What Are Overweight and Obesity?
The terms overweight and
obesity refer to a persons overall body weight and where the
extra weight comes from. Overweight is having extra body weight from muscle,
bone, fat, and/or water. Obesity is having a high amount of extra body fat. The
most useful measure of overweight and obesity is the body mass index (BMI). BMI
is based on height and weight and is used for adults, children, and teens. For
more information about BMI, see How Are
Overweight and Obesity Diagnosed?
Millions of Americans and people worldwide are
overweight or obese. Being overweight or obese puts you at risk for many
diseases and conditions. The more body fat that you carry around and the more
you weigh, the more likely you are to develop
heart
disease,
high
blood pressure, type 2 diabetes, gallstones, breathing problems, and
certain cancers.
A persons weight is a result of many factors.
These factors include environment, family history and genetics, metabolism (the
way your body changes food and oxygen into energy), behavior or habits, and
other factors.
Certain things, like family history, cant be
changed. However, other thingslike a persons lifestyle
habitscan be changed. You can help prevent or treat overweight and
obesity if you:
- Follow a healthful diet, while keeping your
calorie needs in mind
- Are physically active
- Limit the time you spend being physically
inactive
Weight loss medicines and surgery also are options
for some people who need to lose weight if lifestyle changes dont
work.
Outlook
Reaching and staying at a healthy weight is a
long-term challenge for people who are overweight or obese. But it also can be
a chance to lower your risk of other serious health problems. With the right
treatment and motivation, its possible to lose weight and lower your
long-term disease risk.
What Causes Overweight and Obesity?
Energy Balance
For most people, overweight and obesity are caused
by not having energy balance. Weight is balanced by the amount of energy or
calories you get from food and drinks (this is called energy IN) equaling the
energy your body uses for things like breathing, digesting, and being
physically active (this is called energy OUT).
Energy balance means that your energy IN equals your
energy OUT. To maintain a healthy weight, your energy IN and OUT dont
have to balance exactly every day. Its the balance over time that helps
you maintain a healthy weight.
- The same amount of energy IN and energy OUT over
time = weight stays the same
- More IN than OUT over time = weight gain
- More OUT than IN over time = weight loss
Overweight and obesity happen over time when you
take in more calories than you use.
Other Causes
Physical Inactivity
Many Americans arent very physically active.
There are many reasons for this. One reason is that many people spend hours in
front of TVs and computers doing work, schoolwork, and leisure activities. In
fact, more than 2 hours a day of regular TV viewing time has been linked to
overweight and obesity.
Other reasons for not being active include: relying
on cars instead of walking to places, fewer physical demands at work or at home
because modern technology and conveniences reduce the need to burn calories,
and lack of physical education classes in schools for children.
People who are inactive are more likely to gain
weight because they dont burn up the calories that they take in from food
and drinks. An inactive lifestyle also raises your risk for
heart
disease,
high
blood pressure, diabetes, colon cancer, and other health problems.
Environment
Our environment doesnt always help with
healthy lifestyle habits; in fact, it encourages obesity. Some reasons
include:
- Lack of neighborhood sidewalks and safe places
for recreation. Not having area parks, trails, sidewalks, and affordable gyms
makes it hard for people to be physically active.
- Work schedules. People often say that they
dont have time to be physically active given the long hours at work and
the time spent commuting back and forth to work.
- Oversized food portions. Americans are surrounded
by huge food portions in restaurants, fast food places, gas stations, movie
theaters, supermarkets, and even home. Some of these meals and snacks can feed
two or more people. Eating large portions means too much energy IN. Over time,
this will cause weight gain if it isnt balanced with physical
activity.
- Lack of access to healthy foods. Some people
dont live in neighborhoods that have supermarkets that sell healthy foods
such as fresh fruits and vegetables. Or if they do, these items are often too
costly.
- Food advertising. Americans are surrounded by ads
from food companies. Often children are the targets of advertising for
high-calorie, high-fat snacks and sugary drinks. The goal of these ads is to
sway people to buy these high-calorie foods, and often they do.
Genes and Family History
Studies of identical twins who have been raised
apart show that genes have a strong influence on ones weight. Overweight
and obesity tend to run in families. Your chances of being overweight are
greater if one or both of your parents are overweight or obese. Your genes also
may affect the amount of fat you store in your body and where on your body you
carry the extra fat.
Because families also share food and physical
activity habits, there is a link between genes and the environment. Children
adopt the habits of their parents. So, a child with overweight parents who eat
high-calorie foods and are inactive will likely become overweight like the
parents. On the other hand, if a family adopts healthful food and physical
activity habits, the childs chance of being overweight or obese is
reduced.
Health Conditions
Sometimes hormone problems cause overweight and
obesity. These problems include:
- Underactive thyroid (also called hypothyroidism).
