Ожирение 3 степени. Причины ожирения, методы лечения. Ожирение 1, 2, 3 степени :: SYL.ru

К сожалению, проблема ожирения на сегодняшний день актуальна как никогда раньше. Ведь в большинстве случаев жизнь среднестатистического человека включает в себя не только постоянные стрессы, но и отсутствие физических нагрузок, а также неправильное и несбалансированное питание.

Естественно, одним из наиболее тяжелых состояний является ожирение 3 степени. Ведь на данной фазе организм поддается просто невероятным нагрузкам. Избыточный вес — это не просто эстетический недостаток, а серьезное заболевание, которое представляет собой настоящую угрозу здоровью и даже жизни. Именно поэтому сегодня столь актуальной является информация о том, что же представляет собой ожирение и каковы причины его возникновения. Как определить наличие заболевания? Какие методы лечения существуют на сегодняшний день? Ответы на эти вопросы будут интересны многим.

Что такое ожирение? Краткие сведения

На сегодняшний день медицина рассматривает ожирение как хроническое заболевание, связанное с нарушением процессов обмена веществ в человеческом организме. Увеличение массы тела в данном случае происходит за счет скопления жировой ткани. В большинстве случаев жировые отложения появляются в первую очередь в области бедер, молочных желез и живота. На более поздних стадиях количество жировой ткани увеличивается повсеместно, включая и внутренние органы.

К сожалению, количество людей с подобной проблемой возрастает с каждым годом — болезнь нередко диагностируется даже среди детей. Подобный рост заболеваемости, конечно же, связан с особенностями жизни современного человека. Например, в Соединенных штатах Америки практически треть населения страдает от подобной проблемы.

Естественно, здесь существует масса факторов риска, способных вызвать тот или иной сбой в метаболизме. Кстати, ожирение у женщин наблюдается чаще, чем у мужчин. Так с чем связано подобное расстройство?

Основные причины развития заболевания

На самом деле существует множество факторов, способных привести к развитию такого заболевания. Причины ожирения могут крыться как в привычках человека, так и в особенностях функционирования его организма. На сегодняшний день подобное расстройство принято считать многофакторной болезнью.

Первичный набор избыточной жировой массы связан, как правило, с нарушением энергетического баланса. В организм человека попадает намного больше калорий, чем он может израсходовать. Естественно, избыточное количество питательных веществ откладывает в виде подкожной жировой клетчатки.

Чаще всего причины ожирения так или иначе связаны с неправильным питанием. Например, в группе риска люди, употребляющие большие количества жирной и богатой простыми углеводами пищи. Кроме того, не стоит упускать из вида то, что чаще всего современный человек питается на ходу, и нередко его рацион включает в себя блюда быстрого приготовления.

Тем не менее, есть и другие, не менее важные причины. Например, употребление избыточного количества калорий может быть связано с искаженным восприятием пищи у человека (например, если он воспринимает ее как награду и т.д.). Не стоит забывать и о физической активности. Ведь сегодня огромное количество людей проводят практически весь день, сидя за столом.

С другой стороны, ожирение может быть связано и с физиологическими нарушениями. Например, нарушения в работе гипоталамо-гипофизарной системы сказываются в первую очередь на процессе обмена веществ. Различные заболевания щитовидной железы также могут вызвать интенсивное отложение жировых масс. Стоит отметить, что ожирение, вызванное гормональными сбоями, лечить намного тяжелее, так как здесь для начала нужно устранить первопричину.

К факторам риска также можно отнести различные заболевания и расстройства со стороны пищеварительной системы. Не стоит забывать и о постоянных стрессах, так как любое эмоциональное напряжение влечет за собой изменения уровня тех или иных гормонов. Более того, многие люди привыкли буквально «заедать» стресс.

Степени ожирения и краткая характеристика

Естественно, каждый случай подобного заболевания в своем роде уникален. Тем не менее в современной медицине принято выделять так называемые степени ожирения. Для того чтобы понять, имеется ли у вас избыточный вес, для начала нужно определить индекс массы тела. Этот показатель демонстрирует соответствие веса человека и его роста. Для того чтобы определить индекс, нужно массу тела в килограммах разделить на рост в метрах, возведенный в квадрат.

В норме этот показатель должен составлять от 18,5 до 25. Индекс 25-30 уже свидетельствует о наличии избыточных килограммов. Так какие степени ожирения выделяют?

• При первой степени ожирения индекс массы тела колеблется в пределах 30-35.
• Ожирение 2 степени характеризуется показателем в 35-40.
• Если индекс массы тела превышает 40, это свидетельствует о начале третьей стадии. Ожирение 3 степени нередко в современной медицине называют морбидным.

Стоит отметить и тот факт, что при данном заболевании жировые отложения могут накапливаться в различных участках тела. Например, довольно опасной считается централизованна форма болезни, при которой жир накапливается в районе живота. Подобное состояние чревато осложнениями, так как количество жировых тканей увеличивается не только под кожей, но также и на внутренних органах. Одним из часто встречаемых осложнений является ожирение печени. Лечение подобного расстройства попросту необходимо, так как при отсутствии терапевтических мер болезнь будет постоянно прогрессировать.

Первая степень ожирения: симптомы и описание

Согласно статистике, 60% пациентов страдают именно от этой формы болезни. Ожирение 1 степени сопровождается довольно заметным увеличением массы тела. Естественно, все это попросту не может не сказаться на работе всего организма.

К основным жалобам пациентов можно отнести одышку, которая возникает во время физических нагрузок (например, во время ходьбы). Время от времени появляются и боли в суставах, которые не могут справиться с дополнительной нагрузкой.

К счастью, ожирение 1 степени практически всегда поддается лечению консервативными средствами. Правильное питание и соответствующие физические нагрузки помогут избавиться от лишних килограммов и поддерживать организм в тонусе.

Что представляет собой вторая степень ожирения?

На самом деле наличие проблем с лишним весом на данной стадии заболевания вряд ли кто-то поставит под сомнение, так как избыток жировой массы и пресловутые складки на коже видны невооруженным глазом.

Естественно, подобное состояние сказывается на работе всего организма. В первую очередь, конечно же, страдает опорно-двигательный аппарат и суставы, ведь им приходится выдерживать гораздо большие нагрузки. Сам же пациент жалуется на тяжесть и боли, которые усиливаются во время ходьбы или любой другой физической активности. Нередко наблюдается и отек нижних конечностей.

С дополнительной нагрузкой сталкивается и сердечно-сосудистая система. По мере развития заболевания возникает ишемия, боли в области сердца, постоянная одышка и т.д. Ожирение 2 степени также вызывает расстройства со стороны пищеварительной системы, включая нарушения работы желудка, кишечника и печени. Болезнь усложняет работу поджелудочной железы и повышает вероятность развития сахарного диабета второго типа.

Ожирение 3 степени: основные симптомы

В большинстве случаев вторая стадия ожирения переходит в следующую, так как люди не способны избавиться от заболевания самостоятельно или вовсе не считают это существенной проблемой. Тем не менее подобное состояние крайне опасно, так как влечет за собой тяжелые последствия.

Конечно же, ожирение 3 степени (фото выше) видно невооруженным взглядом. Жировые массы в больших количествах распределены по всему телу, а жировые складки уже нельзя скрыть никакой одеждой. Кожа, как правило, покрыта фиолетовыми стриями (растяжками). Нередко можно заметить покрасневшие участки кожных воспалений.

Самочувствие пациентов также значительно ухудшается. Люди, страдающие ожирением, постоянно жалуются на боли в спине. Конечно же, страдают тазобедренные и коленные суставы, поэтому больной человек не может проводить на ногах большое количество времени. Даже незначительные физические нагрузки сопровождаются сильной одышкой. Постоянно появляются отеки, особенно на лодыжках. К симптомам можно отнести также учащенное сердцебиение и периодически возникающие сердечные боли.

Конечно же, ожирение 3 степени сказывается и на эмоциональном состоянии больного. Наблюдается снижение самооценки. Болезнь сказывается на работоспособности. Для пациентов на этой стадии характерны и депрессии.

