Overview

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

There are many reasons why some people have difficulty avoiding obesity. Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices.

The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. Dietary changes, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.

Symptoms

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.

BMI	Weight status
Below 18.5	Underweight
18.5-24.9	Normal
25.0-29.9	Overweight
30.0 and higher	Obesity

Causes

Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat.

Most Americans’ diets are too high in calories — often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.

Risk Factors

Obesity usually results from a combination of causes and contributing factors:

• Family inheritance and influences. Your genes you inherit from your parents may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise. Family members also tend to share similar eating and activity habits.
• Lifestyle choices. Consuming a diet high in calories, eating oversized portions, drinking liquid calories such as sugary soft drinks and a sedentary lifestyle can all causes weight gain.
• Certain diseases and medications. Certain conditions such as Cushing syndrome and some medications can lead to weight gain.
• Social and economic issues. You may not have been taught healthy ways of cooking or have a safe place to exercise.
• As you age, hormonal changes and a less active lifestyle increase your risk of obesity.
• Other factors: pregnancy, quitting smoking, lack of sleep, stress, but microbiome.

Complications

People with obesity are more likely to develop a number of potentially serious health problems, including heart disease, stroke, Type 2 diabetes, certain cancers (uterine, ovarian, breast, colon, esophagus, liver, gallbladder, pancreas, prostate), digestive problems (gallbladder disease), fertility problems, sexual problems, sleep apnea, and arthritis.  Obesity can diminish your overall quality of life. You may not be able to do things you used to do, such as participating in enjoyable activities. You may avoid public places. People with obesity may even encounter discrimination.

Treatment

The goal of obesity treatment is to reach and stay at a healthy weight. This improves your overall health and lowers your risk of developing complications related to obesity. The initial treatment goal is usually a modest weight loss — 5% to 10% of your total weight. That means that if you weigh 200 pounds (91 kg) and have obesity by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9 kg) for your health to begin to improve. However, the more weight you lose, the greater the benefits.

All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your obesity severity, your overall health and your willingness to participate in your weight-loss plan.

These include:

• Dietary changes which include cutting calories, making healthier choices, restricting certain food, and using meal replacements. There is no best weight-loss diet. Be wary of quick fixes such as fad diets that promise fast and easy weight loss.
• Exercise and activity. Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
• Behavior changes A behavior modification program can help you make lifestyle changes and lose weight and keep it off. This includes counseling and support groups.
• Prescription weight-loss medication. In certain situations, prescription weight-loss medication may help.
• Endoscopic procedures for weight loss. There are several different types of endoscopic procedures used for weight loss. One procedure involves placing stitches in your stomach to reduce its size and the amount of food you can eat. In another endoscopic procedure, doctors insert a small balloon into your stomach. The balloon is filled with water to reduce the amount of space available in your stomach. This helps you feel fuller faster.
• Weight-loss surgery. Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that haven’t worked. These include gastric bypass, gastric sleeve and adjustable gastric banding.