This is a condition in which the thyroid gland doesnt make enough thyroid
hormone. Lack of thyroid hormone will slow down your metabolism and cause
weight gain. Youll also feel tired and weak.
- Cushings syndrome. This is a condition in
which the bodys adrenal glands make too much of the hormone cortisol.
Cushings syndrome also can happen when people take high levels of
medicines such as prednisone for long periods of time. People with
Cushings syndrome gain weight, have upper-body obesity, a rounded face,
fat around the neck, and thin arms and legs.
- Polycystic ovarian syndrome (PCOS). This is a
condition that affects about 5 to 10 percent of women of childbearing age.
Women with PCOS often are obese, have excess hair growth, and have reproductive
and other health problems due to high levels of hormones called androgens.
Medicines
Certain medicines such as corticosteroids (for
example, prednisone), antidepressants (for example, Elavil®),
and medicines for seizures (for example, Neurontin®) may cause
you to gain weight. These medicines can slow the rate at which your body burns
calories, increase your appetite, or cause your body to hold on to extra
waterall of which can lead to weight gain.
Emotional Factors
Some people eat more than usual when they are bored,
angry, or stressed. Over time, overeating will lead to weight gain and may
cause overweight or obesity.
Smoking
Some people gain weight when they stop smoking. One
reason is that food often tastes and smells better. Another reason is because
nicotine raises the rate at which your body burns calories, so you burn fewer
calories when you stop smoking. However, smoking is a serious health risk, and
quitting is more important than possible weight gain.
Age
As you get older, you tend to lose muscle,
especially if youre less active. Muscle loss can slow down the rate at
which your body burns calories. If you dont reduce your calorie intake as
you get older, you may gain weight. Midlife weight gain in women is mainly due
to aging and lifestyle, but menopause also plays a role. Many women gain around
5 pounds during menopause and have more fat around the waist than they did
before.
Pregnancy
During pregnancy, women gain weight so that the baby
gets proper nourishment and develops normally. After giving birth, some women
find it hard to lose the weight. This may lead to overweight or obesity,
especially after a few pregnancies.
Lack of Sleep
Studies find that the less people sleep, the more
likely they are to be overweight or obese. People who report sleeping 5 hours a
night, for example, are much more likely to become obese compared to people who
sleep 78 hours a night.
People who sleep fewer hours also seem to prefer
eating foods that are higher in calories and carbohydrates, which can lead to
overeating, weight gain, and obesity over time. Hormones that are released
during sleep control appetite and the bodys use of energy. For example,
insulin controls the rise and fall of blood sugar levels during sleep. People
who dont get enough sleep have insulin and blood sugar levels that are
similar to those in people who are likely to have diabetes.
Also, people who dont get enough sleep on a
regular basis seem to have high levels of a hormone called ghrelin (which
causes hunger) and low levels of a hormone called leptin (which normally helps
to curb hunger).
What Are the Health Risks of Overweight and
Obesity?
Being overweight or obese isnt a cosmetic
problem. It greatly raises the risk in adults for many diseases and
conditions.
Overweight and Obesity-Related Health Problems in
Adults
Heart Disease
This condition occurs when a fatty material called
plaque (plak) builds up on the inside walls of the coronary arteries (the
arteries that supply blood and oxygen to your heart). Plaque narrows the
coronary arteries, which reduces blood flow to your heart. Your chances for
having
heart
disease and a
heart
attack get higher as your body mass index (BMI) increases. Obesity also can
lead to
congestive
heart failure, a serious condition in which the heart cant pump
enough blood to meet your bodys needs.
High Blood Pressure (Hypertension)
This condition occurs when the force of the blood
pushing against the walls of the arteries is too high. Your chances for having
high
blood pressure are greater if youre overweight or obese.
Stroke
Being overweight or obese can lead to a buildup of
fatty deposits in your arteries that form a blood clot. If the clot is close to
your brain, it can block the flow of blood and oxygen and cause a stroke. The
risk of having a stroke rises as BMI increases.
Type 2 Diabetes
This is a disease in which blood sugar (glucose)
levels are too high. Normally, the body makes insulin to move the blood sugar
into cells where its used. In type 2 diabetes, the cells dont
respond enough to the insulin thats made. Diabetes is a leading cause of
early death, heart disease, stroke, kidney disease, and blindness. More than 80
percent of people with type 2 diabetes are overweight.
Abnormal Blood Fats
If youre overweight or obese, you have a
greater chance of having abnormal levels of blood fats. These include high
amounts of triglycerides and low-density lipoprotein (LDL)
cholesterol
(a fat-like substance often called bad cholesterol), and low
high-density lipoprotein (HDL) cholesterol (often called good
cholesterol). Abnormal levels of these blood fats are a risk for heart
disease.
