Obesity



Obesity (o-BEE-si-tee) is a significant excess of body fat. Children with obesity are at higher risk for obesity when they grow up. Adults with obesity are at higher risk for high blood pressure, diabetes, and other health problems. In cultures that value being thin, people with obesity also may experience emotional distress as well.

KEYWORDS

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Adipose

Bariatrics

Binge eating disorder

Body mass Index

Diet

Morbid obesity

Nutrition

Weight control

Prevalence rates for obesity are on the rise in the United States and in other parts of the developed world where lifestyles make it easy for people to take in more calories than their bodies use. How do people take in too many calories? Try fast-food burgers and fries, supersize colas, chips, dips, and nachos. How do people use too few calories? Try car rides instead of walking or riding a bike, and television and video games instead of sports. The result? Chubby couch potatoes who are banking extra deposits of adipose (fatty) tissue.

Lifestyle is not the only cause of obesity. Researchers believe that genes and heredity also play a very important role in many cases. People with a history of obesity in one or both parents are at higher risk of becoming obese themselves. People who have inherited "obesity genes" may use calories at a slower rate than others, or they may not have the same appetite "shutoff" control system that helps lean people stop eating when they have taken in enough calories. Also, people who become obese as children may increase the total number of fat cells in their bodies, making it much more likely that they will be obese as adults.

Body Mass Index

Body mass index (BMI) is a mathematical formula that doctors and dietitians use to measure whether people are at a healthy weight relative to their height. t It is based on weight measured in kilograms and height measured in meters: BMI = kg/m 2 . BMI charts classify adult obesity in ranges; for example:

  • BMIs 19-21: lean people, such as marathon runners
  • BMls 22-24: people of average weight
  • BMIs 25-29: people who are muscular or mildly overweight
  • BMIs 30-35: people who are overweight and who are at significantly higher risk for health problems
  • BMIs >40: people with severe obesity who are at very high risk for health problems.

†Although BMI tends to reflect how much fat a person has, it does not measure body fatness directly. For example, a muscular athlete might have a higher than average weight and BMI measurement despite having a lower than average amount of body fat.

What Happens to People with Obesity?

Children

Children who weigh more than 20 percent more than they should for their height and age may be considered overweight, and those who weigh more than 30 percent more may be considered obese. Diets that severely restrict calorie intake often are not a good idea for children because of their need for energy to support normal growth, but doctors may suggest that overweight children be offered fewer calorie-laden foods and find ways to become more physically active after school and on weekends. Certainly they are likelier than normal-weight children to have problems with their peers. They may have trouble keeping up with other kids in sports and other activities, they may tire and get out of breath more quickly, and they may be called cruel names.

Teens

Teenagers with obesity may have the same problems as obese children, but they also may start having aches and pains as the extra fat in their bodies stresses their joints and overloads their muscles and tendons. Obese teens, as well as some younger children, sometimes may begin to show some of the health problems commonly seen in obese adults such as high blood pressure and diabetes. Also, they may have less active dating and social lives, and they may be at risk for binge eating disorder.

Binge eating disorder

Binge eating disorder also is known as compulsive overeating. Like other eating disorders, it often involves feelings of anxiety, stress, anger, being out of control during a binge, and being remorseful after a binge. It also may involve hiding food and secret eating, behaviors that interfere with social activities. Eventually, it may lead to obesity, still another cause of stress in a culture that seems to believe a person can never be too thin.

Adults

In addition to aches and pains and physical limitations, obese adults face a higher risk of a number of health problems, including high blood pressure, diabetes, heart disease, and stroke. They may face discrimination when they apply for jobs or promotions, and studies have shown that they may be unfairly viewed by others as lazy or less intelligent. Adults with obesity often experience the inconvenience and frustration of needing large-size clothing, large-size movie seats and airplane seats, and large-size seat belts in a world designed by and for medium-size people.

Severe obesity

Severe obesity also is called "morbid" obesity because it is so frequently accompanied by serious health complications. People with severe obesity almost always experience problems with everyday living. They may have trouble walking or exercising, they may have difficulty breathing while they sleep (sleep apnea), and they may be treated with a prescription medication or gastric (stomach) surgery to help bring their weight down to a healthier level.

Rx: Weight Loss

The weight-loss industry is a big business, including over-the-counter medications such as Metabolife and organizations such as Weight Watchers. Unfortunately, many media-promoted weight-loss products and programs are based on fads or gimmicks that raise false hopes but have not been shown to produce long-term improvements in weight. Experts stress that weight loss produced by "crash" dieting is almost never sustained unless a person learns to permanently modify eating and exercise habits—and those lifestyle changes are difficult to maintain.

There are also prescription medications for weight loss, presently approved only for treatment of severely obese adults:

  • Orlistat (Xenical) reduces the body's ability to absorb fat that has been eaten. However, it also can interfere with the absorption of vitamins, and may cause oily or fatty bowel movements.
  • Subutramine (Meridia) is an appetite suppressant that affects the body's brain chemistry. It is not recommended for people with high blood pressure, heart disease, or risk of stroke.

Is It Possible to Be Fit, Fat, and Happy?

Yes, it is, and there are many media role models showing how, including weightlifter Cheryl Haworth, model Emme, and actress Camryn Manheim. Working with peer support groups and therapists can help people learn ways to resist the stigma attached to being fat in a culture that values thinness. Working with psychotherapists can help people with binge eating disorder learn healthier ways to cope with anxiety and stress. Working with medical doctors can help people with severe obesity get treatment for related health problems, such as high blood pressure or sleep apnea, and it also can help them decide whether prescription medications or surgery are appropriate treatments. Eating a balanced diet can benefit everyone. And getting lots of physical activity can make anyone fitter and happier, no matter how fat or thin the person is.

Actress Camryn Manheim won an Emmy award in 1998 for her role in the television series The Practice. She has become a role model for people struggling with body-image issues in shattering the stereotype that a beautiful, successful woman must be thin. AFP/Corbis
Actress Camryn Manheim won an Emmy award in 1998 for her role in the television series The Practice. She has become a role model for people struggling with body-image issues in shattering the stereotype that a beautiful, successful woman must be thin.
AFP/Corbis

See also
Anorexia
Body Image
Bulimia
Eating Disorders
Genetics and Behavior
Therapy

Resources

Organizations

American Society of Bariatric Physicians, 5600 South Quebec Street, Suite 109A, Englewood, CO 80111. This group is a national professional society for physicians who specialize in the medical treatment of obesity and related conditions.
Telephone 303-779-4833 (for referral to a physician)
http://www.asbp.org

KidsHealth.org . The medical experts at the Nemours Foundation in Wilmington, Delaware, post fact sheets on their website for children, teens, and parents covering obesity, body mass index, eating disorders, activity patterns for children and teens, and other topics.
http://www.KidsHealth.org

Overeaters Anonymous, 6075 Zenith Court Northeast, Rio Rancho, NM 87124. This network of peer support groups helps people find local meetings that use fellowship and a 12-step technique for lifelong control of binge eating disorder.
Telephone 505-891-2664
http://www.overeatersanonymous.org

Weight-Control Information Network (WIN), 1 WIN Way, Bethesda, MD 20892-3665. This division of the U.S. National Institute for Diabetes and Digestive and Kidney Diseases provides information about obesity, weight control, nutrition, weight-loss medications, and gastric surgery.
Telephone 877-946-4627
http://www.niddk.nih.gov/health/nutrit/nutrit.htm

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