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What Is It?
Obesity is a complex disorder. It is caused by multiple factors, both environmental and inherited, including excessive calorie and food intake, decreased physical activity and genetic influences.
America has become a country with a rapidly expanding population of overweight people. Today approximately 68.3 percent of American adults are either overweight or obese, and 33.9 percent are obese, according to the Centers for Disease Control and Prevention (CDC). The obesity epidemic is a rapidly growing problem in this country. In 2000, no state had an obesity prevalence of 30 percent or more. In 2009, nine states had obesity rates of 30 percent or more. And by 2010, the number of states that had obesity rates of 30 percent or more increased to 12. Why are these facts alarming?
Obesity, defined as a body mass index (BMI) of 30 or more, is the second leading cause of preventable death in the United States and results in an estimated $147 billion in health care costs each year.
Overweight individuals, defined as having a BMI between 25 and 29.9, are more likely to have high blood pressure and high blood cholesterol, major risk factors for heart disease and stroke. Additionally, the results of a large study supported by the U.S. National Heart, Lung, and Blood Institute (NHLBI) suggest that excess body weight is strongly and independently associated with an increased risk of heart failure.
Overweight and obesity also are major risk factors for developing type 2 diabetes. Diabetes is a major cause of early death, heart disease, kidney disease, stroke, blindness and amputation.
Several types of cancer are associated with being overweight, including cancer of the uterus, gallbladder, kidney, breast and colon. Other conditions linked with obesity include sleep apnea, osteoarthritis, gout, gallbladder disease and infertility. Obesity-related conditions worsen as weight increases and often improve as the excess weight is lost.
Obesity is a major component of a group of metabolic risk factors known collectively as metabolic syndrome, which is defined as having at least three of the following five markers:
Health conditions that promote metabolic syndrome are overweight/obesity, physical inactivity and genetic factors. People who have this syndrome are at increased risk for developing coronary heart disease, stroke, peripheral arterial disease and type 2 diabetes.
Obesity is a complex disorder. It is caused by multiple factors, both environmental and inherited, including excessive calorie and food intake, decreased physical activity and genetic influences. Though there may be other factors that affect weight gain, such as genetic and environmental influences, you most likely gain weight because you consume more calories (energy) than your body uses or needs.
What's the difference between being obese and being overweight? The defining characteristic in both overweight and obese people is excess body fat. The difference is a matter of degree.
Health care professionals use a simple calculation called the body mass index (BMI) to determine body weight relative to height. In adults, the BMI calculation strongly correlates with total body fat content in adults. Overweight is defined as having a body mass index (BMI) between 25 and 29.9. Obesity is defined as having a BMI of 30 or more. Use HealthyWomen's online calculator to check your BMI. Another way to determine your risk relative to your weight is to measure your waist circumference. Women with a waist circumference over 35 inches (and men over 40 inches) are at greater risk for disease.
Where excess body fat is distributed on your body also plays a role in your risk for disease. Weight gain around your waist (specifically in your abdominal area) is more of a health risk than weight gained on your hips and thighs. Unlike fat around the thighs, which is more common in women and is more likely to serve as an energy reservoir, abdominal fat deposits fatty acids directly into the bloodstream for immediate short-term energy, increasing triglyceride and, eventually, cholesterol levels. Therefore, excess abdominal fat is associated with an increase in blood cholesterol and insulin resistance, which may result in diabetes. An "apple shaped" figure may also raise your risks for other life-threatening illnesses, such as heart disease and stroke.
An excess of body fat—the defining characteristic of obesity—results from an imbalance between the amount of calories you take in and those you expend. The reasons for this imbalance are unclear, and the relationship between energy intake/expenditure and body fat storage and distribution varies from person to person. Factors that promote obesity include:
Measuring Obesity
Assessing your weight to determine if you are obese involves two key measurements—body mass index (BMI) and waist circumference. Understanding your risk factors for conditions associated with obesity, according to clinical practice guidelines issued by the National Heart, Lung, and Blood Institute (NHLBI), is important. First, your health care professional should determine your body mass index (BMI), which describes your body weight relative to your height. It is strongly correlated with total body fat content in adults. Your BMI is your weight in pounds divided by your height in inches squared, then multiplied by 703. The following chart shows body mass indices for people of various heights and weights. To determine your BMI, find the row that most closely approximates your weight. Read across the row until it crosses the column closest to your height. You may also use HealthyWomen's online calculator.