К сожалению, на данном этапе простая диета и физические нагрузки вряд ли помогут, так как люди попросту не могут выполнять все упражнения и бессознательно нарушают правила питания. В данном случае медикаментозная или даже хирургическая терапия попросту необходимы. Ведь ожирение 3 степени крайне опасно для здоровья и даже жизни пациента.

Четвертая степень ожирения

На самом деле ожирение человека в четвертой стадии встречается крайне редко. Почему? Большинство людей при отсутствии лечебных мер попросту не доживают до этого момента. Ведь вес пациента превышает норму как минимум в два раза. Естественно, только здоровый организм может справиться с такой нагрузкой.

Многие люди на этой стадии ожирения не способны двигаться — некоторые из них даже не покидают кровать, так как нагрузка на суставы и кости слишком велика. Одышка возникает даже в состоянии покоя. Пациентов постоянно беспокоят проблемы с сердцем. Ранняя смерть в данном случае отнюдь не редкость.

Стоит отметить, что даже если человеку на этой стадии болезни удается справиться с ситуацией и избавиться от лишних килограммов, то впереди его ждут многочисленные хирургические операции, направленные на коррекцию форм тела и удаление отвисших участков кожи.

К каким осложнениям приводит заболевание?

На самом деле ожирение чаще всего приводит к неприятным и опасным осложнениям. В первую очередь стоит отметить расстройства со стороны пищеварительной системы. Неправильное питание и сбой метаболизма приводит к таким заболеваниям, как холецистит (воспалительный процесс в желчном пузыре), образование желчных камней, а также жировая дистрофия печени, воспаление поджелудочной железы. Ни для кого не секрет также, что ожирение способствует развитию сахарного диабета второго типа.

Естественно, от наличия избыточного веса страдает и опорно-двигательная система. В частности, у пациентов со временем развиваются артриты и деформирующие остеоартрозы. Нельзя считать редкостью и межпозвоночные грыжи, так как именно позвоночнику приходится справляться и лишним весом во время движения.

С другой стороны, ожирение способствует развитию тех или иных заболеваний сердечно-сосудистой системы. Наиболее распространенными осложнениями в данном случае считаются ишемическая болезнь сердца и артериальная гипертензия. Подобные болезни при отсутствии лечения могут привести к инфаркту миокарда или же инсульту.

У некоторых пациентов наблюдается развитие так называемой альвеолярной гиповентиляции. Подобное нарушение наиболее характерно для людей с крайне степенью ожирения. Из-за избыточного веса и разрастания жировых тканей они не могут глубоко дышать, что приводит к хроническому кислородному голоданию.

Ожирение у детей

К сожалению, даже среди маленьких детей нередко встречается такая проблема, как ожирение. Отзывы врачей и статистические исследования свидетельствуют о том, что существует три критических периода, когда ребенок наиболее склонен к набору избыточной жировой массы:

• Ранний возраст — от рождения и до трех лет.
• Дошкольный возраст — от пяти до семи лет.
• Подростковый возраст — от 12 до 14 лет.
• Отдельно стоит выделить и период полового созревания, так как нередко гормональная перестройка способствует увеличению жировой прослойки.

Что же касается причин ожирения, то у детей они выглядят преимущественно так же, как и у взрослых пациентов. Естественно, важную роль здесь играет генетическая наследственность — если оба родители страдают от избыточного веса, то высока вероятность появления той же проблемы у ребенка. Нередко болезнь связана с различными расстройствами эндокринной системы, включая заболевания щитовидной железы, дефицит йода и т.д.

Тем не менее в большинстве случаев ожирение развивается на фоне неправильного питания и отсутствия физической активности. В любом случае на начальных стадиях избавиться от этой проблемы намного проще. Поэтому при малейших подозрениях стоит обратиться к врачу. После проведения диагностики специалист назначит препараты (если имеют место проблемы с гормональным фоном), а также составит индивидуальную схему питания и порекомендует специальные комплексы упражнений.

Основные методы диагностики

Безусловно, быстрое увеличение массы тела — это серьезный повод обратиться к врачу. Для начала специалист соберет полный анамнез и проведет необходимые изменения (вес, рост, объемы). Уже первичный осмотр сможет показать наличие расстройств. Дальнейшие исследования предназначены для того, чтобы определить наличие осложнений и оценить работу всего организма.

Наиболее точной считается компьютерная томография, которая позволяет определить не только количество избыточных жировых масс, но и место их локализации. Кроме того, проводятся различные ультразвуковые и рентгенологические исследования — они помогают оценить работу всего организма. Безусловно, нужно пройти осмотр у эндокринолога и сдать анализы на гормоны, так как довольно часто именно с такими нарушениями связано развитие ожирения. Кроме того, пациента наверняка отправят к психотерапевту, так как чаще всего заболевание сопряжено с некоторыми психическими расстройствами, которые также необходимо устранить.

Медикаментозное лечение ожирения

Если ожирение 1 степени устранить помогут диета и спорт, то при дальнейшем его развитии излечиться самостоятельно практически невозможно. Именно поэтому многие медики назначают своим пациентам некоторые лекарства.

На самом деле подобные препараты не помогут навсегда избавиться от ожирения — они предназначены лишь для того, чтобы нормализировать процесс пищеварения и снизить аппетит. Например, такие препараты, как фентермин, сибутрамин, бупропион изменяют уровень норадреналина и серотонина в крови, воздействуя тем самым на центры насыщения и подавляя голод. Терапия также включает в себя прием лекарств, замедляющих процесс усваивания жиров, что препятствует набору массы. По рекомендации психотерапевта пациенту могут быть назначены антидепрессанты и дополнительные сеансы психотерапии. Естественно, при наличии осложнения (панкреатит, ожирение печени) проводят дополнительное лечение.

Стоит отметить, что все вышеперечисленные лекарства не обладают пролонгированным эффектом — их воздействие исчезает сразу же после прекращения приема. Именно поэтому даже после терапии человек обязан придерживаться здорового образа жизни, тщательно следить за питанием, заниматься физическим трудом или каким-либо видом спорта, а также регулярно проходить проверки.

На сегодняшний день популярностью пользуются и некоторые альтернативные методы лечения. Например, кодирование от ожирения обещает быстро избавить от лишних килограммов. В чем заключает суть методики? Врач-психотерапевт работает с пациентом, воздействуя на его подсознание, помогая устранить приступы голода и т.д. На сегодняшний день единого мнения по этому поводу попросту не существует. Некоторые пациенты остаются довольны кодированием. В то же время другие люди и вовсе не чувствуют эффекта.

Диетотерапия

На самом деле правильное питание — крайне важный фактор, наличие которого попросту необходимо для успешной терапии. С его помощью лечится и ожирение 3 степени. Диета в данном случае должна составляться индивидуально. Безусловно, резкое ограничение в питании не подходит, так как это может привести к последующему срыву и оказать негативное влияние на организм.

Питание при ожирении 3 степени обязательно должно быть сбалансированным. Сладости, выпечка, сахар, копчености, алкоголь, соленые, острые, жирные и жареные блюда должны быть исключены из рациона. Заменить их можно и нужно свежими фруктами и овощами, злаками, крупами, бобовыми, кисломолочными продуктами, зеленью и т. д. Мясо и рыба обязательно должны присутствовать в меню, но только в отварном виде, и желательно нежирных сортов.

Хирургические методы лечения

К сожалению, медикаментозная терапия и правильное питание помогают далеко не всегда. Например, лечение ожирения 3 степени проводят преимущественно с помощью хирургических методов, так как это наиболее быстрый и эффективный способ обезопасить организм от дальнейшего прогрессирования болезни.

Наиболее часто используются следующие три процедуры:

• Довольно популярным на сегодняшний день считается желудочное шунтирование. К слову, это первая операция подобного рода, появившаяся в хирургии. Во время процедуры врач разделяет желудок на две части, которые не контактируют с собой. К меньшей части желудка прикрепляется тонкая кишка. Таким образом, путь пищевых масс становиться короче, да и объем желудка уменьшается до 50 мл.
• Не менее эффективным и популярным считается бандажирование. Во время операции врач крепит специальный силиконовый бандаж на границе между пищеводом и желудком. Прохождение пищи усложняется, что воздействует на центры головного мозга, отвечающие за чувство насыщения.
• Сравнительно новой процедурой является так называемая рукавная гастропластика. Во время операции часть тканей желудка удаляется, в то время как оставшуюся часть превращают в тонкую длинную трубку. Такая процедура уменьшает объем желудка примерно в 10 раз.

