Article Obesity

8/14/2019 Article Obesity

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Introduction

Obesity has become a growing epidemic that plaques people of different cultures worldwide.

Obesity is such a major health concern because it leads to several fatal diseases. Obesitysufferers are prone to cardiovascular problems, diabetes, stroke and heart attack. Many ofthese health issues are called silent-killers because the victim does not even know they havethese diseases. Obesity is not only negatively affecting adults but it affects the youngergeneration as well. Children and teenagers are becoming obese at alarming rates. It is said thatif this trend continues our childrens generation will not live as long as their parents. This is aserious fact that is terrifying on every level. Obesity does not discriminate as it takes out somany in its path. Obesity ispreventable.

The leading cause of obesityis the intake of caloric food consumed being more than theoutput of energy the body exerts in a day. Our intake of food must match our output ofenergy. If these two numbers do not correspond then fat cells multiply and make a home in

the tissues of the body. Once this occurs a person is on a dangerous path leading to obesity.Other causes of obesity are a sedentary lifestyle, a decrease in physical activities and manuallabor. We live in a technological revolution. Gadgets make everyday tasks easier andtherefore we have to exert less energy. This is a negative influence though, because it leads tothe onset of obesity and severe health problems.

Obesity is calculated by estimating an individualsBody Mass Index. A BMI test is a provenway to calculate obesity and its chance of occurrence. A BMI test calculates and divides a

persons weight by their height. This gives a percentage and alerts the person to their rate andchance of being obese. An above normal BMI percentage is twenty-five percent or higher of anormal body weight. Many Americans fall into this category, causing America, to become anation of obese people.

There are many treatment options for people who are suffering from obesity. The besttreatment is for an obese individual to decrease their calorie intake, to decrease their fatconsumption, to only use clinically proven obesity treatment product, to become more activeand to participate in physical manual labor. All of these factors form a winning therapy inorder to fight obesity. Many people will try weight loss pills, whetherprescribed orherbal,

but they only work in conjunction with a healthy diet and vigorous exercise program. Peopleusing these pills should be reminded of their serious side effects. Obese people also have thechoice to have surgeryperformed but this option is usually only used in severe cases.

It used to be that obese people were looked towards as signs of strength and fertility. Todayobese people are stereotyped as they are considered to be lazy and dull minded. These two

factors are far from the truth. Obesity is a huge that problem that keeps getting bigger.Peoples waistlines are rapidly growing and this is leading to a lifetime of health problems.The sad thing is that obesity affects one generation after another. This is a raging epidemicthat calls for stricter government regulations and a greater sense of personal responsibility.Obesity can be stopped in its tracks and prevented.

Definition Of Obesity

The English word Obesity derives from the Latin Obesus meaning fat or plump. The first

English use of the word was made in 1651 inNoah Biggs medical bookMataeotechniaMedicinae Praxeos.
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In medical studies, obesity is defined as a person having more than 20 per cent of idealweight. Ideal weight takes into account height, age, sex and build of a person. According to

National Health Institute, USA, the Body Mass Index of a person is the key factor todefine obesity. As per NHI standard, a person with 30 pounds of more fat content in his orher body is considered obese.

Body Mass Index, or BMI, is a health indicator of the diseases associated with obese men andwomen. These health factors include silent-killers such as: diabetes, heart disease andcancer. Many obese individuals do not even realize they have one or more of these diseases.

By waist measurement and BMI, body fat can be measured. Obesity is defined as a waistlineof 35 inches or higher for woman and for men a waistline of 40 inches or higher. TheBMI formula calculates body weight and height. The formula works by dividing anindividuals weight (Kg) by their height (meters squared). It can also be worked out bymultiplying weight in pounds by 703, and dividing height in inches. Again a division isnecessary by height (inches).

Obesity can also be defined as a BMI of 30 pounds over a person considered normal

weight. Weight standards are calculated according to a persons height. Excessive obesity isdefined as a BMI of 40 or higher. There is another way ofdefining obesity. It is overweight,with a BMI of 25 to less than 30. A persons BMI of about 25 kg/m (squared) corresponds toabout 10 per cent over a normal weight.

Broadly speaking, obesity can be defined as a bodys extra fat that is stored in tissues as aresult of excessive consumption of caloric food, which is not compatible with the routinemanual labor undertaken. Simply put, what a person takes in they must put out. This involvesthe physical act of eating in comparison with the level of physical movement.

Cultural & Social Significance

An obese person, in several different cultures, is associated with strength, fertility and wealth.In the great Indian epic, The Ramayana, the villainRavana has an obese brother named

Kumbhakarna who is a strong man with superior fighting qualities.

TheLaughing Buddha in ancient China is associated with wealth and

prosperity. The Venus figurines in western culture are obese females, which indicate fertilityand those able to survive famines.
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The paintings ofRubens (15771640) are plump female figures suggesting fertility and asymbol of social prestige.

Now, an obese individual has unfortunately become a social and cultural outcast. Thecrude treatment put upon obese people is noticed in the past as well as in the present. Anobese is held as somebody with unnatural traits. He or she is often called names. Many times

obese people are considered to be lazy and less intelligent. It is a standard that some membersof society have accepted and have unfairly instrumented this falsity into their thinkingstructure.

In the Shakespearean comedy Much Ado about Nothing the obese constable Dogberry iscalled an Ass a Coxcomb much to the pleasure of the audience. Nobody takes any offensein maltreatment of an obese.

The great western comic characterHardy, inLaurel and Hardy, routinely madefun of his issues surrounding his own obesity. The people crowded the movie halls to see thetantrums of Laurel and burst into roars of laughter.

In todays figure conscious society, an obese is a cultural outcast. The overweight body ofan obese with wide waistline is a butt of ridicule. They are always shown in movies and playsas laughing stocks. In some radical religious beliefs an obese is even held as a person withoutsoul!

The obese are objects of entertainment. In circus, we see jokers and clowns are always shortand fat. The obesity of humans has even transformed into animals to get uncensored laughter.Such occurrences are prevalent in cartoon films. Adults and minors are brought together tolaugh at the obese creatures.

Contemporary Culture

Both in fantasy and in real life we see the pathetic conditions of obese people. They areostracized once they become overweight. The idea that an obese is worthless dominates the

mindset of contemporary culture.No scientific analysis is made on the cause of obesity or on the mental conditions of theobese. The dignity of obese people is sacrificed to the wild and wanton desire of people with anormal physique. In this process, the cultural common-sense of people, in general, isdarkened.

In contemporary culture, the obese provides enough space to produce laugh scenes indifferent mediums of arts. In literary creations, films and cartoons, they are seen inabundance. The obese sometimes takes the form of a bully, sometimes a selfish human andagain in just a jest-giver.

The post-modern time has arrived with all its complexities. There is the old crude and shabby

social and cultural treatment of the obese individual. Because of this there arises a newconsciousness about the physical and mental conditions of an obese person. There are
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listeners to his or her agony. There are voices of protest against maltreatment to a personsuffering from obesity. He or she is no longer treated as a grotesque character in social andcultural settings by a group of enlightened and educated people.

The social significance of friendly treatment towards an obese lies in the scientific outlookacquired by the common masses. An obese is a patient, he needs love and affection, care and

treatment this is the growing trend of a sizeable section of the population these days.

In the post-modern social and cultural milieu, the obese are not stigmatized and ostracized.The new generation of youth is also taking more health conscious steps towards the earlydetection and prevention of obesity. Such occurrences are prevalent in cartoon films. Adultsand minors are brought together to laugh at these obese creatures.

Popular Culture

The obese are commonly treated as a stock of ridicule. Selfishness and bullying are theircharacteristics in popular culture. These are shown with such traits in adults as well aschildrens movies, books, cartoons and other art forms.

