Obesity is a health condition characterized by an unhealthy amount of body fat, which can lead to various health problems such as diabetes, heart disease, high blood pressure, and elevated cholesterol levels.

How do you get Obesity?

Obesity can be caused by factors such as consuming more energy from food than is burned through activities, genetic predisposition, lack of physical activity, certain hormone disorders, certain medications, excessive carbohydrate and high-sugar food intake, and having a slow metabolism.

What else can Obesity be?

The other conditions that a doctor needs to rule out when diagnosing Obesity are: - Acromegaly (abnormal growth typically in hands, feet, and face) - Adipose dolorosa (also known as Dercum's disease, a rare condition characterized by painful fatty tissue) - Ascites (accumulation of fluid in the abdominal cavity) - Cushing syndrome (a hormonal disorder caused by long time exposure to high levels of the hormone cortisol) - Hypothyroidism (underactive thyroid) - Iatrogenic Cushing syndrome (caused by an overuse of corticosteroid medications) - Insulinoma (a tumor in the pancreas that produces excess insulin) - Kallman syndrome and idiopathic hypogonadotropic hypogonadism (conditions that affect sexual development) - Generalized lipodystrophy (rare disorder where fat tissue is lost from many areas of the body) - Polycystic ovarian disease (known as PCOS, a hormonal disorder causing enlarged ovaries with small cysts on the outer edges)

What kinds of test are needed for Obesity?

To properly diagnose obesity, a doctor may order the following tests: - Body Mass Index (BMI) calculation - Waist-to-hip ratio measurement - In-depth body composition tests such as skinfold thickness, bioelectric impedance analysis, CT scans, MRIs, DEXA scans, water displacement, and air densitometry studies - Laboratory tests including a complete blood count, metabolic panel, kidney and liver function tests, cholesterol profile, HbA1C for blood sugar levels, TSH for thyroid function, vitamin D levels, and a urinalysis - Additional tests like an ECG for heart function and sleep studies to evaluate any related health conditions

How is Obesity treated?

Obesity is treated through a multi-faceted approach that includes changes to diet, behavior, the use of medication, and, in some cases, surgery. Doctors tailor the treatment plan to the individual and address any other health issues that might be causing obesity. This can involve recommending a low-calorie diet, monitoring progress, and considering low-carb or low-fat diets. Behavioral changes, such as counseling or therapy, are also encouraged. Anti-obesity medications may be used for individuals with a high body mass index (BMI), and surgery may be considered for those with a BMI above a certain threshold. However, both medication and surgery come with potential risks and complications.

What are the side effects when treating Obesity?

When treating obesity, there can be potential side effects depending on the approach taken. Here are some possible side effects: - Low-calorie diets: Sticking to the diet plan is crucial for weight loss. - Low-carb diets: Can lead to more weight loss in the early months compared to low-fat diets. - Behavioural changes: Encouraging individuals to seek out interventions to change behavior patterns. - Anti-obesity medications: Orlistat is often the first choice due to its lack of side effects. - Surgery: Potential risks and complications, such as electrolyte imbalances, heart irregularities, high uric acid levels, gallstones, changes to mood and behavior, ulcers, malabsorption of nutrients, diarrhea, vitamin deficiency, leakage around the surgical site, and unsuccessful surgery.

What type of doctor should I see for Obesity?

A primary care doctor or a specialist in obesity management.

Obesity

What is Obesity?

Obesity is a health condition which can be described as having an unhealthy amount of body fat. This can cause various health problems such as diabetes, heart disease, high blood pressure and elevated cholesterol levels. In recent times, obesity has become a major public health concern which has continued to grow worse over the past 50 years. Being the second leading cause of preventable death after smoking, obesity is regarded as a complex disease because it has many causes. To manage obesity, a comprehensive and ongoing treatment strategy is often needed. Losing just 5% to 10% of body weight can have a significant impact on health, well-being, and finances, not just for the individual but also for a country’s economy.

The yearly healthcare costs of obesity are massive, exceeding $700 billion. In the United States alone, the financial impact is estimated to amount to $100 billion every year. To determine if someone is obese, the body mass index (BMI) is usually used, which is a calculation based on a person’s weight and height. However, this may not be fully accurate in certain groups like Asians and older people, as a seemingly normal BMI might actually mask excessive fat. Methods such as measuring the thickness of skin in particular parts of the body or using a specialized type of X-ray scan known as a DEXA scan can also be used to estimate body fat and diagnose obesity.

What Causes Obesity?

Obesity happens when the energy we take in from food every day is more than the energy we burn with activities, leading to excessive weight gain. There are many factors that can cause obesity, including our genes, culture, and society. Studies have shown that certain genes can make a person more likely to gain weight.

Obesity can also be caused by not being active enough, having trouble sleeping, certain hormone disorders, taking certain medications, eating too much carbohydrate and high-sugar foods, and having a slow metabolism.

There are some conditions that are commonly associated with obesity, like Prader-Willi syndrome and MC4R syndromes. Some less common conditions include fragile X, Bardet-Beidl syndrome, Wilson Turner congenital leptin deficiency, and Alstrom syndrome.

Risk Factors and Frequency for Obesity

Obesity is a prevalent issue in the United States, affecting both adults and younger populations.

Nearly a third of adults and 17% of teenagers in the US are obese.
Based on 2011-2012 data from the Centers for Disease Control and Prevention (CDC), one out of five teenagers, one out of six primary school students, and one out of twelve preschoolers are obese.
Obesity is most common among African Americans, followed by Hispanics, and then Whites.
Obesity rates are highest in the Southern US states, followed by the Midwest, the Northeast, and the West.
On a global scale, obesity rates are rising rapidly, now affecting over 500 million adults.