Metabolic Syndrome
This is the name for a group of risk factors linked
to overweight and obesity that raise your chance for heart disease and other
health problems such as diabetes and stroke. A person can develop any one of
these risk factors by itself, but they tend to occur together.
Metabolic
syndrome occurs when a person has at least three of these heart disease
risk factors:
- A large waistline. This is also called abdominal
obesity or having an apple shape. Having extra fat in the waist
area is a greater risk factor for heart disease than having extra fat in other
parts of the body, such as on the hips.
- Abnormal blood fat levels, including high
triglycerides and low HDL cholesterol.
- Higher than normal blood pressure.
- Higher than normal fasting blood sugar
levels.
Cancer
Being overweight or obese raises the risk for colon,
breast, endometrial, and gallbladder cancers.
Osteoarthritis
This is a common joint problem of the knees, hips,
and lower back. It occurs when the tissue that protects the joints wears away.
Extra weight can put more pressure and wear on joints, causing pain.
Sleep Apnea
This condition causes a person to stop breathing for
short periods during sleep. A person with
sleep
apnea may have more fat stored around the neck. This can make the breathing
airway smaller so that its hard to breathe.
Reproductive Problems
Obesity can cause menstrual irregularity and
infertility in women.
Gallstones
These are hard pieces of stone-like material that
form in the gallbladder. Theyre mostly made of cholesterol and can cause
abdominal or back pain. People who are overweight or obese have a greater
chance of having gallstones. Also, being overweight may result in an enlarged
gallbladder that may not work properly.
Overweight and Obesity-Related Health Problems in
Children and Teens
Overweight and obesity also increase the health
risks for children and teens. Type 2 diabetes was once rare in American
children. Now it accounts for 8 to 45 percent of newly diagnosed diabetes
cases. Also, overweight children are more likely to become overweight or obese
as adults, with the same risks for disease.
Who Is At Risk for Overweight and Obesity?
Populations Affected
Overweight and obesity affect Americans of all ages,
sexes, racial/ethnic groups, and educational levels. This serious health
problem has been growing over the years. In fact, overweight and obesity in
adults have doubled since 1980, and overweight in children and teens has
tripled.
Adults
According to the National Health and Nutrition
Examination Survey (NHANES) 20032004, about one-third of adults in the
United States are overweight and slightly more than one-third are obese. The
survey also shows differences in overweight and obesity according to
racial/ethnic groups.
- In women, overweight and obesity are highest for
non-Hispanic Black women (about 82 percent), compared to about 75 percent for
Mexican American women and 58 percent for non-Hispanic White women.
- In men, overweight and obesity also are higher
for minority groups. Theyre highest for Mexican American men (about 76
percent), compared to about 71 percent for non-Hispanic White men and about 69
percent for non-Hispanic Black men.
Children and Teens
According to NHANES 20032004, overweight and
the risk for overweight is rising in children and teens. The survey shows
that:
- About 19 percent of school-aged children and
about 17 percent of teens are overweight.
- About 18 percent of school-aged children and
about 17 percent of teens are at risk for overweight.
There are also some differences in overweight
according to racial/ethnic groups.
- In male children and teens, overweight is highest
for Mexican Americans (about 22 percent), compared to 17 percent for
non-Hispanic Whites and about 16 percent for non-Hispanic Blacks.
- In female children and teens, overweight is
highest for non-Hispanic Blacks (23 percent), compared to 16 percent for
Mexican Americans and about 14 percent for non-Hispanic Whites.
Income
Overweight and obesity are also common in groups
with low incomes. Women with low incomes are about 50 percent more likely to be
obese than women with higher incomes. Among children and teens, overweight in
non-Hispanic White teens is related to a lower family income.
Low-income families also buy more high-calorie,
high-fat foods, which may add to the problem. This is because they tend to cost
less than more healthful foods such as fruits and vegetables.
What Are the Signs and Symptoms of Overweight and
Obesity?
Weight gain usually happens over time. Most people
know when theyve gained weight. Some of the signs of overweight or
obesity include:
- Clothes feeling tight and needing a larger
size.
- The scale showing that youve gained
weight.
- Having extra fat around the waist.
- A higher than normal body mass index and waist
circumference. (See How Are Overweight and
Obesity Diagnosed?)
How Are Overweight and Obesity Diagnosed?
The most common way to find out whether youre
overweight or obese is to figure out your body mass index (BMI). BMI is an
estimate of body fat and a good gauge of your risk for diseases that occur with
more body fat. The higher your BMI, the higher your risk of disease. BMI is
calculated from your height and weight. You or your health care provider can
use the chart below or the National Heart, Lung, and Blood Institutes
online BMI calculator to figure
out your BMI.
