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Obesity is a serious disorder, which is an excessive amount of body fat. This disorder increases the chance to have other diseases, as heart problems, high blood pressure and diabetes. This is not just a cosmetic concern, according to some studies from the National Center for Health Statistics, in the United States, increased from obesity individuals from 19.4% in 1997 to 31.4% for the period January-September 2017 in people over the age of 20. Fortunately, this complex disorder has different kinds of treatment. Changing your lifestyle can help you to lose weight and prevent or decrease the chance of having health problems associated with obesity. Dietary changes, physical exercises and other habits can help you to lose weight. You can also have other options as prescription medications and surgery.
What are the signs and symptoms?
There are some classifications to define your degree of obesity. However, there are two widely accepted. The first one is from the World Health Organization (WHO), which is based on body mass index (BMI). Your body mass is calculated by dividing your weight in kilograms by your height in meters squared. If your body mass index is 30 or higher you are considered obese.
Please find below the chart below, which shows the index and the weight status.
|30.0-34.9||Obese (Class I)|
|35.0-39.9||Obese (Class II)|
|40.0 or higher||Extremely Obese (Class III)|
For most people, the BMI can provide a reasonable estimate of body fat. However, for athletes and people who have more muscle, they can fall in the obese category even if they do not have excess of body fat. Therefore, BMI should be evaluated differently in these type of people. The second classification widely accepted is the definition of obesity based on percentage of body fat, as follow:
Percentage of body fat Man: Higher than 25% and the limit from 21-25% Woman: Higher than 33% and the limit from 31-33%
|Percentage of body fat|
|Man: Higher than 25% and the limit from 21-25%|
|Woman: Higher than 33% and the limit from 31-33%|
When is it important to see a doctor?
If your BMI or your percentage of body fat is in the obese range, it is important to see a doctor. Your GP can help you to understand the causes and the possible treatments to lose weight. To diagnose obesity and possible treatments first, he will ask some exams and tests, as follow:
- The doctor will do general physical exams: measuring your height, checking your heart, lungs and abdomen, checking your vital signs, such as heart rate, temperature and blood pressure;
- He will ask you about your health history: This is important to diagnosis the possible causes of your obesity. For example, your current diet, your stress levels, if you are taking other medications and any other issues about your health. He can also ask you about your family´s health history to analyze if you have the tendency to be obese.
- He will calculate your BMI and will measure your waist circumferences: Both tests are important to determinate your overall health risks and it is good to do at least once a year. Fat stored in your waist can increase the chances to have some diseases, such as heart attack or diabetes. For men, if you have a waist circumference greater than 102 centimeters, and for women, if you have more than 80 centimeters, the chances of having more health risks are higher than people with smaller waist circumferences.
- Your GP can also ask for blood tests: According to the other tests and exams above, the doctor can ask for complement blood tests, for example, liver function tests, cholesterol test, thyroid test and others.
After all these tests, the doctor can determine the cases of obesity and which treatment is adequate to your case.
What can cause Obesity? Which are the risk factors?
There are many risk factors and causes that may cause obesity. However, obesity happens when your body absorbs more calories than it is able to burn. The body stores these excess calories in fat form. There are some disorders that can cause obesity, for example, Cushing´s syndrome and Prader-Will syndrome, but usually they are rare. The most common causes are: inactivity, unhealthy diet and unhealthy eating habits.
There are also some risk factors that can improve the chance to have obesity, as follow:
- Sedentary: If you usually do not do exercise, you can easily consume more calories than you can burn. Then, this kind of lifestyle can lead you to obesity. Usually some people who have some medical problems, for example, arthritis, can decrease the activity, leading to weight gain. It is always better to increase the level of daily exercises to avoid the weight gain;
- Unhealthy diet and eating habits: The type of food and the quantity you eat, can interfere strongly in obesity. Nowadays, most of the people are consuming a diet full of fast food and are not eating healthy food such as vegetables and fruits, which increases the chance to have obesity. Changing your eating habits can help you to keep your weight under control;
- Some medications: There are some medications that can you lead you to gain weight, if you do not compensate increasing in your routine the level of exercises, you will end up gaining more weight. There are a lot of medicines but the most common ones are diabetes medications, anti-seizure medications, and antidepressants ;
- Genetics: Your genes can also affect the way and where your body stores fat. Some people have higher propensity to gain weight because their body can not burn fat efficiently as other people;
- Family habits: The way your family eats can impact in the way you eat. This can happen because usually family members share the same activities and eating habits;
- Age: Despite the fact that obesity can occur at any age, but the tendency to gain weight will increase proportionally with age. This happens because during the years your metabolism is becoming slower and if you do not decrease the amount of food you eat, or increase the level of exercise, chances of suffering from obesity will rise.
