Weight Loss & Obesity

Weight Loss

What Is Weight Loss

Obesity is a multi-faceted and complex medical condition, characterized by a person being grossly fat or overweight. One can be overweight without being obese—some people weigh more than the average for their height because of muscles, bone, or water weight. But if you have too much fat, it can endanger your health and put you at serious risk of health conditions such as heart disease, diabetes, and high blood pressure.

According to the National Health and Nutrition Examination Survey, more than 2 out of every 3 adults—and 1 out of every 3 children—are overweight, and more than half of these overweight people are obese.

The main tool used to measure body fat—and can hence tell whether one is overweight or obese—is the body mass index (BMI). You can calculate your body mass index by dividing your weight in kilograms (1 kg ≈ 2.2 lb) by your height in meters squared (1 m ≈ 3.28 ft; 1 m²≈ 10.76 ft²). You can find out your BMI online by entering your height and weight into the BMI calculator provided by the Centers for Disease Control and Prevention.

A typical healthy person has a BMI of 18.5 to 24.9. A BMI of 25 or greater is considered overweight, and a BMI of 30 or greater is likely to be obese.

BMI	Weight status
Below 18.5	Underweight
18.5-24.9	Normal
25.0-29.9	Overweight
30.0-34.9	Obese (Class I)
35.0-39.9	Obese (Class II)
40.0 and higher	Extreme obesity (Class III)

BMI is not a perfect measurement. Some people may have a BMI in the overweight or obese category, even if they don’t have a lot of body fat. Very muscular people are one example, and some people may have a high weight because of bone mass, excess water, or a stocky build. But for most people, BMI is a reasonable place to start when you want to know if you have a healthy weight.

Fortunately, if you are overweight or obese, even a little weight loss can help you improve your health and prevent some of the health problems that obesity may cause. Losing weight isn’t easy. It can take time and effort to get rid of excess pounds and keep them off. But losing weight can make a permanent difference in your overall health

What Causes Weight Loss

Risk Factors For Weight Loss

Not everyone has the same risk of obesity. Some factors that can make you likely to be overweight or obese include:

Genetics. Different bodies use energy differently, and your genes may affect how efficiently your body uses energy. A person is more likely to become obese if one or both parents are obese. Genetics also affect fat regulation hormones, which can impact weight. One genetic cause of obesity is leptin deficiency. Leptin—a hormone produced in fat cells, as well as in the placenta—controls weight by signaling the brain to eat less when body stores of fat are too high. If the body does not produce sufficient leptin, however, or leptin cannot signal the brain to eat less, then this measure of hormonal check and balance is lost, and can lead to obesity. esearch is currently being done on the role of leptin replacement as a treatment for obesity.
Learned habits. Genes aren’t all you inherit from your parents. The eating and exercise habits you learn as a child may stick with you into your adult life.
Inactivity. Days behind a desk or evenings in front of a TV can make it hard to use the calories you eat. Sedentary people burn fewer calories than people who are active—and this physical inactivity is strongly correlated with weight gain.
Overeating and unhealthy eating habits, such as skipping breakfast, eating too much fast food, or not eating enough fruits and vegetables can lead to weight gain.
Eating a diet high in fat, sugar, and carbodydrates contributes to weight gain, especially when a person over consumes food. Research has shown that simple carbohydrates (like sugars, white bread and pasta, desserts, soft drinks, beer, wine, and more) contribute to weight gain because they are more rapidly absorbed into the bloodstream than complex carbohydrates (like whole wheat bread and pasta, brown rice, grains, vegetables, raw fruits, and more)—causing a more pronounced insulin release after meals than complex carbohydrates. Research has shown that this higher insulin release contributes to weight gain.
Quitting smoking. In the long run, quitting smoking can be a great benefit to your health, but in the short term it sometimes leads to stress-related eating and weight gain.
Pregnancy. The weight a woman gains while pregnant is usually more than the weight of the baby, and it can sometimes be hard to lose the extra weight after giving birth.
Lack of sleep can cause changes in hormones that affect appetite, decrease your willpower, and make you too tired to get up and move. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
Taking certain medications, such as antidepressants, lithium, corticosteroids, anticonvulsants, diabetes medications, oral contraceptives, or certain medications for heart problems. Weight gain may also be seen with some high blood pressure medications and antihistamines. The reason for the weight gain with the medications differs for each medication. It’s important to discuss your medications with your healthcare professional if you are experiencing unwanted weight gain. Don’t discontinue taking your medication, as that could have a potentially serious impact on your health.
Your age. As we age, hormonal changes and a less active lifestyle increase risk of obesity. As well, muscle mass in the body tends to decrease with age, which leads to a decrease in metabolism. As hormonal shifts and muscle mass changes occur, calorie needs are reduced, which can make it harder to keep off excess weight. If you are not more careful with what you eat, and don’t become more physically active as you age, you’ll likely gain weight.
Social and economic issues can have a big impact on weight problems and obesity. It can be time-consuming and hard to cook healthy food on a budget, and if you work extra hours to make ends meet, you may end up relying on unhealthy fast foods that seem “cheap.” Perhaps you were not taught how to cook healthy food. As well, the people you spend time with may influence your weight—you’re more likely to become overweight if you have overweight relatives or friends.
Psychological factors. For some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredom, sadness, stress, or anger. While most overweight people have no more psychological disturbances than normal weight people, about 30% of the people who seek treatment for serious weight problems have difficulties with binge eating.
A medical problem, such as Prader-Willi syndrome, Cushing’s syndrome, hypothyroidism, insulin resistance, polycystic ovary syndrome, among other conditionsare also contributors to obesity.