Стоит отметить, что данные процедуры осуществляются с помощью лапароскопических методов — не требуется массивных разрезов, а на коже после операции остаются лишь небольшие следы. Кстати, стоит отметить, что такие широко известные методики, как абдоминопластика или липосакция, не относятся к способам лечения ожирения. Подобные процедуры применяют для коррекции форм тела.

90000 Obesity — Diagnosis and treatment 90001 90002 Diagnosis 90003 90004 To diagnose obesity, your doctor will typically perform a physical exam and recommend some tests. 90005 90004 These exams and tests generally include: 90005 90008 90009 90010 Taking your health history. 90011 Your doctor may review your weight history, weight-loss efforts, physical activity and exercise habits, eating patterns and appetite control, what other conditions you’ve had, medications, stress levels, and other issues about your health.Your doctor may also review your family’s health history to see if you may be predisposed to certain conditions. 90012 90009 90010 A general physical exam. 90011 This includes measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen. 90012 90009 90010 Calculating your 90019 BMI 90020. 90011 Your doctor will check your body mass index (BMI). A 90019 BMI 90020 of 30 or higher is considered obesity.Numbers higher than 30 increase your health risks even more. Your 90019 BMI 90020 should be checked at least once a year because it can help determine your overall health risks and what treatments may be appropriate. 90012 90009 90010 Measuring your waist circumference. 90011 Fat stored around your waist, sometimes called visceral fat or abdominal fat, may further increase your risk of heart disease and diabetes. Women with a waist measurement (circumference) of more than 35 inches (89 centimeters, or cm) and men with a waist measurement of more than 40 inches (102 cm) may have more health risks than do people with smaller waist measurements.Like the 90019 BMI 90020 measurement, your waist circumference should be checked at least once a year. 90012 90009 90010 Checking for other health problems. 90011 If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure and diabetes. Your doctor may also recommend certain heart tests, such as an electrocardiogram. 90012 90009 90010 Blood tests. 90011 What tests you have depend on your health, risk factors and any current symptoms you may be having.Blood tests may include a cholesterol test, liver function tests, a fasting glucose, a thyroid test and others. 90012 90041 90004 Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you already have. And this will guide treatment decisions. 90005 90044 More Information 90045 Show more related information 90002 Treatment 90003 90004 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. You may need to work with a team of health professionals — including a dietitian, behavioral counselor or an obesity specialist — to help you understand and make changes in your eating and activity habits. 90005 90004 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 90019 BMI 90020 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. 90005 90004 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. 90005 90044 Dietary changes 90045 90004 Reducing calories and practicing healthier eating habits are vital to overcoming obesity.Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently. 90005 90004 Avoid drastic and unrealistic diet changes, such as crash diets, because they’re unlikely to help you keep excess weight off for the long term. 90005 90004 Plan to participate in a comprehensive weight-loss program for at least six months and in the maintenance phase of a program for at least a year to boost your odds of weight-loss success.90005 90004 There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include: 90005 90008 90009 90010 Cutting calories. 90011 The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You and your doctor can decide how many calories you need to take in each day to lose weight, but a typical amount is 1,200 to 1,500 calories for women and 1,500 to 1,800 for men.90012 90009 90010 Feeling full on less. 90011 Some foods — such as desserts, candies, fats and processed foods — contain a large amount of calories for a small portion. In contrast, fruits and vegetables provide a larger portion size with fewer calories. By eating larger portions of foods that have fewer calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall. 90012 90009 90010 Making healthier choices.90011 To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein — such as beans, lentils and soy — and lean meats. If you like fish, try to include fish twice a week. Limit salt and added sugar. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as olive, canola and nut oils. 90012 90009 90010 Restricting certain foods. 90011 Certain diets limit the amount of a particular food group, such as high-carbohydrate or full-fat foods.Ask your doctor which diet plans have been found effective and which might be helpful for you. Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended, and limiting these drinks or eliminating them altogether is a good place to start cutting calories. 90012 90009 90010 Meal replacements. 90011 These plans suggest that you replace one or two meals with their products — such as low-calorie shakes or meal bars — and eat healthy snacks and a healthy, balanced third meal that’s low in fat and calories.In the short term, this type of diet can help you lose weight. Keep in mind that these diets likely will not teach you how to change your overall lifestyle, though, so you may have to keep this up if you want to keep your weight off. 90012 90041 90004 Be wary of quick fixes. You may be tempted by fad diets that promise fast and easy weight loss. The reality, however, is that there are no magic foods or quick fixes. Fad diets may help in the short term, but the long-term results do not appear to be any better than other diets.90005 90004 Similarly, you may lose weight on a crash diet, but you’re likely to regain it when you stop the diet. To lose weight — and keep it off — you have to adopt healthy-eating habits that you can maintain over time. 90005 90044 Exercise and activity 90045 90004 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.90005 90004 To boost your activity level: 90005 90008 90009 90010 Exercise. 90011 People with obesity need to get at least 150 minutes a week of moderate-intensity physical activity to prevent further weight gain or to maintain the loss of a modest amount of weight. To achieve more-significant weight loss, you may need to exercise 300 minutes or more a week. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve. 90012 90009 90010 Keep moving.90011 Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Making simple changes throughout your day can add up to big benefits. Park farther from store entrances, rev up your household chores, garden, get up and move around periodically, and wear a pedometer to track how many steps you actually take over the course of a day. A nice recommended goal is to try to reach 10,000 steps every day. Gradually increase the amount of steps to reach that goal.90012 90041 90044 Behavior changes 90045 90004 A behavior modification program can help you make lifestyle changes and lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesity. 90005 90004 Everyone is different and has different obstacles to managing weight, such as a lack of time to exercise or late-night eating. Tailor your behavior changes to address your individual concerns.90005 90004 Behavior modification, sometimes called behavior therapy, can include: 90005 90008 90009 90010 Counseling. 90011 Talking with a mental health professional can help you address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You can also learn how to monitor your diet and activity, understand eating triggers, and cope with food cravings. Counseling can be one-on-one or in a group.More-intensive programs — those that include 12 to 26 sessions a year — may be more helpful in achieving your weight-loss goals. 90012 90009 90010 Support groups. 90011 You can find camaraderie and understanding in support groups where others share similar challenges with obesity. Check with your doctor, local hospitals or commercial weight-loss programs for support groups in your area. 90012 90041 90044 Prescription weight-loss medication 90045 90004 Losing weight requires a healthy diet and regular exercise.But in certain situations, prescription weight-loss medication may help. 90005 90004 Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. The main purpose of weight-loss medications, also known as anti-obesity medications, is to help you to stick to a low-calorie diet by stopping the hunger and lack of fullness signals that appear when trying to lose weight. 90005 90004 Your doctor may recommend weight-loss medication if other diet and exercise programs have not worked and you meet one of these criteria: 90005 90008 90009 Your body mass index (BMI) is 30 or greater 90012 90009 Your 90019 BMI 90020 is greater than 27, and you also have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea 90012 90041 90004 Before selecting a medication for you, your doctor will consider your health history, as well as possible side effects.Some weight-loss medications can not be used by women who are pregnant or by people who take certain medications or have chronic health conditions. 