MD

Definition

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: 25-29.9
  • Obese: 30 or above
  • Morbid obesity: 40

Causes    TOP

Being 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 includes physical activity and basic bodily 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 the development of obesity include:

Risk Factors    TOP

Factors that may increase your chance of becoming overweight include:

  • Eating large portions of food
  • Sedentary lifestyle—Getting too little exercise and spending too much time in front of a television or computer
  • Eating until full and eating quickly
  • High level of fast food intake
  • Advancing age
  • High alcohol consumption
  • Working varied shifts
  • Not getting enough sleep

Symptoms    TOP

Symptoms may include:

  • Increased weight
  • Thickness around the midsection
  • Obvious areas of fat deposits

Complications of Excessive Weight Gain    TOP

Excessive weight gain has been linked to:

An increased risk of:

Decrease in quality of life associated with:

Being overweight can also affect pregnancy. Some complications include high blood pressure, diabetes, problems during labor and deliver, or malformations of the baby.

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. 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
  • Water-displacement tests

Your doctor may order blood tests to eliminate the possibility of other medical conditions.

Treatment    TOP

Obesity is difficult to treat. Things that affect treatment are:

  • Cultural factors
  • Personal habits
  • Lifestyle
  • Genetics

You and your doctor will talk about the best treatment plan for you. There are many different approaches to treating obesity based on lifestyle changes. You are more likely to successfully lose weight and keep it off by using a combination of strategies. These can include eating healthy, exercise, counseling, and/or medication. Plans for weight loss may include:

Diet

Your doctor may recommend that you spread your calorie intake throughout the day rather than getting it all in a few large meals. You may also need a special diet that will eliminate specific types of food. Examples of these are low-fat or low-carbohydrate diets.

Talk to your doctor or ask for a referral to a dietician. They can help you develop a plan that is best for you.

Calorie Intake

The key to weight loss is reducing the total number of calories that you eat. Following a specific kind of diet, like a low-carbohydrate 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. Calorie intake is based on your current weight and your weight loss goals.

Portion, or serving size, also plays an important role. Using special portion control plates may help you succeed.

Food Diary

Keep track of everything you eat and drink.

Exercise

Ask your doctor about an exercise program. Even moderate-intensity exercise, like brisk walking, can help you lose weight.

There are many easy ways to add extra activity into your daily routine. Take stairs instead of elevators. Park your car a little further away. Limit the amount of time you spend watching television and using the computer and substitute it with activity.

Behavior Therapy

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 may work for some people. Some studies also suggest that a partner or group may help you improve your eating habits and fitness.

Medications

Weight loss medications, like orlistat , 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.

Medication alone is 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

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.

Gastric Bypass

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Prevention    TOP

Controlling your weight can be difficult. To reduce your chance of getting overweight, take these steps:

  • Talk to your doctor or a dietician about an appropriate number of calories to eat per day 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.
  • 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.

RESOURCES:

American Academy of Nutrition and Dietetics
http://www.eatright.org
The Obesity Society
http://www.obesity.org

CANADIAN RESOURCES:

Canada's Food Guide
Health Canada
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html
Dietitians of Canada
http://www.dietitians.ca/

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Last reviewed February 2013 by Brian Randall, MD
Last Updated: 3/21/2013
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