Weight | 100 | 105 | 110 | 115 | 120 | 125 | 130 | 135 | 140 | 145 | 150 |
Height | |||||||||||
5'0" | 20 | 21 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 |
5'1" | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 26 | 27 | 28 |
5'2" | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 27 |
5'3" | 18 | 19 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 |
5'4" | 17 | 18 | 19 | 20 | 21 | 21 | 22 | 23 | 24 | 25 | 26 |
5'5" | 17 | 17 | 18 | 19 | 20 | 21 | 22 | 22 | 23 | 24 | 25 |
5'6" | 16 | 17 | 18 | 19 | 19 | 20 | 21 | 22 | 23 | 23 | 24 |
5'7" | 16 | 16 | 17 | 18 | 19 | 20 | 20 | 21 | 22 | 23 | 23 |
5'8" | 15 | 16 | 17 | 17 | 18 | 19 | 20 | 21 | 21 | 22 | 23 |
5'9" | 15 | 16 | 16 | 17 | 18 | 18 | 19 | 20 | 21 | 21 | 22 |
5'10" | 14 | 15 | 16 | 17 | 17 | 18 | 19 | 19 | 20 | 21 | 22 |
5'11" | 14 | 15 | 15 | 16 | 17 | 17 | 18 | 19 | 20 | 20 | 21 |
6'0" | 14 | 14 | 15 | 16 | 16 | 17 | 18 | 18 | 19 | 20 | 20 |
6'1" | 13 | 14 | 15 | 15 | 16 | 16 | 17 | 18 | 18 | 19 | 20 |
6'2" | 13 | 13 | 14 | 15 | 15 | 16 | 17 | 17 | 18 | 19 | 19 |
6'3" | 12 | 13 | 14 | 14 | 15 | 16 | 16 | 17 | 17 | 18 | 19 |
6'4" | 12 | 13 | 13 | 14 | 15 | 15 | 16 | 16 | 17 | 18 | 18 |
Weight | 155 | 160 | 165 | 170 | 175 | 180 | 185 | 190 | 195 | 200 |
Height | ||||||||||
5'0" | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 |
5'1" | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 |
5'2" | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 |
5'3" | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 35 |
5'4" | 27 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 33 | 34 |
5'5" | 26 | 27 | 27 | 28 | 29 | 30 | 31 | 32 | 32 | 33 |
5'6" | 25 | 26 | 27 | 27 | 28 | 29 | 30 | 31 | 31 | 32 |
5'7" | 24 | 25 | 26 | 27 | 27 | 28 | 29 | 30 | 31 | 31 |
5'8" | 24 | 24 | 25 | 26 | 27 | 27 | 28 | 29 | 30 | 30 |
5'9" | 23 | 24 | 24 | 25 | 26 | 27 | 27 | 28 | 29 | 30 |
5'10" | 22 | 23 | 24 | 24 | 25 | 26 | 27 | 27 | 28 | 29 |
5'11" | 22 | 22 | 23 | 24 | 24 | 25 | 26 | 26 | 27 | 28 |
6'0" | 21 | 22 | 22 | 23 | 24 | 24 | 25 | 26 | 26 | 27 |
6'1" | 20 | 21 | 22 | 22 | 23 | 24 | 24 | 25 | 26 | 26 |
6'2" | 20 | 21 | 21 | 22 | 22 | 23 | 24 | 24 | 25 | 26 |
6'3" | 19 | 20 | 21 | 21 | 22 | 22 | 23 | 24 | 24 | 25 |
6'4" | 19 | 19 | 20 | 21 | 21 | 22 | 23 | 23 | 24 | 24 |
Weight | 205 | 210 | 215 | 220 | 225 | 230 | 235 | 240 | 245 | 250 |
Height | ||||||||||
5'0" | 40 | 41 | 42 | 43 | 44 | 45 | 46 | 47 | 48 | 49 |
5'1" | 39 | 40 | 41 | 42 | 43 | 43 | 44 | 45 | 46 | 47 |
5'2" | 37 | 38 | 39 | 40 | 41 | 42 | 43 | 44 | 45 | 46 |
5'3" | 36 | 37 | 37 | 38 | 39 | 40 | 41 | 42 | 43 | 44 |
5'4" | 35 | 35 | 36 | 37 | 38 | 39 | 40 | 41 | 42 | 43 |
5'5" | 34 | 35 | 36 | 37 | 37 | 38 | 39 | 40 | 41 | 42 |
5'6" | 33 | 34 | 35 | 36 | 36 | 37 | 38 | 39 | 40 | 40 |
5'7" | 32 | 33 | 34 | 34 | 35 | 36 | 37 | 38 | 38 | 39 |
5'8" | 31 | 32 | 33 | 33 | 34 | 35 | 36 | 36 | 37 | 38 |
5'9" | 30 | 31 | 32 | 32 | 33 | 34 | 35 | 35 | 36 | 37 |
5'10" | 29 | 30 | 31 | 32 | 32 | 33 | 34 | 34 | 35 | 36 |
5'11" | 29 | 29 | 30 | 31 | 31 | 32 | 33 | 33 | 34 | 35 |
6'0" | 28 | 28 | 29 | 30 | 31 | 31 | 32 | 33 | 33 | 34 |
6'1" | 27 | 28 | 28 | 29 | 30 | 30 | 31 | 32 | 32 | 33 |