90005 90004 Anti-obesity medications approved by the Food and Drug Administration (FDA) include: 90005 90008 90009 Orlistat (Alli, Xenical) 90012 90009 Phentermine and topiramate (Qsymia) 90012 90009 Bupropion and naltrexone (Contrave) 90012 90009 Liraglutide (Saxenda, Victoza) 90012 90041 90004 You’ll need close medical monitoring while taking a prescription weight-loss medication.Also, keep in mind that a weight-loss medication may not work for everyone, and the effects may wane over time. When you stop taking a weight-loss medication, you may regain much or all of the weight you lost. 90005 90044 Endoscopic procedures for weight loss 90045 90004 These types of procedures do not require any incisions in your skin. After you receive anesthesia, flexible tubes and tools are inserted through your mouth and down your throat into your stomach.90005 90004 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 comfortably consume. 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. 90005 90004 These procedures are usually approved for people with 90165 BMIs 90020 of 30 or above when diet and exercise alone have not been successful.The expected weight loss varies among procedures from 5% to 20% of total body weight loss. 90005 90044 Weight-loss surgery 90045 90004 In some people, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories, or it does both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks.90005 90004 Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that have not worked and: 90005 90008 90009 You have extreme obesity (90019 BMI 90020 of 40 or higher) 90012 90009 Your 90019 BMI 90020 is 35 to 39.9, and you also have a serious weight-related health problem, such as diabetes or high blood pressure 90012 90009 You’re committed to making the lifestyle changes that are necessary for surgery to work 90012 90041 90004 Weight-loss surgery helps some people lose as much as 35% or more of their excess body weight.But weight-loss surgery is not a miracle obesity cure. 90005 90004 It does not guarantee that you’ll lose all of your excess weight or that you’ll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits. 90005 90004 Common weight-loss surgeries include: 90005 90008 90009 90010 Gastric bypass surgery. 90011 In gastric bypass (Roux-en-Y gastric bypass), the surgeon creates a small pouch at the top of your stomach.The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of your stomach. 90012 90009 90010 Adjustable gastric banding. 90011 In this procedure, your stomach is separated into two pouches with an inflatable band. Pulling the band tight, like a belt, the surgeon creates a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently.90012 90009 90010 Biliopancreatic diversion with duodenal switch. 90011 This procedure begins with the surgeon removing a large part of the stomach. The surgeon leaves the valve that releases food to the small intestine and the first part of the small intestine (duodenum). Then the surgeon closes off the middle section of the intestine and attaches the last part directly to the duodenum. The separated section of the intestine is reattached to the end of the intestine to allow bile and digestive juices to flow into this part of the intestine.90012 90009 90010 Gastric sleeve. 90011 In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It’s a less complicated surgery than gastric bypass or biliopancreatic diversion with duodenal switch. 90012 90041 90044 Other treatments 90045 90004 Vagal nerve blockade is another treatment for obesity. It involves implanting a device under the skin of the abdomen that sends intermittent electrical pulses to the abdominal vagus nerve, which tells the brain when the stomach feels empty or full.This new technology received 90213 FDA 90020 approval in 2014 for use by adults who have not been able to lose weight with a weight-loss program and who have a 90019 BMI 90020 of 35 to 45 with at least one obesity-related condition, such as type 2 diabetes. 90005 90044 Preventing weight regain after obesity treatment 90045 90004 Unfortunately, it’s common to regain weight no matter what obesity treatment methods you try. If you take weight-loss medications, you’ll probably regain weight when you stop taking them.You might even regain weight after weight-loss surgery if you continue to overeat or overindulge in high-calorie foods or high-calorie beverages. 90005 90004 One of the best ways to prevent regaining the weight you’ve lost is to get regular physical activity. Aim for 45 to 60 minutes a day. 90005 90004 Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.90005 90004 You may always have to remain vigilant about your weight. Combining a healthier diet and more activity in a practical and sustainable manner is the best way to keep the weight you lost off for the long term. 90005 90004 Take your weight loss and weight maintenance one day at a time and surround yourself with supportive resources to help ensure your success. Find a healthier way of living that you can stick with for the long term. 90005 90044 More Information 90045 Show more related information 90002 Clinical trials 90003 90004 Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.90005 90002 Lifestyle and home remedies 90003 90004 Your effort to overcome obesity is more likely to be successful if you follow strategies at home in addition to your formal treatment plan. These can include: 90005 90008 90009 90010 Learning about your condition. 90011 Education about obesity can help you learn more about why you developed obesity and what you can do about it. You may feel more empowered to take control and stick to your treatment plan.Read reputable self-help books and consider talking about them with your doctor or therapist. 90012 90009 90010 Setting realistic goals. 90011 When you have to lose a significant amount of weight, you may set goals that are unrealistic, such as trying to lose too much too fast. Do not set yourself up for failure. Set daily or weekly goals for exercise and weight loss. Make small changes in your diet instead of attempting drastic changes that you’re not likely to stick with for the long haul.90012 90009 90010 Sticking to your treatment plan. 90011 Changing a lifestyle you may have lived with for many years can be difficult. Be honest with your doctor, therapist or other health care professionals if you find your activity or eating goals slipping. You can work together to come up with new ideas or new approaches. 90012 90009 90010 Enlisting support. 90011 Get your family and friends on board with your weight-loss goals. Surround yourself with people who will support you and help you, not sabotage your efforts.Make sure they understand how important weight loss is to your health. You might also want to join a weight-loss support group. 90012 90009 90010 Keeping a record. 90011 Keep a food and activity log. This record can help you remain accountable for your eating and exercise habits. You can discover behavior that may be holding you back and, conversely, what works well for you. You can also use your log to track other important health parameters such as blood pressure and cholesterol levels and overall fitness.90012 90009 90010 Identifying and avoiding food triggers. 90011 Distract yourself from your desire to eat with something positive, such as calling a friend. Practice saying no to unhealthy foods and big portions. Eat when you’re actually hungry — not simply when the clock says it’s time to eat. 90012 90009 90010 Taking your medications as directed. 90011 If you take weight-loss medications or medications to treat obesity-related conditions, such as high blood pressure or diabetes, take them exactly as prescribed.If you have a problem sticking with your medication regimen or have unpleasant side effects, talk to your doctor. 90012 90041 90002 Alternative medicine 90003 90004 Numerous dietary supplements that promise to help you shed weight quickly are available. The effectiveness, particularly the long-term effectiveness, and safety of these products are often questionable. 90005 90004 Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, do not have the same rigorous testing and labeling process as over-the-counter and prescription medications do.90005 90004 Yet some of these substances, including products labeled as «natural,» have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. Ingredients may not be standard, and they can cause unpredictable and harmful side effects. Dietary supplements can also cause dangerous interactions with prescription medications you take. Talk to your doctor before taking any dietary supplements. 90005 90004 Mind-body therapies — such as acupuncture, mindfulness meditation and yoga — may complement other obesity treatments.However, these therapies generally have not been well studied in the treatment of weight loss. Talk to your doctor if you’re interested in adding a mind-body therapy to your treatment. 90005 90002 Coping and support 90003 90004 Talk to your doctor or therapist about improving your coping skills and consider these tips to cope with obesity and your weight-loss efforts: 90005 90008 90009 90010 Journal. 90011 Write in a journal to express pain, anger, fear or other emotions.90012 90009 90010 Connect. 90011 Do not become isolated. Try to participate in regular activities and get together with family or friends periodically. 90012 90009 90010 Join. 90011 Join a support group so that you can connect with others facing similar challenges. 90012 90009 90010 Focus. 90011 Stay focused on your goals. Overcoming obesity is an ongoing process. Stay motivated by keeping your goals in mind. Remind yourself that you’re responsible for managing your condition and working toward your goals.90012 90009 90010 Relax. 90011 Learn relaxation and stress management. Learning to recognize stress and developing stress management and relaxation skills can help you gain control of unhealthy eating habits. 