Obesity

Obesity is a health condition characterized by too much fat in the body. It’s a complex medical disorder with several causes that can lead to significant health conditions, including diabetes, cardiovascular disease, and some types of cancer.

According to the Centers for Disease Control (CDC), there were more than 93 million adults living with obesity in 2016, which means obesity directly affects nearly 40 percent of the adult population. It’s an expensive problem too. The average annual cost of medical care for people who are obese is more than $1400 higher than for people whose weight is normal.

While people from all races and cultures suffer from obesity, it’s a more prevalent problem in Hispanic people and non-Hispanic black people than in non-Hispanic white people and non-Hispanic Asian people. Non-Hispanic Asians have the lowest adjusted rates of obesity at just under 13 percent of their population. The obesity epidemic is also worse in people who don’t have college degrees.

Obesity rates has reached epidemic proportions in the United States, regardless of race, culture, education, and socioeconomic status: One in three adults suffers from obesity.

Common causes of obesity

Having a sedentary lifestyle and a poor diet are among the most common causes of obesity in this country. According to the U.S. SurgeonGeneral, an unhealthy diet combined with inactivity is nearly as dangerous to our health as tobacco use. 

Generally speaking, consuming more calories than one burns is what causes weight gain and obesity. But that’s a simple answer to a complex question. There are several factors that can lead to weight gain and ultimately cause obesity. These causes range from genetics to behavioral factors to hormonal fluctuations and imbalances. Rare medical conditions, such as Cushing’s syndrome or Prader-Willi syndrome can cause obesity, but not many people have these conditions, so they don’t account for most cases of obesity.

The most common causes of obesity are an unhealthy diet and a sedentary lifestyle, but several factors can put you at greater risk for obesity:

• Genetics – Evidence shows a link between your genes and the amount of fat in your body (and where your body tends to store fat). Genetics may also partially determine your metabolic rate, which is how fast and efficiently your body uses the calories you consume.
• Family history – Family history may be part due to genetics and part due to the lifestyle your parents taught you. When you eat most of your meals with the same people, you tend to pick up on their eating habits. So if your parents served large portions and insisted you eat everything on your plate, you may have learned to do the same thing. 
• Inactivity – People who don’t spend a lot of time being active don’t burn as many calories as people who engage in regular activity. If you’re sitting at your desk all day, for example, you’ll burn fewer calories than if you have an active job. And when you’re sitting most of the time, you’re more likely to snack throughout the day than people who spend their time moving around. 
• Medications – Some medications increase your risk for weight gain, such as beta-blockers, antidepressants, anticonvulsants, diabetes medications, and steroids. 
• Medical problems – Some health conditions, like the two we mentioned earlier, could directly lead to weight gain and obesity. But other medical conditions, like arthritis, can make it more difficult to be active. And when you’re less active, you’re more likely to gain weight. 
• Socioeconomics – The place you live, your culture, how much money you earn, and the way you were raised can all affect your risk for obesity. For example, eating a healthy diet can be expensive than eating white pasta and a jar of sauce. Fresh vegetables and fruits can also be hard for people in some areas to access. Some chain pharmacies are now selling fresh produce to encourage healthier eating in their neighborhoods, but people in some urban areas still struggle to find fresh, affordable options. People who live in certain areas may also struggle to find safe and affordable places to exercise, and lack of exercise increases the risk for obesity. 
• Hormonal changes – As people age, their hormone levels can change. Hormones that help regulate the metabolic rate, for example, may decrease with age, making it harder for people to keep weight off. Some hormone-related conditions, like thyroid disease, can also affect metabolism.

A risk factor is just a risk factor. Having one (or even all) of these risk factors does not predetermine your weight. Even if it feels like the deck is stacked against you, you can take steps to improve your lifestyle, lose weight, and maintain a healthy weight throughout your life. It takes work, but once you develop the healthy eating and exercise habits you need, that healthy lifestyle will become easier and easier.

The above numbers are guidelines for the average person. BMI can provide estimates of body fat percentage, but it doesn’t actually measure body fat. Some people may have high BMIs without a high percentage of body fat, so the BMI calculator won’t tell the whole story. For example, a 6’1” male athlete who weighs 280 pounds but has lots of muscle mass will have a higher BMI than a male of the same height who weighs 250 pounds but has a larger percentage of body fat. 

