Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It’s a medical problem that increases the risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
There are many reasons why some people have difficulty losing weight. Usually, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices.
The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.
Read the symptoms of obesity with Pritish Kumar Halder.
Body mass index (BMI) is often used to diagnose obesity. To calculate BMI, multiply weight in pounds by 703, divide by height in inches and then divide again by height in inches. Or divide weight in kilograms by height in meters squared.
Asians with BMI of 23 or higher may have an increased risk of health problems.
For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.
Many doctors also measure a person’s waist circumference to help guide treatment decisions. Weight-related health problems are more common in men with a waist circumference over 40 inches (102 centimeters) and in women with a waist measurement over 35 inches (89 centimeters).
When to see a doctor
If you’re concerned about your weight or weight-related health problems, ask your doctor about obesity management. You and your doctor can evaluate your health risks and discuss your weight-loss options.
Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through normal daily activities and exercise. Your body stores these excess calories as fat.
In the United States, most people’s diets are too high in calories — often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.
Many people who live in Western countries now have jobs that are much less physically demanding, so they don’t tend to burn as many calories at work. Even daily activities use fewer calories, courtesy of conveniences such as remote controls, escalators, online shopping and drive-through banks.
Obesity usually results from a combination of causes and contributing factors:
Family inheritance and influences
The genes you inherit from your parents may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise.
Obesity tends to run in families. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.
A diet that’s high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.
People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages, such as sugared soft drinks, can contribute to significant weight gain.
If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet and phone screens is a sedentary activity. The number of hours spent in front of a screen is highly associated with weight gain.
Certain diseases and medications
In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.
Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.
Social and economic issues
Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight — you’re more likely to develop obesity if you have friends or relatives with obesity.
Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.
Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.
Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. In the long run, however, quitting smoking is still a greater benefit to your health than is continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.
Lack of sleep
Not getting enough sleep or getting too much sleep can cause changes in hormones that increase appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
Many external factors that affect mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.
Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.
Even if you have one or more of these risk factors, it doesn’t mean that you’re destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.
People with obesity are more likely to develop a number of potentially serious health problems, including:
Heart disease and strokes.
Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
Type 2 diabetes
Obesity can affect the way the body uses insulin to control blood sugar levels. This raises the risk of insulin resistance and diabetes.
Obesity may increase the risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
Obesity increases the likelihood of developing heartburn, gallbladder disease and liver problems.
People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.
Severe COVID-19 symptoms.
Obesity increases the risk of developing severe symptoms if you become infected with the virus that causes coronavirus disease 2019 (COVID-19). People who have severe cases of COVID-19 may require treatment in intensive care units or even mechanical assistance to breathe.
Why Do People Become Overweight?
When people eat more calories than they use, their bodies store the extra calories as fat. A couple pounds of extra body fat usually doesn’t cause problems for most people. But when people keep up a pattern of eating more calories than they burn, more and more fat builds up in their bodies.
Weight problems tends to run in families. Some people have a genetic tendency to gain weight more easily than others. Although genes strongly influence body type and size, the environment also plays a role.
Unhealthy food habits
People today are gaining weight because of unhealthy food choices (like fast food) and family habits (like eating in front of the TV instead of around a table). High-calorie, low-nutrient snacks (like chips, cookies, and ice cream) and beverages (like soda, juice, and sports drinks), bigger portions of food, and less-active lifestyles are all contributing to the obesity epidemic. And people who don’t get enough sleep are more likely to be overweight.
Sometimes people turn to food for emotional reasons, such as when they feel upset, anxious, sad, stressed out, or even bored. When this happens, they often eat more than they need.
Figuring out if a teen is overweight is a little more complicated than it is for adults. That’s because teens are still growing and developing.
Doctors and other health care professionals use a measurement called body mass index (BMI) to tell if someone is overweight.
The doctor calculates BMI using a person’s height and weight, and then plots that number on a chart to see what weight category they are in. There are different charts for girls or guys. BMI estimates how much body fat the person has. People with high BMI are more likely to have weight-related health problems.
Doctors use four categories to describe a person’s weight:
A person weighs less than the healthy range for their age, gender, and height.
A person’s weight is in the healthy range for their age, gender, and height.
A person weighs more than the healthy range for their age, gender, and height.
A person weighs much more than the healthy range for their age, gender, and height.
Because muscle weighs more than fat, a muscular person can have a high BMI, but not too much body fat. Likewise, it’s possible for someone to have a low or ideal BMI but still have too much body fat.
You may get a BMI report from school, but the best way to understand BMI is to talk to your doctor.
Health Problems of Being Overweight
Weight-related health problems include:
Obesity increases the chance of having asthma. Breathing problems related to weight can make it harder to keep up with friends, play sports, or just walk from class to class.
This condition (where a person temporarily stops breathing during sleep) is a serious problem for many overweight kids and adults. Sleep apnea can leave people feeling tired and having trouble paying attention and learning. It also may lead to heart problems.
High blood pressure
When blood pressure is high, the heart has to work harder. If the problem continues for a long time, high blood pressure can damage the heart and arteries.
Abnormal blood lipid levels, including high cholesterol, low HDL (“good”) cholesterol, and high triglyceride levels, increase the chances of having a heart attack or stroke when a person gets older.
A buildup of bile that hardens in the gallbladder forms gallstones. These can be painful and require surgery.
If fat builds up in the liver, it can cause inflammation, scarring, and permanent liver damage.
Joint and muscle pain
Wear and tear on the joints from carrying extra weight can cause pain and may lead to arthritis in adulthood.
Slipped capital femoral epiphyses
SCFE is a painful hip problem that requires immediate attention and surgery to prevent further damage to the joint.
This is a rare cause of severe headaches in obese teens and adults. There is no tumor, but pressure builds in the brain. Besides headaches, symptoms may include vomiting, double vision, and other vision problems.
Polycystic ovary syndrome
Although it’s normal for girls to have some testosterone (the male hormone), girls with PCOS have higher testosterone levels in the blood. This leads to irregular periods, too much hair growth, and bad acne.
Insulin resistance and diabetes
Insulin is a hormone that lowers the level of glucose (a type of sugar) in the blood. When there is too much body fat, insulin doesn’t work as well getting glucose, the body’s main source of energy, into cells. The body then needs more insulin to keep a normal blood sugar level. For some overweight teens, insulin resistance can progress to prediabetes and diabetes (high blood sugar).
People with weight problems are more likely to be depressed and have lower self-esteem.
Luckily, it’s never too late to make changes that can help control weight gain and the health problems it causes. Those changes don’t have to be big. For a start, make a plan to cut back on sugary beverages, control portions, and get more exercise, even if it’s just 5–10 minutes a day. Build your way up to big changes by making a series of small ones. And don’t be afraid to ask for help!