90012 90041 90002 Preparing for your appointment 90003 90004 Talking to your doctor openly and honestly about your weight concerns is one of the best things you can do for your health. In some cases, you may be referred to an obesity specialist — if one is available in your area.You may also be referred to a behavioral counselor, dietitian or nutrition specialist. 90005 90044 What you can do 90045 90004 Being an active participant in your care is important. One way to do this is by preparing for your appointment. Think about your needs and goals for treatment. Also, write down a list of questions to ask. These questions may include: 90005 90008 90009 What eating or activity habits are likely contributing to my health concerns and weight gain? 90012 90009 What can I do about the challenges I face in managing my weight? 90012 90009 Do I have other health problems that are caused by obesity? 90012 90009 Should I see a dietitian? 90012 90009 Should I see a behavioral counselor with expertise in weight management? 90012 90009 What are the treatment options for obesity and my other health problems? 90012 90009 Is weight-loss intervention an option for me? 90012 90041 90004 Be sure to let your doctor know about any medical conditions you have and about any prescription or over-the-counter medications, vitamins or supplements that you take.90005 90044 What to expect from your doctor 90045 90004 During your appointment, your doctor is likely to ask you a number of questions about your weight, eating, activity, mood and thoughts, and any symptoms you might have. You may be asked such questions as: 90005 90008 90009 How much did you weigh in high school? 90012 90009 What life events may have been associated with weight gain? 90012 90009 What and how much do you eat in a typical day? 90012 90009 How much activity do you get in a typical day? 90012 90009 During what periods of your life did you gain weight? 90012 90009 What are the factors that you believe affect your weight? 90012 90009 How is your daily life affected by your weight? 90012 90009 What diets or treatments have you tried to lose weight? 90012 90009 What are your weight-loss goals? 90012 90009 Are you ready to make changes in your lifestyle to lose weight? 90012 90009 What do you think might prevent you from losing weight? 90012 90041 90044 What you can do in the meantime 90045 90004 If you have time before your scheduled appointment, you can help prepare for the appointment by keeping a diet diary for two weeks prior to the appointment and by recording how many steps you take in a day by using a step counter (pedometer).90005 90004 You can also begin to make choices that will help you start to lose weight, including: 90005 90008 90009 90010 Making healthy changes in your diet. 90011 Include more fruits, vegetables and whole grains in your diet. Begin to reduce portion sizes. 90012 90009 90010 Increasing your activity level. 90011 Try to get up and move around your home more frequently. Start gradually if you are not in good shape or are not used to exercising. Even a 10-minute daily walk can help.If you have any health conditions or are over a certain age — over 40 for men and over 50 for women — wait until you’ve talked to your doctor before you start a new exercise program. 90012 90041 90004 Feb. 15, 2020 90005.90000 Obesity — Treatment — NHS 90001 90002 90003 If you’re obese, speak to your GP for advice about losing weight safely. 90004 90005 90002 Your GP can advise you about losing weight safely by eating a healthy, balanced diet and regular physical activity. 90005 90002 They can also let you know about other useful services, such as: 90005 90010 90011 90003 local weight loss groups 90004 — these could be provided by your local authority, the NHS, or commercial services you may have to pay for 90014 90011 90003 exercise on prescription 90004 — where you’re referred to a local active health team for a number of sessions under the supervision of a qualified trainer 90014 90019 90002 If you have underlying problems associated with obesity, such as polycystic ovary syndrome (PCOS), high blood pressure, diabetes or sleep apnoea, your GP may recommend further tests or specific treatment.In some cases, they may refer you to a specialist. 90005 90002 Read more about how your GP can help you lose weight. 90005 90024 Diet 90025 90002 There’s no single rule that applies to everyone, but to lose weight at a safe and sustainable rate of 0.5 to 1kg a week, most people are advised to reduce their energy intake by 600 calories a day. 90005 90002 For most men, this will mean consuming no more than 1,900 calories a day, and for most women, no more than 1,400 calories a day.90005 90002 The best way to achieve this is to swap unhealthy and high-energy food choices — such as fast food, processed food and sugary drinks (including alcohol) — for healthier choices. 90005 90002 A healthy diet should consist of: 90005 90010 90011 plenty of fruit and vegetables 90014 90011 plenty of potatoes, bread, rice, pasta and other starchy foods (ideally you should choose wholegrain varieties) 90014 90011 some milk and dairy foods 90014 90011 some meat, fish, eggs, beans and other non-dairy sources of protein 90014 90011 just small amounts of food and drinks that are high in fat and sugar 90014 90019 90002 Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already obese.Read some tips for a lower-salt diet. 90005 90002 You’ll also need to check calorie information for each type of food and drink you consume to make sure you do not go over your daily limit. 90005 90002 Some restaurants, cafés and fast food outlets provide calorie information per portion, although providing this information is not compulsory. Be careful when eating out because some foods can quickly take you over the limit, such as burgers, fried chicken, and some curries or Chinese dishes. 90005 90002 Read more about calorie counting.90005 90054 Diet programmes and fad diets 90055 90002 Avoid fad diets that recommend unsafe practices, such as fasting (going without food for long periods of time) or cutting out entire food groups. These types of diets do not work, can make you feel ill, and are not sustainable because they do not teach you long-term healthy eating habits. 90005 90002 This is not to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well for some people.90005 90002 A responsible diet programme should: 90005 90010 90011 educate you about issues such as portion size, making behavioural changes and healthy eating 90014 90011 not be overly restrictive in terms of the type of foods you can eat 90014 90011 be based on achieving gradual, sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last 90014 90019 90002 Read about the pros and cons of different diets. 90005 90054 Very low calorie diets 90055 90002 A very low calorie diet (VLCD) is where you consume less than 800 calories a day.90005 90002 These diets can lead to rapid weight loss, but they are not a suitable or safe method for everyone, and they are not routinely recommended for managing obesity. 90005 90002 VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss. 90005 90002 VLCDs should not usually be followed for longer than 12 weeks at a time, and they should only be used under the supervision of a suitably qualified healthcare professional. 90005 90002 Speak to your GP first if you’re considering this type of diet.90005 90054 Further information 90055 90002 For more information about diet and weight loss, read: 90005 90024 Exercise 90025 90002 Reducing the amount of calories in your diet will help you lose weight, but maintaining a healthy weight requires physical activity to burn energy. 90005 90002 As well as helping you maintain a healthy weight, physical activity also has wider health benefits. For example, it can help prevent and manage more than 20 conditions, such as reducing the risk of type 2 diabetes by 40%.90005 90002 The Chief Medical Officers recommend that adults should do a minimum of 150 minutes moderate-intensity activity a week — for example, 5 sessions of 30-minute exercise a week. Something is better than nothing, and doing just 10 minutes of exercise at a time is beneficial. 90005 90002 Moderate-intensity activity is any activity that increases your heart and breathing rate, such as: 90005 90002 Alternatively, you could do 75 minutes of vigorous-intensity activity a week, or a combination of moderate and vigorous activity.90005 90002 During vigorous activity, breathing is very hard, your heart beats rapidly and you may be unable to hold a conversation. Examples include: 90005 90010 90011 running 90014 90011 most competitive sports 90014 90011 circuit training 90014 90019 90002 You should also do strength exercises and balance training 2 days a week. This could be in the form of a gym workout, carrying shopping bags, or doing an activity such as tai chi. It’s also critical that you break up sitting (sedentary) time by getting up and moving around.90005 90002 Your GP, weight loss adviser or staff at your local sports centre can help you create a plan suited to your own personal needs and circumstances, with achievable and motivating goals. Start small and build up gradually. 