Obesity

Patients who are obese have more fat than normal, healthy individuals of the same age, gender, and height. They may have difficulty walking, experience shortness of breath, and become tired after very little physical exertion.

A healthcare provider diagnoses obesity after measuring the patient's body mass index (BMI) and hip to waist ratio.

The BMI is a measurement of weight (in pounds) for height (in inches) in adults who are older than 20 years of age. BMI falls into one of these categories: below 18.5 units is underweight, 18.5-24.9 is normal, 25.0-29.9 is overweight, and 30.0 and above is obese. For adults, the accepted formula for BMI is: BMI=703 x [Weight in pounds/(Height in inches)²].

Waist to hip ratio (WHR) is the circumference of the waist divided by the circumference of the hips. For women, a healthy ratio is 0.8 or lower. For men, a healthy ratio is 1.0 or lower. A high ratio means that the patient is overweight or obese. A low ratio means that the patient is underweight.

Depression: Individuals who are obese often suffer from depression. This may occur if the patient's weight limits his/her ability to perform certain activities. Depression may also occur if the patient has poor self-esteem as a result of his/her weight.

Heart disease: Obese individuals have an increased risk of developing high blood pressure. This is because the extra fat tissue, like other tissues in the body, requires oxygen from the blood. Therefore, the circulatory system is strained and the heart rate increases as it tries to supply a larger-than-normal body with enough oxygenated blood.

In addition, obesity tends to increase the amount of insulin in the blood. High levels of insulin cause the body to retain sodium and water, which increases blood volume.

Individuals who are overweight also have an increased risk of developing high cholesterol. High cholesterol can cause plaque deposits to form in the arteries. Plaque is composed of cholesterol, other fatty substances, fibrous tissue, and calcium. When plaque builds up in the arteries, it causes atherosclerosis (hardening of the arteries) or coronary artery disease (CAD). Atherosclerosis can lead to plaque ruptures and blockages in the arteries. If the blood supply to the heart is blocked, a heart attack may occur. If blood supply to the brain is blocked, a stroke may occur.

Sleep apnea: Obese patients have an increased risk of developing sleep apnea, a serious condition that occurs when the individual stops breathing for short periods of time during sleep. In obese patients, sleep apnea typically occurs when excess fat in the upper airway obstructs breathing. Because sleep apnea causes individuals to wake up frequently throughout the night, patients are often drowsy during the day.

Diabetes: Obese patients are more likely to develop type 2 diabetes. This condition occurs when the body becomes resistant to a hormone called insulin. As a result, patients with type 2 diabetes have too much sugar in their bloodstream.

Cancer: Many types of cancer, including colon cancer, rectal colon, esophageal cancer, kidney cancer, breast cancer, and prostate cancer, are associated with being overweight.

Physical discomfort: Obese patients may suffer from chronic pain in various parts of the body. This is because fat eventually starts to crowd the space near the internal organs, impairs blood circulation, and puts extra strain and pressure on the body's joints. Sometimes the fat in the abdomen prevents patients from sitting comfortably. Pain is most likely to develop in the feet, joints, back, and muscles. It may be difficult for obese patients to breathe when they are sitting up.

Fertility problems and sexual dysfunction: Men and women who are obese may suffer from fertility problems. In general, being obese decreases an individual's sex drive (libido). It may also make it be difficult for males to achieve or maintain an erection.

In addition, several studies have found that obesity may decrease an individual's sexual quality of life. Researchers have found that obesity is associated with a lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Many studies have also found that obese patients who lose weight experience an increase in their sexual quality of life.

Birth defects: Obese females have an increased risk of having children with gestational diabetes or other complications during pregnancy that may lead to birth defects.

Osteoarthritis: Obese individuals are more likely to develop a degenerative joint disease called osteoarthritis. This is because being overweight increases the strain put on the weight-bearing joints, such as the knees and ankles.

Osteoporosis: Obese individuals have an increased risk of developing osteoporosis, which causes the bones to become weak and brittle. The bones become porous and less dense. As a result, individuals are more likely to fracture their bones if they slip, fall, or injure themselves. Some evidence suggests that osteoporosis may develop in obese patients because fat cells infiltrate the bone marrow. In addition, it has been shown that individuals who live sedentary lifestyles have an increased risk of developing osteoporosis.

General: There are many potential causes of obesity. Some patients may be obese for multiple reasons.

Poor diet: Individuals who regularly consume foods that are high in calories and saturated fats have an increased risk of becoming obese. Examples of foods and beverages that may lead to obesity include fast food, fried food, sodas, candy, and desserts.

To maintain a healthy weight, an individual's intake of calories should be about equal to the calories used or burned during the day. If an individual eats more calories than are burned, the body stores the extra calories as fat. That is why someone who leads a sedentary, or inactive, lifestyle would most likely gain weight if they ate the same amount of food as someone who goes running every day.

Overeating: Consistently eating too much food also increases the risk of becoming obese. Individuals who regularly eat extra-large portions of food, eat until they are full, or eat many times throughout the day are more likely to become obese.

Inactivity: Individuals who do not exercise regularly are more likely to become obese. Physical activity is needed to burn the calories that are consumed in the diet. If these calories are not burned, they will be stored as fat in the body. Most experts recommend at least 30 minutes of moderate exercise three or more times per week to help maintain a healthy weight.

Pregnancy: During pregnancy, the female's body weight increases, not only because she is carrying a baby, but also because the mother's body needs to support the growing fetus. The average weight gain after pregnancy is typically 25-35 pounds. Researchers believe that this weight gain may contribute to the development of obesity.

Medications: Some medications, including corticosteroids and tricyclic antidepressants, may cause weight gain as a side effect.

Medical conditions: Although it is uncommon, sometimes obesity is caused by medical conditions. For instance, if the thyroid does not produce enough thyroid hormone, the metabolism slows down and it may lead to mild weight gain and difficulty losing extra weight.

In addition, some long-term conditions, such as emphysema or arthritis, may limit an individual's ability to exercise. As a result, individuals may become overweight or obese.

Stress: Stress may also contribute to obesity. When an individual becomes stressed, it signals the adrenal glands to release a hormone called cortisol. Research suggests that increase in cortisol levels may lead to increased fat around the midsection.

In addition, recent research suggests that there is a connection between high levels of stress and the desire to eat. It has been proposed that comfort foods, specifically those that are high in fats and sugars, may help reduce the body's response to stress and limit the amount of cortisol that is released. However, individuals who frequently indulge in these foods typically develop excess abdominal fat, which has been associated with an increased risk of heart disease and stroke.

Genetics: Genetics may also contribute to obesity. For instance, a patient's genetics may affect how much fat is stored and where it is distributed in the body. Genetics may also affect how quickly the body is able to convert food into energy and how efficiently the body is able to burn calories during physical activity. Although genetics can increase an individual's risk of becoming obese, it is not the only factor for the condition. In other words, individuals who are genetically predisposed to become obese will not always become obese, especially if they make the right lifestyle choices.

Gender: Women are more likely to become obese than men. This is because women naturally have more body fat and less muscle mass than men. In addition, women burn fewer calories at rest than men do. As a result, women are more likely experience an increase in body fat than males.

Age: Age may also contribute to obesity. Muscle mass tends to decrease with age, which decreases the body's metabolism, or rate at which the body is able to process fats. In addition, most patients become less active as they age. All of these changes lead to a decrease in the amount of calories that body needs. If individuals do not decrease the amount of calories they consume, they will start to gain weight.