Obesity And Weight Loss
| Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. How many people in the United States are overweight or obese?Among U.S. women 20 years and older, over 64 million are overweight and over 34 million are obese. How do I know if I’m overweight or obese?Obesity is measured with a body mass index (BMI), a measure of body fat based on height and weight. Individuals with a BMI of 25 to 29.9 are considered overweight, while individuals with a BMI of 30 or more are considered obese. See the following table for an example.
Body Mass Index You can find out your BMI using the calculator at About BMI for Adults
Other methods of estimating body fat and body fat distribution include measurements of skinfold thickness and waist circumference, calculation of waist-to-hip circumference ratios, and techniques such as ultrasound, computed tomography, and magnetic resonance imaging (MRI).
What causes someone to become overweight or obese?See also Obesity and Genetics.An unhealthy diet and physical inactivity are contributing factors to becoming overweight or obese. Overweight and obesity are problems that continue to get worse in the United States. Bigger portion sizes, little time to exercise or cook healthy meals, and relying on cars to get around are just a few reasons for this increase. Along with being overweight or obese, the following conditions (or risk factors) will put you at greater risk for heart disease and other conditions:
Understanding Obesity: The Five Medical Causes (Your Personal Health)
What are the health effects of being overweight or obese?BMI is just one indicator of potential health risks associated with being overweight or obese. For assessing someone's likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:
An unhealthy diet and physical inactivity can increase your chances of getting heart disease, cancer, stroke, type 2 diabetes, high blood pressure, breathing problems, arthritis, gallbladder disease, and osteoarthritis.
Women with a “pear” shape tend to store fat in their hips and buttocks. Women with an “apple” shape store fat around their waists. For most women, carrying extra weight around their waists (larger than 35 inches) raises health risks like heart disease, diabetes, or cancer more than carrying extra weight around the hips or thighs. For men waist size greater than 40 inches increases health risks. Obesity can also affect medical care. Too much fat can obscure imaging tests, like X-rays, CT scans, ultrasound, and magnetic resonance imaging (MRI). For example, in an ultrasound, the beam may not be able get through layers of fat to get an image of a person’s appendix, gallbladder, or kidneys. Too much body fat can make it harder for a doctor to make a medical diagnosis and treat a patient. Fat - What No One Is Telling You (DVD)Health Matters: What You Need to Know About Cancer, Heart Disease, Depression, and Obesity (DVD) Arriva Travel-Tec Travel Legwear with Smart Compression Technology Support Plus Obesity Support Belt - 65"-75"
Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risks
* Disease risk for type 2 diabetes,
hypertension, and CVD. How do I find out what the best way is for me to lose weight?Changing the way you approach weight loss can help you be more successful at weight management. Most people who are trying to lose weight focus on just the goal of weight loss. However, setting the right goals and focusing on lifestyle changes such as following a healthy eating plan, watching portion sizes, being physically active, and reducing sedentary time are much more effective.
If you’re interested in a weight-loss program, it should encourage healthy behaviors that help you lose weight that you can maintain over time. Before you start a weight-loss program, talk to your doctor. The 17 Day Diet: A Doctor's Plan Designed for Rapid Results Safe and effective weight-loss programs should include these components:
Guide to Behavior Change
Your Weight Is ImportantOver the past few years it has become clear that weight is an important health issue. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health care encounters in which they felt blamed, but not helped. Successful weight management is a long-term challenge. Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who carry the excess weight. The amount of weight loss needed to improve your health may be much less than you wish to lose, when you consider how you evaluate your weight. Research has shown that your health can be greatly improved by a loss of 5–10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5–10 percent of your starting weight is both realistic and valuable.
Behaviors That Will Help You Lose Weight and Maintain ItSet the Right Goals: Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and physical activity changes that will lead to long-term weight change. Successful weight managers are those who select two or three goals at a time that are manageable. Useful goals should be (1) specific; (2) attainable (doable); and (3) forgiving (less than perfect). "Exercise more" is a great goal, but it's not specific. "Walk 5 miles every day" is specific and measurable, but is it doable if you're just starting out? "Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, 5 days each week" is specific, doable, and forgiving. In short, a great goal!
Nothing Succeeds Like SuccessShaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: (1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and (2) consecutive rewards keep the overall effort invigorated.
Reward Success (But Not With Food)An effective reward is something that is desirable, timely, and dependent on meeting your goal. The rewards you choose may be material (e.g., a movie or music CD, or a payment toward buying a more costly item) or an act of self-kindness (e.g., an afternoon off from work or just an hour of quiet time away from family). Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort.