90005 90002 It’s also important to find activities you enjoy and want to keep doing. Activities with a social element or exercising with friends or family can help keep you motivated. Make a start today — it’s never too late. 90005 90002 Read more about the physical activity guidelines for adults and the physical activity guidelines for older adults.90005 90002 You may need to exercise for longer each day to prevent obesity or to avoid regaining weight if you’ve been obese. To prevent obesity, 45-60 minutes of moderate-intensity activity a day is recommended. To avoid regaining weight after being obese, you may need to do 60-90 minutes of activity each day. 90005 90002 Your GP or weight loss adviser will be able to advise you further about the type of exercise you should do and for how long taking into account your current fitness level and individual circumstances.90005 90054 Further information 90055 90002 For more information about exercise, see: 90005 90024 Other useful strategies 90025 90002 Evidence has shown that weight loss can be more successful if it involves other strategies, alongside diet and lifestyle changes. This could include things like: 90005 90010 90011 90003 setting realistic weight loss goals 90004 — if you’re obese, losing just 3% of your original body weight can significantly reduce your risk of developing obesity-related complications 90014 90011 90003 eating more slowly and being mindful of what and when you’re eating 90004 — for example, not being distracted by watching TV 90014 90011 90003 avoiding situations where you know you may be tempted to overeat 90004 90014 90011 90003 involving your family and friends with your weight loss efforts 90004 — they can help to motivate you 90014 90011 90003 monitoring your progress 90004 — for example, weigh yourself regularly and make a note of your weight in a diary 90014 90019 90002 Getting psychological support from a trained healthcare professional may also help you change the way you think about food and eating.Techniques such as cognitive behavioural therapy (CBT) can be useful. 90005 90054 Avoiding weight regain 90055 90002 It’s important to remember that as you lose weight your body needs less food (calories), so after a few months, weight loss slows and levels off, even if you continue to follow a diet. 90005 90002 If you go back to your previous calorie intake once you’ve lost weight, it’s very likely you’ll put the weight back on. Increasing physical activity to up to 60 minutes a day and continuing to watch what you eat may help you keep the weight off.90005 90024 Medication 90025 90002 Many different types of anti-obesity medicines have been tested in clinical trials, but the only one that has proved to be safe and effective is orlistat. 90005 90002 You can only use orlistat if a doctor or pharmacist thinks it’s the right medicine for you. In most cases, orlistat is only available on prescription. The only product available over the counter directly from pharmacies is Alli, under the supervision of a pharmacist.90005 90002 Orlistat works by preventing around a third of the fat from the food you eat being absorbed. The undigested fat is not absorbed into your body and is passed out with your poo. This will help you avoid gaining weight, but will not necessarily cause you to lose weight. 90005 90002 A balanced diet and exercise programme should be started before beginning treatment with orlistat, and you should continue this programme during treatment and after you stop taking orlistat. 90005 90054 When orlistat should be used 90055 90002 Orlistat will usually only be recommended if you’ve made a significant effort to lose weight through diet, exercise or changing your lifestyle.90005 90002 Even then, orlistat is only prescribed if you have a: 90005 90010 90011 body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes 90014 90011 BMI of 30 or more 90014 90019 90002 Before prescribing orlistat, your doctor will discuss the benefits and potential limitations with you, including any potential side effects. 90005 90002 Treatment with orlistat must be combined with a balanced low-fat diet and other weight loss strategies, such as doing more exercise.It’s important that the diet is nutritionally balanced over 3 main meals. 90005 90002 If you’re prescribed orlistat, you’ll also be offered advice and support about diet, exercise and making lifestyle changes. 90005 90002 Orlistat is not usually recommended for pregnant or breastfeeding women. 90005 90054 Dosage and duration of treatment 90055 90002 A single orlistat capsule is taken with water immediately before, during or up to 1 hour after, each main meal (up to a maximum of 3 capsules a day).90005 90002 If you miss a meal, or the meal does not contain any fat, you should not take the orlistat capsule. Your doctor should explain this to you, or you can check the patient information leaflet that comes with your medicine. 90005 90002 Treatment with orlistat should only continue beyond 3 months if you’ve lost 5% of your body weight. It usually starts to affect how you digest fat within 1 to 2 days. 90005 90002 If you have not lost weight after taking orlistat for 3 months, it’s unlikely to be an effective treatment for you.Consult your doctor or pharmacist, as it may be necessary to stop your treatment. 90005 90054 Taking orlistat with other health conditions 90055 90002 See your GP before starting treatment with orlistat if you have another serious health condition, such as type 2 diabetes, high blood pressure, or kidney disease, which you’re taking medication for. It may be necessary to change the dose of your medicine. 90005 90002 If you have type 2 diabetes, it may take you longer to lose weight using orlistat, so your target weight loss after 3 months may therefore be slightly lower.90005 90002 You’ll have a review after you’ve been using orlistat for 3 months. If you’ve lost weight, your GP may suggest continuing to use orlistat for 12 months or more. They’ll discuss the benefits, limitations and side effects with you. 90005 90054 Side effects 90055 90002 Common side effects of orlistat include: 90005 90002 These side effects are much less likely to occur if you stick to a low-fat diet. 90005 90002 Women taking the oral contraceptive pill should use an additional method of contraception, such as a condom, if they experience severe diarrhoea while taking orlistat.This is because the contraceptive pill may not be absorbed by your body if you have diarrhoea, so it may not be effective. 90005 90024 Surgery 90025 90002 Weight loss surgery, also called bariatric surgery, is sometimes used to treat people who are severely obese. 90005 90002 Bariatric surgery is usually only available on the NHS to treat people with severe obesity who fulfil all of the following criteria: 90005 90010 90011 they have a BMI of 40 or more, or between 35 and 40 and another serious health condition that could be improved with weight loss, such as type 2 diabetes or high blood pressure 90014 90011 all appropriate non-surgical measures have been tried, but the person has not achieved or maintained adequate, clinically beneficial weight loss 90014 90011 the person is fit enough to have anaesthesia and surgery 90014 90011 the person has been receiving, or will receive, intensive management as part of their treatment 90014 90011 the person commits to the need for long-term follow-up 90014 90019 90002 Bariatric surgery may also be considered as a possible treatment option for people with a BMI of 30 to 35 who have recently (in the last 10 years) been diagnosed with type 2 diabetes.90005 90002 In rare cases, surgery may be recommended as the first treatment (instead of lifestyle treatments and medication) if a person’s BMI is 50 or above. 90005 90054 Treating obesity in children 90055 90002 Treating obesity in children usually involves improvements to diet and increasing physical activity using behaviour change strategies. 90005 90002 The amount of calories your child should eat each day will depend on their age and height. Your GP should be able to advise you about a recommended daily limit, and they may also be able to refer you to your local family healthy lifestyle programme.90005 90002 Children over the age of 5 should ideally get at least 60 minutes of vigorous-intensity exercise a day, such as running or playing football or netball. Sedentary activities, such as watching television and playing computer games, should be restricted. 90005 90002 Read more about the physical activity guidelines for children and young people. 90005 90002 Referral to a specialist in treating childhood obesity may be recommended if your child develops an obesity-related complication, or there’s thought to be an underlying medical condition causing obesity.90005 90002 The use of orlistat in children is only recommended in exceptional circumstances, such as if a child is severely obese and has an obesity-related complication. 90005 90002 Bariatric surgery is not generally recommended for children, but may be considered for young people in exceptional circumstances, and if they’ve achieved, or nearly achieved, physiological maturity. 90005 90054 Further information 90055 90002 For more information about diet and exercise in children, read: 90005 90002 Page last reviewed: 16 May 2019 90259 Next review due: 16 May дві тисячі двадцять дві 90005 .90000 Causes, Symptoms and Treatment Options 90001 90002 Medically reviewed by Drugs.com. Last updated on Jun 8, 2020. 90003 90004 What is Obesity? 90005 90006 90002 Obesity is an excess of body fat. 90003 90002 It is difficult to directly measure body fat. Body mass index (BMI) is a popular method of defining a healthy weight. BMI should be used as a guide, along with waist size, to help estimate the amount of body fat. 90003 90002 BMI estimates a healthy weight based on your height.Because it considers height as well as weight, it is a more accurate guide than body weight alone. 