Obesity

Signs and symptoms of obesity include:

• Accumulation of fat, including around the abdomen, thighs, buttocks, and upper arms
• Breathlessness with minimal physical activity
• Pain in joints, especially hips, knees, and back
• Generalized fatigue and tiredness
• Snoring
• Mental distress, such as anxiety, low self-esteem, and depression

According to the Centers for Disease Control and Prevention, obesity is subdivided into classes using the Body Mass Index (BMI) calculated outcome of a patient. If a patient is placed in the Class 3 category, he or she is considered a severe or extreme case of obesity.

Class 1: BMI of 30 to < 35

Class 2: BMI of 35 to < 40

Class 3: BMI of 40 or higher

Weight gain occurs when a person consumes more calories than the body is using to burn energy. Sedentary behavior and the overconsumption of food causes the accumulation of weight, which over time leads to obesity. The bottom line is that when you eat more calories than you burn, you will gain weight. Two factors that affect energy consumption and expenditure are diet and exercise. Spending the day in front of the television, on the computer, or using a smartphone is a common behavior for many of us, especially during the current Covid-19 pandemic.

Obesity is a complex disease resulting from a combination of hereditary and environmental factors and the reasons vary from person to person. Biological, psychological, and physiological disruptions can all play a role in the development of obesity. Lifestyle behaviors, like a sedentary lifestyle and poor nutrition, are major contributors to obesity. However, genetic variation in responses to food intake and hunger can predispose some people to gain too much weight. Certain diseases and medications can also increase risks for obesity.

Diet: Poor dietary choices add empty calories to your diet with low nutritional value. Foods high in sugar, high-fructose corn syrup, saturated fats, and highly processed foods increase the risk factor for obesity.

Exercise: Low physical activity burns fewer calories and will cause weight gain, especially when combined with a nutritionally poor and calorie-rich diet.

Sleep deprivation: Studies have shown that getting too little sleep can cause metabolic and hormonal changes in the body that boosts hunger signals that will lead to overeating.

Stress: Stress and anxiety disorders can cause a person to find comfort in eating food to relieve depressive and anxious symptoms. Chronic stress will also elevate cortisol levels which can cause metabolic changes, including weight gain.

Genes: Genes inherited from parents may affect how a person’s body stores fat and where the fat is distributed (e.g., abdominal fat). Genes may also affect how efficiently the body stores food and responds to exercise as well as appetite and satiety.

Diseases and disorders:

• Arthritis and other chronic pain conditions
• Cushing’s syndrome
• Hormonal conditions, including menopause
• Hypothyroidism
• Insulin resistance
• Polycystic ovary syndrome (PCOS)
• Prader-Willi syndrome

Medications:

• Anticonvulsants
• Antidepressants
• Antihistamines
• Corticosteroids
• Diabetes medications
• High blood pressure medications

Obesity is a condition that is diagnosed on an individual basis. Physicians use several factors to determine the extent that excessive weight is affecting health. Health professionals will use measurements of BMI, waist-to-hip ratio, waist circumference, excessive abdominal fat, and genetic risk factors when assessing the health of their patients. The following table (Table 1) gives you an idea of how your physician may use BMI to assess your risk factors for obesity.

 

Table 1: BMI Risk Factors (Adapted from Drugs.com)

BMI	Category
Below 18.5	Underweight
Between 18.5 – 24.9	Normal
Between 25.0 – 29.9	Overweight
Above 30	Obesity

BMI is calculated by taking the person’s weight and dividing it by the square of height in meters. The National Institute for Health and Center for Disease Control offers these two resources to calculate Body Mass Index: Adult BMI Index Chart and Adult BMI calculator. Your physician will ask about your family history to see if you at a higher risk for co-morbid complications such as cardiovascular disease and/or type 2 diabetes. If you are concerned about rapid weight gain or are unable to control your eating habits, seek a medical professional to start a treatment plan.

Common treatments for obesity include:

• Designing a healthy diet and exercise plan
• Joining a formal weight management program
• Nutritional support therapy
• Prescribing weight-loss medications
• Prescribing weight-loss devices
• Bariatric surgery

Because the largest contributors to obesity are modifiable behaviors, the first line of treatment is changing lifestyle habits related to diet and exercise. Obesity can have a large impact on a person’s quality of life and his or her mental health. Seeking mental health therapy will improve treatment outcomes.

