Overweight in Adults

(Obesity; Morbid Obesity)

Overview

Definition

Definition

Being overweight or obese means your weight is above an ideal weight range. Excess weight creates an increase in the risk of serious diseases like heart disease, certain cancers, and diabetes.

One tool used to estimate weight range is called the body mass index (BMI). This scale determines weight ranges based on height. BMI levels in adults include:

  • Ideal weight range: 18.5-24.9
  • Overweight: 25-29.9
  • Obese: 30 or above
  • Morbid obesity: 40

Causes

Causes

Being overweight is caused by taking in more calories than we use. Calories are taken in through food. All activity in our bodies is fueled by calories. This includes physical activity and basic bodily functions. Excess weight gain occurs when this relationship is not kept in balance. If this imbalance happens regularly it will lead to obesity.

Factors that can influence the development of obesity include:

Risk Factors

Risk Factors

This condition is more common in older adults.

Factors that may increase your chance of becoming overweight include:

  • Family history of obersity
  • Eating large portions of food
  • Sedentary lifestyle—Getting too little exercise and spending too much time in front of a television or computer
  • Eating until full and eating quickly
  • High level of fast food intake
  • High alcohol consumption
  • Working varied shifts
  • Not getting enough sleep
  • Post-traumatic stress disorder in women

Symptoms

Symptoms

Symptoms may include:

  • Increased weight
  • Thickness around the midsection
  • Obvious areas of fat deposits

Complications of Excessive Weight Gain

Complications of Excessive Weight Gain

Excessive weight gain has been linked to:

An increased risk of:

Decrease in quality of life associated with:

Being overweight can also affect pregnancy. Some complications include:

You may also experience problems during labor and deliver, have a baby with a high birth weight, or have a baby with malformations.

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Obesity is diagnosed by visual exam and body measurements using:

  • Height and weight tables
  • Body mass index
  • Measuring body folds with a caliper
  • Measuring waist circumference
  • Water-displacement tests

Your bodily fluids may be tested. This can be done with blood tests.

Treatment

Treatment

Obesity is difficult to treat. Things that affect treatment are:

  • Cultural factors
  • Personal habits
  • Lifestyle
  • Genetics

You and your doctor will talk about the best treatment plan for you. There are many different approaches to treating obesity based on lifestyle changes. You are more likely to successfully lose weight and keep it off by using a combination of strategies. These can include eating healthy, exercise, counseling, and/or medication. Plans for weight loss may include:

Diet

Your doctor may recommend that you spread your calorie intake throughout the day rather than getting it all in a few large meals. You may also need a special diet that will eliminate specific types of food.

Talk to your doctor or ask for a referral to a dietitian. A dietitian can help you develop a plan that is best for you.

Calorie Intake

The key to weight loss is reducing the total number of calories that you eat. Following a specific kind of diet, like a low-carbohydrate diet, is not necessary. It is much more important to choose a low calorie diet that you can stick with long term.

A dietitian can help you with your total calorie intake goal. Calorie intake is based on your current weight and your weight loss goals.

Portion, or serving size, also plays an important role. Using special portion control plates may help you succeed.

Food Diary

Keep track of everything you eat and drink.

Exercise

Ask your doctor about an exercise program. Even moderate-intensity exercise, like brisk walking, can help you lose weight.

There are many easy ways to add extra activity into your daily routine. Take stairs instead of elevators. Park your car a little further away. Limit the amount of time you spend watching television and using the computer and substitute it with activity.

Behavior Therapy

Behavior therapy may help you understand:

  • When you tend to overeat
  • Why you tend to overeat
  • How to combat overeating habits

When combined with diet and exercise, therapy can help you with your weight reduction.

Weight Loss Programs

Weight loss programs may work for some people. Some studies also suggest that a partner or group may help you improve your eating habits and fitness.

Medications

Weight loss medications may be prescribed. Medication alone is not enough to lose weight and keep it off. Some medications have serious side effects. There are also risks associated with over-the-counter and herbal products. Talk to your doctor before taking any of these.

Bariatric Surgery

Bariatric surgery makes the stomach smaller. In some cases, it will also rearrange the digestive tract. The smaller stomach can only hold a tiny portion of food at a time. Examples of procedures include:

These procedures may be a good option for people who are severely obese who are having trouble losing weight by other means.

Gastric Bypass

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Balloon Procedure

A non-surgical temporary balloon device has been approved to promote weight loss. The device is inserted into the stomach through the mouth. It occupies space in the stomach and triggers a feeling of fullness. The device is removed 6 months after insertion. Talk to your doctor for more information about this procedure.