90003 90002 To calculate your BMI: 90003 90015 90016 Multiply your weight in pounds by 703 90017 90016 Divide that answer by your height in inches 90017 90016 Divide that answer by your height in inches again 90017 90022 90002 Then use the chart below to see what category your BMI falls into. 90003 90025 90026 90027 90028 90002 90030 BMI 90031 90003 90033 90028 90002 90030 Category 90031 90003 90033 90040 90027 90028 90002 Below 18.5 90003 90033 90028 90002 Underweight 90003 90033 90040 90027 90028 90002 18.5 — 24.9 90003 90033 90028 90002 Healthy 90003 90033 90040 90027 90028 90002 25.0 — 29.9 90003 90033 90028 90002 Overweight 90003 90033 90040 90027 90028 90002 30.0 — 39.9 90003 90033 90028 90002 Obese 90003 90033 90040 90027 90028 90002 Over 40 90003 90033 90028 90002 Morbidly obese 90003 90033 90040 90091 90092 90002 Obesity can shorten your life. 90003 90002 It can also put you at risk of developing a number of conditions.These include: 90003 90097 90016 High blood pressure 90017 90016 Diabetes 90017 90016 Heart disease 90017 90016 Some forms of cancer 90017 90106 90002 Many other health risks are higher for people who are obese. These risks may increase as the degree of obesity increases. 90003 90002 Where you carry the extra weight is also important. People who carry extra weight around their waist may be more likely to experience health problems caused by obesity than those who carry it in their legs and thighs.90003 90002 People become obese for a number of reasons. Often, several of these factors are involved. 90003 90002 Some of the most common reasons for obesity are: 90003 90097 90016 90030 Genetic influences 90031: Your genetic makeup plays a significant role in your chances of becoming obese. However, you still maintain most of the control when it comes to your weight. 90017 90106 90002 Some rare genetic diseases make it almost impossible to avoid obesity.90003 90097 90016 90030 Physiological influences 90031: Some researchers believe that every person has a predetermined weight that the body resists moving away from. Also, people of the same age, sex and body size often have different metabolic rates. This means their bodies burn food differently. Someone with a low metabolic rate may require fewer calories to maintain approximately the same weight as someone whose metabolic rate is high. 90017 90016 90030 Food intake and eating disorders 90031: If you eat a lot, especially foods that are high in fat and calories, you can become obese.Obesity also can result from eating disorders, such as a tendency to binge. 90017 90016 90030 Lifestyle 90031: If you lead a sedentary lifestyle, you are at a higher risk of becoming obese. 90097 90016 90030 Your weight history 90031: If you were overweight as a child or adolescent, you are more likely to be obese as an adult. 90017 90016 90030 Pregnancy 90031: Pregnancy can contribute to obesity. Many women weigh more after each pregnancy. 90017 90016 90030 Drugs 90031: Some drugs can cause obesity.These include steroid hormones and many drugs used to treat psychiatric conditions. 90017 90106 90017 90106 90004 Symptoms 90005 90002 The primary warning sign of obesity is an above-average body weight. 90003 90002 If you are obese, you may also experience: 90003 90097 90016 Trouble sleeping 90017 90016 Sleep apnea. This is a condition in which breathing is irregular and periodically stops during sleep. 90017 90016 Shortness of breath 90017 90016 Varicose veins 90017 90016 Skin problems caused by moisture that accumulates in the folds of your skin 90017 90016 Gallstones 90017 90016 Osteoarthritis in weight-bearing joints, especially the knees 90017 90106 90002 Obesity increases your risk for: 90003 90097 90016 High blood pressure 90017 90016 High levels of blood sugar (diabetes) 90017 90016 High cholesterol 90017 90016 High triglycerides levels 90017 90106 90004 Diagnosis 90005 90002 Obesity is diagnosed by calculating your BMI.BMI is based on your height and weight. A BMI of 30 or more defines obesity. In general, this means your body weight is 35% to 40% more than your ideal body weight. 90003 90002 Your body fat also can be calculated by using skin calipers. Calipers are an instrument that measures the thickness of your skin. 90003 90002 Body shape is also important. People who carry most of their weight around the waist (apple shaped) have a greater risk of heart disease and diabetes than do people with big hips and thighs (pear shaped).90003 90002 90003 90002 Waist circumference is a good measure of abdominal obesity. Women with a waist more than 35 inches or men with a waist more than 40 inches are at increased risk. 90003 90004 Expected Duration 90005 90002 Obesity is often a lifelong problem. Once excess weight is gained, it is not easy to lose. Once lost, you will have to work at maintaining your healthier weight. 90003 90002 The length of time it takes to reach your weight goal depends on: 90003 90097 90016 How much you have to lose 90017 90016 Your activity level 90017 90016 The type of treatment or weight-loss program you choose 90017 90106 90002 Diseases and conditions caused by obesity often improve as you lose weight.90003 90004 Prevention 90005 90002 To prevent obesity and maintain a healthy body weight, eat a well-balanced diet and exercise regularly. 90003 90002 Preventing obesity is important. Once fat cells form, they remain in your body forever. Although you can reduce the size of fat cells, you can not get rid of them. 90003 90004 Treatment 90005 90002 Weight reduction is achieved by: 90003 90097 90016 Consuming fewer calories 90017 90016 Increasing activity and exercise 90017 90106 90002 Structured approaches and therapies to reduce weight include: 90003 90097 90016 90030 A modified diet.90031 A reasonable weight loss goal is 1 to 2 pounds per week. This can usually be achieved by eating 500 to 1,000 fewer calories each day. Whether you concentrate on eating less fat or fewer carbohydrates is up to you. Fats have more than twice as many calories per ounce than carbohydrates or protein. If you cut out carbohydrates, you still need to limit fat intake. Choose healthy fats, such as monounsaturated and polyunsaturated oils. 90017 90016 90030 Regular exercise. 90031 To effectively lose weight, most people need to do moderate intensity exercise for 60 minutes most days of the week.Add more activity during the day. Take the stairs and get up often from your desk or sofa. 90017 90016 90030 Non-prescription orlistat (Alli). 90031 Orlistat inhibits fat absorption in the intestine. Originally, this medication was only available by prescription (Xenical). The over-the-counter medicine is sold at a lower dose than Xenical. But the active ingredient is the same. 90017 90016 90030 Other non-prescription diet pills. 90031 Over-the-counter diet pills often contain ingredients that can increase heart rate and blood pressure.It is not clear how effective they are in producing weight loss that can be maintained over time. Common side effects include feeling jittery and nervous and having heart palpitations. Some experts believe they may be associated with an increased risk of stroke. 90017 90016 90030 Prescription diet pills. 90031 To help you lose weight, your doctor may prescribe medications along with a calorie-restricted diet. Almost all people regain weight when they stop using these medications. The effects of long-term use of these drugs have not been determined.90017 90016 90030 Surgery. 90031 In general, weight-loss surgery (called bariatric surgery) may be considered if your BMI is 40 or greater, or your BMI is 30-35 or greater and you have at least one medical condition directly related to obesity. In addition, you must have participated in a structured weight loss program without success. 90017 90106 90002 The more common types of surgical procedures include: 90003 90097 90016 90030 Gastroplasty 90031 — also known as stomach stapling.A surgeon creates a small pouch in the stomach that allows only limited amounts of food to be eaten at one time. 90017 90016 90030 Laparoscopic adjustable gastric banding. 90031 A surgeon places an adjustable band around the stomach with minimally invasive surgery. 90017 90106 90002 90003 90097 90016 90030 Gastric bypass. 90031 This is the most effective weight loss surgery. However, it also carries a greater risk of complications, both short term and long term.A surgeon creates a small pouch in the upper part of the stomach. A hole is made in the small intestine beyond the normal stomach attachment. The pouch is attached to the hole, bypassing the rest of the stomach and the top part of the small intestine. 90017 90106 90004 When To Call a Professional 90005 90002 Call your doctor if you need help losing weight. Also call if you have any of the symptoms or complications of obesity. 90003 90004 Prognosis 90005 90002 Others, however, find it difficult to maintain the weight loss for long.Most people return to their pretreatment weight within five years. 90003 90004 Learn more about Obesity 90005 90287 Associated drugs 90288 90287 IBM Watson Micromedex 90288 90287 Mayo Clinic Reference 90288 90293 External resources 90294 90002 90030 Academy of Nutrition and Dietetics 90031 90298 http://www.eatright.org/ 90003 90002 90030 National Heart, Lung, and Blood Institute (NHLBI) 90031 90298 http: // www.nhlbi.nih.gov/ 90003 90002 90030 Centers for Disease Control and Prevention (CDC) 90031 90298 http://www.cdc.gov/ 90003 90002 90030 Center for Food Safety & Applied Nutrition 90031 90298 http://www.fda.gov/Food/default.htm 90003 90002 90003 90298 90004 Further information 90005 90002 Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.90003 90002 Medical Disclaimer 90003.90000 6 possible treatments for obesity 90001 90002 Obesity can happen for a number of reasons, including diet, a sedentary lifestyle, genetic factors, a health condition, or the use of certain medications. A number of treatment options can help people to achieve and maintain a suitable weight. 