Overview

Obesity is a complex disease characterized by excessive body fat, and it goes beyond being a cosmetic concern. It’s a
serious medical condition that increases the risk of various health problems, including heart disease, diabetes, high
blood pressure, high cholesterol, liver disease, sleep apnea, and certain cancers.

Symptoms and Diagnosis

Body mass index (BMI) is commonly used to diagnose obesity. However, BMI doesn’t directly measure body fat. People
with high muscle mass may have an elevated BMI even without excess body fat. Waist circumference and body fat
percentage measurements are additional tools to assess obesity and track progress during weight loss programs.

A BMI of 30 or higher is classified as obesity. Asians with a BMI of 23 or higher may have an increased risk of health
problems. It’s essential to consult with a healthcare professional to evaluate your health risks and discuss
weight-loss options if needed.

Causes and Risk Factors

Obesity can result from various causes and contributing factors, including genetics, lifestyle choices, certain
medical conditions, social and economic influences, age, and other factors. Family history, unhealthy diet, physical
inactivity, certain medications, and lack of sleep are common risk factors associated with obesity.

Complications

Obesity can lead to severe health complications, such as heart disease, type 2 diabetes, various cancers, digestive
problems, sleep apnea, osteoarthritis, fatty liver disease, and an increased risk of severe symptoms from infections
like COVID-19. It can also impact overall quality of life, leading to reduced physical activities, social isolation,
and psychological issues such as depression and guilt.

Treatment and Prevention

The good news is that even modest weight loss can improve or prevent obesity-related health problems. A combination of
a healthier diet, increased physical activity, and behavior changes can help with weight loss. Prescription medicines
and weight-loss procedures are other options for treating obesity when necessary. Prevention involves making healthy
lifestyle choices, avoiding excessive calorie intake, staying physically active, and seeking support when needed.

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Diagnosis

To diagnose obesity, your health care professional will conduct a comprehensive evaluation, which includes:

  • Taking your health history, weight history, and eating patterns
  • Performing a general physical exam, including measuring your BMI
  • Measuring your waist size to assess abdominal fat
  • Checking for other health problems such as high blood pressure, high cholesterol, and diabetes

Gathering this information helps your health care team determine the best treatment plan for you.

Treatment

The primary goal of obesity treatment is achieving and maintaining a healthy weight to reduce health risks. This often
involves working with a team of health professionals, including dietitians, behavioral counselors, or obesity
specialists. The treatment plan may include:

Dietary Changes:

  • Reducing calorie intake and practicing healthier eating habits
  • Feeling full on fewer calories by choosing larger portions of low-calorie foods
  • Opting for a balanced and nutritious diet with lean protein, fruits, vegetables, and whole grains
  • Avoiding high-calorie beverages and limiting added sugar and salt

Exercise and Activity:

  • Engaging in at least 150 minutes of moderate-intensity physical activity per week
  • Incorporating more movement throughout the day to burn extra calories

Behavior Changes:

  • Participating in counseling or support groups to address emotional and behavioral aspects of eating
  • Developing stress management and relaxation skills to control unhealthy eating habits

Weight-Loss Medications:

Prescription medications may be considered along with lifestyle changes to aid weight loss. Commonly used medications
include Bupropion-naltrexone, Liraglutide, Orlistat, Phentermine-topiramate, and Semaglutide.

Endoscopic Procedures:

Non-surgical endoscopic procedures can help reduce stomach size and food intake. Common procedures include Endoscopic
Sleeve Gastroplasty and Intragastric Balloon placement.

Weight-Loss Surgery (Bariatric Surgery):

For severe obesity, bariatric surgery may be an option. Procedures like Gastric Bypass, Gastric Sleeve, and Adjustable
Gastric Banding can limit food intake and promote weight loss. Weight-loss surgery requires a commitment to lifelong
lifestyle changes.

Other Treatments:

Other treatments include hydrogels, vagal nerve blockade, and gastric aspirate, which are still being studied and may
be available in the future.

Lifestyle and Home Remedies

Successful obesity management also involves lifestyle changes at home, including:

  • Learning about obesity and understanding its causes
  • Setting realistic weight-loss goals and tracking progress
  • Staying committed to your treatment plan and seeking support from family and friends
  • Keeping a food and activity log to stay accountable

Coping and Support

Coping with obesity and weight-loss efforts may require emotional support and coping skills:

  • Expressing emotions through journaling
  • Connecting with others through support groups
  • Staying focused on goals and practicing relaxation and stress management

Preparing for Your Appointment

Being an active participant in your care is essential. Before your appointment:

  • Think about your needs and goals for treatment
  • Write down questions to ask your health care professional
  • Be prepared to discuss your weight, eating habits, activity level, and any medical conditions

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