The difference between being overweight and obese

Being overweight and being obese are two different things. Obesity is a point along the continuum of weight. There are many people who are overweight but not obese. If you use the BMI scale, for example, you can see that a BMI of 26 would put you in the overweight category, but you’d have to have a BMI of 30 or higher to be considered obese. 

Let’s look at an example. A woman who’s 5’5” tall and weighs 155 pounds is slightly overweight by BMI standards. Her BMI is 25.79. She can weigh as much as 180 pounds and still be considered overweight yet not obese. But if she gains weight and weighs 182 pounds, she will have a BMI of 30.28 and will be considered class one obese.

Being overweight puts you at an increased risk for several health conditions, and the more overweight you are, the greater your risks are. But as you can see, losing just a few pounds in some cases can reduce your risk. If you consider a 5’5” woman who weighs 159 pounds is overweight and at higher risk for cardiovascular disease, just dropping five pounds would put her into a normal weight category and reduce her risk. That’s true for many people – losing even a little weight can make a difference in your health. When you think weight loss that way, it may feel more manageable. 

Take weight loss in increments, setting small goals along the way. So rather than deciding you’re doing to lose 50 pounds, start with a short-term goal of losing 5 pounds in three weeks. Just remember, it’s important to talk to your doctor before you start any diet or exercise plan to make sure you do it safely. Depending in your weight and overall health, you may benefit from a medical weight loss program or a consultation with a nutritionist.

Treatment for obesity

Losing weight is more difficult for some people than others. Age, medical conditions, lifestyle, and genetics can all affect your ability to lose weight and keep it off.

If you suffer from obesity, the goal of your treatment is to get you to a healthy weight safely. For some people, lifestyle changes are enough to move the scale and improve their health. Lifestyle changes may include:

• Eating a healthy, balanced diet with the recommended range of calories and plenty of nutrients
• Limiting sugar, salt, and processed foods
• Quitting smoking and staying away from secondhand smoke
• Making exercise a priority and exercising most days of the week
• Avoiding excessive alcohol consumption
• Focusing on lifestyle and diet changes rather than fad dieting and fasting
• Working with a nutritionist to find manageable, realistic ways to reach goals
• Addressing any underlying psychological or emotional issues that may affect eating habits

Some people benefit from participating in a medical weight loss program like the one offered at Beaumont. A program like this gives you the opportunity to work closely with doctors and other medical professionals to change habits and lose weight safely in a way that helps you maintain your goal weight in the future.

Weight loss medication may help some people as well. Talk to your doctor about what’ right for you.

Surgical options for weight loss

If your guided weight loss attempts are unsuccessful or there are medical reasons to lose weight rapidly, you may want to consider weight loss surgery. There are several surgical procedures, often called bariatric surgery, that can help you lose weight faster than just diet and exercise alone will allow. Your doctor may recommend weight loss surgery if some or all the following criteria apply to you:

• You’ve tried medical weight loss options and have been unable to lose sufficient weight
• You have a BMI of 40 or higher
• You have a BMI between 35 and 39.9 and have a health condition, like diabetes, that is related to your weight
• Your doctor believes you will be able to maintain the lifestyle changes required to keep you healthy after surgery

Some of the common weight loss surgeries are:

• Gastric bypass surgery – This surgery, also called Roux-en-Y gastric bypass, involves creating a pouch on top of the stomach and connecting this pouch to the small intestine. After this surgery, everything you eat or drink will bypass the majority of your stomach and will instead move from your mouth through your esophagus to the new pouch and into your small intestine where it will continue the normal route of digestion.
• Laparoscopic adjustable gastric band – This surgery, abbreviated as LAGB, is a procedure in which your surgeon separates your stomach into two sections using an inflatable band, which creates a channel between the two sections of your stomach. 
• Gastric sleeve – During this surgery, the doctor removes part of the stomach so your stomach can’t hold as much food.
• Biliopancreatic diversion with duodenal switch – This is a complex procedure that involves removing much of the stomach and part of the intestine and connecting the lower part of the small intestine to the duodenum (at the base of the stomach).

Weight loss surgery can help you lose weight quickly, but it also comes with risks. If you believe you might be a candidate for weight loss surgery, make an appointment with a bariatric surgeon at Beaumont for a consultation. Call 800-633-7377 today to begin your journey.