What is obesity?

Obesity is generally defined as the condition of weighing 20% or more over your ideal weight. You can find the ideal weight for your height and sex from a weight chart. Forty million Americans are obese. Thirty percent of men and 40% of women between the ages of 40 and 49 are at least 20% over their ideal weight. Obesity increases as people age.

Obesity is a serious condition because it increases your risk of having major illnesses, such as:

• stroke

• heart disease

• diabetes

• some types of cancer, such as colon, breast, and uterine cancer

• osteoarthritis (the stiff, sore joints that you can get as you get older).

Obesity makes it harder for your health care provider to give you a good physical exam. Looking at the inside of your body with X-rays and other types of scans, as well as surgery, may also be more difficult.

How does it occur?

The causes of obesity are not clear. Overeating is not always the cause. The amount of energy (calories) your body needs when you are at rest may be important. You get energy from the food you eat. The energy you do not use is stored as fat. Obese people may use less energy when they are at rest than people who are not obese. Also, they may burn fewer calories than nonobese people because it is harder to be physically active.

The genes you inherit from your parents can affect your weight. Children of obese parents are 10 times more likely to become obese than children whose parents are not obese. Unhealthy family eating habits may also be a reason several members of a family are obese.

Rarely, hormone imbalance causes obesity.

How is it diagnosed?

Your health care provider will measure your weight. He or she may perform a physical exam and ask about your medical history. Your blood may be tested to measure the amounts of sugar, cholesterol, and triglycerides in it.

If your provider thinks you might have hypothyroidism, a thyroid-stimulating hormone test might be done. Hypothyroidism is a condition in which the body does not produce enough thyroid hormone. Thyroid hormone controls the amount of energy the body uses.

How is it treated?

Evaluation of your diet is an important first step. To help you lose weight, your diet should provide fewer calories a day than your body needs to maintain your ideal weight. A dietitian may prescribe a diet for you. He or she will make sure your new diet provides fewer calories but is healthy and allows you to lose weight safely. Your diet should allow you to lose 1 to 2 pounds a week. Do not fast, follow fad diets, or take drugs that curb your appetite.

You will be taught to change patterns of behavior. For example, some people eat as a way to cope with emotional problems. If you have serious emotional problems, your health care provider may refer you to a counselor for therapy. You will need to deal with psychological and emotional problems if your weight-loss program is to be successful.

Physical activity is a very important part of a successful weight-loss program. Once you reach a lower weight, exercise also helps you stay at that weight. Having a total of 30 minutes of physical activity on most days of the week will lower your blood pressure, pulse, cholesterol, and blood sugar. Regular exercise also increases your metabolic rate, which means your body burns more calories, even as you sleep.

Physical activity alone may be the first step in your weight-loss or weight-maintenance program if you are not yet ready to make changes in your diet. The sense of well-being that you will get from exercise may motivate you to choose healthier foods.

Physical activity may include walking, jogging, swimming, cycling, aerobics, or a step aerobics program. Almost any activity that involves mild to moderate exertion is good. Tell your health care provider the ways you plan to exercise. If you have a physical disability, your provider will help you find exercise alternatives.

Support from other people can help motivate you. Your main support group can be your family and friends. Look also for weight-loss support groups in your community.

How can I take care of myself?

To help yourself, follow these guidelines:

• Follow your plan for healthy eating.

• Take a class in preparing low-calorie meals.

• Use low-calorie cookbooks. Check your public library or local county extension program.

• Keep a daily record of the foods you eat and drink. Write everything down.

• Stick to your diet and don't get discouraged.

• Take vitamins and mineral supplements only if your health care provider recommends them. They may make you hungrier.

• Drink at least six 8-ounce glasses of water a day. Choose other drinks with no calories.

• Avoid alcohol.

• Join a weight-loss support group.

• Read books and articles or watch TV shows that discuss losing weight.

• Perform regular physical activity in moderation, following your health care provider's recommendations.

• Keep a daily record of your exercise.

• Find a friend to exercise with you.

• Keep your appointments with the dietitian or therapist.

• Learn to use relaxation techniques such as deep breathing to help you deal with stress.

• Discuss your feelings, challenges, and successes at a support group or with your health care provider.

Many obese people have trouble keeping weight off. Often this is caused by emotional problems that occur when they are trying to lose weight. Weight loss can trigger severe depression or even psychosis if you were obese as a child or if you have been depressed because of your obesity. If you feel compelled to eat excessively or raid the refrigerator late at night, you may be suffering emotional distress. If you are already under stress, your health care provider may decide that you should not try to lose weight until your life becomes more stable.

Be aware that after you lose weight, the ways you relate to other people may change because of your improved self-image.

How can I avoid obesity?

Gaining excess weight occurs over a long period. Losing that weight requires motivation and discipline. To maintain a healthy weight you must eat healthy foods and develop the habit of being physically active. Try to stay as close to your ideal weight as possible.