Managing obesity and your health

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health.


People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight. Some East Asian countries use lower values. Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility. A few cases are caused primarily by genes, endocrine disorders, medications, or mental illness. Evidence to support the view that obese people eat little yet gain weight due to a slow metabolism is not generally supported. On average, obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an
increased body mass.

Obesity is mostly preventable through a combination of social changes and personal choices. Changes to diet and exercising are the main treatments. Diet quality can be improved by reducing the consumption of energy-dense foods, such as those high in fat and sugars, and by increasing the intake of dietary fiber. Medications may be taken, along with a suitable diet, to reduce appetite or decrease fat absorption. If diet, exercise, and medication are not effective, a gastric balloon or surgery may be performed to reduce stomach volume or bowel length, leading to feeling full earlier or a reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. In 2014, 600 million adults (13%) and 42 million children under the age of five were obese. Obesity is more common in women than men. Authorities view it as one of the most serious public health problems of the 21st century.

Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was seen as a symbol of wealth and fertility at other times in history and still is in some parts of the world. In 2013, the American Medical Association classified obesity as a disease.

What Are the Health Risks of Overweight and Obesity?

Being overweight or obese isn’t a cosmetic problem. These conditions
greatly raise your risk for other health problems.

Overweight and Obesity-Related Health Problems in Adults



Coronary Heart Disease

As your body mass index rises, so does your risk for coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle. This can cause angina (an-JI-nuh or AN-juh-nuh) or a heart attack. (Angina is chest pain or discomfort.)

Obesity also can lead to heart failure. This is a serious condition in which your heart can’t pump enough blood to meet your body’s needs.

High Blood Pressure

Blood pressure is the force of blood pushing against the walls of thearteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Your chances of having high blood pressure are greater if you’re overweight or obese.

Stroke

Being overweight or obese can lead to a buildup of plaque in your arteries. Eventually, an area of plaque can rupture, causing a blood clot to form.

If the clot is close to your brain, it can block the flow of blood and oxygen to your brain and cause a stroke. The risk of having a stroke rises as BMI increases.

Type 2 Diabetes

Diabetes is a disease in which the body’s blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.

In type 2 diabetes, the body’s cells don’t use insulin properly. At first, the body reacts by making more insulin. Over time, however, the body can’t make enough insulin to control its blood sugar level.

Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and blindness. Most people who have type 2 diabetes are overweight.

Abnormal Blood Fats

If you’re overweight or obese, you’re at increased risk of having abnormal levels of blood fats. These include high levels of triglycerides and LDL (“bad”) cholesterol and low levels of HDL (“good”)
cholesterol. Abnormal levels of these blood fats are a risk factor for CHD.

Metabolic Syndrome

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.

You can develop any one of these risk factors by itself, but they tend to occur together. A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors:


A large waistline. This is called abdominal obesity or “having an apple shape.” Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips.
A higher than normal triglyceride level (or you’re on medicine to treat high triglycerides).
A lower than normal HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol).
Higher than normal blood pressure (or you’re on medicine to treat high blood pressure).
Higher than normal fasting blood sugar (or you’re on medicine to treat diabetes).

Cancer

Being overweight or obese raises your risk for colon, breast, endometrial, and gallbladder cancers.

Osteoarthritis

Osteoarthritis is a common joint problem of the knees, hips, and lower back. The condition occurs if the tissue that protects the joints wears away. Extra weight can put more pressure and wear on joints, causing pain.

Sleep Apnea

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

A person who has sleep apnea may have more fat stored around the neck. This can narrow the airway, making it hard to breathe.

Obesity Hypoventilation Syndrome

Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some obese people. In OHS, poor breathing results in too much carbon dioxide (hypoventilation) and too little oxygen in the blood (hypoxemia). OHS can lead to serious health problems and may even cause death.

Reproductive Problems

Obesity can cause menstrual issues and infertility in women.

Gallstones

Gallstones are hard pieces of stone-like material that form in the gallbladder. They’re mostly made of cholesterol. Gallstones can cause stomach or back pain.

People who are overweight or obese are at increased risk of having gallstones. Also, being overweight may result in an enlarged gallbladder that doesn’t work well.

Overweight and Obesity-Related Health Problems in Children and Teens

Overweight and obesity also increase the health risks for children and
teens. Type 2 diabetes once was rare in American children, but an
increasing number of children are developing the disease.