Body Mass Index for Adults
Height |
21 |
22 |
23 |
24 |
25 |
26 |
27 |
28 |
29 |
30 |
31 |
4'10" |
100 |
105 |
110 |
115 |
119 |
124 |
129 |
134 |
138 |
143 |
148 |
5'0" |
107 |
112 |
118 |
123 |
128 |
133 |
138 |
143 |
148 |
153 |
158 |
5'1" |
111 |
116 |
122 |
127 |
132 |
137 |
143 |
148 |
153 |
158 |
164 |
5'3" |
118 |
124 |
130 |
135 |
141 |
146 |
152 |
158 |
163 |
169 |
175 |
5'5" |
126 |
132 |
138 |
144 |
150 |
156 |
162 |
168 |
174 |
180 |
186 |
5'7" |
134 |
140 |
146 |
153 |
159 |
166 |
172 |
178 |
185 |
191 |
198 |
5'9" |
142 |
149 |
155 |
162 |
169 |
176 |
182 |
189 |
196 |
203 |
209 |
5'11" |
150 |
157 |
165 |
172 |
179 |
186 |
193 |
200 |
208 |
215 |
222 |
6'1" |
159 |
166 |
174 |
182 |
189 |
197 |
204 |
212 |
219 |
227 |
235 |
6'3" |
168 |
176 |
184 |
192 |
200 |
208 |
216 |
224 |
232 |
240 |
248 |
* Weight is measured with underwear but no
shoes.
Use this table to learn your BMI.
First, find your height on the far left column. Next, move across the row to
find your weight. Once youve found your weight, move to the very top of
that column. This number is your BMI.
What Does Body Mass Index Mean?
BMI |
|
18.524.9 |
Normal weight |
25.029.9 |
Overweight |
30.039.9 |
Obese |
40.0 and above |
Extreme obesity |
Although BMI can be used for most men and women, it
does have some limits:
- It may overestimate body fat in athletes and
others who have a muscular build.
- It may underestimate body fat in older persons
and others who have lost muscle.
Body Mass Index for Children and Teens
Overweight is defined differently for children and
teens than it is for adults. Because children are still growing and boys and
girls mature at different rates, BMIs for children and teens compare their
heights and weights against growth charts that take age and sex into account.
This is called BMI-for-age percentile. A child or teens BMI-for-age
percentile shows how his or her BMI compares with other boys and girls of the
same age.
For more information about BMI-for-age and growth
charts for children, go to the Centers for Disease Control and
Preventions
BMI-for-age calculator.
What Does the BMI-for-Age Percentile Mean?
BMI-for-Age Percentile |
|
Less than 5th percentile |
Underweight |
5th percentile to less than the 85th percentile |
Healthy weight |
85th percentile to less than the 95th percentile |
Risk of overweight |
95th percentile or greater |
Overweight |
Waist Circumference
Health care professionals also may take your waist
measurement. This helps to screen for the possible health risks that come with
overweight and obesity in adults. If you have abdominal obesity and most of
your fat is around your waist rather than at your hips, youre at higher
risk for
heart
disease and type 2 diabetes. This risk goes up with a waist size that is
greater than 35 inches for women or greater than 40 inches for men.
You too may want to measure your waist size. To do
so correctly, stand and place a tape measure around your middle, just above
your hipbones. Measure your waist just after you breathe out.
Specialists Involved
A primary care doctor (or pediatrician for children
and teens) will assess your BMI, waist measurement, and overall health risk. If
youre overweight or obese, or have a large waist size, your doctor should
explain the health risks and find out whether youre interested and
willing to lose weight. If you are, you and your doctor should work together to
create a treatment plan. The plan should include weight loss goals and
treatment options that are realistic for you.
Your doctor may send you to other health care
specialists if you need expert care. These specialists may include:
- An endocrinologist if you need to be treated for
type 2 diabetes or a hormone problem such as an underactive thyroid.
- A registered dietitian or nutritionist to work
with you on ways to change your eating habits.
- An exercise physiologist or trainer to figure out
your level of fitness and show you how to start physical activities suitable
for you.
- A bariatric surgeon if weight loss surgery is an
option for you.
- A psychiatrist, psychologist, or clinical social
worker to help treat depression or stress.
How Are Overweight and Obesity Treated?
Successful treatments for weight loss include
setting goals and making lifestyle changes such as eating fewer calories and
being more physically active. Drug therapy and weight loss surgery are also
options for some people if lifestyle changes dont work.
Set Realistic (Do-able) Goals
Setting the right weight loss goals is an important
first step to losing and maintaining weight.
For Adults
- Lose just 5 to 10 percent of your current weight
over 6 months. This will lower your risk for
heart
disease and other conditions.
- The best way to lose weight is slowly. A weight
loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the
weight. It also will give you the time to make new, healthy lifestyle
changes.
- If youve lost 10 percent of your body
weight, have kept it off for 6 months, and are still overweight or obese, you
may want to consider further weight loss.
