Obesity is defined as having an excessive amount of body fat. Obesity is more than just a cosmetic concern, though. It increases your risk of diseases and health problems such as heart disease, diabetes and high blood pressure.

Doctors often use a formula based on your height and weight, called the body mass index (BMI), to determine if you are obese.

BMI and Weight status

Below 18.5 is considered Underweight
18.5 to 24.9 is considered Normal
25.0 to 29.9 is considered Overweight
30.0 and higher is considered Obese
40.0 and higher is considered Extreme obesity

Being extremely obese means you are especially likely to have health problems related to your weight.

The good news is that even modest weight loss can improve or prevent the health problems associated with obesity.

Symptoms

The primary symptom of obesity is having a body mass index (BMI) of 30 or higher. Your body mass index is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.

Because BMI does not directly measure body fat, some people, such as muscular athletes, may have a BMI in the obese category even though they do not have excess body fat.

Causes

Although there are genetic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, including:

1) Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities.

2) Unhealthy diet and eating habits. Having a diet that is high in calories, eating fast food, skipping breakfast, eating most of your calories at night, drinking high-calorie beverages and eating oversized portions all contribute to weight gain.

3) Pregnancy. During pregnancy, a woman's weight necessarily increases. 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.

4) Lack of sleep. Getting less than seven hours of sleep a night can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.

Certain medications. Some medications can lead to weight gain if you do not compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

Medical problems. Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, polycystic ovary syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.

Western Medicine Treatment

The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits. You can start feeling better and seeing improvements in your health with just modest weight loss, 5 to 10 percent of your total weight. That means that if you weigh 200 pounds (91 kg) and are obese by BMI standards, you would need to
lose only about 10 to 20 pounds (4.5 to 9.1 kg) to start seeing benefits.

The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan. Treatment methods include:

1) Dietary changes
2) Exercise and activity
3) Behavior change
4) Prescription weight-loss medications
5) Weight-loss surgery

Losing weight is usually done by making changes in your lifestyle, dietary changes, increased activity and behavior change. Prescription medication or weight-loss surgery is typically used in addition to lifestyle changes in more serious cases.

Dietary changes

Reducing calories and eating healthier are vital to overcoming obesity. Although you may lose weight quickly at first, slow and steady weight loss of 1 or 2 pounds (1/2 to 1 kilogram) a week over the long term is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.

Dietary ways to overcome obesity include:

1)Taking in fewer calories. The key to weight loss is reducing how many calories you take in. You and your health care providers can review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You and your doctor can decide how many calories you need to take in each day to lose weight, but a typical amount is 1,000 to 1,600 calories.

2)Feeling full on less. The concept of energy density can help you satisfy your hunger with fewer calories. All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies, fats and processed foods, are high in energy density. This means that a small volume of that food has a large number of calories. In contrast, other foods, such as fruits and vegetables, have low energy density. These foods provide a larger portion size with a fewer number of calories. By eating larger portions of foods less packed with calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.

3)Adopting a healthy-eating plan. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein, such as beans, lentils and soy, and lean meats. Try to include fish twice a week. Limit salt and added sugar. Stick with low-fat dairy products. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as nuts and olive, canola and nut oils.

4)Meal replacements. These plans suggest that you replace one or two meals with their products such as low-calorie shakes or meal bars, and eat healthy snacks and a healthy, balanced third meal that is low in fat and calories. In the short term, this type of diet can help you lose weight. Keep in mind that these diets likely will not teach you how to change your overall lifestyle, though, so you may have to keep this up if you want to keep your weight off.

Be wary of quick fixes

You may be tempted by fad diets that promise fast and easy weight loss. The reality, however, is that there are no magic foods or quick fixes. Fad diets may help in the short term, but the long-term results do not appear to be any better than other diets. Similarly, you may lose weight on a crash diet, but you a;re likely to regain it when you stop the diet. To lose weight, and keep it off, you have to adopt healthy-eating habits that you can maintain over time.

Increased activity

Increased physical activity or exercise also is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.

To boost your activity level:

1) Exercise. The American College of Sports Medicine recommends that people who are overweight or obese get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to lose a modest amount of weight. But to achieve significant weight loss, you may need to get as much as 250 to 300 minutes of exercise a week. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve. To make your own exercise goal more doable, break it up into several sessions throughout the day, doing just five or six minutes at a time.

2) Increase your daily activity. Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burnalories. Making simple changes throughout your day can add up to big benefits. Park farther from store entrances, rev up your household chores, garden, get up and move around periodically, and wear a pedometer to track how many steps you actually take over the course of a day.

Behavior changes

A behavior modification program can help you make lifestyle changes, lose weight and keep it off. Steps to take include examining your current habits to find out what factors or situations may have contributed to your obesity.

