ConditionandTreatments

Overview

Obesity is a chronic health condition characterized by excessive body fat accumulation. It is commonly measured using the Body Mass Index (BMI), with a BMI of 30 or higher generally classified as obese. Obesity is associated with numerous health risks, including heart disease, diabetes, and certain cancers. In the Asian population, a BMI more than 22 is considered to be overweight.

Symptoms and Causes of Obesity

How Obesity Affects Your Body

Obesity impacts your body in various ways:

• Mechanical Effects: Extra body fat increases pressure on your skeleton and joints.
• Metabolic Changes: Excess calories turn into fat, leading to enlarged fat cells that secrete hormones and cause inflammation. This inflammation contributes to insulin resistance, high blood sugar, and metabolic syndrome, which includes risks like Type 2 diabetes, cardiovascular diseases, fatty liver disease, kidney issues, and gallstones.
• Direct Effects: Obesity can lead to respiratory problems (asthma, sleep apnea), musculoskeletal issues (osteoarthritis, back pain), and gout.
• Indirect Effects: It is linked to cognitive decline (e.g., Alzheimer’s), infertility, mood disorders, and certain cancers.

Causes of Obesity

Obesity often results from consuming more calories than you expend. Contributing factors include:

• Diet: High intake of fast foods, sugary drinks, and processed snacks.
• Lifestyle: Sedentary behavior due to screen time, desk jobs, and lack of exercise.
• Psychological Factors: Emotional eating due to stress, boredom, or depression.
• Hormones: Disruptions in hunger and satiety signals.
• Medications: Some drugs can cause weight gain.
• Environmental Factors: Limited access to healthy food, safe exercise areas, and inactive childcare environments.

There are three general classes of obesity that healthcare providers use to evaluate what treatments may work best for each person. They include:

• Class I obesity: BMI 30 to <35 kg/m².
• Class II obesity: BMI 35 to <40 kg/m².
• Class III obesity: BMI 40+ kg/m².

Diagnosis

Diagnosing obesity typically involves:

• Body Mass Index (BMI): Calculated using weight and height. A BMI of 30 or above indicates obesity.
• Waist Circumference Measurement: Used to assess abdominal fat. Excessive abdominal fat can indicate higher health risks.
• Medical History: Review of personal and family health history to identify potential underlying causes.
• Blood Tests: To check for conditions such as diabetes, cholesterol levels, and thyroid function.
• Imaging Tests: In some cases, imaging tests like CT scans may be used to evaluate fat distribution and related health issues.

Management and Treatment

How is Obesity Treated?

Obesity, characterized by excessive fat accumulation that harms health, requires a personalized treatment approach based on your overall health profile. Treatment plans typically begin with addressing the most urgent health concerns and then move on to long-term weight management strategies. Immediate interventions might include medication adjustments, while a gradual, comprehensive plan usually incorporates various elements. Successful weight management often involves intense, team-based programs with frequent communication between you and your healthcare provider.

Your Treatment Plan May Include:

Dietary Changes

Personalized adjustments in diet, such as reducing portion sizes or altering food choices, can be crucial. Increasing intake of fruits, vegetables, whole grains, and legumes can enhance nutrition and satiety, helping you feel fuller on fewer calories.

Increased Activity

Exercise is vital for weight loss and maintenance. Regular, moderate activity, such as walking for 30 minutes five days a week, can be effective. It doesn’t require a gym membership—simple daily walks can have significant benefits.

Behavioral Therapies

Counseling, support groups, and cognitive behavioral therapy can support weight loss by addressing emotional and psychological factors. These therapies can help manage stress and reinforce positive behavior changes.

Medication

Medications can complement other treatments by targeting specific weight-related issues. Common FDA-approved options include:

• Orlistat: Reduces fat absorption.
• Phentermine: Suppresses appetite.
• Bupropion-naltrexone: Reduces cravings.
• Liraglutide: Controls appetite and digestion.
• Semaglutide (Wegovy®): Suppresses appetite.
• Lisdexamfetamine dimesylate: Manages binge eating disorder.
• Phentermine-topiramate (Qsymia®): Reduces hunger.

Weight Loss Surgery

For individuals with class III obesity, bariatric surgery can be an effective solution. These surgeries alter the digestive system to restrict calorie intake and absorption, and influence hormonal factors that affect metabolism and hunger. Options include:

• Gastric Sleeve (Sleeve Gastrectomy): Reduces the size of the stomach.
• Gastric Band (LAP-BAND): Places an adjustable band around the stomach.
• Gastric Bypass (Roux-en-Y): Creates a small stomach pouch and bypasses part of the small intestine.
• Duodenal Switch: Combines sleeve gastrectomy with intestinal bypass.

FAQ

• What causes obesity?

  Obesity can be caused by a combination of genetic, environmental, and behavioral factors. Common contributors include poor diet, lack of physical activity, hormonal imbalances, and certain medications.

• Is obesity a disease?

  Yes, obesity is recognized as a chronic disease that affects various aspects of health and increases the risk of other serious health conditions.

• How can I prevent obesity?

  Preventing obesity involves maintaining a healthy diet, engaging in regular physical activity, and managing stress. Regular health check-ups can help identify and address potential issues early.

• When should I consider weight loss surgery?

  Weight loss surgery may be considered if you have severe obesity and have not achieved significant weight loss through lifestyle changes and medication. It is typically recommended for individuals with a BMI of 40 or higher, or a BMI of 35 with obesity-related health conditions.

• What are the potential risks of obesity?

  Obesity is associated with several health risks, including heart disease, type 2 diabetes, high blood pressure, certain cancers, sleep apnea, and joint problems.