For Children and Teens
- If your child is overweight or at risk of
overweight, the goal is to maintain his or her current weight and to focus on
eating healthy and being physically active. This should be part of a family
effort to make lifestyle changes.
- If your child is overweight and has a health
condition related to overweight or obesity, your doctor should refer you to a
pediatric obesity treatment center.
Lifestyle Changes
For long-term weight loss success, its
important for you and your family to make lifestyle changes:
- Focus on energy IN (calories from food and
drinks) and energy OUT (physical activity)
- Follow a healthy eating plan
- Learn how to adopt more healthful lifestyle
habits
Over time, these changes will become part of your
everyday life.
Calories
Cutting back on calories (energy IN) will help you
lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie
intake by 500 to 1,000 calories a day.
- In general, 1,000 to 1,200 calories a day will
help most women lose weight safely.
- In general, 1,200 to 1,600 calories a day will
help most men lose weight safely. This calorie range is also suitable for women
who weigh 165 pounds or more or who exercise routinely.
These calorie levels are a guide and may need to be
adjusted. If you eat 1,600 calories a day but dont lose weight, then you
may want to cut back to 1,200 calories. If youre hungry on either diet,
then you may want to boost your calories by 100 to 200 a day. Very low-calorie
diets of less than 800 calories a day shouldnt be used unless your doctor
is monitoring you.
For overweight children or teens, its
important to slow the rate of weight gain; however, reduced-calorie diets
arent advised before you talk to a health care provider.
Healthy Eating Plan
A healthy eating plan gives your body the nutrients
it needs every day. It has enough calories for good health, but not so many
that you gain weight.
A healthy eating plan also will lower your risk for
heart disease and other conditions. A plan low in total, saturated, and
trans fat; cholesterol; and sodium (salt) will help to lower your risk
for heart disease. Cutting down on fats and added sugars also can help you eat
fewer calories and lose weight. Healthful foods include:
- Fat-free and low-fat milk and milk products such
as low-fat yogurt, cheese, and milk.
- Lean meat, fish, poultry, cooked beans, and
peas.
- Whole grain foods such as whole wheat bread,
oatmeal, and brown rice. Other grain foods like pasta, cereal, bagels, bread,
tortillas, couscous, and crackers.
- Fruits, which can be canned (in juice or water),
fresh, frozen, or dried.
- Vegetables, which can be canned (without salt),
fresh, frozen, or dried.
Canola or olive oils and soft margarines made from
these oils are heart healthy. They should be used in small amounts because
theyre high in calories. Unsalted nuts, like walnuts and almonds, also
can be built into a healthful diet as long as you watch the amount you eat,
because nuts are high in calories.
The National Heart, Lung, and Blood Institutes
Aim for
a Healthy Weight patient booklet provides more information on
following a healthy eating plan.
Foods to limit. Foods that are high
in saturated and trans fats and cholesterol raise blood cholesterol
levels and also may be high in calories. These fats raise the risk of heart
disease, so they should be limited.
Saturated fat is found mainly in:
- Fatty cuts of meat such as ground beef, sausage,
and processed meats such as bologna, hot dogs, and deli meats
- Poultry with the skin
- High-fat milk and milk products like whole-milk
cheeses, whole milk, cream, butter, and ice cream
- Lard, coconut, and palm oils found in many
processed foods
Trans fat is found mainly in:
- Foods with partially hydrogenated oils such as
many hard margarines and shortening
- Baked products and snack foods such as crackers,
cookies, doughnuts, and breads
- Food fried in hydrogenated shortening such as
french fries and chicken
Cholesterol is found mainly in:
- Egg yolks
- Organ meats such as liver
- Shrimp
- Whole milk or whole-milk products, including
butter, cream, and cheese
Limiting foods and drinks with added sugars, like
high-fructose corn syrup, is important. Added sugars will give you extra
calories without nutrients like vitamins and minerals. Added sugars are found
in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet
drinks. Check the nutrition label on food packages for added sugars like
high-fructose corn syrup. Drinks with alcohol also will add calories, so
its a good idea to watch alcohol intake.
Portion size. A portion is the
amount of food that you choose to eat for a meal or snack. Its different
from a serving, which is a measured amount of food and is noted on the
nutrition label on food packages.
Anyone who has eaten out lately is likely to notice
how big the portions are. In fact, theyre oversized. These ever-larger
portions have changed what we think of as normal.
Cutting back on portion size is a good way to help
you eat fewer calories and balance your energy IN. To quiz yourself on how
todays portions compare to those from 20 years ago, visit the National
Heart, Lung, and Blood Institutes
Portion Distortion Web
pages.