Obesity can be taxing on the body. Inform your health care provider about any weight loss program, supplements, or herbal remedies you use to ensure the alternative treatment is safe.

Nutritional treatment. Minimize consumption of animal-based foods high in fat. Eat a diet rich in raw or slightly cooked veggies, beans, legumes, and whole grains.

Detoxification therapy. Fat cells store toxins efficiently which can build up in the system. Weight loss can release these toxins and a detoxification regime can help remove these toxins. Fasting and using herbal teas that contain burdock or dandelion root improve toxin levels.

Other therapies:

• Positive thinking and visualization – Encourages positive thought processes and visualizing weight loss and healthy behavioral
• Herbal medicine – Uses green tea, St. John’s Wort, ginseng, fenugreek, licorice root
• Mental health therapy – Finds negative thinking patterns and treats anxiety and depressive disorders
• Traditional Chinese Medicine – Uses herbal therapy, acupuncture, hydrotherapy, and acupressure to aid weight loss

If you notice you have been gaining weight, talk to your healthcare provider and check to make sure you do not have an underlying condition. Preventing obesity begins with changing habits and starting a healthy eating plan with regular physical activity. Yet, it is difficult to change negative behavior patterns. Be patient with yourself while you are making strides to losing weight. It is hard but rewarding work!

Obesity left untreated and unmanaged can lead to the development of serious chronic diseases such as type 2 diabetes and heart disease. Fat produces chemicals that increase inflammation in the body, which causes a cascade of ill effects in the body’s systems. Excess fat can cause your body to become resistant to insulin (the hormone responsible for the regulation of glucose in your body) and build up plaque in your arteries. However, if you start to manage your condition with lifestyle modifications and treatment from your healthcare team, you will find a better path to health.

Complications

List adapted from the CDC.

• Arthritis
• Cancer (breast, colon, esophagus, kidney, pancreas, prostrate, uterus)
• Female disorders (abnormal periods, infertility)
• Gallstones
• Gout
• Heart disease (diabetes, high blood pressure)
• Inflammation of the veins (blood clots)
• Liver disease
• Lung disease (asthma, pulmonary blood clots)
• Pancreatitis
• Sleep apnea and snoring
• Stroke

Obesity can be treated without the use of medication and/or surgery. Lifestyle modifications are the first line in the treatment of obesity.

Step 1: Change your diet

• Limit processed foods and focus on nutritional therapy.
• Avoid fast food
• Make a home-cooked meal plan
• Replace processed grains with whole grains
• Eat fresh and local. Consume fruits, vegetables, nuts, and healthy sources of protein
• Hydrate! Staying hydrated clears the body of toxins and stifles cravings for junk food

Step 2: Change your sedentary behavior.

• Get up every 15 minutes
• Start walking routine 30-60 minutes daily
• Make an exercise plan that involves cardio and weightlifting
• Start a new hobby that involves movement: ballroom dancing or yoga

Step 3: Set reachable goals

• Write down a short-term goal that is realistic in the near future
• Set a long-term goal that is reachable in the distant future

Step 4: Change your sleeping and stress-coping patterns

• Develop healthy sleeping patterns
• Practice stress-reduction techniques

CDC. (2020, September 17). Adult obesity causes and consequences. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/obesity/adult/causes.html

Liu et al. (2017). Herbal medicine for the treatment of obesity: An overview of
scientific evidence from 2007 to 2017. Retrieved from Hindawi Online: https://www.hindawi.com/journals/ecam/2017/8943059/

NIH. (2018, February). Treatment for overweight and obesity. Retrieved from National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/treatment

Stanford, C. et al. (2018). Facing overweight and obesity: A complete guide for children and adults. The Massachusetts General Hospital Psychiatry Academy. Boston, MA.

Xuejuan et al. (2020, February). Association of sleep duration with weight gain and general and central obesity risk in Chinese adults: A prospective study. Retrieved from Wiley Online Library: https://onlinelibrary.wiley.com/doi/pdf/10.1002/oby.22713

Yasmine, S. A. (2020, June 08). Causes and risk factors of obesity. Retrieved from Very Well Health: https://www.verywellhealth.com/obesity-causes-4014562