Obesity and When to Seek Help (original) (raw)

Doctors define obesity as a chronic (long-lasting) disease that results when have you have excess body fat that puts your health at risk.

It's a complicated condition, and it's about much more than the number on the scale. Carrying extra weight affects the way your body works. These changes influence almost every system in your body. They contribute to diseases like heart disease, diabetes, and cancer.

Obesity is a growing problem in many areas of the world. According to the World Health Organization, more than 4 million people die every year due to obesity or overweight.

Doctors have traditionally used body mass index (BMI) as a tool to determine whether someone is overweight or obese. BMI is a calculation that compares your weight to your height. A BMI of 30 or more is in the obese category. If your BMI is 25 to 29.9, your weight is classified as overweight but not obese.

Measuring your waist is another way to check your risk for weight-related conditions. A waist size over 40 inches (102 centimeters) for men or 35 inches (88 centimeters) for women is considered high.

Some day-to-day symptoms you might have with obesity include:

Doctors divide obesity into three classes:

Class I: You're in this category if your BMI is between 30 and 35.

Class II: People in this category have a BMI between 35 and 40.

Class III: In this category, your BMI is 40 or above.

Morbid obesity

You might have heard the term "morbid obesity" to refer to obesity that's likely to pose serious threats to your health. Doctors formerly used to use this phrase to describe what they now call class III obesity.

Many things contribute to obesity, including your genes, your eating patterns, and how much activity you get. Hormones and your emotions play a role, too. Some illnesses and some medications can also lead to weight gain.

Other things that may be involved include:

You're more likely to have obesity if others in your family do. Experts think genes affect your metabolism, your appetite, and how much body fat you tend to store. Also, people around you influence your diet and exercise patterns.

Other risk factors for obesity include:

Obesity epidemiology

Obesity is very common. More than 40% of adults in the U.S. are considered obese, as are nearly 20% of children.

Among adults in the U.S., rates of obesity by race/ethnicity are:

The rates among children are:

(National obesity rates for American Indian/Alaska Native children were not available.)

Obesity is more common in people at middle age and older. By age, obesity rates are:

Although researchers say that overall rates of obesity are similar for men and women, women are more likely to have severe, or class 3, obesity.

To screen you for obesity, your doctor might talk to you about your health history to learn about your eating and activity patterns, history of weight gain and loss, and more.

They may also do a:

There are many treatments for weight loss that can make a big difference to your health and how you feel. Even a small reduction in weight benefits your health.

No matter what type of treatment or program you use, overcoming obesity will require you to change your eating and exercise habits. Your doctor can help you determine what method might be best for you.

You might start with a supervised weight loss and exercise program. Ask your doctor to help you set personal goals and refer you to other professionals who can help. For example, a dietitian can work with you to develop a plan for healthy nutrition, and a physical therapist or trainer can help you move more. A bariatric medicine or weight loss specialist can also be a part of your health care team.

You’ll want to go for steady progress over time and to make lifestyle changes that work for you in the long run. That way you can start losing weight, feel better, and keep the weight off.

Medications for obesity

Along with lifestyle changes, your doctor may recommend prescription medications that decrease your appetite, help you feel full with less food, or help you lose weight in other ways. Keep in mind that these drugs may not work for everyone, and you might regain weight when you stop taking them.

Some drugs the FDA has approved to treat obesity are:

Doctors may also prescribe certain diabetes drugs, such as tirzepatide (Mounjaro), "off-label" for weight loss even though they're not FDA-approved for that purpose.

Find out about the latest drug treatments for obesity.

Procedures and surgeries for obesity

These procedures change your digestive system to limit how much food you're able to eat or how many calories your body can absorb. Some also affect hormones that play a role in hunger and metabolism.

These procedures may not only help with weight loss but also improve weight-related conditions like type 2 diabetes and heart disease. If you get one of them, you'll still need to adopt healthy lifestyle changes.

Nonsurgical procedures include:

If you have class 3 obesity, you might be able to get weight loss (bariatric) surgery. These surgeries include:

Therapy for obesity

Cognitive behavioral therapy teaches you behavior changes that can lead to weight loss, such as finding non-food ways to reward yourself or deal with negative emotions. It can also help you learn techniques to reduce stress, which often contributes to overeating.

Alternative treatments for obesity

You can buy many types of herbs and supplements that claim to help with weight loss. But there's little scientific evidence that any of them are effective.

Some research has found that acupuncture or acupressure could have a small effect on weight. These techniques stimulate certain spots on your body to try to boost levels of serotonin, a chemical involved in moods, emotions, and appetite.

There's some evidence that hypnosis might help with weight loss, especially when used together with therapy, diet, and exercise. But not all research into this technique showed the same results.

Learn more about the treatment options for obesity.

Anyone can have obesity, but it's more common in minority populations. Scientists don't know all of the reasons why. They include genetics as well as family and cultural eating habits. They may also include social aspects like:

Men have similar rates of obesity no matter what their income level. High-income women are less likely to have it than those with lower incomes. But most women with obesity aren't considered low-income. In the U.S., people living in the Southeast and in rural areas are at higher risk.

