Internal Medicine

Obesity

Overweight and obesity are increasingly common conditions in the United States. They are caused by the increase in the size and the amount of fat cells in the body. Doctors measure body mass index (BMI) and waist circumference to screen and diagnose overweight and obesity.  Body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared. Obesity is a serious medical condition that can cause complications such as metabolic syndrome, high blood pressure, atherosclerosis, heart disease, diabetes, high blood cholesterol, cancers and sleep disorders.

Causes

An individual’s weight is the result of many overlapping factors, including environment, family history, metabolism (the rate at which the body converts food and oxygen into energy), behavior, and more. Some of these factors, such as family history, cannot be changed. However, other factors which are lifestyle habits —such as exercise habits and dietary choices—are factors in your control. If you’re not very active, you don’t burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities. Weight gain is inevitable if you regularly eat more calories than you burn. And most Americans’ diets are too high in calories and are full of fast food and high-calorie beverages. Obesity can also be caused by certain medications (e.g. antidepressants, steroids, anti-seizure medications) and medical conditions, such as hypothyroidism and sleep apnea.

Complications

If you’re obese, you’re more likely to develop a number of potentially serious health problems, including:

  • High triglycerides and low high-density lipoprotein (HDL) cholesterol
  • Type 2 diabetes
  • High blood pressure
  • Metabolic syndrome — a combination of high blood sugar, high blood pressure, high triglycerides and low HDL cholesterol
  • Heart disease
  • Stroke
  • Cancer, including cancer of the uterus, cervix, endometrium, ovaries, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate
  • Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts, can cause and also be caused by obesity
  • Gallbladder disease
  • Gynecological problems, such as infertility and irregular periods
  • Erectile dysfunction and sexual health issues
  • Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring
  • Osteoarthritis

When you’re obese, your overall quality of life may be diminished. You may not be able to do things you used to do, such as participating in enjoyable activities. Weight-related issues that may affect your quality of life include depression, sexual problems, social isolation, lower work achievement and in some cases, discrimination.

Prevention

Whether you’re at risk of becoming obese, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. The steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly.You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
  • Follow a healthy eating plan.Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular meals a day with limited snacking.
  • Know and avoid the food traps that cause you to eat.Identify situations that trigger out-of-control eating. You can plan ahead and develop strategies for handling these types of situations and stay in control of your eating behaviors.
  • Monitor your weight regularly.People who weigh themselves at least once a week are more successful in keeping off excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gains before they become big problems.
  • Get enough sleep.Not getting enough sleep or getting too much sleep can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain. Research shows that when you do not sleep enough, your body produces ghrelin, a hormone that stimulates appetite. At the same time, a lack of sleep also results in a lower production of leptin, a hormone that suppresses the appetite.
  • Be consistent.Sticking to your healthy-weight plan during the week, on the weekends, and amidst vacation and holidays as much as possible increases your chances of long-term success.

When dieting, the main goal should be to learn new, healthy ways of eating and make them a part of an everyday routine. Quick weight-loss methods do not often lead to lasting results. Evidence shows that relying on diet aids like drinks, prepackaged foods or pills don’t work over the long term either. Modest goals and a slow pace will increase their chances of losing the weight and keeping it off.

When to see a doctor

If you think you may be obese, and especially if you’re concerned about weight-related health problems, see your health care provider. You and your provider can evaluate your health risks and discuss your weight-loss options.  Your doctor can evaluate your BMI, waist measurement, and other risk factors for heart disease.  Treatment depends on the cause and severity of your condition and whether you have complications. Treatments include lifestyle changes, such as heart-healthy eating and increased physical activity, and Food and Drug Administration (FDA)-approved weight-loss medicines. To schedule a visit with a CareMount Medical primary care provider, make an appointment online at caremountmedical.com/247.