Obesity
Obesity is a chronic condition defined by an excess of body fat. Body fat has several important functions in the body, such as storing energy and providing insulation. Excess body fat, however, may interfere with an individual's health and well-being, particularly if a patient becomes morbidly obese. Not only does obesity interfere with everyday activities, it also increases the risk of developing serious medical conditions, such as high blood pressure and diabetes. Obesity is a serious health issue presently reaching epidemic proportions in society. It results in medical complications and early morbidity for a great many people. Other health conditions caused or exacerbated by obesity may include heart disease, osteoarthritis, sleep apnea, high cholesterol and asthma. The good news is that obesity is a treatable ailment and that modern medicine provides more remedies for the condition than previously existed.
Causes of Obesity
The balance between calorie intake and energy expenditure determines a person's weight. If a greater number of calories is consumed than expended through exercise and daily activities, a person will gain weight since their body stores excess calories. Obesity is, however, a complex problem. Research has shown that obesity does not simply result from lack of self-control. Causes of obesity are varied and may include hereditary, social, psychological and environmental factors as well as metabolic ones. Factors that may contribute to obesity include:
- Genetics
- Diet
- Inactivity
- Pregnancy
- Psychological stress
- Medications
- Gut microbiome
- muscle mass/lean body mass
- metabolic health
- hormonal health
Certain medical conditions, such as hypothyroidism and Cushing's syndrome may contribute to obesity.
Diagnosis of Obesity
Obesity is diagnosed not only by the number of excess pounds an individual carries, but by the individual's body mass index, or BMI. The BMI is calculated by dividing weight in kilograms by height in meters squared. Designations of normal and abnormal weight are as follows:
- Underweight: BMI below 18.5.
- Normal weight: BMI 18.5 to 24.9
- Overweight: BMI 25 to 29
- Obese: BMI 30 to 39
- Morbidly obese: BMI 40 or higher
Since BMI doesn't directly measure body fat, it is possible for some people, such as extremely muscular individuals or geriatric patients, to be inaccurately categorized using this system.
Obesity Treatment
Obesity is a serious problem. Overcoming obesity requires a commitment to lifestyle changes. People become overweight when they consume more calories than they expend. To lose weight, the number of calories your body takes in needs to be reduced or the number of calories your body expends needs to be increased. Achieving a balanced calories in/calories out equation is not simple, because there are many factors that influence how many calories your body takes in and expends (AKA your energy balance) to include genetics, physical activity levels, muscle mass, hormonal status, health of the gut microbiome, quality/quantity of sleep, mood, metabolic health, digestive health, medications, and other health related factors.
Balancing energy intake and expenditure (i.e. improving your body's energy balance) can be achieved in several ways to include choosing nutritious whole foods that improve your gut microbiome, improving metabolic health through diet, exercise, good sleep, and medication, managing stress, adhering to a weight-loss diet that eliminates ultra-processed foods and limits high calorie foods, such as fatty foods and foods high in sugar, and limiting or avoiding alcoholic consumption. Portion sizes for high calorie foods should be reduced and the consumption of high fiber foods, such as fruits and vegetables, increased.Physical activity in the form of regular exercise will also assist in weight management.
There are several methods of treatment for obesity.
Proper Diet
A safe and effective long-term weight-loss diet must contain balanced, nutritious foods to avoid vitamin deficiencies and malnutrition. A healthy diet should:
- Be high in whole grains, fiber, fruits and vegetables
- Contain lean meat, fish or vegetable protein
- Be low in sweets, fats, and fried foods
- Include whole grains and high fiber
- Eliminate consumption of fast food and ultra-processed foods
Adopting good eating habits is essential in achieving a healthy weight.
Physical Activity
Regular exercise is an important part of a healthy life. Physical activity and exercise help to burn calories. The number of calories burned depends on the type, duration, and intensity of the activity. Treating obesity with exercise is most effective when combined with a healthy diet since exercise alone will have a limited effect on weight loss. Recommendations for healthy exercise habits include getting 30 minutes of moderate exercise 5 to 7 days a week.
Prescription Weight-loss Medication
Weight loss is best achieved through a healthy diet and regular exercise. For some individuals, weight-loss medications may be of help. Such medications are not usually prescribed unless diet and exercise have already been tried and failed. Even with prescribed medications, lifestyle changes must be implemented for obesity to be treated successfully.
Counseling or Psychotherapy
In many cases, talking with a counselor is helpful to a patient suffering from obesity, almost always in combination with other methods of weight loss. Most people who are obese have psychological issues around food and may have a family history which has predisposed them to eating when they are under stress. While diet and exercise must always be included in weight loss treatment, talking to a trained professional can also be of help.
Bariatric Surgery
When other methods of weight loss are unsuccessful, particularly when an individual suffers from obesity-related medical conditions, bariatric surgery may be considered. Under the proper conditions, bariatric surgery may be a lifesaving procedure, though the patient will still be required to make permanent lifestyle changes. Before and after weight loss surgery, counseling is necessary to assist the patient in achieving and maintaining lasting positive results.
Too often, people think they can lose weight quickly through a brief, strenuous dieting or sudden spurts of exercise. In fact, however, a great majority of people who lose weight rapidly regain that weight within 5 years. More methodical, ongoing treatment is usually more effective and more long-lasting.