6'2" | 26 | 27 | 28 | 28 | 29 | 30 | 30 | 31 | 31 | 32 |
6'3" | 26 | 26 | 27 | 27 | 28 | 29 | 29 | 30 | 31 | 31 |
6'4" | 25 | 26 | 26 | 27 | 27 | 28 | 29 | 29 | 30 | 30 |
A woman or man with a BMI between 25 and 29.9 is considered overweight; 30 or more is considered obese; and 40 or greater is considered extreme obesity. Women in the highest obesity category have a significantly higher risk of hypertension and/or high blood cholesterol than women of normal weight.
How can you estimate your body fat distribution? Look at yourself in the mirror. If you are more apple-shaped than pear-shaped, you probably have visceral fat accumulation. Women with a waist circumference over 35 inches (and men over 40 inches) are at greater risk.
Your health care professional also should ask you about or conduct tests to determine other risk factors for disease and conditions associated with obesity. This includes:
It is important to tell your health care professional about any medical or health conditions you have and any medications, vitamins, minerals, herbs or nutritional supplements you're taking. Also let your health care professional know if you are pregnant or breast-feeding or if you're planning on surgery that requires general anesthesia.
The types of health care professionals you might consult to diagnose and treat obesity include:
Losing as little as 5 percent to 10 percent of your body weight and maintaining that loss can significantly improve your health by increasing glucose tolerance and lowering blood pressure and cholesterol levels. Thus, if you're overweight or obese, you may need to seek medical help to lose weight as well as to maintain it.
Experts recommend losing no more than one to two pounds per week. Maintaining weight loss can be more difficult than losing the weight to begin with, so long-term lifestyle change is key.
The National Weight Control Registry is tracking over 10,000 individuals who have lost significant amounts of weight and kept it off for extended periods of time. Members of the registry have lost an average of 66 pounds and kept the weight off for an average of 5.5 years. The individuals who are listed in the registry have reported the following:
Other key habits of people who successfully maintain their weight loss include weighing themselves routinely and writing down their daily food intake in a journal or tracking it with an online application.
The good news is that burning off more calories than you're taking in will cause you to lose weight. The bad news is that there's no magic formula. Studies find that if you lose the weight slowly, you'll be much more effective at keeping it off, especially if you incorporate exercise into your routine and reduce other sedentary behavior, such as watching TV.
The safest way to lose weight is to eat a nutritionally complete diet that is moderate in calories and fat, add exercise to your daily routine and decrease sedentary activities. In some cases, for example, if your health is being immediately and severely compromised because of your weight, faster weight loss may be appropriate. In these cases, your health care professional may recommend drug therapy or surgery.