Behavior modification, sometimes called behavior therapy, can include:

1) Counseling. Therapy or interventions with trained mental health or other professionals can help you address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You can also learn how to monitor your diet and activity, understand eating triggers and cope with food cravings. Counseling may be available by telephone, email or Internet-based programs if travel is difficult. Therapy can take place on both an individual and group basis.

2) Support groups. You can find camaraderie and understanding in support groups where others share similar challenges with obesity. Check with your doctor, local hospitals or commercial weight-loss programs for support groups in your area, such as Weight Watchers.

Prescription weight-loss medication

It is best to lose weight through a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may be an option. Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don't make these other changes in your life, medication is unlikely to work.

Your doctor may recommend weight-loss medication if:

1) Other methods of weight loss haven't worked for you

2) Your body mass index (BMI) is greater than 27 and you also have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea.

Orlistat (Xenical) is a weight-loss medication that has been approved by the Food and Drug Administration for long-term weight loss. This medication blocks the digestion and absorption of fat in your stomach and intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is only about 5 to 7 pounds (2.5 to 3.2 kilograms) more than you can get from diet and exercise after one or two years of taking the medication.

Side effects associated with orlistat include oily and frequent bowel movements, bowel urgency, and flatulence with discharge. These side effects can be minimized as you reduce fat in your diet. Because orlistat blocks absorption of some nutrients, take a multivitamin while taking orlistat to prevent nutritional deficiencies.

The FDA has approved orlistat for use in adults, children and adolescents. The FDA also has approved a reduced-strength version of orlistat (Alli) to be sold over-the-counter, without a prescription. This medication works the same as prescription-strength orlistat and is meant only to supplement, not replace, a healthy diet and regular exercise.

You need close medical monitoring while taking a prescription weight-loss medication. Also, keep in mind that a weight-loss medication may not work for everyone. If the medication does work, its effects tend to level off after six months of use like any other method of weight loss. You may need to take a weight-loss medication indefinitely. When you stop taking a weight-loss medication, you are likely to regain much or all of the weight you lost.

Phentermine is a weight-loss medication that was approved in the 1970s only for short-term (three months) use. Using weight-loss medications short-term does not usually lead to long-term weight loss. While some health care providers prescribe phentermine long-term, there are few studies that have evaluated its safety and weight-loss results long term.

Weight-loss surgery

In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery offers the best chance of losing the most weight, but it can pose serious risks. Weight-loss surgery limits the amount of food you're able to comfortably eat or decreases the absorption of food and calories, or both.

Weight-loss surgery for obesity may be considered if:

1) You have extreme obesity, with a body mass index (BMI) of 40 or higher

2) Your BMI is 35 to 39.9, and you also have a serious weight-related health problem, such as diabetes or high blood pressure

3) You are committed to making the lifestyle changes that are necessary for surgery to work

Weight-loss surgery can often help you lose as much as 50 percent or more of your excess body weight. But weight-loss surgery is not a miracle obesity cure. It does not guarantee that you will lose all of your excess weight or that you will keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.

There are numerous types of weight-loss surgery. Some types cause weight loss by restricting how much your stomach can hold. Others prevent your body from absorbing calories and nutrients. Others are a combination of these two types. Common weight-loss surgeries include:

1) Gastric bypass surgery. This is the favored weight-loss surgery in the United States because it has shown relatively good long-term results. In gastric bypass (Roux-en-Y gastric bypass), the surgeon creates a small pouch at the top of your stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of your stomach.

2) Laparoscopic adjustable gastric banding (LAGB). In this procedure, your stomach is separated into two pouches with an inflatable band. Pulling the band tight, like a belt, the surgeon creates a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently. LAGB is popular because it is less invasive, generally causes slow, steady weight loss and the band can be adjusted if needed. However, as with other procedures, this won't work without changes in your behavior. Results are usually not as good as with other procedures.

3) Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. There are ongoing studies evaluating this procedure.

4) Biliopancreatic diversion with duodenal switch. In this procedure, most of your stomach is surgically removed. This weight-loss surgery offers sustained weight loss, but it poses a greater risk of malnutrition and vitamin deficiencies, and you require close monitoring for health problems. It's generally used for people who have a body mass index of 50 or more.

Preventing weight regain after obesity treatment

Unfortunately, it is common to regain weight no matter what obesity treatment methods you try. But that does not mean your weight-loss efforts are futile.

One of the best ways to prevent regaining the weight you have lost is getting regular physical activity. Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.

You may always have to remain vigilant about your weight. Combining a healthier diet and more activity is the best way to lose weight and keep it off for the long term. If you take weight-loss medications, you will probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or eat foods laden with fat and calories.

Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term.

Adopted From mayoclonic.com