Food weight. Studies have shown
that we all tend to eat a constant weight of food. Ounce for ounce,
our food intake is fairly constant. Knowing this, you can lose weight if you
eat foods that are lower in calories and fat for a given measure of food. For
example, replacing a full-fat food product that weighs 2 ounces with one
thats the same weight but lower in fat helps you cut back on calories.
Another helpful practice is to eat foods that contain a lot of water like
vegetables, fruits, and soups.
Physical Activity
Staying active and eating fewer calories will help
you lose weight and keep the weight off over time. Physical activity also will
benefit you in other ways. It will:
- Lower the risk of heart disease, diabetes, and
cancers (such as breast, uterus, and colon)
- Strengthen your lungs and help them to work
better
- Strengthen your muscles and keep your joints in
good condition
- Slow bone loss
- Give you more energy
- Help you to relax and cope better with
stress
- Allow you to fall asleep more quickly and sleep
more soundly
- Give you an enjoyable way to share time with
friends and family
In general, adults should follow these guidelines in
relation to physical activity.
- For overall health and to lower the risk of
disease, aim for at least 30 minutes of moderate-intensity physical activity
most days of the week.
- To help manage body weight and prevent gradual
weight gain, aim for 60 minutes of moderate-to-vigorous intensity physical
activity most days of the week.
- To maintain weight loss, aim for at least 60 to
90 minutes of daily moderate-intensity physical activity.
In general, children and teens should aim for at
least 60 minutes of physical activity on most, if not all, days of the
week.
Many people lead inactive lives and may not be
motivated to do more physical activity. Some people may need help and
supervision when they start a physical activity program to avoid injury.
If youre obese, or if you havent been
active in the past, start physical activity slowly and build up the intensity a
little at a time. When starting out, one way to be active is to do more
everyday activities such as taking the stairs instead of the
elevator and doing household chores and yard work. The next step is to start
walking, biking, or swimming at a slow pace, and then build up the amount of
time you exercise or the intensity level of the activity.
To lose weight and gain better health, its
important to get moderate-intensity physical activity. Choose activities that
you enjoy and that fit into your daily life. A daily, brisk walk is an easy way
to be more active and improve your health. Use a pedometer to count your daily
steps and keep track of how much youre walking. Try to increase the
number of steps you take each day.
Other examples of moderate-intensity physical
activity include dancing, bicycling, gardening, and swimming. For greater
health benefits, try to step up your level of activity or the length of time
youre active. For example, start walking for 10 to 15 minutes three times
a week, and then build up to brisk walking for 60 minutes, 5 days a week. You
also can break up the amount of time that youre physically active into
shorter amounts such as 15 minutes at a time.
Behavioral Changes
Changing your behaviors or habits around food and
physical activity is important for losing weight. The first step is to
understand the things that lead you to overeat or have an inactive lifestyle.
The next step is to change these habits.
The list below gives you some simple tips to help
build healthier habits.
Change your surroundings. You may
be more likely to overeat when watching TV, when treats are available in the
office break room, or when youre with a certain friend. You also may not
be motivated to take the exercise class you signed up for. But you can change
these habits.
- Instead of watching TV, dance to music in your
living room or go for a walk.
- Leave the office break room right after you get a
cup of coffee.
- Bring a change of clothes to work. Head straight
to the exercise class on the way home from work.
- Put a note on your calendar to remind yourself to
take a walk or go to your activity class.
Keep a record. A record of your
food intake and the amount of physical activity that you do each day will help
to inspire you. You also can keep track of your weight. For example, when the
record shows that youve been meeting your goal to be more active,
youll want to keep it up. A record is also an easy way to track how
youre doing, especially if youre working with a registered
dietitian or nutritionist.
Seek support. Ask for help or
encouragement from your friends, family, and health care provider. You can get
support in person, through e-mail, or by talking on the phone. You also can
join a support group.
Reward success. Reward your success
for meeting your weight loss goals or other achievements with something you
would like to do, not with food. Choose rewards that youll enjoy, such as
a movie, music CD, an afternoon off from work, a massage, or personal time.
Weight Loss Medicines
Weight loss medicines approved by the Food and Drug
Administration (FDA) may be an option for some people. If youre not
successful at losing 1 pound a week after 6 months of using lifestyle changes,
medicines may help. These medicines should be used only as part of a program
that includes diet, physical activity, and behavioral changes.
Weight loss medicines may be suitable for adults who
are obese (a BMI of 30 or greater). People who have BMIs of 27 or greater and a
risk for heart disease and other health conditions also may benefit from
medicines.
The FDA has approved two prescription weight loss
medicines for long-term use: sibutramine (Meridia®) and orlistat
(Xenical®). These medicines cause a weight loss between 4 and 22
pounds, although some people lose more weight. Most of the weight loss occurs
within the first 6 months of taking the medicine.
- Sibutramine (Meridia). This medicine sends
signals to your brain to curb your appetite. Sibutramine raises blood pressure
and pulse. You shouldnt take it if you have
high
blood pressure or a history of heart disease or stroke.