The characterDudley Dursley in British writerJoan Cathlene Rowlings superhit bookHarry Potterseries is a selfish bully. The rock lifting overweight Mr. Flintstones in

the cartoon The Flintstones is made fun of because of his dull head and weight. He is a fooland enjoys being a fool. We are given obesity related humor inBustopher Jones fat cat in themusical Cats who rises to fame only because he is a regular visitor of well-known clubswhere heavy dishes are served. And he, already 25-pound, is putting on weight everyday.Another obese comic cartoon character is Garfield, an idle fat cat, who enjoys eating lasagnaand sleeping.

In Hollywood, an obese actors best choice is to play a clown likeDrew Carey. He may alsoplay a funny guy likeLou Costello or a gangster like Victor Buono with 400 pound or puremenace like Sidney Greenstreetwith 357 pound in The Maltese Falcon. In the filmJurassic

Park, the selfish manDenis Nerdy is an obese. He is portrayed as a thief.

In Bollywood, we also see people make fun out of the obesity of a person in hindi movies.

Kumkum, an obese unmarried woman of yesteryears, was a comic female character, the only
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one in the hindi film history. She was always shown as a female pining for marriage andshunned by the man, she chose because of her obesity.

Famous hindi film actorAmjad Khan was a great hit since his debut film Sholay in 1975. Butsoon he fell victim of obesity by taking heavy doses of pain killers after suffering an accident.He lost all chances to act in films. He died at the tender age of 40.

Thus both in reel and real life the obese receive a shabby jests in popular culture. The oldidea has been lost of being a stout and strong man. His or herobesity has made them a jokerin popular art forms.

Effects On Health

An obese person is prey to certain critical health disorders. These disorders includecardiovascular problems like stroke, diabetes milletus type 2, sleep apnea, depression,osteoarthiritis, cancer, hormone deficiency, especially a sharp fall in testosterone level in men,fast ageing and Obesity Hypoventilation Syndrome (OHS).

Obesity raises cholesterol and triglycide levels and lowers HDL goodcholesterol leading to stroke. It also raises the levels of blood pressure and blood sugar. Thiscombination increases the risk of heart attack.

Obesity also causes osteoarthritis in the hand, hip, back and knee. Obesity issues affect post-menopausal women by increasing their chances of having breast cancer. Obese men may also

suffer from breast cancer. Increased BMI may cause cancer of the esophagus. A person withsuper weight may have endometrial and renal cell cancer particularly for women.

Obesity increases the risk of cardiovascular diseases, carpal tunnel syndrome, chronic venousinsufficiency, gallbladder problems, daytime sleeping, fatigue, gout, hypertension, pancreatic

problems, infertility and low back pain. Obstetric and gynecological complications in womenare also reported.

Otherobesity related diseases are abdominal hernias, acanthosis nigricans, endocrineabnormalities, chronic hypoxia and hypercapnia, dermatological effects, depression,elephantitis, gastro esophageal reflux, heel spurs, hirsutism, lower extremity edema,mammegaly (causing considerable problems such as bra strap pain, skin damage, cervical

pain, chronic odors and infections in the skin folds under the breasts, etc.), large anteriorabdominal wall masses (abdominal paniculitis with frequent panniculitis, impeding walking,
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causing frequent infections, odors, clothing difficulties, low back pain), musculoskeletaldisease, prostate cancer, pseudo tumor cerebri (or benign intracranial hypertension), andsliding hiatil hernia.

The cause of Obesity Hypoventilation Syndrome (OHS) is generally unknown, but is likelyrelated to a combination of a disorder in the brains control over breathing and the effects of

obesity on the chest wall. With the excess weight of massive obesity, the muscles of the chestwall can have difficulty expanding the chest enough to exchange air efficiently. This results ina decreased ability to oxygenate the blood, and the retention of carbon dioxide. Affected

people suffer from chronic fatigue due to sleep loss; poor sleep quality, and chronic hypoxiameaning decreased blood oxygen.

Metrics

Body mass index (BMI), developed by Belgian anthropometristAdolphe Quetelet, is awidely accepted scale to measure obesity. Its formula is division of the weight of an obese inkilograms by his height in square metres. Another formula is BMI = weight (lbs.) * 703 /height (inches)2

Top of Form

Body Mass Index

cm/kg

in/lb

Height:

Weight:

BMI:

Bottom of Form

The following values are commonly accepted: A BMI less than 18.5 is underweight

A BMI of 18.5 24.9 is normal weight

A BMI of 25.0 29.9 is overweight

A BMI of 30.0 39.9 is obese

A BMI of 40.0 or higher is severely (or morbidly) obese

A BMI of 35.0 or higher in the presence of at least one other significant co morbidityis also classified by some bodies as morbid obesity.

To interpret BMI, physicians take into account race, ethnicity, lean mass, age, sex and other

similar factors. Although there is no dispute to accept BMI to measure obesity, but it is notaccurate in judging body fact of a very muscular person, for example an athlete or the lost
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mass of an old person. It is also not correct in measuring waist circumference as it does nottake into account differing ratios of adipose to lean tissues. BMI also cannot differentiate

between separate types of adiposity, which on many occasions relates to cardiovasculardanger.

There is an alternative way. Scientists and physicians believe that men with over 25 per cent

body fat and women with over 30 per cent body fat are obese. There is, however, difficulty inprecisely measuring excessive fat of a persons body. Experts suggest that the underwaterweight of a person could be closer to an accurate answer. But underwater measurement isnot generally possible for all the people. It can be conducted in laboratories only.

Another alternative is the skinfold test which is dependable and can be easily conducted. Thebioelectrical impedance analysis is also acceptable to doctors because of its easyconductibility in medical clinics. Other types of measurement are computed tomography(CT/CAT scan) and magnetic resonance imaging (MRI/NMR) and dual energy X-rayabsorptiometry (DXA). Measurement of risk factors and diseases associated withoverweight can be judged by clinical analysis. Coronary heart problems diabetes type 2 andsleep apnea are common ailments for an obese. These are life-threatening diseases.

Smoking, blood pressure, age and family history can multiply the risk factors for disease. Soit is understood that there are several methods to quantify body weight of an obese with eachhaving its advantages and disadvantages. The physicians resort to methods which arecommonly practiced and can give accurate figures.

Causes Of Obesity

Overeating

Overeating is the main cause of obesity. When the consumption intakedoes not match physical expenditure in a single day, obesity begins. The extra fat gained bythe negative subtraction of the tow factors mentioned above allows pockets of fat depositsaccumulate within the human body. A man or a woman of such a high-consumption naturefalls prey to extra fat, bypassing the normal metabolic conditions of a human being.

The extra energy produces fat which is reserved into tissues. This imbalance in energyconservation leads to overweight over a period of time.

Eating disorders, unscheduled timing of meals and a wide time gap between eating allincrease the chance of being an obese.

Genetic
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Besides overeating there are other reasons for getting weight. Some geneticdisorders, carried by generations lead to overweight. In these cases people are helpless asthey are biologically destined to have super weight. According to a study conducted by theWorld Health Organization (WHO), the people of Indian sub-continent are more prone todiabetes which presupposes an over weight condition.

Some illness like hypothyroidism leads to obesity. Here too things are not in the hands ofthe suffering people.

Gender plays an important part to play in causing obesity. On an average, a man has moremuscles than a woman. Since muscles consume more calories than other forms of tissues, aman uses more calories than a woman even when he is not doing anything.

It proves that women are more vulnerable to obesity than men with same food intake.

Age is also a vital factor. Older people lose more muscles and thereby they tend to getfatter than the youth. Elderly people thus become obese more than the young generation.

