Overcoming Obesity

Even a modest weight loss can improve overall health.

In the past 2 decades in the United States, there has been an alarming increase in obesity rates among all age groups, even children. It is estimated that more than one-third of adults and 17% of children and adolescents are obese.^1,2 Obese children and adolescents are at greater risk of developing health complications that are typically associated with adults, such as cardiovascular disease and type 2 diabetes mellitus (T2DM).³ Excess weight can increase your risk of developing certain health problems, but the good news is that even a modest weight loss can improve your overall health (Table 1⁴). Some studies have shown that a 5% to 10% loss in weight can improve overall health.

Identifying Overweight and Obesity

The most common tools health care professionals use to determine whether individuals are overweight or obese are body mass index (BMI) and waist measurements, both of which estimate how fat is distributed in the body (Online Table 2³). BMI is a measure of body fat based on an individual’s height and weight, but it may not accurately estimate body fat content in athletes or individuals with muscular builds.^4,5 According to the National Institutes of Health, if you have excess abdominal (belly) fat, you are at an increased risk for health issues such as cardiovascular disease and T2DM.^4,5 It is important to talk with your doctor about your overall health risks. The risks increase with a waist circumference of greater than 40 inches in males and greater than 35 inches in females.^4,5

Causes of Obesity

Typically, weight gain and obesity are caused by consuming more calories than the body needs, having an inactive (sedentary) lifestyle, and having poor lifestyle and dietary habits. In addition, studies have linked obesity to genetics and certain medical conditions, such as hypothyroidism, Cushing’s syndrome, and polycystic ovarian syndrome. Weight gain may also be caused by the use of certain medications (eg, corticosteroids, antiseizure medications, antidepressants), hormonal issues, stress, smoking cessation, and lack of sleep.

Health Risks

Being overweight or obese can increase your risk of developing certain health complications. As body weight increases, so can health risks. Weight-related health complications include:

• Coronary artery disease
• Elevated LDL (bad) cholesterol and triglyceride levels
• Low HDL (good) cholesterol level
• Hypertension
• T2DM
• Certain cancers (eg, breast, colon, and endometrial cancers)
• Sleep apnea and respiratory issues
• Infertility and irregular menstrual cycles
• Metabolic syndrome
• Gallbladder and liver disease
• Osteoarthritis

Treatment

If you are struggling with weight issues, the first step is to talk to your primary health care provider so he or she can determine your best plan for weight loss, including a diet plan. Your health care provider will probably give you a physical exam, order some blood tests, and assess your health risks, overall health, and medical history. Selection of a diet plan is likely to be based on your current health issues and the amount of weight you need to lose.

Some health care providers may prescribe medications for treating obesity in individuals with a BMI of 30 kg/m² or higher or with a BMI of 27 kg/m² or higher who have weight-related health issues or risks. Your health care provider will determine whether you are a candidate for these medications and may suggest following a well-known diet plan or visiting a nutritionist to design a dietary plan suited to your needs.

Effective weight loss typically involves more than 1 approach, and your health care provider will determine which options are right for you. Weight loss approaches include the following:

• Dietary changes, including caloric restriction, altering proportions of certain food groups (eg, low-fat or low-carbohydrate diet plans), meal replacement therapy, and structured commercial weight loss programs
• Exercise and activity
• Prescription weight loss medication
• Weight loss surgery

Lifestyle Measures to Achieve and Maintain Weight Loss

To achieve and maintain weight loss, the following can be incorporated into your daily routine:

• Set realistic goals: losing 1 to 2 pounds per week is generally doable.⁶
• Adhere to a healthy daily eating pattern: eat a variety of foods, including whole grains, vegetables, lean proteins, healthy fats, and fruits.
• Eat breakfast daily to avoid overeating later in the day.
• Avoid sugary beverages: drink water or unsweetened tea.
• Don’t skip meals.
• Eat small portions.
• Avoid or limit intake of sugar and refined carbohydrates.
• Replace high-calorie snacks with vegetables and fruits.
• Make healthy choices, especially when eating at restaurants.
• Maintain adequate hydration with water.
• Be as physically active as you can by maintaining an exercise routine several times a week for at least 30 minutes each time.
• Get a sufficient amount of sleep, because poor sleep is associated with weight gain and obesity.
• Reduce stress, and relax when needed.
• Get support from family, friends, and support groups.
• Monitor weight loss not only by weighing yourself but also by using a tape measure and noting how your clothes fit.
• Keep a weight loss journal to chart your progress and caloric intake.
• Because of potential drug interactions and contraindications, never use an OTC dietary supplement without first discussing it with your health care provider or pharmacist.
• Always maintain routine visits with your health care provider, especially if you have any medical conditions or are taking any medications.

Endnote

Losing weight is not always easy, and there is no quick fix. But with motivation and dedication to adopting healthy lifestyle habits, including eating a healthy, balanced diet, following an appropriate exercise routine, and managing stress, you can achieve successful weight loss, take control of your health, and enhance your overall quality of life (Online Table 3). Take the first step toward improving your health: talk to your primary health care provider about safe and effective weight loss options.

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References:

1. Adult obesity facts. CDC website. www.cdc.gov/obesity/data/adult.html. Accessed September 11, 2014.

2. Childhood obesity facts. CDC website. www.cdc.gov/healthyyouth/obesity/facts.htm. Accessed September 11, 2014.

3. Overweight and obesity statistics. National Institute of Diabetes and Digestive and Kidney Diseases Weight-control Information Network website. http://win.niddk.nih.gov/statistics. Accessed September 11, 2014.

4. Assessing your weight and health risk. National Heart, Lung and Blood Institute website. www.nhlbi.nih.gov/health/educational/lose_wt/risk.htm. Accessed September 11, 2014.

5. Assessing your weight. CDC website. www.cdc.gov/healthyweight/assessing/Index.html. Accessed September 11, 2014.

6. Interested in losing weight? Nutrition.gov website. www.nutrition.gov/weight-management/strategies-success/interested-losing-weight. Accessed September 11, 2014.