Balance Your Food Checkbook"Self-monitoring" refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, amount of physical activity, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually moves you closer to the desired direction and can produce "real-time" records for review by you and your health care provider. For example, keeping a record of your physical activity can let you and your provider know quickly how you're doing. When the record shows that your activity is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system. While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change from day to day, and water changes are often the result of things that have nothing to do with your weight-management efforts.
Avoid a Chain ReactionStimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to change the situation, such as by separating the association of eating from the cue (don't eat while watching television), avoiding or eliminating the cue (leave the coffee room immediately after pouring coffee), or changing the circumstances surrounding the cue (plan to meet your friend in a nonfood setting). In general, visible and reachable food items are often cues for unplanned eating.
Get the Fullness MessageChanging the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message that you've been fed. Eating slowly will help you feel satisfied. Eating lots of vegetables and fruits can make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear too small. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.
What steps can I take to have a healthier diet?To lose weight, it's important to make lifestyle changes with a focus on reducing calories from food and beverages, a healthy eating plan, and portion control. Over time, these changes will become part of your everyday routine.You can use the American Dietetic Association food exchange lists to check out serving sizes for each group of foods and to see what other food choices are available for each group of foods. Follow these tips on healthy eating.
CaloriesTo lose weight, most people need to reduce the number of calories they get from food and beverages (energy IN) and increase their physical activity (energy OUT). For a weight loss of 1–2 pounds per week, daily intake should be reduced by 500 to 1,000 calories. In general:
If you eat 1,600 calories a day but do not lose weight, then you may want to cut back to 1,200 calories. If you are hungry on either diet, then you may want to boost your calories by 100 to 200 per day. Very low calorie diets of fewer than 800 calories per day should not be used unless you are being monitored by your doctor.
How can physical activity help?An active lifestyle can help every woman. You don’t have to be as fit as a professional athlete to benefit from physical activity. In fact, 30 minutes of moderate physical activity on most days of the week can greatly improve your health. Most people can get greater health benefits by engaging in physical activity of more vigorous intensity or longer duration.Click here for a comprehensive fitness fundamentals article. To help manage body weight and prevent gradual, unhealthy body weight gain, get about 60 minutes of moderate- to vigorous-intensity activity on most days of the week, while not exceeding caloric intake requirements. To keep weight loss off, get at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with their doctor before participating in this level of activity. Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance. Physical activity has these benefits:
Increase your physical activity by taking
Selecting a Weight-Loss ProgramCheck It Out: Before You Sign Up for Any Weight-Loss ProgramSome people lose weight on their own; others like the support of a structured program. Overweight people who are successful at losing weight, and keeping it off, can reduce their risk factors for heart disease. If you decide to join any kind of weight-control program, here are some questions to ask before you join.
Does the program provide counseling to help you change your eating activity and personal habits?The program should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical activity, that have contributed to weight gain.
Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?You need to be evaluated by a physician if you have any health problems, are currently taking any medicine or plan on taking any medicine, or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet (a special liquid formula that replaces all food for 1 to 4 months), an exam and followup visits by a doctor also are needed.
Is training available on how to deal with times when you may feel stressed and slip back to old habits?The program should provide long-term strategies to deal with weight problems you may have in the future. These strategies might include things like setting up a support system and establishing a physical activity routine.
Is attention paid to keeping the weight off? How long is this phase?Choose a program that teaches skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight gain.
Are food choices flexible and suitable? Are weight goals set by the client and the health professional?The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned. There are other questions you can ask about how well a weight-loss program works. Because many programs don't gather this information, you may not get answers. But it's still important to ask them:
Remember, quick weight loss methods don't provide lasting results. Weight-loss methods that rely on diet aids like drinks, prepackaged foods, or diet pills don't work in the long run. Whether you lose weight on your own or with a group, remember that the most important changes are long term. No matter how much weight you have to lose, modest goals and a slow course will increase your chances of both losing the weight and keeping it off.