During pregnancy, women get extra weight. This weight gain may lead to obesity. This cancompound with each pregnancy.

Medication and Drugs

Certain medications also lead to overweight. For example taking too many pain killers,sedatives, anti-depressants and typical antipsychotics cause extra fat to build in an

individual.

People should be very cautious in consuming such drugs. The less you take the better. Overconsumption of alcohols also causes extra fat cells to develop.

Lack of Exercise

Sedentary lifestyle lacking in the realm of manual labor in the days schedule also leads toobesity. Those who do not spend a few hours engrossed in manual works give way to

becoming heavy weight. Lack of physical exercise also leads to the miserable fall outbecoming heavyweight.

Wrong Diet

A high glycemic diet, for example, a diet that consists of meals having high postpandial bloodsugarcauses a person to become obese. Heavy consumption of sugary food raises bloodsugar level which in its turn makes one overweight.

A repeated attempt to lose weight by dieting is also risky. Eminent pop singer Carpenter diedby practicing over dieting.

Depression


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Themost effective therapy to cure obesity is to change certain behavior patterns. An obeseindividual should lower their food intake, consuming low calorie food, use of a clinicallyproven weight loss product, participating in regular physical work and exercise three times aweek or more.

The intake of lesser food amounts and low calorie food at that will automatically generate a

smaller amount of food energy taken-in therefore causes a person to be of a lower weight.Care should be taken that the diet is still nutritionally balanced. A balance must be struck

between adequate food and luxury dishes.

The obese individual must take great care in learning about food nutrition. A little amount ofnutritional food would make up a huge intake of junk food. Green vegetables play animportant role in the daily meal of an obese. Consumption of green vegetables in place ofstarchy food aids in weight loss.

Alcohol should be avoided religiously. All attempts should be made to avoid getting alcoholicfat cells in the tissues of the body. Nobody is asking someone to practice one-hundred percentabstinence but a restriction is imperative.

The overzealous use of painkillers, sedatives, tranquilizers, anti-depressants and birth controlpills should be stopped if they can be. These drugs cause immense fat as they increase apersons appetite and the need to eat more to ease their increased hunger pains.

A healthy food chart should be maintained so that there isnt any additional fat added to thebody of an overweight individual. In this effort, help may be sought form anutritionist.Weight loss product can be a big help. But with thousands of products out there,one should only use clinically proven and medically backed with clinical studiesproducts. The most effective weight loss product used by doctors for treatment of obesity isProactol.

Once food intake is properly managed, an effort should be made to reduce the weight of an

obese person through physical labor and exercising. Routine physical labor consumes extra fatcells therefore causing a noticeable reduction in weight. To add to this endeavor, regularphysical exercises would further the use of stored calories.

Brisk walking for a considerable amount of time a day, would increase the burning ofcalories, enabling an obese individual to lose more weight at a quicker pace.

Attention should be directed to the overseeing that a person suffering from obesity hasreceives an adequate amount of sleep each night and is not emotionally distressed.Sleeplessness takes a toll on the health of an obese person. Excessive emotions can alsoinfluence ones diet and thus jeopardize all their positive efforts to reduce fat cells.

Environmental FactorsEnvironment plays a major role in people becoming obese. Here the environment standsfor the surroundings an American is born and grows up. The sedentary life style of anaverage American is mainly responsible for the citizens becoming obese in such largequantities. That is why it is so important for parents to instill a love for exercise at an earlyage.

An obese parent genetically hands over his fat to the next generation. The cycle thus hasbecome vicious. The early Americans were British colonialists. These colonists were hardworking and therefore they did not have to deal with the issues and complications of obesity.

With the growth of economy, people find no interest in manual labor and there for havestarted the production of a society of people greatly suffering from obesity. History tells us
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that since the Second World War, the average weight of Americans increased, but they did notsuffer from such intense obesity.

But things started to take a turn for the worse, once the cost of food products decreased in the1980s. People have enough money to buy food, especially sugar and corn products, plus hugefood consumption, such as restaurant portions, combined with little physical labor add to this

perplexing dilemma. These factors have caused people to become thick around the middle.Some foodstuffs have been subsidized leading to a sharp fall in their prices.

With the opening of economy lead by the Regan administration in the 1980s adults andchildren fell prey to seductive advertisements for junk food and cold drinks, which consist ofa large amount of calories that cause a person to become obese. With new gadgets for cookingand household work appearing on the scene, people, especially women, do less physical workleading to their becoming obese.

Increasing affluence in society also has caused over consumption of food by Americans. Theelderly population tends to be more obese. The number of elderly people in the USA isgrowing since the mortality rate has increased over the years. And with this the number of

obese people in the United States has grown rapidly from year to passing year.A lack of physical work and exercise also contributes to the formation of a large number of

people becoming obese. Since the service sector is booming in American industry, people aremostly occupied with cool and comfortable sitting jobs in air-conditioned rooms. Thisincreases obesity among the average worker.

As for the need for physical exercise, many people have become largely indifferent to thisneed. With heavy foods in the stomach, people find no outlet to use up the stored calories.This causes obesity.

Americans should pay immediate attention to theirenvironment, they should eliminate anyfactors that affect their health negatively. They should undertake more manual labor and

physical exercise and teach their children about the importance of these factors to ensure ahealthy body. Since obesity is associated with several fatal diseases, obese Americans willsoon be treated as social outcasts and the USA, as a country of patients.

General Causes of Modern Obesity

Thr risk factors and contributory causes of obesity - a disease of excess body fatcharacterised by a body mass index of 30+ - include a range of well-documented geneticand environmental factors. But the relative effect of these causes on the development ofobesity, remains unclear. Before examining possible causes, note that obesity, especiallysevere clinical obesity like morbid or malignant obesity, carries greater risks of morbidityand premature mortality than simple overweight.

Problem 1: Diagnosing Causes For Sudden Rise in Obesity Levels

Any explanation of the root causes of the current obesity epidemic must account for itssudden appearance. Six million American adults are now morbidly obese (BMI 40+),

almost twice as high as 1980 severe obesity rates, while another 9.6 million have a BMIof 35-40. The percentage of overweight children 6-11 has nearly doubled since the early1980's. (Source: US Census 2000; NHANES III data estimates). Thus genetic causes are


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unlikely to be significant. Because while a predisposition to obesity can be inherited, thefact that obesity has increased so much in the last few decades appears to discountgenetics as a major main cause. Also, the fact that each succeeding generation is heavierthan the last indicates that changes in our environment are playing the key role.

Problem 2: Separating Genetic Causes From Environmental Causes

Obesity tends to run in families, suggesting a genetic link. Yet families also sharecommon dietary, physical exercise, attitude and lifestyle habits that may also contribute

to obesity. Separating these from purely genetic factors is not an easy statistical ordiagnostic task.

Environmental Causes of Obesity

In view of the sudden rise in weight levels - which is a worldwide trend as reflected in the

new word "globesity" - environmental factors must be the prime cause of modernobesity.

Overconsumption - A Possible Root Cause

Eating too many calories for our enery needs must be a major candidate for the main

cause of the modern obesity epidemic. According to Dr. Marion Nestle, Professor andChair of the Department of Nutrition and Food Studies at New York University, USagribusiness now produces 3,800 calories of food a day for every American, 500 caloriesmore than 30 years ago but at much lower per-calorie costs. Increases in consumptionof calorie-dense foods, as evidenced by the growth of fast-food chains and higher softdrink consumption, also point to a higher energy-intake.

