Obesity is a complex disease involving an excessive amount of body fat. It is not just a cosmetic concern; it is a medical condition that increases the risk of other diseases like heart disease, diabetes, and high blood pressure.
The Good News: You don't need to reach an "ideal" weight to see benefits. Even modest weight loss (5–10%) can significantly improve your health.
Diagnosis & BMI
Obesity is diagnosed when your Body Mass Index (BMI) is 30 or higher. BMI is calculated by dividing your weight in kilograms by your height in meters squared.
[Image of body mass index chart]| BMI Range | Weight Status |
|---|---|
| Below 18.5 | Underweight |
| 18.5 - 24.9 | Normal |
| 25.0 - 29.9 | Overweight |
| 30.0 - 34.9 | Obese (Class I) |
| 35.0 - 39.9 | Obese (Class II) |
| 40.0 and higher | Extreme Obesity (Class III) |
Note: BMI doesn't measure body fat directly. Athletes with high muscle mass may fall into the obese category without having excess body fat.
Causes & Risk Factors
Obesity occurs when you take in more calories than you burn. However, it is rarely due to just one cause. It is usually a combination of:
1. Lifestyle Factors
- Inactivity: A sedentary lifestyle means you burn fewer calories.
- Unhealthy Diet: Diets high in fast food, high-calorie beverages, and oversized portions.
- Lack of Sleep: Hormonal changes from sleep deprivation can increase appetite and cravings for carbohydrates.
2. Biological & Medical Factors
- Genetics: Your genes affect how your body stores fat and converts food into energy.
- Medical Conditions: Prader-Willi syndrome, Cushing's syndrome, and arthritis (which limits activity).
- Medications: Some antidepressants, anti-seizure meds, diabetes meds, steroids, and beta-blockers can lead to weight gain.
- Pregnancy: Weight gained during pregnancy can sometimes be difficult to lose.
Complications
Obesity affects nearly every part of the body. Common complications include:
- Metabolic: Type 2 Diabetes, High Blood Pressure, High Cholesterol.
- Structural: Osteoarthritis (joint pain), Sleep Apnea (breathing stops during sleep).
- Organ Health: Fatty Liver Disease, Gallbladder disease, and Heart Disease.
- Reproductive: Infertility, irregular periods, and erectile dysfunction.
- Mental Health: Depression, social isolation, and guilt.
Diagnosis
Beyond BMI, your doctor may check:
- Waist Circumference: Abdominal fat (visceral fat) increases risk. Men >40 inches and Women >35 inches are at higher risk.
- Blood Tests: To check cholesterol, liver function, fasting glucose, and thyroid levels.
Treatment Options
The goal is to reach and stay at a healthy weight. Treatment is often a "stepped" approach.
1. Dietary & Lifestyle Changes
- Reduce Calories: Typical goals are 1,200–1,500 calories/day for women and 1,500–1,800 for men.
- Energy Density: Eat larger portions of foods with fewer calories (fruits/vegetables) to feel full.
- Activity: Aim for 150 minutes of moderate activity per week (e.g., walking) to maintain weight loss.
2. Prescription Medications
If BMI is >30 (or >27 with complications), doctors may prescribe medication to be used alongside diet and exercise:
- Orlistat (Xenical/Alli): Blocks the absorption of fat in the gut.
- Lorcaserin (Belviq): Affects brain chemicals to decrease appetite.
- Phentermine-Topiramate (Qsymia): Makes you feel full sooner.
3. Weight-Loss Surgery (Bariatric Surgery)
Considered if BMI is >40 (or >35 with serious health issues). These are major procedures that alter your digestive system.
[Image of gastric bypass and gastric sleeve surgery comparison]- Gastric Bypass: Creates a small stomach pouch and bypasses part of the intestine to limit calorie absorption.
- Gastric Sleeve: Removes part of the stomach to create a smaller reservoir for food.
- Gastric Banding (LAGB): An inflatable band separates the stomach into two pouches.
Regaining weight is common. The best way to prevent it is combining a sustainable healthy diet with 200–300 minutes of physical activity a week.
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