Prevention

Prevention

Controlling your weight can be difficult. To reduce your chance of getting overweight, take these steps:

  • Talk to your doctor or a dietitian about an appropriate number of calories to eat per day that will help you maintain a healthy weight or lose weight if necessary.
  • Learn to eat smaller portions of food.
  • Limit the amount of time you spend doing sedentary activities. This includes watching TV or using the computer.
  • Talk to your doctor or an exercise professional about working activity into your daily life.

RESOURCES:

Academy of Nutrition and Dietetics http://www.eatright.org

The Obesity Society http://www.obesity.org

CANADIAN RESOURCES:

Health Canada http://www.hc-sc.gc.ca

Dietitians of Canada http://www.dietitians.ca

References:

Body mass index (BMI calculator). American Heart Association website. Available at:
http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/BodyMassIndex/Body-Mass-Index-BMI-Calculator_UCM_307849_Article.jsp
Updated August 26, 2014. Accessed January 16, 2015.

Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at:
http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf
Accessed January 16, 2015.

Obesity in adults. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated December 18, 2014. Accessed January 16, 2015.

Obesity, bias, and stigmatization. The Obesity Society website. Available at:
http://www.obesity.org/resources-for/obesity-bias-and-stigmatization.htm
Accessed January 16, 2015.

Thompson WG, Cook DA, Clark MM, Bardia A, Levine JA. Treatment of obesity. Mayo Clin Proc. 2007;82:93-101.

Weight loss medications for obesity in adults. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
. Updated June 16, 2014. Accessed January 16, 2015.

8/21/2007 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Pedersen SD, Kang J, Kline GA. Portion control plate for weight loss in obese patients with type 2 diabetes mellitus: a controlled clinical trial. Arch Intern Med. 2007;167:1277-1283.

7/22/2008 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229-241.

9/30/2008 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Samuels-Kalow ME, Funai EF, Buhimschi C, et al. Pre-pregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am J Obstet Gynecol. 2007;197:490.e1-6. Epub 2007 Aug 21.

12/2/2008 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Maruyama K, Ohira T, Maeda K, et al. The joint impact on being overweight of self reported behaviours of eating quickly and eating until full: cross sectional survey. BMJ. 2008;337.

12/2/2008 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105-2120.

2/5/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Subak L, Wing R, Smith West D, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360:481-490.

4/14/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859-873.

4/16/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Neovius M, Sundström J, Rasmussen F. Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ. 2009 Feb 24;338:b496.

5/11/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Luttikhuis HO, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;(1):CD001872.

7/6/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47:573-582. Epub 2008 Jan 16.

9/25/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Garipağaoğlu M, Sahip Y, Darendeliler F, Akdikmen O, Kopuz S, Sut N. Family-based group treatment versus individual treatment in the management of childhood obesity: randomized, prospective clinical trial. Eur J Pediatr. 2009;168:1091-1099.

10/16/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7:352-356.

11/10/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Laurson KR, Eisenmann JC, Welk GJ, Wickel EE, Gentile Da, Walsh DA. Combined influence of physical activity and screen time recommendations on childhood overweight. J Pediatr. 2008;153(2):209-214.

1/15/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171(2):135-54.

1/29/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Kuk JL, Ardern CI. Influence of age on the association between various measures of obesity and all-cause mortality. J Am Geriatr Soc. 2009 Sep 15.

1/29/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Berkey CS, Rockett HR, Colditz GA. Weight gain in older adolescent females: the internet, sleep, coffee, and alcohol. J Pediatr. 2008;153(5):635-639.

2/19/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1-190, 215-357, iii-iv.

2/19/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
O’Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303(6):519-526.

10/15/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Published October 8, 2010. Accessed February 27, 2014.

12/17/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
US Food and Drug Administration. FDA: Tainted products marketed as dietary supplements potentially dangerous. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm236967.htm. Updated December 15, 2010. Accessed February 27, 2014.

11/25/2013 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Kubzansky L, Bordelois P, et al. The weight of traumatic stress: A prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiatry; 2013 Nov 20.

5/17/2014 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Kim SY, Sharma AJ, et al. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births. Obstet Gynecol. 2014 Apr;123(4):737-744.

5/27/2014 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Molyneaux E, Poston L, et al. Obesity and mental disorders during pregnancy and postpartum: A systematic review and meta-analysis. Obstet Gynecol. 2014;123(4):857-867.

10/1/2014 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Bhaskaran K, Douglas I, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.

8/3/2015 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
US Food and Drug Administration. FDA approves non-surgical temporary balloon device to treat obesity. FDA Press Release. 2015 Jul 28. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm456296.htm. Accessed August 3, 2015.

Last reviewed January 2015 by Kim Carmichael, MD
Last Updated: 10/1/1014

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