NOTE: For an explanation of how surplus calories - from dietary fat, protein orcarbohydrate - are stored as body fat, please see: Body Fat/Adipose Tissue - Why

We Gain Fat

Eating Too Many High-Fat or Refined Sugary Foods

The type of food eaten may also play an important role in the rise of obesity.Researchers continue to discover more metabolic and digestive disorders resulting from

overconsumption of trans-fats and refined white flour carbohydrates, combined with lowfiber intake. These eating patterns are known to interfere with food and energymetabolism in the body, and cause excessive fat storage. Associated health disordersinclude insulin resistance, type 2 diabetes as well as obesity. Incidence of these "modern"diseases is increasing worldwide.

Reduced Energy Expenditure - A Possible Root Cause

People who eat more calories need to burn more calories, otherwise their calorie surplusis stored as fat. For example, if we eat 100 more food calories a day than we burn, wegain about 1 pound in a month. Thats about 10 pounds in a year. Over two decades thisenergy surplus causes a weight gain of 200 pounds!

Assessing the contribution of lack of exercise to obesity is hampered by lack of research.According to existing surveys, only 20 percent of the population are frequent exercisers.

In addition, only a small minority of children (1 in 5) regularly participate in after-schoolsports or extra-curricular physical activity. Since 1990, among adults there has been a

per capita decline of 15 percent in frequent exercise activity (100+ days per year in anyone activity). Among teenagers and adolescents aged 12-17, the plunge is 41 percent.

However, data on correlation between BMI and exercise frequency is almost non-existent, so we are unable to say exactly what effect lack of exercise has on obesity.What we do know is that severe clinical obesity leads to serious mobility problems causedby respiratory and musculoskeletal disorders. Thus the fitness capacity of obeseindividuals, especially those suffering from morbid obesity, is typically diminished.

Family Influence - A Major Contributory Cause to Obesity

Parental behavioral patterns concerning shopping, cooking, eating and exercise, have animportant influence on a child's energy balance and ultimately their weight. Thus family
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diet and lifestyle are important contributory causes to modern child obesity, especially ata time of rising affluence. Since obese children and adolescents frequently grow up tobecome obese adults, it's clear that family influence also extends to adult obesity.

Genetic Causes of Modern Obesity

Genes affect a number of weight-related processes in the body, such as metabolic rate,

blood glucose metabolism, fat-storage, hormones, to name but a few. Also, some studiesof adopted children indicate that adopted children tend to develop weight problems

similar to their biological, rather than adoptive, parents. In addition, infants born tooverweight mothers have been found to be less active and to gain more weight by the

age of three months when compared with infants of normal weight mothers, suggesting apossible inborn drive to conserve energy. Research has also shown that normal-weight

children of obese parents may have a lower metabolic rate than normal-weight childrenof non-obese parents, which can lead to weight problems in adulthood. All of thissuggests that a predisposition to obesity can be inherited.

However, the fact that obesity has increased so much in the last few decades appears todiscount genetics as the main cause. According to Stephen O'Rahilly, professor of clinicalbiochemistry and medicine at Cambridge University, the influence of genetics on modern

levels of obesity is insignificant:

What is Obesity?

If someone is obese, it means they are seriously overweight as a result of having toomuch body fat. In adults, the exact level of obesity is determined by reference to theBody Mass Index (BMI). A score of 30+ on the BMI indicates mild obesity. Types ofsevere clinical obesity include morbid obesity (BMI 40+) and malignant or super obesity(BMI 50+). At the extreme end of the scale is super-super obesity (BMI 60+). Child

obesity is measured differently. It is based on BMI-for-age, and is assessed in relation tothe weight of other children of a similar age and gender. Central or abdominal obesity,

now classified as an independent risk factor for some serious diseases, refers toexcessive fat around the stomach, abdomen or middle.

Health Effects of Obesity

Obesity, especially morbid and super obesity, has been linked to raised incidence of

premature death as well as several serious medical conditions, including type 2 diabetes,insulin resistance, heart disease, high blood cholesterol, high blood pressure, and stroke.

Obesity is also a risk factor in higher rates of certain types of cancer, as well as fatty liverdisease, vascular disorders, thrombosis, obstructive sleep apnea, musculoskeletal

problems and gastroesophageal reflux. Abdominal obesity is associated with insulinresistance syndrome and cardiovascular disease. But if you are very overweight, do notdespair. Losing even 5-10 per cent of your body weight can cause a significantimprovement in your health.See also: Weight Loss Guide For Super-Obese.

Obesity in Women

Obese women are more likely than non-obese women to die from cancer of thegallbladder, breast, uterus, cervix and ovaries. In addition, obesity can lead to an

increased risk of many obstetric and gynecological complications for women. Theseinclude infertility, menstrual abnormality, miscarriage and birth problems for both mother

and child. Before menopause, women suffer less from abdominal obesity because

estrogen levels cause fat to be stored around the hips and thighs. But after menopause,women tend to store more fat around their middle, with a consequent rise in associatedhealth risks. See also: Body Fat/Adipose Tissue - Why We Gain Fat
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Obesity in Men

Being typically apple-shaped, men have a higher risk for abdominal obesity which is anindependent risk factor for heart disease and type 2 diabetes. Morbidly obese whitemales aged 20-30 years old with a body mass index exceeding 45, can shorten their lifeexpectancy by 13 years. Morbidly obese African American men of similar age and body

mass index can lose up to 20 years of life. Abdominal obesity, characterized by a fatbelly, is more common in men as males typically store fat around their middle. Men

suffering from stress are especially at risk because stress causes the body to producecortisol, a hormone which is believed to stimulate the storage of fat around the abdomen.

Abdominal obesity is one of a cluster of interlinked symptoms (including, raisedcholesterol levels, hypertension, insulin insensitivity, raised levels of inflammatory andclotting components in the blood) that make up 'metabolic syndrome'. This metabolicdisorder has been identified as a serious risk factor for heart disease. Estimates suggestthat up to 1 in 3 of overweight men have metabolic syndrome.

Obesity in Children and Teenagers

According to the Center For Disease Control (CDC), the percentage of overweightchildren aged 6-11 years has almost doubled since the early 1980's. The percentage of

overweight adolescents has risen by nearly 300 percent. This is reflected in the increasedprescription of weight loss drugs and the introduction of Lap-Band gastric reduction

surgeries for obese teenagers.

Drug Treatment For Obesity

Mildly obese patients can benefit from diet and exercise treatments, sometimes providedin conjunction with weight loss medication. FDA-approved obesity drugs like Meridia

(sibutramine) orXenical(orlistat) can provide some assistance to some obese patients,although long term results are not encouraging. Clinical studies of weight loss pills showminimal benefits for obese patients, perhaps because drugs are not yet able to treat theemotional factors behind disordered eating patterns.

Bariatric Surgery

Patients with morbid obesity, especially those with serious co-morbid conditions, mayqualify for bariatric surgical treatments such as Lap Band or Roux-en-Y gastric bypass.Gastric reduction surgery is an important treatment option for obese patients with severehealth problems. Initially, it leads to very significant weight loss in the 2 year periodfollowing their gastric bypass or banding operation, but it deals with symptoms (our

excess weight) not causes (why we overeat). As a result, about 2-5 years after theiroperation, up to 40 percent of bariatric patients find it too arduous to follow the

recommended dietary guidelines and end up regaining weight.

