Obesity
What is Obesity?
Obesity is an excess accumulation of body fat. Most commonly, obesity occurs when energy intake (calories) exceeds energy use (exogenous obesity). Obesity can also occur when there are disturbances in body hormones or as a result of specific genetic conditions such as endogenous obesity.
How is it diagnosed?
History: Individuals are frequently conscious of being overweight and may complain of shortness of breath (dyspnea), fatigue, joint pains in the hips, knees and ankles, and a general dissatisfaction with their state of health. A family history may point to diabetes. There may also be a family history of obesity.
Physical exam includes measuring height and weight, as well as waist and hip girths. Skinfold measurements taken by skinfold calipers are measured at various places on the individual's body. Body mass index (BMI) is a method for measuring obesity, in which the individual's weight in kilograms is divided by height in meters squared. Obesity is a BMI in excess of 27 for men and women. Obesity can also be measured by finding the percentage difference between ideal weight and actual body weight. Obesity is defined as actual weight in excess of ideal weight by more than twenty percent.
Tests: Lab tests should include tests to measure blood sugar (glucose) at various times including after a fast and after ingestion of glucose (glucose tolerance test). Blood pressure tests will usually reveal high blood pressure. Blood tests may also reveal high cholesterol, high fats (hyperlipidemia) and elevated uric acid levels (hyperuricemia).
How is Obesity treated?
Primary treatment involves decreased calorie intake and exercise. A reduction of 500 calories in the daily diet can lead to a five-pound weight loss in one month. Exercise can be started slowly if there are hip, knee or ankle problems. Diet pills (anorectic drugs) may help the individual. Slow and steady weight loss is the key to recovery.
Medications
Alli (Orlistat), Florinef (Fludrocortisone), Meridia (Sibutramine)
Activity
- Increase your current level of activity. Daily exercise (bicycle riding, walking, swimming and others) helps you lose weight, feel better and control appetite.
- 30 minutes of activity, 5 times a week should be the goal. Keep an activity diary to monitor your progress.
- Fitness appears to be a more important factor in wellness than obtaining ideal body weight. No matter what, exercise.
Diet
- Many different diet plans are available to choose from. Diets that are not nutritionally balanced can cause more problems than the obesity. Crash diets and fad diets don’t produce long-term results. Schemes that promise easy weight loss are usually unsuccessful.
- During your diet and exercise program, there may be periods when you don’t lose weight. This is normal; don’t stop the program. Weight loss will begin again in a week or two.
- A realistic weight loss is 1 to 2-1/2 pounds a week. This may seem slow, but 1 pound of fat lost per week totals 52 pounds in 1 year! Keep a food diary to record everything you eat.
What might complicate it?
Possible complications include individual's continued inability to lose weight, degenerative joint disease, arthritis, motivation, diabetes and high blood pressure.
Predicted outcome
Weight loss requires sustained motivation. Many individuals who lose weight often put the weight back on in a few months. If the individual is not willing to address the weight issue, the prognosis is poor.
Alternatives
Hormonal disorders such as primary hypothyroidism, Cushing's syndrome, tumors of the adrenal or pituitary glands, or genetic disorders, such as Down's syndrome, severe familial obesity, and severe familial hyperlipidemia may present with similar signs and symptoms.
Appropriate specialists
Registered dietitian, neurologist, and psychiatrist.
Last updated 6 April 2018