Black people are often less likely than others to be diagnosed with obesity, although they have the condition at higher rates.

Some research has found obesity treatments aren't as widely used or as effective for minorities. One study found that after 6 months of behavior therapy for weight loss, Black participants lost less weight than White ones. Certain weight loss drugs, such as orlistat, may be less effective for Black people. Others, like metformin, might not work as well for Hispanic people.

Members of racial and ethnic minority groups tend to lose less weight after weight loss surgery. Men and African-American people are less likely to consider the surgery in the first place.

One of the hardest parts of living with obesity is the stigma that surrounds it. Some people stereotype those with obesity as undisciplined or lazy. You may face discrimination in the workplace and from health care providers. Research suggests that people who have obesity deal with stigma almost every day.

But there are signs of progress. In 2013, the American Medication Association recognized obesity as a chronic disease. And advocacy organizations like the World Obesity Federation and Obesity Action Coalition are bringing attention to the need for change.

Stigma can take a toll on your mental health. There's not a lot of research on obesity stigma. But one study found that people who dealt with it by reframing their bad experiences in a more positive way had less depression and better self-esteem. For example, they focused on good things that have happened to them and reminded themselves that many people like them just as they are.

Extra weight means extra stress on your bones and muscles and less space for your lungs and other organs. It makes your heart and circulation system work harder and increases inflammation in your body. Obesity raises your risk of several other chronic conditions, including:

Type 2 Diabetes

When you have obesity, you're seven times more likely to get type 2 if you're male (or were assigned male gender at birth). You're 12 times more likely to get it if you're female or were assigned female at birth.

Cardiovascular disease

Obesity boosts your risk for high cholesterol, blood pressure, and blood sugar as well as inflammation. All these things are risk factors for cardiovascular (heart and blood vessel) conditions like heart attack, stroke, and coronary artery disease.

Cancer

People with obesity are at higher risk for several types of cancer, including:

Digestive Conditions

With obesity, you're more prone to heartburn and gallbladder disease as well as liver problems like fatty liver disease. Fatty liver disease happens when too much fat builds up in your liver and leads to damage.

Obesity also puts you at higher risk for:

While not everyone with obesity has other serious health problems, research shows that it's rare to be both obese and healthy for the long term.

But you don't need to lose a lot of weight to improve your health. You could lower your risk for complications like diabetes and heart failure by 10%-25% by losing just 15-20 pounds.

Obesity diet

No single diet is best for weight loss. What works for one person may not work for another. Your doctor or a dietitian can help you find an eating plan that suits your needs and lifestyle. In general, a healthy plan will include:

Be wary of fad diets that promise fast weight loss. While you might lose some weight quickly, you're likely to gain it back once you go off the diet. It's better to adopt changes you can live with long-term.

Along with diet, exercise should be part of your weight loss plan. Ask your doctor about what kind of exercise, and how much, is best for you.

Obesity costs

Obesity and the medical conditions that can come with it bring extra expenses for treatments, doctor visits, hospitalizations, and more. A 2021 study found that, on average, adults in the U.S. with obesity spent $1,800 more on health care than others.

That doesn't include indirect costs like:

Managing obesity

These steps can boost your chances for successfully managing obesity:

Obesity and mental health

People with obesity are at higher risk for mood and anxiety disorders. One study found that those with obesity were 55% more likely than others to develop depression during their lifetimes. At the same time, people with depression had a 58% higher chance of obesity.

Some of the reasons for this link include:

Losing weight can help ease depression. But you're not likely to succeed at weight loss when you're feeling sad or stressed. Think about getting treatment for any emotional health issues before you try to overhaul your eating and exercise habits.

Can obesity be cured?

Some obesity experts believe diet and exercise just aren't enough to address obesity. They say our bodies evolved to help us survive periods when food was scarce. So whenever we cut back on calories, our bodies drive us to eat high-calorie foods and gain weight. That's why most weight loss efforts don't succeed in the end.

These experts believe that people with obesity who do manage to lose weight are biologically different from people who've never had obesity. They consider obese people who've lost weight to be in remission rather than cured.

What to expect with obesity

Even moderate obesity (defined as having a BMI of 30-35) can shorten your lifespan by 3 years. Severe obesity (a BMI of 40-50), could take 10 years off your life. That's about the same as a lifetime of smoking.

Weight loss can prevent and sometimes reverse most of the health problems linked to obesity. But losing weight and keeping it off takes commitment and time. While many people can lose some weight with diet and exercise alone, only 10% to 20% are able to maintain the loss for a long time.

Research shows that treatment programs in which you and your doctor work closely together are most effective for long-term weight loss. Weight loss surgery has a high success rate: Some 90% of people who have it are able to lose at least 50% of their extra weight and maintain the loss. And some newer obesity medications are so promising that many doctors consider them game-changers.

It's easier to prevent obesity than to treat it. If obesity runs in your family or you notice you've picked up a few pounds, start taking simple steps to improve your health habits. You might:

Obesity is not a personal failing. It's a complicated disease that requires lifelong management. Fortunately, more treatment options are available than ever before. Work together with your doctor to get control of your weight and your health.