Changing Your Diet
The first element of treatment is changing your diet. Your health care professional should provide detailed guidance on the number and types of calories you should eat. As a rule of thumb, however, if you take in about 250 calories per day less than is needed to maintain your current weight, combined with an exercise regime that burns an additional 250 calories a day, you'll lose about a pound a week.
The number of calories your body needs to maintain its basic functions such as breathing and digestion is known as your basal metabolic rate (BMR). Several factors go into the calculation of your BMR, including your age, height, weight and gender. To get an idea of your BMR, go to https://www.bmi-calculator.net/bmr-calculator.
It's difficult to determine exactly how many calories you need to maintain your weight at your current level of physical activity. One way to estimate your BMR is to keep a detailed food diary over the course of a few days to a week during which you maintain your weight. Determine exactly how many calories you eat on an average day (several books and Web sites provide calorie counts for thousands of foods) and use that figure as a starting place from which you then subtract 250 calories.
After you've determined how many calories a day you should eat, you need to plan daily menus. A dietitian or nutritionist can help you plan menus that include the types and amounts of food you should eat, which, in most cases, should be based on guidelines developed by the federal government in its 2010 Dietary Guidelines for Americans. The guidelines emphasize calorie reduction as well as balance, moderation and variety in food choices, with an emphasis on whole-grain products, vegetables and fruits.
To satisfy basic nutritional needs, eat a variety of foods including low-fat dairy, healthy protein sources like chicken, fish, eggs and soy products, vegetables and whole grains, and allow for an occasional treat. While you should try to cut back on excess fats and sugars, all foods and beverages can be consumed in moderation. As soon as you label a food as "off limits," chances are you will crave and perhaps even binge on it.
The 2010 Dietary Guidelines recommend the following (based on a 2,000 calorie-per-day diet). These are general guidelines from the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. The amount you personally need will vary based on many factors, including your age, weight, activity level and personal medical history, so be sure to discuss your diet with your health care professional.
Meat and beans (protein)
Fruits, vegetables and dairy
Carbohydrates
Sodium and potassium
Balanced food plans encourage making wise choices about everyday foods so you can maintain a healthy weight throughout your lifetime. Many popular diet plans, however, such as the high-protein/low-carbohydrate diet, don't include balanced choices. While women can lose weight on these diets, they may find themselves dangerously deficient in certain nutrients or food groups and dangerously high in others. In most cases, women who go on these diets tend to regain any lost weight when the diet ends. That's because these diets don't help you change your lifestyle and your way of handling food and temptation in the long run.
Most successful weight-loss plans call for a reduction in both calories and fat. Overall, managing caloric intake and increasing physical activity are most important.
Many health care professionals and dietary guidelines recommend women moderate their fat consumption to 20 percent to 35 percent or less of total calorie intake, with saturated fats accounting for less than 10 percent and the rest comprised of equal amounts of monounsaturated fat and polyunsaturated fats. These fats come from vegetable, not animal, sources.
Also, reduce your cholesterol intake to less than 300 mg per day. Strategies for reducing saturated fat and cholesterol include:
In addition to low-fat dietary approaches, some large studies point to the Mediterranean-style diet as an alternative pattern of eating to reduce your risk of heart disease. Like the low-fat diets, the Mediterranean eating pattern focuses on fruits, vegetables, whole grains, nuts and seeds, but it also includes substituting olive oil (a monounsaturated fat) for saturated fats and drinking wine in low to moderate amounts. The major protein sources are dairy, fish and poultry, with minimal red meat.
The Mediterranean eating style allows a somewhat higher percentage of calories from fat than the low-fat diets typically endorsed by health organizations. Several recent major studies have shown that the diet is an alternative to low-fat diets, especially for lowering risk of diabetes and heart attacks, often related to weight.
Increasing Physical Activity
The second element to losing weight and maintaining a healthy weight is adding exercise to your daily routine and reducing the time you spend sitting. Exercise not only burns calories, it also tempers your appetite, boosts metabolism, improves sleep and provides psychological benefits, such as stress reduction and an increased feeling of control and self-esteem.
