Featured obesity patient discussions on effective treatments
"My weight is 320 pounds. I have tried everything. The more I try to lose weight, the more I gain. My back hurts, and my legs and feet hurt so bad that sometimes I cannot walk. My husband tells me he loves me more than anything. I’ve been married for 32 years now, and he tries his best to help me."
"7 years ago I went from 230 pounds to 175 in a matter of days. I had high volumn liposuction done, then Tummy tuck. I went from a size 24 to a size 12. Today 7 years latter I am a size 8 and weigh 165 pounds. Since the surgeries I exercise mostly walking once a week for 30 minutes. I watch what I eat. I eat small portions of food and an apple before each meal. I eat meat 3 times a week."
"I spent my life trying to lose weight. I tried everything, even an operation of the stomach. Nothing worked except for OA: Overeaters Anonymous. I have lost all my weight, and it's not coming back. For me, food is an addiction, and I need to work through a 12-step group. It's an incredible program that changed my life. There are meetings all over the world. Good luck."
Patient Discussions are not a substitute
for professional medical advice, or treatment.
See the disclaimer at the
bottom of the comments page.
What is obesity?
The definition of obesity varies depending on what one reads, but in general,
it is a chronic condition defined by an excess amount body fat. A certain amount
of body fat is necessary for storing energy, heat insulation, shock absorption,
and other functions. The normal amount of body fat (expressed as percentage of
body fat) is between 25%-30% in women and 18%-23% in men. Women with over 30% body
fat and men with over 25% body fat are considered obese.
The calculation of body mass index (BMI) has also been used in the definition of obesity. The body mass index (BMI) equals a person's weight in kilograms (kg) divided by their height in meters (m) squared. Since BMI describes body weight relative to height, it is strongly correlated with total body fat content in adults.
"Obesity" is defined as a BMI of 30 and above.
How common is obesity?
Obesity has reached epidemic proportions in the United States. One in three Americans is obese. The prevalence of obesity in children has increased markedly, with approximately 20%-25 % of children either overweight or obese. Obesity is also increasing rapidly throughout the world, and the incidence of obesity nearly doubled form 1991 to 1998.
What are the health risks associated with obesity?
Obesity is not just a cosmetic consideration; it is a dire health dilemma directly harmful to one's health. In the United States, roughly 300,000 deaths per year are directly related to obesity, and more than 80% of these deaths are in patients with a BMI (body mass index, which will be discussed later in this article) over 30. For patients with a BMI over 40, life expectancy is reduces significantly (as much as 20 years for men and 5 years for women ). Obesity also increases the risk of developing a number of chronic diseases including:
Insulin Resistance. Insulin is necessary for the transport of blood
glucose (sugar) into the cells of muscle and fat (which is then used for
energy). By transporting glucose into cells, insulin keeps the blood glucose
levels in the normal range. Insulin resistance (IR) is the condition whereby the
effectiveness of insulin in transporting glucose (sugar) into cells is
diminished. Fat cells are more insulin resistant than muscle cells; therefore,
one important cause of insulin resistance is obesity. The pancreas initially responds to
insulin resistance by producing more insulin. As long as the pancreas can
produce enough insulin to overcome this resistance, blood glucose levels remain
normal. This insulin resistance state
(characterized by normal blood glucose levels and high insulin levels) can last
for years. Once the pancreas can no longer keep up with producing high levels of
insulin, blood glucose levels begin to rise, resulting in type 2 diabetes, thus
insulin resistance is a pre-diabetes condition. In fact scientists now believe that the
atherosclerosis (hardening of the arteries) associated with diabetes likely
develops during this insulin resistance period.
Type 2 (adult-onset) diabetes. The risk of
type 2 diabetes increases with
the degree and duration of obesity. Type 2 diabetes is associated with central
obesity; a person with central obesity has excess fat around his/her waist, so
that the body is shaped like an apple.
High blood pressure (hypertension). Hypertension is common among obese
adults. A Norwegian study showed that weight gain tended to increase blood
pressure in women more significantly than in men. The risk of developing
high
blood pressure is also higher in obese people who are apple shaped (central
obesity) than in people who are pear shaped (fat distribution mainly in hips and
thighs).
Heart attack. A
prospective study found that the risk of developing
coronary artery disease increased three to four times in women who had a BMI greater
than 29. A Finnish study showed that for every one kilogram (2.2 pounds)
increase in body weight, the risk of death from coronary artery disease
increased by one percent. In patients who have already had a heart attack,
obesity is associated with an increased likelihood of a second heart attack.
Cancer. While not conclusively proven, some observational studies have
linked obesity to cancer of the colon in men and women, cancer of the rectum and
prostate in men, and
cancer of the gallbladder and
uterus in women. Obesity may
also be associated with breast cancer, particularly in postmenopausal women. Fat
tissue is important in the production of estrogen, and prolonged exposure to
high levels of estrogen increases the risk of breast cancer.
