OBESITY

General Information

DEFINITION--A condition of excess body weight. May be defined as: Males over 20% body fat or females over 25% body fat are considered obese. The concept that obesity is a will-power or self-discipline problem is outmoded. However, there is no clear understanding of the biochemical defects that cause it.

BODY PARTS INVOLVED--Total body.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Excessive body fat composition.
• Emotional problems.
• Poor exercise tolerance. Excess weight increases the heart's work.

CAUSES

Genetic factors. > Environmental factors: Diet and eating habits, activity levels, stress (emotional and physical), drugs, cultural.

• Metabolic and endocrine disorders.
• Abnormal regulation of body weight to body fat.
• Central nervous system lesions.

RISK INCREASES WITH--Those listed in Causes.

HOW TO PREVENT--Life-long adherence to a program consisting of proper diet and nutrition, exercising, and behavior and lifestyle modification as needed. OTHER--Surgery to reduce weight, such as bypassing part of the intestine or stomach, cutting away fat, fat suctioning or wiring the jaw shut, are rare, desperate measures.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Medical assessment to determine the degree of health risk. The most accurate method of determining body composition remains underwater weighing and skinfold measurements. Also used are BMI (body mass index) and waist to hip ratio (WHR).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment (sometimes).
• Psychotherapy or counseling.

POSSIBLE COMPLICATIONS

• Obesity may contribute to the development of diabetes, high blood pressure, heart disease and gallbladder disease. It complicates treatment and decreases survival chances of patients with stroke, kidney disease and other disorders.
• Psychosocial complications (poor self-image, difficulty in getting jobs, lack of social contacts with opposite sex).

PROBABLE OUTCOME--Obesity can be controlled if motivation stays high for life. Long-term management of weight loss is extremely difficult.

How To Treat

GENERAL MEASURES--

• Many commercial and community programs are available that provide help in losing weight. Choose a program whose diet plans meet the recommended guidelines for nutrients, provides exercise and behavior counseling and includes long-term maintenance support.
• Keep diaries for food intake, exercise activities and behavior changes. Review them with your weight loss advisor weekly.
• Several techniques exist for behavioral modification. Determine the type that fits your needs (e.g., assertiveness, rewards, cognitive, substitution, imagery and others).

MEDICATION--Most doctors don't recommend medication to aid weight loss. Medications often cause harmful side effects or adverse reactions. At best, they control appetite only for short time periods and don't help change eating habits.

ACTIVITY--

• Increase your current level of activity. Daily exercise (bicycle riding, walking, swimming and others) helps you lose weight, feel better and control appetite.
• 30 minutes of activity, 5 times a week should be the goal. Keep an activity diary to monitor your progress.

DIET--

• Many different diet plans are available to choose from. Diets that are not nutritionally balanced can cause more problems than the obesity. Crash diets and fad diets don't produce long-term results. Schemes which promise easy weight loss are usually unsuccessful.
• During your diet and exercise program, there may be periods when you don't lose weight. This is normal; don't stop the program. Weight loss will begin again in a week or two.
• A realistic weight loss is 1 to 2-1/2 pounds a week. This may seem slow, but 1 pound of fat lost per week totals 52 pounds in 1 year! Keep a food diary to record everything you eat.

Call Your Doctor If

Obesity increases, despite your self-help measures.