Recommended Non-Surgical Treatment For Obesity

So what can you do if you're obese? How can you begin to regain control over yourweight and shape? Here are two suggestions: first, get yourself a good incentive to

reduce weight. Next, join a healthy weight loss program. One that allows youplenty to eat, explains whatexercise is necessary, and why, and gives you tons ofpersonal support to overcome the normal dieting headaches that cause you to quit. Ifyou need help, then check out Anne Collins Weight Loss Diet Program. It includes arange of easy diets, great motivation advice, and a really friendly online weight lossforum with over 10,000 members to help you lose weight and keep it off. It is used bydoctors and obesity clinics, as well as dieters from every state in America, and 20 othercountries worldwide. The program's success in helping obese patients lose up to 170

pounds of body fat, by healthy eating and friendly community support, is astonishing. Tosee how effective the diet program is, see Before-and-After Weight Loss Photos.
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Energy Balance

For most people, overweight and obesity are caused by not having energy balance. Weight isbalanced by the amount of energy or calories you get from food and drinks (this is calledenergy IN) equaling the energy your body uses for things like breathing, digesting, and being

physically active (this is called energy OUT).

Energy balance means that your energy IN equals your energy OUT. To maintain a healthy

weight, your energy IN and OUT dont have to balance exactly every day. Its the balanceover time that helps you maintain a healthy weight.

The same amount of energy IN and energy OUT over time = weight staysthe same

More IN than OUT over time = weight gain

More OUT than IN over time = weight loss

Overweight and obesity happen over time when you take in more calories than you use.

Other Causes

Physical InactivityMany Americans arent very physically active. There are many reasons for this. One reason isthat many people spend hours in front of TVs and computers doing work, schoolwork, andleisure activities. In fact, more than 2 hours a day of regular TV viewing time has been linkedto overweight and obesity.

Other reasons for not being active include: relying on cars instead of walking to places, fewerphysical demands at work or at home because modern technology and conveniences reducethe need to burn calories, and lack of physical education classes in schools for children.

People who are inactive are more likely to gain weight because they dont burn up the caloriesthat they take in from food and drinks. An inactive lifestyle also raises your risk forheart

disease,high blood pressure, diabetes, colon cancer, and other health problems.

Environment

Our environment doesnt always help with healthy lifestyle habits; in fact, it encouragesobesity. Some reasons include:

Lack of neighborhood sidewalks and safe places for recreation. Not havingarea parks, trails, sidewalks, and affordable gyms makes it hard for peopleto be physically active.

Work schedules. People often say that they dont have time to bephysically active given the long hours at work and the time spentcommuting back and forth to work.
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Oversized food portions. Americans are surrounded by huge food portionsin restaurants, fast food places, gas stations, movie theaters,supermarkets, and even home. Some of these meals and snacks can feedtwo or more people. Eating large portions means too much energy IN. Overtime, this will cause weight gain if it isnt balanced with physical activity.

Lack of access to healthy foods. Some people dont live in neighborhoodsthat have supermarkets that sell healthy foods such as fresh fruits andvegetables. Or if they do, these items are often too costly.

Food advertising. Americans are surrounded by ads from food companies.Often children are the targets of advertising for high-calorie, high-fatsnacks and sugary drinks. The goal of these ads is to sway people to buythese high-calorie foods, and often they do.

Genes and Family History

Studies of identical twins who have been raised apart show that genes have a strong influenceon ones weight. Overweight and obesity tend to run in families. Your chances of being

overweight are greater if one or both of your parents are overweight or obese. Your genes alsomay affect the amount of fat you store in your body and where on your body you carry theextra fat.

Because families also share food and physical activity habits, there is a link between genesand the environment. Children adopt the habits of their parents. So, a child with overweight

parents who eat high-calorie foods and are inactive will likely become overweight like theparents. On the other hand, if a family adopts healthful food and physical activity habits, thechilds chance of being overweight or obese is reduced.

Health Conditions

Sometimes hormone problems cause overweight and obesity. These problems include:

Underactive thyroid (also called hypothyroidism). This is a condition inwhich the thyroid gland doesnt make enough thyroid hormone. Lack ofthyroid hormone will slow down your metabolism and cause weight gain.

Youll also feel tired and weak.

Cushings syndrome. This is a condition in which the bodys adrenal glandsmake too much of the hormone cortisol. Cushings syndrome also canhappen when people take high levels of medicines such as prednisone forlong periods of time. People with Cushings syndrome gain weight, haveupper-body obesity, a rounded face, fat around the neck, and thin armsand legs.

Polycystic ovarian syndrome (PCOS). This is a condition that affects about5 to 10 percent of women of childbearing age. Women with PCOS often areobese, have excess hair growth, and have reproductive and other healthproblems due to high levels of hormones called androgens.

Medicines

Certain medicines such as corticosteroids (for example, prednisone), antidepressants (forexample, Elavil), and medicines for seizures (for example, Neurontin) may cause you togain weight. These medicines can slow the rate at which your body burns calories, increaseyour appetite, or cause your body to hold on to extra waterall of which can lead to weightgain.


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Emotional Factors

Some people eat more than usual when they are bored, angry, or stressed. Over time,overeating will lead to weight gain and may cause overweight or obesity.

Smoking

Some people gain weight when they stop smoking. One reason is that food often tastes andsmells better. Another reason is because nicotine raises the rate at which your body burnscalories, so you burn fewer calories when you stop smoking. However, smoking is a serioushealth risk, and quitting is more important than possible weight gain.

Age

As you get older, you tend to lose muscle, especially if youre less active. Muscle loss canslow down the rate at which your body burns calories. If you dont reduce your calorie intakeas you get older, you may gain weight. Midlife weight gain in women is mainly due to agingand lifestyle, but menopause also plays a role. Many women gain around 5 pounds duringmenopause and have more fat around the waist than they did before.

Pregnancy

During pregnancy, women gain weight so that the baby gets proper nourishment and developsnormally. After giving birth, some women find it hard to lose the weight. This may lead tooverweight or obesity, especially after a few pregnancies.

Lack of Sleep

Studies find that the less people sleep, the more likely they are to be overweight or obese.People who report sleeping 5 hours a night, for example, are much more likely to becomeobese compared to people who sleep 78 hours a night.

People who sleep fewer hours also seem to prefer eating foods that are higher in calories andcarbohydrates, which can lead to overeating, weight gain, and obesity over time. Hormonesthat are released during sleep control appetite and the bodys use of energy. For example,insulin controls the rise and fall of blood sugar levels during sleep. People who dont getenough sleep have insulin and blood sugar levels that are similar to those in people who arelikely to have diabetes.

Also, people who dont get enough sleep on a regular basis seem to have high levels of ahormone called ghrelin (which causes hunger) and low levels of a hormone called leptin(which normally helps to curb hunger).

What Are the Health Risks of Overweightand Obesity?Being overweight or obese isnt a cosmetic problem. It greatly raises the risk in adults for

many diseases and conditions.


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Overweight and Obesity-Related Health Problems in Adults

Heart Disease

This condition occurs when a fatty material called plaque (plak) builds up on the inside wallsof the coronary arteries (the arteries that supply blood and oxygen to your heart). Plaque

narrows the coronary arteries, which reduces blood flow to your heart. Your chances forhavingheart disease and a heart attackget higher as your body mass index (BMI) increases.Obesity also can lead tocongestive heart failure, a serious condition in which the heart cant

pump enough blood to meet your bodys needs.

High Blood Pressure (Hypertension)

This condition occurs when the force of the blood pushing against the walls of the arteries istoo high. Your chances for having high blood pressure are greater if youre overweight orobese.

Stroke

Being overweight or obese can lead to a buildup of fatty deposits in your arteries that form ablood clot. If the clot is close to your brain, it can block the flow of blood and oxygen andcause a stroke. The risk of having a stroke rises as BMI increases.

Type 2 Diabetes

This is a disease in which blood sugar (glucose) levels are too high. Normally, the bodymakes insulin to move the blood sugar into cells where its used. In type 2 diabetes, the cellsdont respond enough to the insulin thats made. Diabetes is a leading cause of early death,heart disease, stroke, kidney disease, and blindness. More than 80 percent of people with type2 diabetes are overweight.

