Obesity

Do you weigh more than you should? If so, you’re like the two-thirds of American adults who are overweight. About one in three American adults is considered to be obese.

Obesity, in simple terms, is having a high proportion of body fat. Fat is important for storing energy and insulating your body, among other functions. The human body can handle carrying some extra fat, but beyond a certain point, body fat can begin to interfere with your health. For this reason, obesity is more than a cosmetic concern. Obesity puts you at greater risk of developing high blood pressure, diabetes and many other serious health problems.

The good news is that even modest weight loss can improve or prevent complications associated with obesity. Weight loss is usually possible through dietary changes, increased physical activity and behavior modification. For people who don’t respond to these lifestyle changes, other more involved obesity treatments are available to enhance weight loss. These include prescription medications and weight-loss surgery.

Although there are genetic and hormonal influences on body weight, ultimately excess weight is a result of an imbalance of calories consumed versus calories burned through physical activity. If you consume more calories than you expend through exercise and daily activities, you gain weight. Your body stores calories that you don’t need for energy as fat.

The following factors — usually working in combination — can contribute to weight gain and obesity.

• Diet. Regular consumption of high-calorie foods, such as fast foods, or increasing their portion sizes contributes to weight gain. High-fat foods are dense in calories. Loading up on soft drinks, candy and desserts also promotes weight gain. Foods and beverages like these are high in sugar and calories. In general, eating away from home also increases calorie intake.
• Inactivity. Sedentary people are more likely to gain weight because they don’t burn calories through physical activities.
• Quitting smoking. Smokers tend to gain weight after quitting. This weight gain may be partially due to nicotine’s ability to raise the rate at which your body burns calories (metabolic rate). When smokers stop, they burn fewer calories. Smoking also affects taste; quitting smoking makes food taste and smell better. Former smokers often gain weight because they eat more after they quit. However, cigarette smoking is still considered a greater threat to your health than is extra weight.
• Pregnancy. During pregnancy a woman’s weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
• Certain medications.Corticosteroids and tricyclic antidepressants, in particular, can lead to weight gain. So can some high blood pressure and antipsychotic medications.
• Medical problems.Uncommonly, obesity can be traced to a medical cause, such as low thyroid function or excess production of hormones by the adrenal glands (Cushing’s syndrome). A low metabolic rate is unlikely to cause obesity. In addition, it’s unclear whether polycystic ovarian syndrome contributes to obesity. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain.

• Genetics. Your genes may affect the amount of body fat you store and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercise. Your genetic makeup doesn’t guarantee that you’ll be obese, however.
• Family history. If one or both of your parents are obese, your chances of being obese are greater. This may be due to shared genes or to a shared environment, which may include high-calorie foods and inactivity.
• Age. As you get older, you tend to be less active. In addition, the amount of muscle in your body tends to decrease with age. This lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs. If you don’t decrease your caloric intake as you age, you’ll likely gain weight.
• Sex. Women are more likely to be obese than are men. Women have less muscle mass and tend to burn fewer calories at rest than men do.

How do you know whether you need to lose weight for medical reasons? Stepping on the scale only tells you your total weight — including bone, muscle and fluid — not how much of your weight is fat. The scale also doesn’t tell you where you’re carrying that fat. In determining health risks, both of these factors are more important than weight alone. Other pre-existing medical conditions, such as diabetes, also play a role in determining the health risks associated with too much body fat.

A threefold approach can help determine whether you need to lose weight for medical reasons. These include body mass index, waist measurement and personal medical history.

Dietary changes
Adopting a new eating style that promotes weight loss must include lowering your total calorie intake. One way you can lower your calorie intake is by eating more plant-based foods — fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without giving up taste or nutrition. Cutting back on calories is easier if you focus on limiting sugar and other refined carbohydrates and some types of fat.

Ask your doctor to help you determine your calorie goals to lose weight. He or she may recommend that you also work with a dietitian or a reputable weight-loss program.

Crash diets to reduce calories aren’t recommended because they can cut so many calories and nutrients that they lead to other health problems, such as vitamin deficiencies. Fasting isn’t the answer, either. Most of the weight you initially lose is from water, and it’s not good for your body to go without food for extended periods.

Very low calorie liquid diets are sometimes prescribed as an intervention for seriously obese people. These mainly liquid diets, such as Medifast or Optifast, provide about 800 calories a day — most adults consume roughly 2,000 to 2,500 calories a day. While people are usually able to lose weight on these very low calorie diets, most people regain the weight just as quickly when they stop following these diets.

Over-the-counter liquid meal replacements, such as Slim-Fast, also cut calories. These plans suggest that you replace one or two meals with their products — low-calorie shakes — then eat snacks of vegetables and fruits and a healthy, balanced third meal that is low in fat and calories. This can be as effective as a traditional calorie-controlled diet.

Increased physical activity
Cutting 250 calories from your daily diet can help you lose about half a pound a week: 3,500 calories equals 1 pound of fat. But add a 30-minute brisk walk four days a week, and you can double your rate of weight loss.

The goal of exercise for weight loss is to burn more calories, although exercise offers many other benefits as well. How many calories you burn depends on the frequency, duration and intensity of your activities. One of the best ways to lose body fat is through steady aerobic exercise — such as walking — for more than 30 minutes most days of the week.

Even though regularly scheduled aerobic exercise is most efficient for losing fat, any extra movement helps burn calories. Lifestyle activities may be easier to fit into your day. Think about ways you can increase your physical activity throughout the day. For example, make several trips up and down stairs instead of using the elevator, or park at the far end of the lot.

If you’re obese, particularly if you’re unfit and have health problems, check with your doctor before starting an exercise program.

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