Signs and Symptoms of Obesity

The United States Preventative Services Task Force (USPSTF) recommends that everyone over the age of six should be checked for obesity. Doctors need to look closely for any underlying causes of obesity. This requires a thorough review of the person’s health history:

Weight history since childhood
Past attempts at weight loss and the results
Overall eating habits
Sleep patterns
Level of physical activity
Record of health issues like heart disease, diabetes, thyroid problems, or depression
Surgical history
Use of medications that can lead to weight gain
Social habits like smoking and drinking
Family health history

As part of this, a full physical exam is performed that includes measuring the body mass index (BMI), checking the waist width, observing body shape, and taking vital sign measurements.

There are various signs that could suggest obesity. These include acne, excessive body hair, skin tags, dark skin patches, stretch marks, abnormal throat structure, a hump of fat on the back of the neck, unusual fat distribution, heartbeat irregularities, male breast enlargement, excess abdominal skin, enlarged liver and spleen, hernias, under-breathing, foot swelling, varicose veins, skin disorders due to circulation issues, and walking difficulties.

Testing for Obesity

Doctors use the Body Mass Index (BMI) as a common method to screen for obesity. The BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters. Here’s how the BMI numbers translate into different weight classes:

– Underweight: BMI less than 18.5 kg/m2
– Normal range: BMI between 18.5 kg/m2 and 24.9 kg/m2
– Overweight: BMI between 25 kg/m2 and 29.9 kg/m2
– Obese, Class I: BMI between 30 kg/m2 and 34.9 kg/m2
– Obese, Class II: BMI between 35 kg/m2 and 39.9 kg/m2
– Obese, Class III: BMI above 40 kg/m2

Another significant measurement to consider is the waist-to-hip ratio. For men, a ratio of more than 1:1, and for women, a ratio of more than 0:8 is of concern.

More in-depth tests can also be performed to evaluate a person’s body composition. These can include skinfold thickness, bioelectric impedance analysis, CT scans, MRIs, DEXA scans, water displacement, and air densitometry studies.

Laboratory tests may include a complete blood count, metabolic panel, kidney and liver function tests, cholesterol profile, HbA1C for blood sugar levels, TSH for thyroid function, vitamin D levels, and a urinalysis. Additional tests like an ECG for heart function, and sleep studies might be conducted to evaluate any related health conditions.

Treatment Options for Obesity

Obesity can lead to many other chronic health problems. Therefore, doctors should use a multi-faceted plan when helping someone manage their obesity. The plan should be tailored to the individual and address any other health issues that might be causing obesity. The approach should include changes to diet, behavior, the use of medication, and, in some cases, surgery.

Making a change to what and how much someone eats is an important part of managing obesity. Doctors should check in regularly to monitor progress. They might recommend a low-calorie diet, which could limit either carbohydrates or fats. Low-carb diets can lead to more weight loss in the early months compared to low-fat diets. However, sticking to their diet plan is the most crucial factor for someone trying to lose weight.

Behavioural changes are also recommended as part of obesity management. Healthcare professionals should encourage individuals to seek out interventions that help change their behaviour patterns. These could include different types of counseling or therapy. Combining these interventions with changes to diet and increased physical activity seems to deliver the best results.

In some cases, anti-obesity medications can also be used along with diet, exercise, and behaviour interventions. These medications are generally recommended for people with a body mass index (BMI) of 30 or above, or a BMI of 27 or above if they also have other health issues. Among the FDA-approved drugs available, Orlistat is often the first choice due to its lack of side effects – it doesn’t get absorbed into the body.

Surgery may also be considered for those with a BMI of 40 or above, or a BMI of 35 or above, if they also have severe related health issues. People considered for surgery must be willing to make lifestyle changes after the operation and follow up on appointments and exercise routines. There are also potential risks that need to be assessed before the procedure. Common weight loss surgeries include gastric banding, gastric bypass, and sleeve gastrectomy. The gastric bypass is the most frequently done and yields quick weight loss, but it also comes with potential complications both immediately after the surgery and later on.

Rapid weight loss can result in its own set of complications, including electrolyte imbalances, heart irregularities, high uric acid levels, gallstones, and changes to mood and behavior. Similarly, weight-loss surgeries can result in issues like ulcers, malabsorption of nutrients, diarrhea, vitamin deficiency, leakage around the surgical site, and unsuccessful surgery.

Acromegaly (abnormal growth typically in hands, feet, and face)
Adipose dolorosa (also known as Dercum’s disease, a rare condition characterized by painful fatty tissue)
Ascites (accumulation of fluid in the abdominal cavity)
Cushing syndrome (a hormonal disorder caused by long time exposure to high levels of the hormone cortisol)
Hypothyroidism (underactive thyroid)
Iatrogenic Cushing syndrome (caused by an overuse of corticosteroid medications)
Insulinoma (a tumor in the pancreas that produces excess insulin)
Kallman syndrome and idiopathic hypogonadotropic hypogonadism (conditions that affect sexual development)
Generalized lipodystrophy (rare disorder where fat tissue is lost from many areas of the body)
Polycystic ovarian disease (known as PCOS, a hormonal disorder causing enlarged ovaries with small cysts on the outer edges)

What to expect with Obesity

Obesity is a serious health condition that has significant negative effects on a person’s health and well-being, and it can even lead to early death. People with obesity have a higher risk for heart problems and strokes. Additionally, they often experience poor quality of life.

Several factors can increase the negative effects of obesity, including: