Overweight and Obesity

The term Obesity derives from the Greek expression: ob-edere, which means overeating. The terms “overweight” and “obesity” refer to a person’s overall body weight and where the extra weight comes from. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat. Obesity is defined as weighing 20% (25% for women) or more over the maximum weight desirable for one's height. Experts believe that a person's body mass index (BMI) is the most accurate measurement of body fat. BMI is based on height and weight and is used for adults, children, and teens. (Click image for large preview).

Since the mid-seventies, the prevalence of overweight and obesity has increased sharply for both adults and children. Data from two NHANES surveys show that among adults aged 20–74 years the prevalence of obesity increased from 15.0% (in the 1976–1980 survey) to 32.9% (in the 2003–2004 survey).

 Causes of Obesity

Weight gain and obesity are caused by consuming more calories than the body needs – most commonly by eating a diet high in fat and calories, being sedentary or both. However, the imbalance between calories consumed and calories burned can also be caused by a number of different obesity-related factors, including genetic, hormonal, behavioral, environmental and even cultural. It is important to remember that obesity is not always simply a behavioral issue. In fact, endocrine researchers are on the forefront of medical research into the mechanisms of metabolism, appetite and satiety and their connection to obesity. (Click image for large preview).

Additional factors include family history and genetics, metabolism (the way your body changes food and oxygen into energy), behavior or habits, and other factors. Certain things, like family history, can’t be changed. However, other things—like a person’s lifestyle habits—can be changed. You can help prevent or treat overweight and obesity if you: Follow a healthful diet, while keeping your calorie needs in mind; are physically active; and limit the time you spend being physically inactive.

 Identifying Other Complications

Scientists--including specialists called endocrinologists--are looking into the many biological angles behind adult obesity, childhood (pediatric) obesity, and obesity-related health problems. Being overweight or obese increases the risk of many diseases and health conditions, including the following:

  • Cardiovascular disease
  • Coronary heart disease
  • Stroke
  • Hypertension (high blood pressure)
  • Hypothyroidism
  • Dyslipidemia
  • Hyperinsulinemia (insulin resistance, glucose intolerance)
  • Type 2 (non-insulin dependent) diabetes
  • Congestive heart failure
  • Angina pectoris
  • Cholecystitis
  • Cholelithiasis
  • Osteoarthritis (degeneration of cartilage and underlying bone)
  • Gout
  • Fatty liver disease
  • Sleep apnea and other respiratory problems
  • Polycystic ovary syndrome (PCOS)
  • Fertility complications
  • Pregnancy complications
  • Psychological disorders
  • Uric acid nephrolithiasis (kidney stones)
  • Stress urinary incontinence
  • Some cancers (endometrial, breast, colon, rectum, esophagus, prostate)
  • Gallbladder disease

Your risk of developing heart disease may be heightened even more by the way your weight is distributed on your body. Fat cells in the upper body have different qualities than those found in hips and thighs. People whose fat collects around the waist - the classic apple shape - are at higher risk of heart disease than their pear-shaped counterparts, whose weight collects around the hips," said Roger S. Blumenthal, M.D., F.A.C.C., director of The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. "The majority of heart disease is preventable."

  What Are the Benefits of Weight Loss?

Although obesity is associated with a number of sometimes serious medical conditions, for most people obesity is a treatable and manageable condition. Weight loss is an essential part of managing and reducing obesity, as weight loss provides many short and long-term health benefits. Physicians typically recommend that obese people lose approximately 10 percent of their weight to significantly decrease obesity-related health risks. According to recent research, the following health benefits are associated with weight loss:

  • Weight loss of five to 15 percent of total body weight can lower an individual’s
    chances for developing heart disease or having a stroke, as weight loss may
    improve blood pressure, triglyceride and cholesterol levels, and decrease
    inflammation throughout the body;
  • Weight loss of 10 to 15 pounds is likely to slow the development of, and halt the symptoms associated with, knee osteoarthritis;
  • Weight loss of five to 10 percent of total body weight can raise high-density
    lipoprotein cholesterol;
  • For every two pounds lost, low-density lipoprotein cholesterol levels are reduced
    by one percent;
  • Overweight or obese people can lower their risk for developing Type 2 diabetes
    by participating in weight loss and increasing physical activity; and
  • Weight loss can also result in lowered blood pressure.

 Pharmecuetical Treatments

For those who need to treat or manage obesity, there are numerous options to consider. Weight loss and weight management efforts to combat obesity require a balanced combination of behavioral change and medical intervention. Although consuming fewer calories and implementing a regular exercise regimen are essential to the weight-loss process, some individuals dealing with obesity may need to incorporate prescription drug therapy into their weight loss program. There are currently two drug types that are approved by the FDA for the long-term treatment of obesity.

  • Sympathomimetic Drugs – These weight loss drugs help treat obesity by suppressing one’s appetite through restricting nerve endings’ ability to pick up norepinephrine and serotonin.
  • Lipase Inhibitors – This class of weight loss drugs prevents the action of lipases – the enzymes that break down fat – produced in the pancreas.

 Surgical Options for the Treatment of Obesity

For cases of extreme obesity and among patients for whom other weight loss treatment options have failed, obesity surgery presents a possible option to achieve weight loss. Obesity surgery is recommended as an option in the treatment of obesity only for patients with either a BMI (body mass index)> 40 or a BMI (body mass index) of 35 to 39.9 combined with other serious obesity-related medical conditions.

Despite much progress in developing safer and more effective surgical techniques, obesity surgery remains a last option for patients attempting weight loss. Before considering obesity surgery, it is important that patients understand all of the risks and benefits associated with obesity surgery. The full team of medical professionals involved in the weight loss planning process – which may include a Dr. John Tapp, an endocrinologist, an ob/gyn, a nutritionist, a psychologist, and others – should be available to offer their expertise and guidance. If the patient has an underlying endocrine or other serious health condition such as cardiovascular disease or risk for stroke, obesity surgery may not be the best option. In addition, surgical candidates must be willing to alter their diet and physical lifestyle following the surgery in order to achieve long-term weight loss success.

Although one of the national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15%, current data indicate that the situation is worsening rather than improving. Over the last few decades, significant progress has been made in identifying the underlying causes of obesity and potential behavioral, pharmacologic, natural/alternative and surgical treatments for obesity. However, the prevalence of overweight and obesity cases continues to soar and additional research is needed. While the federal government allocates spending dollars to research, the increased prevalence of obesity in Americans further highlights the need for funding. Among the federal agencies funding such research initiatives is the National Institutes of Health (NIH), which presents information about research funding opportunities on its Obesity Research website..
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The information contained on this site is not intended to be a substitute for professional medical advice. Please visit Dr. Tapp prior to starting any new treatment or with any questions you may have regarding a medical condition or concern. Medical illustrations containing the ADAM logo is property of A.D.A.M., Inc. All rights reserved. Any duplication or distribution of the information contained herein is strictly prohibited.

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