If you have been inactive for some time, suffer from shortness of breath or weakness that interferes with daily activities or have a chronic health condition such as heart disease, asthma or lung disease, diabetes, liver or kidney disease or arthritis, consult a health care professional before increasing your physical activity. If you're a woman older than 55 and are overweight or are concerned about your family history or personal health history, talk with your health care professional before starting to exercise. Notify him or her about any chest pain, faintness or dizziness, bone or joint pain you're experiencing, and any medications you're taking.
Physical activity is defined as any bodily movement produced by skeletal muscles resulting in energy expenditure. The best kinds of exercises for burning calories are moderate- to vigorous-intensity physical activities. The calories burned per hour are listed for a 140-pound healthy woman.
Moderate-intensity activities include:
Vigorous-intensity physical activities include:
While you and your health care professional should set up a detailed exercise plan based on your individual health status, the 2010 Dietary Guidelines recommend healthy women who want to manage body weight and prevent gradual unhealthy weight gain engage in 150 minutes (2 hours, 30 minutes) a week of moderate-intensity or 75 minutes (1 hour, 15 minutes) of vigorous-intensity aerobic activity or an equivalent combination of moderate- and vigorous-intensity aerobic activity. If you want to reap additional and more extensive health benefits, you should engage in moderate-intensity aerobic activity for 300 minutes (5 hours) or vigorous-intensity activity for 150 minutes per week. The guidelines also recommend that adults perform muscle-strengthening activities that involve all major muscle groups at least two days a week.
You don't have to do all 150 minutes at once; if possible, aerobic activity should be spread throughout each week and can be divided up throughout the day. For example, 30 minutes of an aerobics video in the morning and 30 minutes of brisk walking in the evening works just as well as walking for an hour straight. If you have been inactive, you need to work up slowly to this amount so you don't get injured or overly fatigued and become discouraged. Start with five or 10 minutes (or whatever you're comfortable with) every other day, adding one minute every other session.
Low- to moderate-intensity exercise, like housework, gardening and walking the dog, provide a great deal of general health benefits, but for weight loss, you need to up the ante and exercise at a higher intensity with more vigorous activities like brisk walking or jogging, singles tennis or other racquet sports, aerobics classes, ice or roller skating, swimming or cycling.
The best way to keep weight off once it's been lost is with an average of 60 to 90 minutes of moderate-intensity exercise per day, most days a week, while being careful not to exceed your specific daily calorie requirement.
Because the goal of moderate to vigorous exercise is to work your heart muscle, your exercise needs to increase your heart rate. One way to determine if you are exercising intensely enough is to measure your heart rate. After warming up and then sustaining an aerobic activity for about five to 10 minutes, take your pulse within five seconds of stopping by placing two fingers on the carotid artery on the side of your neck, just under your jaw line and about one to two inches in front of your ear. Count the beats for 10 seconds. Multiply this number by six to determine the heart rate in beats per minute. Your heart rate should be about 50 to 85 percent of its maximum. (You can calculate your maximum heart rate by subtracting your age from 220).
If you're out of shape or older than 60, aim for an intensity at the lower end of the 50 percent to 85 percent range. To determine what your heart rate should be during exercise, subtract your age from 220; divide that number by six for a 10-second heart rate count, then multiply that number by 0.5 for the lower end of the range and 0.85 for the higher end. For example, if you're 70:
The following chart illustrates recommended 10-second heart rate counts; the number of beats you count should fall between the two numbers listed beside your age.
(Age) | 70 % of maximum | 85 % of maximum |
20 | 23 | 28 |
30 | 22 | 27 |
40 | 21 | 26 |
50 | 20 | 24 |
60 | 19 | 23 |
An easier way to judge intensity is the "talk test." You shouldn't be exercising so hard that you can't talk with a friend or recite a poem. If you can't talk without gasping for breath, slow down. On the other hand, if your exercise is easy enough that you can sing a song out loud, you probably need to increase your intensity.