Abnormal Blood Fats

If youre overweight or obese, you have a greater chance of having abnormal levels of bloodfats. These include high amounts of triglycerides and low-density lipoprotein (LDL)cholesterol (a fat-like substance often called bad cholesterol), and low high-densitylipoprotein (HDL) cholesterol (often called good cholesterol). Abnormal levels of these

blood fats are a risk for heart disease.

Metabolic Syndrome

This is the name for a group of risk factors linked to overweight and obesity that raise yourchance for heart disease and other health problems such as diabetes and stroke. A person can

develop any one of these risk factors by itself, but they tend to occur together. Metabolicsyndromeoccurs when a person has at least three of these heart disease risk factors:

A large waistline. This is also called abdominal obesity or having an appleshape. Having extra fat in the waist area is a greater risk factor for heartdisease than having extra fat in other parts of the body, such as on thehips.

Abnormal blood fat levels, including high triglycerides and low HDLcholesterol.

Higher than normal blood pressure.

Higher than normal fasting blood sugar levels.
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Cancer

Being overweight or obese raises the risk for colon, breast, endometrial, and gallbladdercancers.

Osteoarthritis

This is a common joint problem of the knees, hips, and lower back. It occurs when the tissuethat protects the joints wears away. Extra weight can put more pressure and wear on joints,causing pain.

Sleep Apnea

This condition causes a person to stop breathing for short periods during sleep. A person withsleep apnea may have more fat stored around the neck. This can make the breathing airwaysmaller so that its hard to breathe.

Reproductive Problems

Obesity can cause menstrual irregularity and infertility in women.

Gallstones

These are hard pieces of stone-like material that form in the gallbladder. Theyre mostly madeof cholesterol and can cause abdominal or back pain. People who are overweight or obesehave a greater chance of having gallstones. Also, being overweight may result in an enlargedgallbladder that may not work properly.

Overweight and Obesity-Related Health Problems in Children

and Teens

Overweight and obesity also increase the health risks for children and teens. Type 2 diabeteswas once rare in American children. Now it accounts for 8 to 45 percent of newly diagnoseddiabetes cases. Also, overweight children are more likely to become overweight or obese asadults, with the same risks for disease.

Who Is At Risk for Overweight andObesity?

Populations Affected

Overweight and obesity affect Americans of all ages, sexes, racial/ethnic groups, and

educational levels. This serious health problem has been growing over the years. In fact,overweight and obesity in adults have doubled since 1980, and overweight in children andteens has tripled.

Adults

According to the National Health and Nutrition Examination Survey (NHANES) 20032004,about one-third of adults in the United States are overweight and slightly more than one-thirdare obese. The survey also shows differences in overweight and obesity according toracial/ethnic groups.

In women, overweight and obesity are highest for non-Hispanic Black

women (about 82 percent), compared to about 75 percent for MexicanAmerican women and 58 percent for non-Hispanic White women.
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In men, overweight and obesity also are higher for minority groups.Theyre highest for Mexican American men (about 76 percent), comparedto about 71 percent for non-Hispanic White men and about 69 percent fornon-Hispanic Black men.

Children and Teens

According to NHANES 20032004, overweight and the risk for overweight is rising inchildren and teens. The survey shows that:

About 19 percent of school-aged children and about 17 percent of teensare overweight.

About 18 percent of school-aged children and about 17 percent of teensare at risk for overweight.

There are also some differences in overweight according to racial/ethnic groups.

In male children and teens, overweight is highest for Mexican Americans(about 22 percent), compared to 17 percent for non-Hispanic Whites and

about 16 percent for non-Hispanic Blacks.

In female children and teens, overweight is highest for non-Hispanic Blacks(23 percent), compared to 16 percent for Mexican Americans and about 14percent for non-Hispanic Whites.

Income

Overweight and obesity are also common in groups with low incomes. Women with lowincomes are about 50 percent more likely to be obese than women with higher incomes.Among children and teens, overweight in non-Hispanic White teens is related to a lowerfamily income.

Low-income families also buy more high-calorie, high-fat foods, which may add to theproblem. This is because they tend to cost less than more healthful foods such as fruits andvegetables.

How Are Overweight and Obesity Treated?Successful treatments for weight loss include setting goals and making lifestyle changes suchas eating fewer calories and being more physically active. Drug therapy and weight losssurgery are also options for some people if lifestyle changes dont work.

Set Realistic (Do-able) Goals

Setting the right weight loss goals is an important first step to losing and maintaining weight.

For Adults

Lose just 5 to 10 percent of your current weight over 6 months. This willlower your risk for heart disease and other conditions.

The best way to lose weight is slowly. A weight loss of 1 to 2 pounds aweek is do-able, safe, and will help you keep off the weight. It also will giveyou the time to make new, healthy lifestyle changes.

If youve lost 10 percent of your body weight, have kept it off for 6 months,and are still overweight or obese, you may want to consider further weightloss.
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For Children and Teens

If your child is overweight or at risk of overweight, the goal is to maintainhis or her current weight and to focus on eating healthy and beingphysically active. This should be part of a family effort to make lifestylechanges.

If your child is overweight and has a health condition related to overweightor obesity, your doctor should refer you to a pediatric obesity treatmentcenter.

Lifestyle Changes

For long-term weight loss success, its important for you and your family to make lifestylechanges:

Focus on energy IN (calories from food and drinks) and energy OUT(physical activity)

Follow a healthy eating plan

Learn how to adopt more healthful lifestyle habits

Over time, these changes will become part of your everyday life.

Calories

Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week,adults should cut back their calorie intake by 500 to 1,000 calories a day.

In general, 1,000 to 1,200 calories a day will help most women lose weightsafely.

In general, 1,200 to 1,600 calories a day will help most men lose weight

safely. This calorie range is also suitable for women who weigh 165 poundsor more or who exercise routinely.

These calorie levels are a guide and may need to be adjusted. If you eat 1,600 calories a daybut dont lose weight, then you may want to cut back to 1,200 calories. If youre hungry oneither diet, then you may want to boost your calories by 100 to 200 a day. Very low-caloriediets of less than 800 calories a day shouldnt be used unless your doctor is monitoring you.

For overweight children or teens, its important to slow the rate of weight gain; however,reduced-calorie diets arent advised before you talk to a health care provider.

Healthy Eating Plan

A healthy eating plan gives your body the nutrients it needs every day. It has enough caloriesfor good health, but not so many that you gain weight.

A healthy eating plan also will lower your risk for heart disease and other conditions. A planlow in total, saturated, and trans fat; cholesterol; and sodium (salt) will help to lower your riskfor heart disease. Cutting down on fats and added sugars also can help you eat fewer caloriesand lose weight. Healthful foods include:

Fat-free and low-fat milk and milk products such as low-fat yogurt, cheese,and milk.

Lean meat, fish, poultry, cooked beans, and peas.

Whole grain foods such as whole wheat bread, oatmeal, and brown rice.Other grain foods like pasta, cereal, bagels, bread, tortillas, couscous, andcrackers.


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Fruits, which can be canned (in juice or water), fresh, frozen, or dried.

Vegetables, which can be canned (without salt), fresh, frozen, or dried.

Canola or olive oils and soft margarines made from these oils are heart healthy. They shouldbe used in small amounts because theyre high in calories. Unsalted nuts, like walnuts andalmonds, also can be built into a healthful diet as long as you watch the amount you eat,

because nuts are high in calories.

The National Heart, Lung, and Blood Institutes Aim for a Healthy Weight patient bookletprovides more information on following a healthy eating plan.

Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise bloodcholesterol levels and also may be high in calories. These fats raise the risk of heart disease,so they should be limited.

