Obesity is defined as having an excessive amount of body fat. Obesity is more than just a cosmetic concern, though. It increases your risk of diseases and health problems such as heart disease, diabetes and high blood pressure.
Doctors often use a formula based on your height and weight — called the body mass index (BMI) — to determine if you are obese.
Being extremely obese means you are especially likely to have health problems related to your weight.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity.
The primary symptom of obesity is having a body mass index (BMI) of 30 or higher. Your body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.
Because BMI doesn't directly measure body fat, some people, such as muscular athletes, may have a BMI in the obese category even though they don't have excess body fat.
When to see a doctor
Although there are genetic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, including:
Obesity occurs when you eat and drink more calories than you burn through exercise and normal daily activities. Your body stores these extra calories as fat. Obesity usually results from a combination of causes and contributing factors, including:
Even if you have one or more of these risk factors, it doesn't mean that you're destined to become obese. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.
If you're obese, you're more likely to develop a number of potentially serious health problems, including:
Quality of life
Other weight-related issues that may affect your quality of life include:
Preparing for your appointment
Talking to your doctor openly and honestly about your weight is one of the best things you can do for your health. You're likely to start by seeing your primary care doctor. In some cases, you may be referred to an obesity specialist — if one is available in your area. You may also be referred to a mental health provider, dietitian or nutrition specialist.
What you can do
In addition to your prepared questions, don't hesitate to ask questions during your appointment.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
If your doctor believes you are overweight or obese, he or she will typically review your health history in detail, perform a physical exam and recommend some tests.
These exams and tests generally include:
Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you have. And this will shape what treatment options are right for you.
Treatments and drugs
The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits.
You can start feeling better and seeing improvements in your health with just modest weight loss — 5 to 10 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9.1 kg) to start seeing benefits.
The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Treatment methods include:
Losing weight is usually done by making changes in your lifestyle — dietary changes, increased activity and behavior change. Prescription medication or weight-loss surgery is typically used in addition to lifestyle changes in more serious cases.
Dietary ways to overcome obesity include:
Be wary of quick fixes
To boost your activity level:
Behavior modification, sometimes called behavior therapy, can include:
Prescription weight-loss medication
Your doctor may recommend weight-loss medication if:
Orlistat (Xenical) is a weight-loss medication that has been approved by the Food and Drug Administration for long-term weight loss. This medication blocks the digestion and absorption of fat in your stomach and intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is only about 5 to 7 pounds (2.5 to 3.2 kilograms) more than you can get from diet and exercise after one or two years of taking the medication.
Side effects associated with orlistat include oily and frequent bowel movements, bowel urgency, and flatulence with discharge. These side effects can be minimized as you reduce fat in your diet. Because orlistat blocks absorption of some nutrients, take a multivitamin while taking orlistat to prevent nutritional deficiencies.
The FDA has approved orlistat for use in adults, children and adolescents. The FDA also has approved a reduced-strength version of orlistat (Alli) to be sold over-the-counter, without a prescription. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
You need close medical monitoring while taking a prescription weight-loss medication. Also, keep in mind that a weight-loss medication may not work for everyone. If the medication does work, its effects tend to level off after six months of use like any other method of weight loss. You may need to take a weight-loss medication indefinitely. When you stop taking a weight-loss medication, you're likely to regain much or all of the weight you lost.
Phentermine is a weight-loss medication that was approved in the 1970s only for short-term (three months) use. Using weight-loss medications short-term does not usually lead to long-term weight loss. While some health care providers prescribe phentermine long-term, there are few studies that have evaluated its safety and weight-loss results long term.
Weight-loss surgery for obesity may be considered if:
Weight-loss surgery can often help you lose as much as 50 percent or more of your excess body weight. But weight-loss surgery isn't a miracle obesity cure. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
There are numerous types of weight-loss surgery. Some types cause weight loss by restricting how much your stomach can hold. Others prevent your body from absorbing calories and nutrients. Others are a combination of these two types. Common weight-loss surgeries include:
Preventing weight regain after obesity treatment
One of the best ways to prevent regaining the weight you've lost is getting regular physical activity. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
You may always have to remain vigilant about your weight. Combining a healthier diet and more activity is the best way to lose weight and keep it off for the long term. If you take weight-loss medications, you'll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or eat foods laden with fat and calories.
Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.
Lifestyle and home remedies
Your effort to overcome obesity is more likely to be successful it you follow strategies at home in addition to your formal treatment plan. These can include:
Numerous dietary supplements that promise to help you shed weight quickly are available. But in almost all cases, the effectiveness and safety of these products are questionable. Talk to your doctor before taking any dietary supplements.
Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, don't have the same rigorous testing and labeling process as over-the-counter and prescription medications. Yet some of these substances, including products labeled as "natural," have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. Ingredients may not be standard, and they can cause unpredictable and harmful side effects. Dietary supplements can also cause dangerous interactions with prescription medications you take.
It's thought that acupuncture and hypnosis may complement other obesity treatments. Talk to your doctor if you're interested in adding acupuncture or hypnosis to your treatment.
Coping and support
Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts:
Whether you're at risk of becoming obese, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.
Last Updated: 2011-05-06
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