Diagnosing Weight Loss

Symptoms of Weight Loss

Prognosis

Living With Weight Loss

Screening

Prevention

Common Treatment

The first step in weight loss treatment is usually lifestyle changes. Changing the way you eat and getting up to move more often will help you lose weight and get yourself in shape. The general idea is to make sure that the number of calories you use in a day is just a little bit more than the number of calories you consume, so that your body will start to feed off your excess body fat to replace the calories it isn’t getting through food.

There is no one right way to change your eating habits; different approaches work for different people. Some approaches that may help include:

Counting calories. This may be the most straightforward approach–measuring the calories you eat in a day and keeping as close as possible to a number just under the calories you use. Normally that’s about 1,200 to 1,500 calories for women or 1,500 to 1,800 calories for men.
Choosing filling foods with fewer calories. Serving larger portions of low-calorie foods can help you feel full without growing your waistline.
A healthy-eating plan such as the Mediterranean diet, based on fruits, vegetables, whole grains, and lean proteins such as beans and fish.
Limiting specific food types, such as fats, carbohydrates or sugars.

Watch out for fad diets that offer a quick fix. If you want to keep the weight off for the long term, then you need to find a long-term plan that works for you.

Developing an exercise regimen is also a very helpful step in losing weight. Aim to get at least 150 minutes of moderate exercise per week–or half an hour of exercise, five days a week. If you can’t find a half hour at one time, it’s OK to break it into smaller blocks throughout the day. It also helps to find ways to increase the amount you move throughout the day, such as taking the stairs instead of the elevator, or walking to places you would normally drive.

If it’s hard for you to stick with your weight loss program, you may benefit from behavior modification techniques to help you change. These may include:

Counseling with a therapist to help you work through issues and keep yourself on track
A support group where you can talk with other people going through the same challenges

If you are still struggling to lose weight without success despite diet, exercise, and other strategies, then there are medicines to help you lose weight. Your doctor may prescribe medical treatments for weight loss if your BMI is 30 or higher, or if you have weight-related complications and a BMI above 27.

