Understanding Obesity: Causes, Symptoms, & Treatment

What Is Considered Overweight?

You might be asking, ‘what is considered overweight?’ or ‘what is obesity?’ The overweight and obesity definition is, “abnormal or excessive body fat accumulation that presents a risk to health.” Having a certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions. However, when you have an excess amount of body fat, you are considered medically overweight or obese. In order to determine if you are medically overweight or obese, we use a calculation that gives us a BMI score.

Body Mass Index (BMI)

BMI stands for body mass index. It is a value of weight in relation to height. Obesity is defined based on your BMI score. A BMI equal to or greater than 25 is considered overweight, and a BMI equal to or greater than 30 is considered obese.

You can calculate your BMI by dividing your weight in pounds by your height in inches squared, and then multiplying by 703. This calculator can help you find your BMI. Once you have your BMI, you’ll be able to look at a BMI chart, like the obesity chart below, and find your weight category.

BMI provides a reasonable estimate of body fat for the majority of people. Nevertheless, it is still just an estimate since BMI doesn't directly measure body fat. This means that some people, such as muscular athletes, may have a BMI in the obese category despite having no excess body fat.

The table below summarizes the categories of weight status according to BMI:

Obesity Symptoms

The symptoms of obesity can include:

• Increased sweating
• Breathlessness
• Joint and back pain
• Fatigue
• Snoring

Types of Obesity

Morbid obesity

There is a category for people who are ‘extremely obese’ or ‘morbidly obese.’ Someone is considered morbidly obese if he or she is 100 pounds over his/her ideal body weight, has a BMI of 40 or more, or has a BMI of 35 or more and is also experiencing obesity-related health conditions, such as high blood pressure or diabetes. Morbid obesity is a serious and disabling health condition. It may mean you have difficulty with basic physical functions such as breathing or walking.

Childhood obesity

Childhood obesity is defined using a different chart system. Overweight is defined as having a BMI at or above the 85th percentile and below the 95th percentile. Obesity is defined as a BMI at or above the 95th percentile.

Unfortunately, 17% of children aged 6-19 are obese, as are 10% of children aged 2-5.

Did you know?

More people are overweight today than ever before. In fact:

• 70% of Americans aged 20 and older are overweight
• A third of Americans are considered obese

This equates to about about 93.3 million of U.S. adults being obese in 2015-2016.

This obesity incidence map shows that obesity is a serious epidemic in the U.S.

Obesity-Related Conditions

Being overweight or obese is not a cosmetic concern but rather a medical problem. If you are obese, you are at major risk for a number of other chronic diseases, including diabetes, cardiovascular diseases, kidney disease, and cancer. Obesity-related conditions include:

• Diabetes: Being overweight or obese increases the chances of developing type 2 diabetes. The prevalence of type 2 diabetes is 3-7 times higher in those who are affected by obesity than in normal weight adults, and is 20 times more likely in those with a body mass index (BMI) greater than 35.

• Congestive heart failure: Obesity-related factors are estimated to cause 11% of heart failure cases in men and 14% in women. Fat build-up in the arteries can cause arteriosclerosis and cardiovascular disease, and fat build-up in the heart can limit heart function and lead to congestive heart failure.

• Chronic kidney disease: A high body mass index is one of the strongest risk factors for having chronic kidney disease. This is because with excess body fat, there are more demands on the body’s metabolism, and the kidneys have to work harder to filter out unwanted substances from the body. The resulting increase in pressure inside the kidney cells can damage the kidneys and increase the risk of developing this disease.

• Certain cancers: Being overweight or being obese is the second biggest preventable cause of cancer. More than 5% of cancer cases are caused by excess weight. The risk is higher the more weight a person gains and the longer they are overweight for.

• Gynecological and sexual problems: Body fat produces sex hormones which contribute to causing irregular periods and infertility in women and decreased libido and erectile dysfunction in men.

• Sleep apnea: Overweight people are more likely to have sleep apnea. Sleep apnea is a potentially serious disorder in which breathing repeatedly stops and starts during sleep and contributes to chronic heart and lung disease.

• Osteoarthritis: Osteoarthritis is the breakdown of joint cartilage and inflammation in the joints. Excess weight places additional stress on weight-bearing joints and accelerates this inflammation and cartilage breakdown.

• Depression: Being obese increases the risk for depression. This is due to various complex factors that include medication side effects, hormonal effects, and decreased activity due to joint pain.

The good news is that all the above obesity-related conditions can be prevented. Even if you lose only a small 5-10% of weight and keep the weight off, this can make a real difference in reducing your risk of these other conditions.

Is obesity considered a disease?

Obesity was designated as a chronic disease in 2013. Chronic disease is defined as conditions that last one year or more and require ongoing medical attention, limit activities of daily living, or both. This means that the long-standing idea that obesity is caused by insufficient willpower, lack of discipline, and bad choices is slowly changing. There is now more of a mindset in the medical world to carry out more research to find further effective treatments.