- Orlistat (Xenical). This medicine reduces the
absorption of fats, fat calories, and vitamins A, D, E, and K by the body.
Orlistat can result in mild side effects such as oily and loose stools.
The FDA also has approved Alli, an
over-the-counter weight loss aid for adults. Alli is the lower dose form of
orlistat. Its meant to be used along with a reduced-calorie, low-fat diet
and physical activity. In studies, most people taking Alli lost 5 to 10 pounds
over 6 months.
Like orlistat, Alli reduces the absorption of fats,
fat calories, and vitamins A, D, E, and K to promote weight loss. It also has
similar side effects to orlistat. If youre taking orlistat or Alli, you
should take a multivitamin at bedtime due to the possible loss of some
vitamins. You also should talk to your doctor before starting Alli if
youre taking blood-thinning medicines or being treated for diabetes or
thyroid disease.
Combined with healthy eating and physical activity,
these medicines can help people lose weight. If you think you would benefit
from the prescription medicines, sibutramine or orlistat, talk to your doctor.
People taking these medicines need regular checkups with their doctors,
especially in the first year after starting the medicine. During checkups, your
doctor will check your weight, blood pressure, and pulse and order laboratory
tests. He or she also will discuss any medicine side effects and answer your
questions.
Other Medicines
Some prescription medicines are used to treat weight
loss, but aren't FDA-approved for treating obesity. They include:
- Drugs to treat depression. Some medicines for
depression cause an initial weight loss and then a regain of weight while
taking the medicine.
- Drugs to treat seizures. Two drugs used for
seizures, topiramate and zonisamide, have been shown to cause weight loss.
These drugs are being studied to see whether they will be useful in treating
obesity.
- Drugs to treat diabetes. Metformin may cause
small amounts of weight loss in people with obesity and diabetes. Its not
known how this drug causes weight loss, but it has been shown to reduce hunger
and food intake.
Over-the-Counter Products
Over-the-counter (OTC) products often claim that a
person taking them will lose weight. The FDA doesn't regulate these products
because they're considered dietary supplements, not medicines. However, many of
these products have serious side effects and aren't generally recommended. A
few OTC products include:
- Ephedra (also called ma-huang). Ephedra comes
from plants and has been sold as a dietary supplement. The active ingredient in
the plant is called ephedrine. Ephedra can cause short-term weight loss. It
also has serious side effects. It causes high blood pressure and stresses the
heart. In fact, because ephedra poses a serious health risk, the FDA has
advised people to stop using dietary supplements that contain it.
- Chromium. This is a mineral that's sold as a
dietary supplement to reduce body fat. While studies haven't found any weight
loss benefit from chromium, there are few serious side effects from taking
it.
- Diuretics and herbal laxatives. These products
cause you to lose water weight, not fat. They also can lower your body's
potassium levels, which may cause heart and muscle problems.
- Hoodia. Hoodia is a cactus that is native to
Africa. It's sold in pill form as an appetite suppressant. However, there is no
firm evidence that hoodia works. No large-scale research has been done on
humans to show whether hoodia is effective or safe.
Weight Loss Surgery
Weight loss surgery may be an option for people with
extreme obesity (BMI of 40 or greater) when other treatments have failed. It's
also an option for people with a BMI of 35 or greater who have life-threatening
conditions such as:
- Severe
sleep
apnea (a condition in which your breathing stops or gets very shallow while
you're sleeping)
- Obesity-related
cardiomyopathy
(diseases of the heart muscle)
- Severe type 2 diabetes
Two common weight loss surgeries include:
- Banded gastroplasty. For this surgery, a band or
staples are used to create a small pouch at the top of your stomach. This
surgery limits the amount of food and liquids the stomach can hold.
- Roux-en-Y gastric bypass. For this surgery, a
small stomach pouch is created with a bypass around part of the small intestine
where most of the calories you eat are absorbed. This surgery limits food
intake and reduces the calories your body absorbs.
Weight loss surgery can improve your health and
weight. However, the surgery can be risky depending on your overall health.
There are few long-term side effects with gastroplasty; however, you must limit
your food intake dramatically. Roux-en-Y gastric bypass has more side effects.
These include nausea, bloating, diarrhea, and faintness (which are all part of
a condition called dumping syndrome). After Roux-en-Y gastric bypass,
multivitamins and minerals may be needed to prevent nutrient deficiencies.
Lifelong medical followup is needed after both
surgeries. A monitoring program both before and after surgery also is advised
to help you with diet, physical activity, and coping skills.
If you think you would benefit from weight loss
surgery, talk to your doctor. Ask whether you're a candidate for the surgery
and discuss the risks, benefits, and what to expect.