Saturated fat is found mainly in:

Fatty cuts of meat such as ground beef, sausage, and processed meatssuch as bologna, hot dogs, and deli meats

Poultry with the skin High-fat milk and milk products like whole-milk cheeses, whole milk,

cream, butter, and ice cream

Lard, coconut, and palm oils found in many processed foods

Trans fat is found mainly in:

Foods with partially hydrogenated oils such as many hard margarines andshortening

Baked products and snack foods such as crackers, cookies, doughnuts, andbreads

Food fried in hydrogenated shortening such as french fries and chickenCholesterol is found mainly in:

Egg yolks

Organ meats such as liver

Shrimp

Whole milk or whole-milk products, including butter, cream, and cheese

Limiting foods and drinks with added sugars, like high-fructose corn syrup, is important.Added sugars will give you extra calories without nutrients like vitamins and minerals. Addedsugars are found in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet

drinks. Check the nutrition label on food packages for added sugars like high-fructose cornsyrup. Drinks with alcohol also will add calories, so it's a good idea to watch alcohol intake.

Portion size. A portion is the amount of food that you choose to eat for a meal or snack. It'sdifferent from a serving, which is a measured amount of food and is noted on the nutritionlabel on food packages.

Anyone who has eaten out lately is likely to notice how big the portions are. In fact, theyreoversized. These ever-larger portions have changed what we think of as normal.

Cutting back on portion size is a good way to help you eat fewer calories and balance yourenergy IN. To quiz yourself on how today's portions compare to those from 20 years ago, visitthe National Heart, Lung, and Blood Institute'sPortion Distortion Web pages.

Food weight. Studies have shown that we all tend to eat a constant weight of food. Ouncefor ounce, our food intake is fairly constant. Knowing this, you can lose weight if you eat
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foods that are lower in calories and fat for a given measure of food. For example, replacing afull-fat food product that weighs 2 ounces with one that's the same weight but lower in fathelps you cut back on calories. Another helpful practice is to eat foods that contain a lot ofwater like vegetables, fruits, and soups.

Physical Activity

Staying active and eating fewer calories will help you lose weight and keep the weight offover time. Physical activity also will benefit you in other ways. It will:

Lower the risk of heart disease, diabetes, and cancers (such as breast,uterus, and colon)

Strengthen your lungs and help them to work better

Strengthen your muscles and keep your joints in good condition

Slow bone loss

Give you more energy

Help you to relax and cope better with stress Allow you to fall asleep more quickly and sleep more soundly

Give you an enjoyable way to share time with friends and family

In general, adults should follow these guidelines in relation to physical activity.

For overall health and to lower the risk of disease, aim for at least 30minutes of moderate-intensity physical activity most days of the week.

To help manage body weight and prevent gradual weight gain, aim for 60minutes of moderate-to-vigorous intensity physical activity most days ofthe week.

To maintain weight loss, aim for at least 60 to 90 minutes of dailymoderate-intensity physical activity.

In general, children and teens should aim for at least 60 minutes of physical activity on most,if not all, days of the week.

Many people lead inactive lives and may not be motivated to do more physical activity. Somepeople may need help and supervision when they start a physical activity program to avoidinjury.

If you're obese, or if you haven't been active in the past, start physical activity slowly andbuild up the intensity a little at a time. When starting out, one way to be active is to do more"everyday" activities such as taking the stairs instead of the elevator and doing householdchores and yard work. The next step is to start walking, biking, or swimming at a slow pace,and then build up the amount of time you exercise or the intensity level of the activity.

To lose weight and gain better health, it's important to get moderate-intensity physicalactivity. Choose activities that you enjoy and that fit into your daily life. A daily, brisk walk isan easy way to be more active and improve your health. Use a pedometer to count your dailysteps and keep track of how much you're walking. Try to increase the number of steps youtake each day.

Other examples of moderate-intensity physical activity include dancing, bicycling, gardening,and swimming. For greater health benefits, try to step up your level of activity or the length oftime you're active. For example, start walking for 10 to 15 minutes three times a week, andthen build up to brisk walking for 60 minutes, 5 days a week. You also can break up the

amount of time that you're physically active into shorter amounts such as 15 minutes at atime.


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Behavioral Changes

Changing your behaviors or habits around food and physical activity is important for losingweight. The first step is to understand the things that lead you to overeat or have an inactivelifestyle. The next step is to change these habits.

The list below gives you some simple tips to help build healthier habits.Change your surroundings. You may be more likely to overeat when watching TV, whentreats are available in the office break room, or when you're with a certain friend. You alsomay not be motivated to take the exercise class you signed up for. But you can change thesehabits.

Instead of watching TV, dance to music in your living room or go for a walk.

Leave the office break room right after you get a cup of coffee.

Bring a change of clothes to work. Head straight to the exercise class onthe way home from work.

Put a note on your calendar to remind yourself to take a walk or go to your

activity class.

Keep a record. A record of your food intake and the amount of physical activity that you doeach day will help to inspire you. You also can keep track of your weight. For example, whenthe record shows that you've been meeting your goal to be more active, you'll want to keep itup. A record is also an easy way to track how you're doing, especially if you're working with aregistered dietitian or nutritionist.

Seek support. Ask for help or encouragement from your friends, family, and health careprovider. You can get support in person, through e-mail, or by talking on the phone. You alsocan join a support group.

Reward success. Reward your success for meeting your weight loss goals or other

achievements with something you would like to do, not with food. Choose rewards that you'llenjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time.

Weight Loss Medicines

Weight loss medicines approved by the Food and Drug Administration (FDA) may be anoption for some people. If you're not successful at losing 1 pound a week after 6 months ofusing lifestyle changes, medicines may help. These medicines should be used only as part of a

program that includes diet, physical activity, and behavioral changes.

Weight loss medicines may be suitable for adults who are obese (a BMI of 30 or greater).People who have BMIs of 27 or greater and a risk for heart disease and other health

conditions also may benefit from medicines.The FDA has approved two prescription weight loss medicines for long-term use: sibutramine(Meridia) and orlistat (Xenical). These medicines cause a weight loss between 4 and 22

pounds, although some people lose more weight. Most of the weight loss occurs within thefirst 6 months of taking the medicine.

Sibutramine (Meridia). This medicine sends signals to your brain to curbyour appetite. Sibutramine raises blood pressure and pulse. You shouldn'ttake it if you have high blood pressure or a history of heart disease orstroke.

Orlistat (Xenical). This medicine reduces the absorption of fats, fat calories,and vitamins A, D, E, and K by the body. Orlistat can result in mild sideeffects such as oily and loose stools.
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The FDA also has approved Alli, an over-the-counter weight loss aid for adults. Alli is thelower dose form of orlistat. It's meant to be used along with a reduced-calorie, low-fat dietand physical activity. In studies, most people taking Alli lost 5 to 10 pounds over 6 months.

Like orlistat, Alli reduces the absorption of fats, fat calories, and vitamins A, D, E, and K topromote weight loss. It also has similar side effects to orlistat. If you're taking orlistat or Alli,

you should take a multivitamin at bedtime due to the possible loss of some vitamins. You alsoshould talk to your doctor before starting Alli if you're taking blood-thinning medicines or

being treated for diabetes or thyroid disease.

Combined with healthy eating and physical activity, these medicines can help people loseweight. If you think you would benefit from the prescription medicines, sibutramine ororlistat, talk to your doctor. People taking these medicines need regular checkups with theirdoctors, especially in the first year after starting the medicine. During checkups, your doctorwill check your weight, blood pressure, and pulse and order laboratory tests. He or she alsowill discuss any medicine side effects and answer your questions.

Other Medicines

Some prescription medicines are used to treat weight loss, but aren't FDA-approved fortreating obesity. They include:

Drugs to treat depression. Some medicines for depression cause an initialweight loss and then a regain of weight while taking the medicine.