Risk Factors for Obesity

Obesity usually results from a combination of causes and contributing factors including genetic, psychological, physical, metabolic, neurological, and hormonal impairments. We will look at some of these below:

• Genetics: Recent research suggests that genetics contribute to 40-70% of obesity. In fact, more than 400 genes have been discovered that are strongly associated with obesity. Therefore, the genes you inherit from your parents may affect the amount of body fat you store, where that fat is distributed, how efficiently your body converts food into energy, how your body regulates your appetite, and how your body burns calories during exercise.

• Environment: Obesity tends to run in families, not just because of common genes, but also shared eating and activity habits. This also means that if your friends and the people you live with are obese, you may also be overweight through shared lifestyles. Likewise, you may have similar access to healthy foods and safe places to walk or exercise. If you have a profession which requires you to sit and be at a computer all day, you are more likely to gain weight. This is because your sedentary job means it is easy to take in more calories than you burn through exercise and routine daily activities.

• Medications: Medications such as some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids, and beta blockers have weight gain as a side effect. It is important to discuss with your doctor about potential side effects of your medications.

• Other diseases: Obesity can sometimes be linked to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome and other conditions. The symptoms of some medical conditions can also mean it is harder to exercise, such as with arthritis or muscular dystrophies, causing a build-up of excess body fat. Mental health disorders can also increase the risk for obesity due to side effects from medications to treat psychiatric illnesses and through changed behaviors. For example, you may reduce your sleep time and physical activity and have poor eating habits, all of which can contribute to the development of obesity.

• Age: Obesity can occur at any age but as you get older, hormonal changes, reduced muscle mass, and a less active lifestyle can increase your risk of obesity.

Other factors

Various other factors can increase your risk of gaining too much weight:

• Pregnancy: Some women find it difficult to lose weight after pregnancy.

• Quitting smoking: Smokers can sometimes use food to cope with smoking withdrawal which, if not dealt with, can lead to weight gain.

• Poor sleep habits: Not getting enough sleep can cause hormonal and appetite changes.

• Stress: People under a lot of stress with poor coping mechanisms may compensate by seeking more high-calorie food.

• Yo-yo dieting: Previous attempts of weight loss followed by rapid weight gain may contribute to further weight gain by slowing your metabolism.

Just because you may have some of these risk factors doesn’t mean you will necessarily develop obesity. You can counteract most obesity risk factors through diet, physical activity and exercise, and behavioral changes.

Options for Treating Obesity

Research shows that a weight loss program should include three components to be successful: diet, exercise, and behavior modification.

• Diet: A steady weight loss of about one pound a week is the safest way to lose weight. It is a good idea to consult with a registered dietitian to help you plan your diet. Please see K Health’s guide to healthy eating.

• Exercise: The government's current recommendations for exercise call for an hour of moderate to vigorous exercise a day but fewer than 25% of Americans meet that goal. See K Health’s guide to exercise to show what kind of exercise you should be doing routinely. Talk to your doctor before you begin any new exercise program.

• Behavior modification: These include keeping a food diary to track everything you eat, grocery shopping from a list to prevent impulsive unhealthy purchases, not shopping when you're hungry, and taking a different route if you usually pass by a tempting fast food place.

When to See a Doctor

Speak to your doctor about a weight loss program that is safe and right for you. As mentioned above, this program needs to encompass dietary, physical, and behavioral changes. Sometimes having a medical professional monitoring your progress can assist in making sure you achieve your goals.

If you have tried all you can and are now suffering from weight gain from yo-yo dieting or are worried about medical complications from obesity, it might be time to take more drastic steps to give yourself the best chance for significant and sustained weight-loss.

Weight loss medications

Your doctor may prescribe you weight loss medications which may help you feel less hungry or full sooner. Other medications may make it harder for your body to absorb fat from the food you eat. Such medications need to be taken in combination with good nutrition and sufficient exercise, not as a replacement for a healthy lifestyle.

Bariatric surgery

If you have severe obesity, your doctor can talk to you about whether you are a suitable candidate for bariatric surgery. This is a major decision and you will need to talk to your doctor to weigh the benefits against the risks. You will also need to have a psychological evaluation to maximize the success of your surgery and prepare you for the lifestyle you’ll need to follow after the operation.

Bariatric surgery should be considered by those who have a BMI greater than 40, or have a BMI of 35-39.9 and medical problems such as diabetes, heart disease or sleep apnea.

Bariatric surgery changes the normal digestive process. There are three types of surgery: restrictive, malabsorptive and combined restrictive/malabsorptive. The National Institute of Diabetes and Digestive Kidney Diseases (NIH) provides an overview of the procedures and how they produce weight loss.

Studies continue to show that diabetes can be cured in many patients using bariatric surgery. These clinical improvements occur not only because of the significant weight loss, but because of hormonal changes that occur when foods bypass the stomach.

How K Health Can Help

With K Health’s virtual diagnosis tool, you can quickly determine whether the symptoms you may be experiencing from obesity merit a doctor’s visit. Our doctors can help you determine if you can alleviate what you’re feeling from at-home remedies, or if a trip to a medical professional is necessary. Our doctors are also available to help you learn how to ease your symptoms and what you can do to help prevent them in the future.