- Pregnancy: When you are pregnant, your body needs more calories to feed the fetus and you will gain weight. Unfortunately, some women after the baby is born, have difficulty losing weight which can lead to obesity;
There are others factors that can also influence the weight gain. But do not worry if you have one or more risk factors mentioned above. If you control your diet, change your habits and do more exercises, you probably will not become obese.
Obesity can increase the chance to develop serious diseases, including:
- Heart attack;
- High blood pressure;
- Gynecological problems, for example, irregular periods and infertility;
- Diabetes ( Type 2);
- Low high-density lipoprotein (HDL) cholesterol;
- Sleep disorder, for example, sleep apnea;
- Sexual health issues;
An obese person can also feel discriminated and not be able to do the same activities as persons that do not suffer obesity. This can lead to psychological problems, such as depression, social isolation, lower work achievement, among others.
Which treatments are available?
If you are obese, the first thing to do is to go to your GP. Your doctor will be able to help you decide which treatment is more suitable in your case to lose weight safely. Usually the initial treatment goal consists to lose from three to 5% of your weight. For example, if you have 100 kg, you would need to lose from three to 5 kg. The treatment and the quantity you need to lose depends on your level of obesity and your historical health problems. There are a lot of treatments to weight loss, but all the treatments require first changes in your eating habits and the increase of physical activity. The other tools to lose weight include:
The first step to lose weight is to reduce the quantity of calories that you consume per day and to change your eating and drinking habits. Usually, the safe and sustainable quantity to lose per week is from 0.5 to 1 kg, and most of the people are suggested to decrease around 600 calories a day. For men, usually, you should not have a diet with more than 1900 calories per day, and women more than 1400 calories per day. The best way to achieve this is to change the food choices from unhealthy and high calories foods and drinks to healthier choices.
A good diet includes:
- Great quantity of fruits and vegetables;
- Plenty of potatoes, rises, bread and pasta, but it is always recommended to eat whole grain varieties;
- Drink milk and more water;
- Avoid alcohol and food with high quantity in fat and sugar;
- Avoid eating food with a lot of salt because they can also increase your blood pressure, which is dangerous for obese people;
- Eat protein included in meat, fish, egg and others foods, but always trying to consume meat with less fat;
- Try to change also the portion sizes and eat more times a day healthy foods;
The most important thing is to change in long term your eating and drinking habits. Restrictive diets tend to be impossible to keep over the months and probably you will gain weight faster.
The second step to do is to increase your exercises and activities during the day. This step will help you burn more calories and lose weight faster. Some studies have shown that people who do exercises together with a diet can maintain the weight after one year. Walking for at least 30 minutes can help you to maintain the weight over the time. The Chief Medical Officers recommend that adults who are overweight or obese need at least 150 minutes a week of moderate-intensity exercises to maintain the weight and prevent to gain back the loss weight. Alternatively, you can also have 75 minutes a week of vigorous-intensity exercises. It is important to talk to your doctor, be advice what kind of exercise is good for your case, and be able to increase the amount of exercises as your endurance and fitness improve. Try to find some exercise that you enjoy, activities with a friend or family can help you keep you motivated.
There are many different types of anti-obesity medicines, but the safest and effective according to recent studies is Orlistat. All losing-weight programs require diet and exercises, but in some cases, your doctor can recommend weight-loss medication. Possibly, your doctor will recommend you to use weight-loss medication when:
- Your body mass index (BMI) is 30 or greater;
- If your BMI is 27 but you also have medical complication of obesity, as sleep apnea, high blood pressure or diabetes;
Please be aware that this medicine has side-effects and it is always good to talk to your doctor to analyze if it is necessary in your case. The side-effects, include:
- Passing stools more frequently and fatty or oily stools;
- Needing to go urgently to the toilet;
- Stomach pain;
These side-effects are more likely to happen when you do not follow a low-fat diet. Your doctor will evaluate the weight loss every 3 months using orlistat. If you will be still losing weight, your GP will suggest you to keep the treatment for 12 months or more. It is important to talk to your doctor to see the benefits, limitations and side-effects with you.
People who suffer extreme obesity may be suggested to have a weight loss surgery, also called bariatric surgery. Usually, this surgery is recommended if you tried other methods and did not work and if you fill these criteria, below:
- If you have a BMI of 40 or more, or if you have from 35 to 40 and have other serious health problems, as high blood pressure or type 2 diabetes;
- The person is fit enough to have anesthesia;
- If you are committed to change your eating habits after the surgery in order to the surgery works;
How to keep weight after obesity treatment?
Unfortunately, many people gain the weight after stopping the treatments or if they keep eating high-calories food after the weight loss surgery. The best way to maintain your weight is to keep doing exercises, preferably, 60 minutes a day. Try to find ways to be motivated and keep eating healthier, these steps are the key to maintain yourself healthy in the long term.
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