The balance between calorie intake and energy expenditure determines a person's
weight. If a person eats more calories than he or she burns (metabolizes), the person gains
weight (the body will store the excess energy as fat). If a person eats fewer
calories than he or she metabolizes, he or she will lose weight. Therefore the most
common causes of obesity are overeating and physical inactivity. At present, we
know that there are many factors that contribute to obesity, some of which have
a genetic component:
Genetics. A person is more likely to develop obesity if one or both
parents are obese. Genetics also affect hormones involved in fat regulation. For
example, one genetic cause of obesity is leptin deficiency. Leptin is a hormone
produced in fat cells, and also in the placenta. Leptin controls weight by
signaling the brain to eat less when body fat stores are too high. If, for some
reason the body cannot produce enough leptin, or leptin cannot signal the brain
to eat less, this control is lost, and obesity occurs. The role of leptin
replacement as a treatment for obesity is currently being explored.
Overeating. Overeating leads to weight gain, especially if the diet is
high in fat. Foods high in fat or sugar (for example, fast food, fried food, and
sweets) have high energy density (foods that have a lot of calories in a small
amount of food). Epidemiologic studies have shown that diets high in fat
contribute to weight gain.
A diet high in simple carbohydrates. The role of carbohydrates in weight
gain is not clear. Carbohydrates increase blood glucose levels, which in turn
stimulate insulin release by the pancreas, and insulin promotes the growth of
fat tissue and can cause weight gain. Some scientists believe that simple
carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.)
contribute to weight gain because they are more rapidly absorbed into the blood-stream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw
fruits, etc.) and thus cause a more pronounced insulin release after meals than
complex carbohydrates. This higher insulin release, some scientists believe,
contributes to weight gain.
Frequency of eating. The relationship between frequency of eating (how
often you eat) and weight is somewhat controversial. There are many reports of
overweight people eating less often than people with normal weight. Scientists
have observed that people who eat small meals four or five times daily, have
lower cholesterol levels and lower and/or more stable blood sugar levels than
people who eat less frequently (two or three large meals daily). One possible
explanation is that small frequent meals produce stable insulin levels, whereas
large meals cause large spikes of insulin after meals.
Slow metabolism. Women have less muscle than men. Muscle burns
(metabolizes) more
calories than other tissue (which includes fat). As a result, women have a
slower metabolism than men, and hence, have a tendency to put on more weight
than men, and weight loss is more difficult for women. As we age, we tend to
lose muscle and our metabolism slows; therefore, we tend to gain weight as we
get older particularly if we do not reduce our daily caloric intake.
Physical inactivity. Sedentary people burn fewer calories than people who
are active. The National Health and Nutrition Examination Survey (NHANES) showed that
physical inactivity was strongly correlated with weight gain in both sexes.
Medications. Medications associated with weight gain include certain
antidepressants (medications used in treating depression), anti-convulsants
[medications used in controlling
seizures such as carbamazepine
(Tegretol, Tegretol XR , Equetro, Carbatrol) and valproate],
diabetes medications (medications used in lowering blood sugar such as insulin,
sulfonylureas and thiazolidinediones), certain hormones such as oral
contraceptives and most corticosteroids such as Prednisone. Weight gain may also
be seen with some high blood pressure medications and antihistamines.
Psychological factors. For some people, emotions influence eating habits.
Many people eat excessively in response to emotions such as boredom, sadness,
stress or anger. While most overweight people have no more psychological
disturbances than normal weight people, about 30 percent of the people who seek
treatment for serious weight problems have difficulties with binge eating.
Content under this heading is from or created on behalf of the named sponsor. This content is not subject to the WebMD Editorial Policy and is not reviewed by the WebMD Editorial department for accuracy, objectivity or balance.
Suggested Reading by Our Doctors
phentermine, Adipex-P, Fastin, Obenix, Oby-Trim - Explains the medication phentermine (Adipex-P, Fastin, Obenix, Oby-Trim) used as a short- term drug along with diet and behavior modification to treat obesity. Article includes descriptions, uses, drug interactions, and side effects.
Lap Band (Surgery) - Read about the lap band (gastric banding) surgery procedure, risks, complications, changes in diet and lifestyle, and what to expect from this operation.
Gout - Gout and hyperuricemia are caused by uric acid crystals building up in the body. Gout symptoms and signs include joint pain and swelling. Read about treatment and foods to avoid.
Some people have stubborn areas of fat cells that will not shrink no matter how much they diet or exercise. The common areas for these fat pockets include the chin, neck, hips, abdomen, thighs, buttocks and even calves and ankles.
A newer technique called ultrasonic-assisted lipoplasty (UAL) may help you address that unwanted fat. UAL is an enhancement to the currently used tumescent liposuction method. To keep your new shape and new weight after this lipoplasty, you will need to follow a proper diet and exercise plan.
How Does Lipoplasty Differ From Other Liposuction Techniques?
UAL uses high-frequency sound waves to liquefy fat beneath the skin's surface before removing it with gentle suction. Tumescent liposuction and traditional liposuction cannot liquefy fat cells, and this makes the fat more difficult to remove.
Diet & Weight Management RSS
