With a third of Americans classified as obese, this pressing health concern requires diligent eating and exercise habits as well as careful medical attention.
According to the Cleveland Clinic, more than 300,000 deaths each year are linked to obesity, which is defined as weighing at least 100 pounds more than your ideal weight or having a body mass index (BMI) of 35 or higher. BMI is calculated using height and weight measurements.
In simple terms, obesity is caused by eating many more calories than you use, leading to the accumulation of extra fat. Usually, however, becoming overweight is not a simple process and has many potential causes, including illnesses or medications that can trigger weight gain.
Many obese people can trace their condition to external cues that make it easy to overeat and difficult for them to burn enough calories each day. According to the National Institutes of Health, these include:
- Oversized food portions served in restaurants and encouraged by advertising
- Sedentary activities such as computer and TV use
- Deskbound jobs
- Overuse of conveniences such as cars
- Lack of recreational facilities such as gyms, parks or trails
Family history and genetics also have a strong influence on an individual’s weight and body type. But certain health conditions also can lead to weight gain, including:
- Hypothyroidism, an underactive thyroid gland that slows metabolism and causes fatigue and weakness.
- PCOS, or polycystic ovarian syndrome, which affects up to 10 percent of women of childbearing age and can also lead to excess body hair and reproductive problems.
- Cushing’s syndrome, which stems from an overproduction of the hormone cortisol by the adrenal glands and is characterized by weight gain in the upper body, face and neck.
Additionally, some medications slow calorie burn, increase appetite or cause water retention, all of which can lead to extra pounds. These include certain antidepressants, seizure medications and corticosteroids.
Obesity is a pressing health concern because it often triggers the development of other serious medical conditions. According to the Mayo Clinic, these include:
- Cancer, especially in the breast, colon, ovaries and prostate
- Heart disease or stroke
- Sleep apnea
- Type 2 diabetes
- High blood pressure
- Infertility or irregular periods
Extreme obesity, defined as having a BMI of 40 or above, is referred to as morbid obesity because it often leads to death.
Eating Habits & Fitness Options
Most people understand that eating healthy foods and engaging in regular exercise will help them achieve a healthy weight. For obese people, however, these ideals can be difficult to accomplish. Diets often fail because the dieter reverts to previous eating habits afterward, and experts advise small, steady lifestyle changes whose results will endure long-term.
The U.S. Centers for Disease Control encourages keeping a list of daily food habits, including what you eat and how quickly. It also promotes reviewing the cues that trigger excess eating, such as boredom, emotional distress and easily accessible sweets and junk food. Simple changes such as eating more slowly, putting your fork down between bites, drinking more water and planning healthy meals ahead can add up to many calories saved over the course of a day.
Similarly, steady increases in physical activity can lead to a long-term lifestyle change that promotes calorie burn. Rather than embarking on an intimidating fitness program after many years of inactivity, slowly increase your metabolism with daily walks, a family bike ride or dancing. According to the Cleveland Clinic, several short bursts of activity during the day are just as effective as one longer one.
Treatment & Care
For the very obese, diet and exercise changes may not be enough to address the problem. Morbidly obese people and those with BMIs of 35 with related health complications may want to consider bariatric surgery or medical obesity treatments.
In 2009, more than 220,000 Americans underwent bariatric surgery, which prompts weight loss by limiting food intake and/or interfering with the absorption of calories. This surgery costs about $20,000, according to the American Society for Metabolic and Bariatric Surgery.
Possible complications from bariatric surgery may be severe or even life-threatening, the ASMBS says, but it is the most successful, longest-lasting treatment and may even help reverse obesity-related conditions such as diabetes, high blood pressure and sleep apnea.
Other treatment options include certain prescription and over-the-counter medications that curb appetite, such as phentermine and sibutramine, but the drugs can cause side effects such as higher heart rates and blood pressure, according to the NIH. Orlistat, known as Xenical, is a pill that partially blocks the absorption of fat, but may cause side effects such as cramping, diarrhea or greasy stool.