90003 90002 Carrying excess weight can increase the risk of a number of health problems. Losing weight can be frustrating and difficult, but even losing just 5-10 percent of body weight can bring significant health benefits, according to the Centers for Disease Control and Prevention (CDC).90003 90002 For a person who weighs 250 pounds (lb), or 114 kilograms (kg) this would mean losing 12-25 lb, or 5.7-11.4 kg. A small reduction in weight is an important achievement. 90003 90002 Losing weight slowly and constantly, for example, 1-2 lb each week, is often better than losing a lot quickly, because it is more likely to stay off once a person reaches their target weight. 90003 90002 Exercise and dietary changes are useful weight-loss tools. For some people, however, these are not effective.In this case, medication or surgery might be an option. 90003 90002 Sometimes, a health condition — such as a hormonal problem — can result in weight gain. In this case, treating the imbalance can help to solve the problem. 90003 Share on PinterestReplacing high-fat foods with more fruits and vegetables can help a person to lose weight. 90002 One reason why excess weight and fat accumulate is when a person consumes more calories than they use. Over time, this can lead to weight gain. 90003 90002 Some types of food are more likely to lead to weight gain.Some processed foods contain additives, such as high-fructose corn syrup. This can cause changes in the body that result in additional weight gain. 90003 90002 Reducing the intake of processed, refined, and ready-made food that is high in sugar and fat, while increasing the consumption of whole grains and other high-fiber foods — such as fresh fruits and vegetables — can help a person to lose weight. 90003 90002 One advantage of a high-fiber diet is that the body feels full more quickly, making it less tempting to eat more.Whole grains help a person to feel full for longer, because they release their energy more slowly. 90003 90002 Fiber and whole grains can also help to reduce the risk of a number of conditions related to metabolic syndrome. 90003 90002 Metabolic syndrome is a condition that involves a number of health problems, including type 2 diabetes, high blood pressure, and cardiovascular problems. It is more common in people with obesity. 90003 90002 A doctor or dietitian can help to suggest a strategy and possibly a suitable weight-loss program.90003 90028 Avoid crash-dieting 90029 90002 Trying to lose weight quickly by crash-dieting carries the following risks: 90003 90032 90033 New health problems may develop. 90034 90033 Vitamin deficiencies can occur. 90034 90033 It is more difficult to achieve healthy weight loss. 90034 90039 90002 In some cases, a doctor may suggest that a person with severe obesity should follow a very low-calorie liquid diet. A health professional should monitor this strategy to ensure that the person remains safe while following the diet.90003 Share on PinterestClimbing the stairs instead of taking the elevator can be good exercise. 90002 While the body does burn some calories even when a person is just sitting or sleeping, for most people, the more active they are, the more calories the body will burn. 90003 90002 However, this can take time. To lose one pound of fat, a person needs to burn 3,500 calories. 90003 90002 Good ways to start getting active include: 90003 90032 90033 walking briskly 90034 90033 swimming 90034 90033 using the stairs instead of the elevator 90034 90033 getting off the bus or train one stop earlier and walking the rest of the way 90034 90039 90002 Doing chores such as gardening, housework, or walking the dog all contribute.90003 90002 The CDC suggest doing 60-90 minutes of moderately intense activity most days of the week. 90003 90002 People who are not used to exercising or who find it difficult to be active due to health or mobility problems should speak to a health professional about how to exercise and how to get started. 90003 90002 A person who is not in the habit of exercising should not start with too strenuous an activity, as this could pose a health risk. 90003 90002 A doctor will sometimes prescribe medication, such as orlastat (Xenical) to help a person lose weight.90003 90002 However, they usually only do this if: 90003 90032 90033 dietary changes and exercise have not resulted in weight loss 90034 90033 the person’s weight poses a significant risk to their health 90034 90039 90002 The National Institutes of Health note that people should use medication alongside a reduced-calorie diet. Orlastat does not replace lifestyle changes. 90003 90002 Side effects include gastrointestinal symptoms, such as fatty stool and increased or decreased defecation. Some people have reported unwanted effects on the respiratory system, muscles and joints, headaches, and others.90003 90002 From тисяча дев’ятсот дев’яносто сім to 2010 doctors were able to prescribe sibutramine, too, but the United States Food and Drug Administration (FDA) withdrew approval in 2010 due to concerns about serious adverse effects. 90003 90002 Weight loss, or bariatric, surgery involves removing or changing a part of a person’s stomach or small intestine so that they do not consume as much food or absorb as many calories as before. 90003 90002 This can help an individual to lose weight and also reduce the risk of high blood pressure, type 2 diabetes, and other aspects of metabolic syndrome that can occur with obesity.90003 90002 Surgery can either make the stomach smaller, or it can bypass part of the digestive system. 90003 90028 Gastric sleeve or gastric band 90029 90002 The surgeon uses a gastric sleeve or a gastric band to make the stomach smaller. 90003 90002 After the operation, a person can not consume more than about one cup of food during each sitting. This significantly reduces food intake. 90003 90028 Gastric bypass 90029 90002 The procedure enables food to bypass parts of the digestive system, specifically the first part of the mid-section of the small intestine.It may also reduce the size of the stomach. 90003 90002 This is generally more effective than restrictive procedures, but there is a higher risk of vitamin and mineral deficiencies, as the body can no longer absorb as many nutrients. 90003 90002 A doctor may recommend surgery for a person who has a BMI of 30 or above, depending on their individual needs. 90003 90002 These include: 90003 90032 90033 whether or not they have complications due to obesity 90034 90033 the effectiveness of non-surgical treatments they have already undertaken 90034 90039 90002 Surgeons often do bariatric surgery as a laparoscopic, or keyhole procedure.90003 90002 Hormonal treatment might one day help people with obesity. Scientists who published a study in 2014 noted that part of the success of bariatric surgery may be the impact it has on gut hormones. 90003 90002 Harnessing these hormones could lead to novel, non-surgical options. 90003 90002 The researchers suggest that combining certain hormones might provide an effective therapy. 90003 90002 Humans and other mammals contain two types of fat cell: 90003 90032 90033 Brown-fat cells burn calories and produce heat.90034 90033 White-fat cells store calories. 90034 90039 90002 Scientists have been looking for ways to reprogram white-fat cells so that they behave more like brown-fat cells. They call this «beiging» fat cells. 90003 90002 If they can do this, they might be able to produce a therapy that can cause the body to burn fat more quickly. 90003 90002 Experts do not yet know how to achieve this, but a research team who published a review in 90131 Nature Reviews Molecular Cell Biology 90132 expressed hope that new genetic tools in the pipeline might hold the key.90003 90002 Obesity increases the risk of a number of health problems. 90003 90002 Some of these — such as type 2 diabetes, cardiovascular disease, and high blood pressure — come under the umbrella of metabolic syndrome, a collection of features that often occur together, frequently with excess weight and obesity. 90003 90002 Health risks that increase with obesity include: 90003 90002 90141 Osteoarthritis 90142: Additional strain on the joints can lead to bone and cartilage degeneration. 90003 90002 90141 Coronary heart disease 90142: Heart disease becomes more likely when a person carries extra weight.This is often due to high cholesterol levels and the extra weight putting additional strain on the heart and blood vessels. 90003 90002 90141 Gallbladder disease 90142: Consuming foods that are high in sugar and fat may not necessarily lead to obesity, but it can cause the liver to overproduce cholesterol, resulting in gallstones. 90003 90002 90141 High blood pressure 90142: Excess adipose tissue in the body may secrete substances that affect the kidneys. This can result in high blood pressure, or hypertension.The body may also produce extra insulin, and this, too, can raise blood pressure. 90003 90002 90141 Respiratory problems 90142: These can occur if the extra weight puts pressure on the lungs, reducing the space available for breathing. 90003 90002 90141 Several cancers 90142: According to the CDC, 13 types of cancer become more likely to occur if a person has obesity, including colorectal cancer. 90003 90002 90141 Sleep apnea 90142: The National Heart, Lung, and Blood Institute (NHLBI) note that weight reduction often improves the symptoms of sleep apnea.90003 90002 90141 Stroke 90142: Obesity often develops alongside a buildup of cholesterol. In time, this increases the risk of blockages in the blood vessels. These, in turn, can lead to heart disease and stroke. 90003 90002 90141 Type 2 diabetes 90142: This is a key aspect of metabolic syndrome. 90003 90002 Help is available for people who are concerned that they have too much weight. A change in diet and increase in exercise can help in many cases. 90003 90002 If these do not work, a doctor may be able to recommend another solution.90003.