Drugs to treat seizures. Two drugs used for seizures, topiramate andzonisamide, have been shown to cause weight loss. These drugs are beingstudied to see whether they will be useful in treating obesity.

Drugs to treat diabetes. Metformin may cause small amounts of weightloss in people with obesity and diabetes. It's not known how this drugcauses weight loss, but it has been shown to reduce hunger and food

intake.

Over-the-Counter Products

Over-the-counter (OTC) products often claim that a person taking them will lose weight. TheFDA doesn't regulate these products because they're considered dietary supplements, notmedicines. However, many of these products have serious side effects and aren't generallyrecommended. A few OTC products include:

Ephedra (also called ma-huang). Ephedra comes from plants and has beensold as a dietary supplement. The active ingredient in the plant is calledephedrine. Ephedra can cause short-term weight loss. It also has seriousside effects. It causes high blood pressure and stresses the heart. In fact,because ephedra poses a serious health risk, the FDA has advised peopleto stop using dietary supplements that contain it.

Chromium. This is a mineral that's sold as a dietary supplement to reducebody fat. While studies haven't found any weight loss benefit fromchromium, there are few serious side effects from taking it.

Diuretics and herbal laxatives. These products cause you to lose waterweight, not fat. They also can lower your body's potassium levels, whichmay cause heart and muscle problems.

Hoodia. Hoodia is a cactus that is native to Africa. It's sold in pill form as anappetite suppressant. However, there is no firm evidence that hoodia

works. No large-scale research has been done on humans to show whetherhoodia is effective or safe.


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Weight Loss Surgery

Weight loss surgery may be an option for people with extreme obesity (BMI of 40 or greater)when other treatments have failed. It's also an option for people with a BMI of 35 or greaterwho have life-threatening conditions such as:

Severe sleep apnea (a condition in which your breathing stops or gets veryshallow while you're sleeping)

Obesity-related cardiomyopathy (diseases of the heart muscle)

Severe type 2 diabetes

Two common weight loss surgeries include:

Banded gastroplasty. For this surgery, a band or staples are used to createa small pouch at the top of your stomach. This surgery limits the amountof food and liquids the stomach can hold.

Roux-en-Y gastric bypass. For this surgery, a small stomach pouch iscreated with a bypass around part of the small intestine where most of the

calories you eat are absorbed. This surgery limits food intake and reducesthe calories your body absorbs.

Weight loss surgery can improve your health and weight. However, the surgery can be riskydepending on your overall health. There are few long-term side effects with gastroplasty;however, you must limit your food intake dramatically. Roux-en-Y gastric bypass has moreside effects. These include nausea, bloating, diarrhea, and faintness (which are all part of acondition called dumping syndrome). After Roux-en-Y gastric bypass, multivitamins andminerals may be needed to prevent nutrient deficiencies.

Lifelong medical followup is needed after both surgeries. A monitoring program both beforeand after surgery also is advised to help you with diet, physical activity, and coping skills.

If you think you would benefit from weight loss surgery, talk to your doctor. Ask whetheryou're a candidate for the surgery and discuss the risks, benefits, and what to expect.

Weight Loss Maintenance

Maintaining your weight loss over time can be a challenge. For adults, weight loss is asuccess if you lose at least 10 percent of your initial weight and you don't regain more than 6or 7 pounds in 2 years. You also must keep a lower waist circumferenceat least 2 incheslower than your waist circumference before you lost weight.

After 6 months of keeping off the weight, you can think about losing more if:

You've already lost 5 to 10 percent of your body weight

You're still overweight or obese

The key to further weight loss or to maintain your weight loss is to continue with lifestylechanges. Adopt these changes as a new way of life. However, if you want to lose moreweight, you may need to eat fewer calories and increase your activity level. For example, ifyou eat 1,600 calories a day but don't lose weight, you may want to cut back to 1,200 calories.

Adults should aim for 60 to 90 minutes of daily moderate-intensity physical activity. Childrenand teens should aim for 60 minutes of physical activity a day.

How Can Overweight and Obesity Be

Prevented?
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Staying at a healthy weight and preventing overweight and obesity can be achieved throughliving a healthy lifestyle. Because lifetime habits begin in childhood, its important for parentsand families to create habits that encourage healthy food choices and physical activity early inlife.

Follow a healthy eating plan. Make healthful food choices, keep your and your

familys calorie needs in mind, and focus on the balance of energy IN and energyOUT.

Focus on portion size. Watch the size of portions in fast food and other restaurants.The portions served are often enough for two or three people. Childrens portion sizesshould be smaller than those for adults. Cutting back on portion size is a sure way tohelp keep energy IN and energy OUT in balance.

Be active. Make personal and family time active. Find activities that everyone willenjoy. For example, go for a brisk walk, bike or rollerblade, or train together for awalk or run.

Reduce screen time. Limit the use of TVs, computers, DVDs, and video games,

because they crowd out time for physical activity. Health experts recommend 2 hoursor less a day of screen time thats not work- or homework-related.

Keep track of weight and other measurements. Monitor your weight, body mass index,and waist circumference on a regular basis. Also, keep track of your childrensgrowth.

Four Institutes (led by the National Heart, Lung, and Blood Institute) from the NationalInstitutes of Health have come together to promote We Can!Ways to Enhance ChildrensActivity & Nutrition. We Can! is a national education program designed for parents andcaregivers to help children 8 to 13 years old stay at a healthy weight.

The evidence-based program offers parents and families tips and fun activities to encourage

healthy eating, increase physical activity, and reduce time spent being inactive. Currently,more than 140 communities around the country are participating in We Can! programs for

parents and youth. These community groups include hospitals, health departments, clinics,faith-based organizations, YMCAs, schools, and more.

Key Points The terms overweight and obesity refer to a persons overall body weight and

where the extra weight comes from. Overweight is having extra body weight frommuscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.

Millions of Americans and people worldwide are overweight or obese.

Being overweight or obese puts you at risk for many diseases and conditions,including heart disease, high blood pressure, type 2 diabetes, gallbladder disease,

breathing problems, and certain cancers.
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A persons weight is the result of many factors, including environment, family historyand genetics, metabolism (the way your body changes food and oxygen into energy),

behavior or habits, and other factors.

For most people, overweight and obesity are caused by not having energy balance.The amount of calories you get from food and drinks is energy IN. The amount of

energy your body uses daily is energy OUT. To maintain a healthy weight, energy INand energy OUT should balance over time.

Overweight and obesity are calculated using the body mass index (BMI). BMI is anestimate of body fat and a good gauge of your risk for diseases that occur with more

body fat. Adults can calculate their BMI using the National Heart, Lung, and BloodInstitutes online calculator, or your health care provider can calculate your BMI.

Childrens BMI is calculated based on growth charts for their age and sex. This iscalled BMI-for-age percentile. For more information, go to the Centers for DiseaseControl and PreventionsBMI-for-age calculator.

Treatment for overweight and obesity includes lifestyle changes. These changes mean

cutting back on calories, following a healthy eating plan, being physically active, andmaking behavioral changes.

When lifestyle changes arent enough, other treatment options for some people areweight loss medicines and surgery.

To manage weight and prevent unhealthy weight gain, adults should aim for 60minutes of moderate-to-vigorous intensity physical activity most days of the week. Tokeep up weight loss, aim for 60 to 90 minutes of daily moderate-intensity physicalactivity.

Children and teens should strive for 60 minutes of physical activity a day.

Overweight and obesity in children and teens can be prevented with healthy foodchoices and more physical activity. Parents and families should create habits thatencourage healthful food choices and physical activity early in a childs life.
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