What USDA-approved drugs are available for long-term treatment of obesity?Sibutramine. Also called Meridia, it is used together with a reduced-calorie diet to help you lose weight and keep the lost weight from returning. This medicine is approved for people whose initial body mass index (BMI) is at least 30. Patients with other risk factors, such as high blood pressure or diabetes, can be treated with the drug if their BMI is 27 or higher. It can cause an increase in pulse and blood pressure. While you are taking sibutramine, your doctor will check your blood pressure and heart rate at regular visits. People with uncontrolled high blood pressure should not take sibutramine. Other side effects include dry mouth, headache, constipation, insomnia, anxiety, irritability or unusual impatience, nervousness, stuffy or runny nose, or trouble in sleeping. Orlistat. Also called Xenical, it prevents the body from absorbing some of the fat in food. It also prevents the body from absorbing some vitamins and beta carotene. Patients should take a vitamin supplement that contains fat soluble (A, D, E, and K) vitamins and beta carotene. The most common side effects of orlistat are gas with discharge, fecal urgency, fatty/oily stools, and frequent bowel movements. Propolene-Clinically Proven Weightloss, 90ct
What surgical options are available for weight loss? Laparoscopic gastric banding (Lap-Band). An inflatable band is placed around the upper stomach to create a small pouch and narrow passage into the remainder of the stomach. This limits food consumption and creates an earlier feeling of fullness. Once the band is in place, it is inflated with saline. The band is adjusted over time by increasing or decreasing the amount of salt solution to change the size of the passage. The band is intended for severely obese people — those at least 100 pounds overweight or who are at least twice their ideal body weight — who have failed to lose weight by other methods such as a supervised diet and exercise. The band is intended to remain in place permanently, but it can be removed if necessary. People who get the band will need to diet and exercise in order to maintain their weight loss. Complications may include nausea and vomiting, heartburn, abdominal pain, band slippage, or pouch enlargement. Roux-en-Y gastric bypass (RGB). The surgeon makes the stomach smaller by using surgical staples to create a small stomach pouch. The pouch is attached to the middle part of a small intestine. Food bypasses the upper part of the small intestine and stomach and goes into the middle part of the small intestine through a small opening. Bypassing the stomach limits the amount of food a person can eat. By bypassing part of the intestine, the amount of calories and nutrients the body absorbs is reduced. The small opening slows down the rate food leaves the pouch. One risk for patients is "dumping syndrome." This happens when the stomach contents move too rapidly through the small intestine. Symptoms may include nausea, weakness, sweating, faintness, and diarrhea after eating. Side effects include infection, leaking, pulmonary embolism (sudden blockage in a lung artery), gallstones, and nutritional deficiency. Biliopancreatic diversion (BPD). This procedure is not commonly used in the United States. A large part of the stomach is removed. The amount of food is restricted, in addition to stomach acid production. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing other parts of the small intestine. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the colon. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed. This procedure is less frequently used than other types of surgery because of the high risk for nutritional deficiencies. A variation of BPD includes a "duodenal switch," which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum. Is liposuction a treatment for weight loss?Liposuction is a procedure for shaping the body and is not recommended for weight loss. It is a surgical procedure in which fat is removed from under the skin with the use of a vacuum-suction canula (a hollow pen-like instrument) or using an ultrasonic probe that breaks up the fat into small pieces and then removes it with suction. Persons with localized fat may decide to have liposuction to remove fat from that area. It doesn’t guarantee permanent weight loss. To avoid weight gain after liposuction, people need to eat right and be physically active. Complications from liposuction may include infection, embolism (fat gets trapped in the blood vessels, gathers in the lungs, or travels to the brain), puncturing of organs, seroma, pain or numbness, swelling, burns, skin problems, and reactions to the anesthesia. I am concerned about my children’s eating and exercise habits. How can I keep my children healthy?The things kids learn as children become more difficult to change as they get older. This is certainly true for their eating and physical activity habits. Many children today have a poor diet with little physical activity. They eat foods high in calories and saturated fat and don’t eat enough fruits and vegetables. They watch TV, play video games, or use the computer instead of being active. So kids are becoming overweight or obese and have a higher chance of becoming obese adults. Overweight children face health risks, like diabetes, gallstones, sleep apnea, and high blood pressure. Help your child become more active.
We know children do what they see — not always what they are told. Set a good example for your children. Your kids will learn to eat right and be active by watching you. Setting a good example can mean a lifetime of good habits for you and your kids. For more informationYou can find out more about obesity and weight loss by contacting the National Women's Health Information Center (NWHIC) at (800) 994-WOMAN or the following organizations: Agency for Healthcare Research and Quality (AHRQ), OPHS, HHS Federal Trade Commission (FTC) Food and Drug Administration (FDA), HHS Food and Nutrition Information Center, USDA National Heart, Lung, and Blood Institute Information Center (NHLBI) NIH, HHS Steps to a HealthierUS, HHS The President’s Council on Physical Fitness and Sports Weight Control Information Network, NIDDK, NIH, HHS American Heart Association American Obesity Association International Food Information Council | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
But body
weight
isn’t the only problem. The places where you store your body fat also affect your health. Measuring waist circumference helps screen for possible health risks that come with overweight and obesity. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.