Overweight in Adults
(Obesity; Morbid Obesity)
Overweight is a body weight that is above an ideal range. Extra weight can increase the risk of some health problems such as heart disease, certain cancers, and diabetes.
One tool used to check weight range is the body mass index (BMI). This scale creates weight ranges based on height. BMI levels in adults include:
- Ideal weight range: 18.5-24.9
- Overweight: 25-29.9
- Obese: 30 or above
- Morbid obesity: 40 or above
Overweight is caused by taking in more calories than are used. Calories are taken in through food. Physical activity and basic body functions use calories. If more calories are eaten than used, then weight gain will happen.
Things that can influence obesity include:
- Genetics and family history
- Race, ethnicity, and culture
Things that may raise the chance of becoming overweight include:
- Personal history of obesity as a child
- Family history of obesity
- Eating large portions of food
- Sedentary lifestyle—getting too little exercise and spending too much time in front of a television or computer
- Eating until full and eating quickly
- High level of fast food intake
- High alcohol consumption
- Working varied shifts
- Not getting enough sleep
- Medicines such as corticosteroids, antidepressants, or antipsychotics
- Medical conditions such as:
Symptoms may include:
- Increased weight
- Thickness around the midsection
- Areas of fat deposits
Problems from Too Much Weight Gain
Having more weight than is ideal can put people at a higher risk of:
- Early death
- Heart disease and stroke
- Type 2 diabetes
- High blood pressure
- High cholesterol and high triglycerides in the blood
- Gastroesophageal reflux disease (GERD)
- Increased risk of several cancers such as:
- Death from cancer
- Blood clots
- Liver disease, including liver cancer
- Gallstones and gallbladder cancer
- Pancreatitis and pancreatic cancer
Decrease in quality of life linked to:
Being overweight can also affect pregnancy. Some problems that can happen include:
The doctor will ask about symptoms and past health. A physical exam will be done. Obesity is diagnosed by a visual exam and body measurements using:
- Height and weight tables
- Body mass index
- Measuring body folds with a caliper
- Measuring waist circumference
- Water-displacement tests
Obesity can be hard to treat. Things that affect treatment are:
- Cultural factors
- Personal habits and behavior
There are many different options to treating obesity. A mix of treatments may be most successful. It should include changes in diet, activity, counseling, or medicine.
People may need to try different diets before seeing results. Diets may be designed by:
- Registered dietitians—talk to the doctor about a referral
- Internet- or commercial-based groups such as Weight Watchers or Atkins
Different steps may help. This may include avoiding certain types of foods. In general, the focus will be on eating more:
- Fruits and vegetables
- Whole grains
At the same time eating fewer:
- Saturated fats
- Refined carbohydrates—white breads, pasta, or rice
- Processed foods
Work with the doctor to find a plan that works best.
The key to weight loss is to reduce the total number of calories that are eaten. Following a specific kind of diet, like a low-carb diet, is not always needed. What matters is a person chooses a low calorie diet that they can stick with.
Portion, or serving size, also plays a major role. Learning how to read nutrition labels may help change portion sizes. Nutrition labels tell how much of a food is a single serving. Other nutrition information on the label is often based on one serving.
Keeping track of everything taken in during a day can help. There are several tracking apps for phones or tablets that make this much easier.
Ask the doctor about an exercise program. Even moderate intensity exercise, like brisk walking, can help with weight loss.
There are many easy ways to add extra activity into the day. Take stairs instead of elevators. Park the car a little farther away. Limit the amount of time spent watching television. Decrease computer time and substitute it with activity.
There are many tools to help track and measure activity. This includes counting the number of steps during the day. Many of these tools can connect to apps on phones or tablets.
Poor sleep can raise the risk of weight gain. Fatigue may also make people want to eat more and move less. Making small changes to the routine will help improve sleep:
- Get on a regular sleep schedule. Go to bed and get up around the same time every day. Do this even on days off.
- Reduce noise, temperature, and light in the bedroom.
- Avoid caffeine, nicotine, and alcohol before bed.
- Eat a light dinner and avoid heavy evening meals.
- Create a relaxing routine before bed. Try taking a warm bath or reading a book.
Sleep apnea interferes with sleep. People who snore loudly or stop breathing during the night should talk to their doctor about getting a sleep test. Sleep apnea is treatable and it will improve overall health.
Behavior therapy may help people understand:
- When they tend to overeat
- Why they tend to overeat
- How to combat overeating habits
When added to diet and exercise, therapy can help with weight reduction.
Weight Loss Programs
Weight loss programs may work for some people. A partner or group may also help people improve eating habits and fitness.
Weight loss medicine may be prescribed. Medicine alone is not enough to lose weight and keep it off. Some medicine can have serious side effects.
There are also risks linked to over the counter medicine and herbal products. Talk to the doctor before taking any of these.
Bariatric surgery makes the stomach smaller. For some the digestive tract may be rearranged. The smaller stomach can only hold a tiny portion of food at a time. Examples of procedures include:
These procedures may be a good option for people who are severely obese. It may also be advised for people who are having trouble losing weight by other means.
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This option uses a balloon type tool. This balloon fills up the stomach to create a feeling of fullness. The device is inserted into the mouth and passed to the stomach. The device is removed six months after it is placed. Talk to the doctor for more information about this procedure.
Losing weight can be hard. It is best to avoid weight gain. To reduce the chances of gaining too much weight people can:
- Keep track of their weight.
- Talk to the doctor or a dietitian about their daily calorie needs.
- Learn to eat smaller portions of food.
- Limit the amount of time spent doing sedentary activities. This includes watching TV or using the computer.
Talk to the doctor or an exercise professional about adding activity into daily life.
- Body mass index (BMI calculator). American Heart Association website. Available at: http://www.heart.org/HEARTORG/HealthyLiving/WeightManagement/BodyMassIndex/Body-Mass-Index-BMI-Calculator_UCM_307849_Article.jsp#.WrUYzS7wZQJ.
- Complications of obesity. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/complications-of-obesity.
- Diets for weight loss. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/diets-for-weight-loss.
- Dietary guidelines for Americans 2015-2020. US Department of Health and Human Services website. Available at: https://health.gov/dietaryguidelines/2015/guidelines.
- Obesity, bias, and stigmatization. Obesity Society website. Available at: http://www.obesity.org/obesity/resources/facts-about-obesity/bias-stigmatization.
- Obesity in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/obesity-in-adults.
- Physical activity for weight loss. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/physical-activity-for-weight-loss-18.
- Understanding adult overweight & obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity.
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