Weight Loss Maintenance
Maintaining your weight loss over time can be a
challenge. For adults, weight loss is a success if you lose at least 10 percent
of your initial weight and you don't regain more than 6 or 7 pounds in 2 years.
You also must keep a lower waist circumferenceat least 2 inches lower
than your waist circumference before you lost weight.
After 6 months of keeping off the weight, you can
think about losing more if:
- You've already lost 5 to 10 percent of your body
weight
- You're still overweight or obese
The key to further weight loss or to maintain your
weight loss is to continue with lifestyle changes. Adopt these changes as a new
way of life. However, if you want to lose more weight, you may need to eat
fewer calories and increase your activity level. For example, if you eat 1,600
calories a day but don't lose weight, you may want to cut back to 1,200
calories.
Adults should aim for 60 to 90 minutes of daily
moderate-intensity physical activity. Children and teens should aim for 60
minutes of physical activity a day.
How Can Overweight and Obesity Be Prevented?
Staying at a healthy weight and preventing
overweight and obesity can be achieved through living a healthy lifestyle.
Because lifetime habits begin in childhood, it's important for parents and
families to create habits that encourage healthy food choices and physical
activity early in life.
- Follow a healthy eating plan. Make healthful food
choices, keep your and your family's calorie needs in mind, and focus on the
balance of energy IN and energy OUT.
- Focus on portion size. Watch the size of portions
in fast food and other restaurants. The portions served are often enough for
two or three people. Children's portion sizes should be smaller than those for
adults. Cutting back on portion size is a sure way to help keep energy IN and
energy OUT in balance.
- Be active. Make personal and family time active.
Find activities that everyone will enjoy. For example, go for a brisk walk,
bike or rollerblade, or train together for a walk or run.
- Reduce screen time. Limit the use of TVs,
computers, DVDs, and video games, because they crowd out time for physical
activity. Health experts recommend 2 hours or less a day of screen time that's
not work- or homework-related.
- Keep track of weight and other measurements.
Monitor your weight, body mass index, and waist circumference on a regular
basis. Also, keep track of your children's growth.
Four Institutes (led by the National Heart, Lung,
and Blood Institute) from the National Institutes of Health have come together
to promote
We
Can!Ways to Enhance Children's Activity & Nutrition. We
Can! is a national education program designed for parents and caregivers
to help children 8 to 13 years old stay at a healthy weight.
The evidence-based program offers parents and
families tips and fun activities to encourage healthy eating, increase physical
activity, and reduce time spent being inactive. Currently, more than 140
communities around the country are participating in We Can! programs
for parents and youth. These community groups include hospitals, health
departments, clinics, faith-based organizations, YMCAs, schools, and more.
Key Points
- The terms overweight and
obesity refer to a persons overall body weight and where the
extra weight comes from. Overweight is having extra body weight from muscle,
bone, fat, and/or water. Obesity is having a high amount of extra body
fat.
- Millions of Americans and people worldwide are
overweight or obese.
- Being overweight or obese puts you at risk for
many diseases and conditions, including
heart
disease,
high
blood pressure, type 2 diabetes, gallbladder disease, breathing problems,
and certain cancers.
- A persons weight is the result of many
factors, including environment, family history and genetics, metabolism (the
way your body changes food and oxygen into energy), behavior or habits, and
other factors.
- For most people, overweight and obesity are
caused by not having energy balance. The amount of calories you get from food
and drinks is energy IN. The amount of energy your body uses daily is energy
OUT. To maintain a healthy weight, energy IN and energy OUT should balance over
time.
- Overweight and obesity are calculated using the
body mass index (BMI). BMI is an estimate of body fat and a good gauge of your
risk for diseases that occur with more body fat. Adults can calculate their BMI
using the National Heart, Lung, and Blood Institutes
online calculator, or your
health care provider can calculate your BMI.
- Childrens BMI is calculated based on growth
charts for their age and sex. This is called BMI-for-age percentile. For more
information, go to the Centers for Disease Control and Preventions
BMI-for-age calculator.
- Treatment for overweight and obesity includes
lifestyle changes. These changes mean cutting back on calories, following a
healthy eating plan, being physically active, and making behavioral
changes.
- When lifestyle changes arent enough, other
treatment options for some people are weight loss medicines and surgery.
- To manage weight and prevent unhealthy weight
gain, adults should aim for 60 minutes of moderate-to-vigorous intensity
physical activity most days of the week. To keep up weight loss, aim for 60 to
90 minutes of daily moderate-intensity physical activity.
- Children and teens should strive for 60 minutes
of physical activity a day.
- Overweight and obesity in children and teens can
be prevented with healthy food choices and more physical activity. Parents and
families should create habits that encourage healthful food choices and
physical activity early in a childs life.
Links to Other Information About Overweight and
Obesity
NHLBI Resources
Non-NHLBI Resources
|