Keep in mind, though, that medical weight loss treatments are intended for use alongside lifestyle changes, not to take their place. If you don’t stay active and keep watching what you eat, then weight loss medicines aren’t likely to help as much. And when you stop taking a weight loss medicine, you may regain much of the weight you lost. Prescription medicines for weight loss include:

Orlistat (Xenical), which stops your stomach from absorbing fat. Lower-dose orlistat is also sold over the counter as Alli.
Lorcaserin (Belviq), which alters chemicals in your brain to decrease your appetite and help you feel full. However, if you don’t lose about 5% of your body weight in the first 12 weeks of treatment, then lorcaserin probably won’t work for you. Pregnant women should not take lorcaserin.
Phentermine (Adipex-P, Suprenza) for short-term use–though you will need to find another way to keep the weight off in the long term.
Phentermine-topiramate (Qsymia), which combines phentermine with an antiseizure medication to make it safe for long-term use. If you don’t lose 5% of your body weight in the first 12 weeks, your doctor may need to stop this treatment or up your dose. This treatment is not appropriate for pregnant women.

If other treatments don’t help you, weight loss surgery may help you lose up to a third of your excess body weight, but you will still need to watch what you eat if you want to keep the weight off. Surgery may be an option, if:

Your BMI is 40 or higher
You have a serious weight-related problem and a BMI of 35 or higher
You’re committed to making the lifestyle changes you need to make surgery work.

There are several types of weight loss surgeries. Some of the most common surgical treatments for weight loss include:

Gastric bypass, in which the surgeon creates a small pouch at the top of your stomach and connects it directly to your small intestine, so that the food you eat skips your stomach and goes straight into the intestines. Gastric bypass is very effective for long-term weight loss and may help with type 2 diabetes and other complications, but it may cause blood clots, or you may require repeat surgery.
Laparoscopic adjustable gastric banding (LAGB, or Lap Band), in which the surgeon puts an inflatable band around your stomach and uses this band to cinch your stomach into 2 sections, connected by a narrow passage. Health risks include infections, blood clots, or the need to reoperate.
Gastric sleeve, a newer, experimental treatment in which a part of your stomach is removed, to give you a smaller stomach. The risks and benefits of this treatment are still being studied.
Biliopancreatic diversion, a somewhat riskier treatment in which most of the stomach is surgically removed. This highly effective surgery is usually reserved for people with a BMI of 50 or more, because of the risk of malnutrition and surgical complications.

Complementary and Alternative Treatment

Care Guide

Keeping weight off after you’ve lost it can be as hard as or harder than losing the weight in the first place. Many people do suffer relapses and regain some or all of the weight they lost. However, others do manage to keep it off. Some people, including many doctors, will say that 95% percent of people who lose weight will gain it all back–but that figure is based in a small study that’s over 50 years old. More recent estimates suggest that the 95% figure is accurate for crash diets and weight loss fads, but not for all people who make a concerted effort to lose weight. Overall, more than a third of people who lose weight can keep it off for at least 3 years.

Things you can do to help you lose weight and keep off the weight you’ve lost include:

Learn about obesity and weight loss. Understanding the condition and the roots of the problem can help you empower yourself and stick with your treatment plan.
Set realistic goals. Find reasonable, manageable targets that will help you meet your needs and not set you up to fail.
Stick to your treatment plan. Exercise and eat properly. If your doctor prescribed medicine, stick with the treatment, and let your doctor know if you have any side effects.
Tell your doctor If you find yourself slipping. It’s hard to change lifelong habits, but there may be more than one way to reach your goal. Sometimes the real challenge is finding the habits you can change.
Get support. Don’t be afraid to ask family and friends to help you with emotional support.
Watch out for your triggers. Sometimes certain triggers can lead you to eat even if you’re not hungry. Whether it’s snacking while you watch a movie or binge eating when you’re stressed, watch out for the things that incite you to eat, and build new habits to keep you healthy.
Keep a food journal. Track what you eat in a notebook. This helps you keep yourself accountable, and when you look back on it you can sometimes figure out what does and doesn’t work for you.

Weight Loss

What Is Weight Loss

What Causes Weight Loss

Risk Factors For Weight Loss

Diagnosing Weight Loss

Symptoms of Weight Loss

Prognosis

Living With Weight Loss

Screening

Prevention

Common Treatment

Complementary and Alternative Treatment

Care Guide

When To Contact A Doctor

Questions For Your Doctor

Questions For A Doctor

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