Obesity and Weight Management
Obesity means you have excessive body fat, and it is common. In the United States, more than a third of adults are considered overweight and more than a third are obese, according to the Centers for Disease Control and Prevention (CDC). The American Medical Association considers obesity to be a disease.
Doctors measure obesity by calculating your body mass index (BMI), which is the ratio of weight in kilograms to height in meters. For adults, a BMI of more than 30 indicates obesity and a BMI greater than 40 is considered severely obese. For children and adolescents healthy BMI varies by age. In general, doctors call a younger patient obese when their BMI is above the 95th percentile of what is considered within a normal, healthy range for the child’s age. The CDC reports that rates of obesity in adults and young people have been increasing.
In addition to how much fat you have, doctors also worry about where that fat is located on your body. To determine fat distribution, doctors look at the waist-to-hip ratio. We measure the waist at its narrowest point and the hips at their widest point. Women with waist-to-hip ratios of more than 0.8 and men with ratios of more than 1.0 are considered apple-shaped. If you have more of your fat in your hips and buttocks—more common among women—you are pear-shaped. Apple-shaped people may be more likely to develop type 2 diabetes, heart disease, or certain types of cancer.
Effects of Obesity
Many people worry about obesity for aesthetic reasons. But being obese can affect many areas of your health. It can lead to several serious medical conditions such as:
- Breathing (pulmonary) problems
- Depression (due to feelings of rejection, shame, and guilt and problems with body image, social isolation, and self-esteem)
- Gallbladder disease
- Gastroesophageal reflux
- Heart disease, including heart attack, heart failure, and angina
- High blood pressure (hypertension)
- High cholesterol
- Kidney disease
- Liver disease
- Reproductive problems in women
- Sleep apnea, a condition where you do not breathe regularly when you are asleep
- Urinary incontinence
- Women who are pregnant can experience additional problems. If they have excess fat, they may have a higher risk of developing gestational diabetes or high blood pressure during pregnancy (preeclampsia). They are also more likely to need a C-section.
Researchers have found that even a small weight loss of five to ten pounds can decrease these risks in an obese person.
Causes of Obesity
The most common cause of obesity is overeating. If you take in more calories from food and beverages than you burn off, you are likely to gain weight. There are other factors that contribute to how much weight your body stores. These include:
- Family history and genes: Obesity tends to run in families. Your genes can also affect where your body stores extra fat–whether you are pear- or apple-shaped.
- Gender: Men are more likely to be overweight than women, but women are more likely to be obese. However, women are more likely to be pear-shaped while men are often apple shaped, which increases their risk.
- Race: People of different races have varying rates of obesity. About 48 percent of African Americans are obese, followed by Latinos (42 percent), Caucasians (36 percent), and Asian (12 percent), according to the CDC.
- Age: Many people gain weight as they get older. Children who are obese are more likely to become obese adults than children with typical weight.
- Sleep: If you do not get enough sleep, you may consume more calories. Researchers recommend adults up to age 65 get seven to nine hours of sleep a night. Adults who are 65 and older need seven to eight hours.
- Other conditions: Certain medical conditions, some medicines, and stress can also lead to weight gain.
If you have a diagnosis of obesity or obesity-related health issues, you may be interested in the possibility of weight-loss surgery. Our bariatric surgery evaluation program provides surgery authorization.
Our doctors and researchers are committed to discovering new ways to treat obesity and weight management. Studies show that the most effective weight loss treatments for children and adolescents involve the whole family. Parents are particularly important. Adults can participate in programs such as diabetes prevention programs which can help you lose weight gradually—and keep it off.