Another type of exercise has received much attention over the past several years for its contribution to weight loss efforts. Strength training, which includes weight lifting and isometrics, or using your own body weight as resistance, not only improves muscular strength and endurance but raises metabolism, enabling you to burn more calories.
Make sure you take a few minutes to stretch and warm up before doing any kind of exercise.
It's best to incorporate a combination of both types of exercise into your lifestyle—moderate to vigorous physical activities to burn fat and strength training to build muscle. Neither is as effective alone.
At the same time, you need to reduce the amount of television you watch, since TV watching is independently associated with obesity.
Medications for Treating Obesity
Women with increased medical risk from their obesity may benefit from adding a weight-loss medication to their nutritional/exercise regimen.
Most research-based and professional associations recommend lifestyle therapy for at least six months before embarking on a weight-loss plan using physician-prescribed drug therapy. Even then, it must be used only as part of a comprehensive weight loss program that includes dietary therapy and physical activity. Currently available prescription medications include:
Lorcaserin is the newest drug available. It was approved by the FDA in 2012 and is expected to be available in the United States starting in early 2013. In clinical trials, the drug was twice as effective as a placebo in helping people lose 5 percent or more of their weight. The most common side effects are headaches, nausea and dizziness, but it also can cause neuropsychiatric and cognitive problems.
Orlistat also is now available over the counter under the brand name Alli in 60-milligram pills, half the strength of the prescription dosage in Xenical. It is the first FDA-approved over-the-counter weight loss drug. Like Xenical, Alli blocks digestion of about 25 percent of the fat eaten at a meal. Orlistat has been found to be safe and effective in combination with a low-fat (less than 30 percent fat), low-calorie diet, though it can cause significant gastrointestinal side effects, especially when you start using it. In clinical trials, people taking the drug lost 4.4 to 6.6 pounds more over a year than those not taking the drug.
Phentermine is a widely prescribed appetite suppressant. It is often prescribed to help control portions and manage hunger.
Qsymia, which combines phentermine and topiramate (a drug also used to prevent migraines and treat epilepsy), is a newly approved weight loss drug that produces weight loss via complementary mechanisms and allows for the use of each agent at a lower dose. This potentially minimizes side effects and maximizes weight loss benefits. Data has shown that people who take the highest dose of Qsymia can achieve up to a 10.5 percent weight loss after two years of treatment. As with all medications, the risks and benefits of treatment need to be evaluated by your health care provider. Certain people are not good candidates for treatment, including those with uncontrolled high blood pressure, cardiac disease or unstable psychiatric disease.
If you are pregnant or plan to become pregnant, talk to your health care provider about using Qsymia or any medications.
If you are considering taking drugs for weight loss, remember: NEVER take a drug or herb that hasn't been prescribed or recommended by your health care professional. There are numerous potentially dangerous over-the-counter drugs and herbs that claim to help you lose weight, but, except for Alli, they have not been approved by the FDA and may cause significant health complications and even death.
Surgery
For clinically severe obesity, your health care provider may recommend surgery. Many people, including some health care professionals, wrongly believe that obese people merely need to stop eating so much to lose weight. In reality, extreme obesity is a potentially deadly disease that sometimes requires a treatment as dramatic as surgery. Surgery is an option for carefully selected patients under the care of a health care professional. Most physicians consider people for the surgery who:
There are several types of bariatric surgery:
Other less common procedures include:
All procedures can lead to "full and rapid" remission of diabetes, sleep apnea, hypertension, kidney failure and other weight-related medical conditions.
While bariatric surgery is extremely safe, the greatest risks come after the surgery. Some occur soon after the operation, such as hemorrhage, obstruction, infection, hernias, pulmonary embolisms (blood clots in the lung) and leaks between the areas where tissue was sewn together.
Long-term complications include nutritional deficiencies, including malabsorption of vitamin B12, iron, thiamine and calcium; and hypoglycemia, or low blood sugar, which can lead to various medical conditions, including neuropathy.
The average person undergoing bariatric surgery loses about 60 percent to 80 percent of excess body weight. That means if you weigh 250 pounds and your "ideal" body weight is 150 pounds, you have an "excess" of 100 pounds. On average, you may lose 60 80 pounds after surgery, putting you at a weight of about 170 to 190 pounds after the procedure.
