The foods we eat every day contribute to our well-being. Foods provide us with the nutrients we need for healthy bodies and the calories we need for energy.
If we eat too much, however, the extra food turns to fat and is stored in our bodies. If we overeat regularly, we gain weight, and if we continue to gain weight, we may become obese.
Obesity means accumulation of excess fat on the body. Obesity is considered a chronic (long-term) disease, like high blood pressure or diabetes. It has many serious long-term consequences for your health, and it is the second leading cause of preventable deaths in the United States (tobacco is the first). Obesity is defined as having a body mass index (BMI) of greater than 30. The BMI is a measure of your weight relative to your height. See eMedicine's Body Mass Index Calculator.
Obesity is an epidemic in the United States and in other developed countries. More than half of Americans are overweight-including at least 1 in 5 children. Nearly one third are obese. Obesity is on the rise in our society because food is abundant and physical activity is optional.
Each year, Americans spend billions of dollars on dieting, diet foods, diet books, diet pills, and the like. Another $45 billion is spent on treating the diseases associated with obesity. Furthermore, businesses suffer an estimated $20 billion loss in productivity each year from absence due to illness caused by obesity.
The following are the most common symptoms that indicate an adolescent is obese. However, the patient's appearance is sufficient to arrive at a diagnosis in most cases, determined by the persons BMI (body mass index) depending on weight to height, though each adolescent may experience symptoms differently.
Symptoms may include:
- Large body frame.
- Difficulty in doing daily activities.
- Disproportionate facial features.
- Breast region adiposity - (sagging fat cells) in boys.
- Big belly (abdomen), sometimes marked with white or purple blemishes.
- Male external genitalia may appear disproportionately small.
- Early arrival of puberty.
- Flabby fat in the upper arms and thighs.
- Knock-knees (Genu valgum) is common.
The symptoms of obesity may resemble other medical problems or conditions. Psychological disturbances are also very common as well as stress, social pressure and doing developmental chores. Always consult your adolescent's doctor for a diagnosis.
Weight gain occurs when you eat more calories than your body uses up. If the food you eat provides more calories than your body needs, the excess is converted to fat. Initially, fat cells increase in size. When they can no longer expand, they increase in number. If you lose weight, the size of the fat cells decreases, but the number of cells does not.
Obesity, however, has many causes. The reasons for the imbalance between calorie intake and consumption vary by individual. Your age, sex, and genes, psychological makeup, and environmental factors all may contribute.
Obesity tends to run in families. This is caused both by genes and by shared diet and lifestyle habits. Having obese relatives does not guarantee that you will be obese.
Some people overeat because of depression, hopelessness, anger, boredom, and many other reasons that have nothing to do with hunger. This doesn't mean that overweight and obese people have more emotional problems than other people. It just means that their feelings influence their eating habits, causing them to overeat.
In some unusual cases, obesity may be used as a defense mechanism because of the perceived social pressures related to being more physically desirable, particularly in young girls. In these cases, as with the other emotional causes, psychological intervention may be helpful.
The most important environmental factor is lifestyle. Your eating habits and activity level are partly learned from the people around you. Overeating and sedentary habits (inactivity) are the most important risk factors for obesity.
Men have more muscle than women, on average. Because muscle burns more calories than other types of tissue, men use more calories than women, even at rest. Thus, women are more likely than men to gain weight with the same calorie intake.
People tend to lose muscle and gain fat as they age. Their metabolism also slows somewhat. Both of these lower their calorie requirements.
Women tend to weigh an average of 4-6 pounds more after a pregnancy than they did before the pregnancy. This can compound with each pregnancy. This weight gain may contribute to obesity in women.
Certain medical conditions and medications can cause or promote obesity, although these are much less common causes of obesity than overeating and inactivity.
Some examples of these are as follows:
- Cushing syndrome.
- Certain medications (examples are steroids, antidepressants, birth control pills).
- Prader-Willi syndrome.
- Polycystic ovarian syndrome.
- "Glands" (hormonal problems) are rarely the cause of obesity.
- Obesity can be associated with other eating disorders, such as binge eating or bulimia.
The distribution of your body fat also plays a role in determining your risk of obesity-related health problems. There are at least 2 different kinds of body fat. Studies conducted in Scandinavia have shown that excess body fat distributed around the waist ("apple"-shaped figure, intra-abdominal fat) carries more risk than fat distributed on the hips and thighs ("pear"-shaped figure, fat under the skin).
Medical treatment of obesity focuses on lifestyle changes such as eating less and increasing activity level. There are medications that can promote weight loss, although they work only in conjunction with eating less and exercising more.
Most medications that promote weight loss work by suppressing the appetite. Some medications used in the past have been shown to be unsafe and are no longer available. The newer appetite-suppressing medications are thought to be safe, but they do have side effects and may interact with certain other drugs. They are used only under the supervision of a health care provider.
For more information about weight-loss medications, go to the article Medication in the Treatment of Obesity.