After surgery, you have to learn to eat smaller amounts of food at one time, to chew food well and to eat slowly. If you don't adjust your eating habits, you won't lose as much weight. Additionally, especially in the first three months after surgery, you must be sure to eat the proper amounts of protein, calories, minerals and vitamins as recommended by your health care professional, and you will likely need nutritional supplements for the rest of your life.
Behavioral Strategies
Another key to successful weight loss is incorporating behavioral strategies into your new eating and exercise activities. These include learning about nutrition, planning what to eat and making sure you eat regularly to end impulsive and thoughtless eating.
Some specific and helpful behavioral strategies include:
Health care professionals and researchers stress that if you are obese, losing as little as 5 percent to 10 percent of your body weight can improve or prevent many of the health problems linked to your condition, such as high blood pressure and diabetes.
Review the following Questions to Ask about obesity so you're prepared to discuss this important health issue with your health care professional.
In both overweight and obese people, the defining characteristic is excess body fat. The difference is a matter of degree. Overweight people usually have a body mass index (BMI), or ratio of weight to height, of 25 to 29.9. Obesity is usually defined as a BMI of 30 or more. Another measure of obesity is having more than 30 percent body fat. While overweight people have a higher incidence of certain diseases and conditions than normal weight individuals, as people gain weight, they become even more prone to these often life-threatening problems.
Being overweight or obese is bad for your health, even if you're only slightly overweight. Excess weight is a major risk factor for heart disease and stroke and is linked to a higher incidence of diabetes, which you are twice as likely to develop as a person of normal weight. In addition, it is associated with several types of cancers, gout, gallbladder disease and other diseases.
Don't give up. Losing as little as 5 percent to 10 percent of your body weight—in your case, 12 to 24 pounds—can significantly improve your health. Health care professionals recommend that your first effort at losing weight should be at this level, followed by a period of maintenance before trying to lose more.
The safest way to lose weight is, in most cases, to eat a nutritionally complete diet that cuts about 250 calories a day from the number of calories your body requires to maintain its present weight, plus add an exercise regime that burns an additional 250 calories a day. If you do this, you will lose about a pound a week. All of these moderate-intensity activities will burn at least 250 calories per hour for a 140-pound, healthy woman:
More vigorous activities, such as calisthenics, running, swimming, downhill skiing and high-speed bicycling, will burn 500 or more calories per hour.
You don't have to exercise, but it is extremely beneficial. Not only will exercise make the weight come off more quickly and easily, it will make your weight loss much easier to maintain. Regular physical activity also can help reduce your risk of certain health problems.
For clinically severe obesity, bariatric surgery is safer than remaining severely obese. Because there are various types of operative procedures, you should speak with your health care professional about the specific safety statistics of the ones that might be best for you. In addition, consistent follow-up and patient compliance with post-surgical treatment is crucial to the success of these surgeries. These surgical procedures are used only in patients who have been unsuccessful at losing weight in other ways.
Organizations and Support
For information and support on Obesity, please see the recommended organizations and Spanish-language resources listed below.
American Council on Exercise
Website: https://www.acefitness.org/
Address: 4851 Paramount Drive
San Diego, California 92123
Phone: 888-825-3636
Overeaters Anonymous
Website: https://www.oa.org
Address: P.O. Box 44020
Rio Rancho, NM 87174
Phone: 505-891-2664
Shape Up America!
Website: https://www.shapeup.org
Address: 15009 Native Dancer Road
North Potomac, MD 20878
Staying Fit on Campus
Affordable Colleges Resource Center
Website: https://www.affordablecollegesonline.org/college-resource-center/staying-fit-on-campus/
Spanish-language resources
Medline Plus: Weight Control
Website: https://www.nlm.nih.gov/medlineplus/spanish/weightcontrol.html
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: custserv@nlm.nih.gov
Teens Health from Nemours
Website: https://kidshealth.org/teen/en_espanol/cuerpo/dieting_esp.html
HealthyWomen content is for informational purposes only. Please consult your healthcare provider for medical advice, diagnosis or treatment.