Obesity

What is obesity?

Obesity is when your body has much more weight than it needs. Having too much body fat puts you at a higher risk of having medical problems including diabetes and heart disease. Obesity is a long-lasting problem that may get worse over time. Using your height and weight, your caregiver will learn your BMI, or body mass index. Your caregiver uses this measurement to see if you are overweight. A BMI between 25 and 29 means that you are overweight. You are obese if your BMI is between 30 and 39. A BMI of 40 or more means that you are morbidly (very) obese. Losing weight may decrease your risk of getting heart problems, diabetes, and certain other diseases. With weight loss, you may gain more energy.

What causes obesity, or increases my risk of becoming obese?

If you eat more calories than your body can use, your body will store the extra calories as fat. A calorie is a unit (measure) of energy that your body gets from food. This extra fat adds weight to your body. Eating too many calories and not being physically active increases your risk for obesity. As you get older, changes in your body may cause you to gain weight. Some medicines may also cause weight gain. You may also be at a higher risk if you have a family member who is obese. Being overweight as a child makes you more likely to be overweight or obese as an adult.

What signs and symptoms may I have with obesity?

You may have one or more of the following:

• Snoring.
  
  
• Tiredness.
  
  
• Trouble moving.
  
  
• Shortness of breath with movement, or even at rest.
  
  
• Your waist may be getting bigger.
  
  
• You may find that your clothes do not fit.

How is obesity diagnosed?

Your caregiver will check your weight and height. He may also measure your waist. A large waist size means that there is too much fat around your abdomen (stomach). Your caregiver may want to check for other medical problems that may be caused by obesity. He may test your blood and urine for extra sugar. He may also check your cholesterol blood level and your liver with blood tests. He may do an electrocardiogram (EKG) to check how your heart is working. Your caregiver may ask you if you feel that you are ready to lose weight. He may ask you if you feel depressed (very sad).

What medical conditions may be caused by obesity?

Being obese puts you at a higher risk of getting the following:

• Heart problems: Coronary artery disease is a condition where the blood vessels of the heart become narrow and blocked. This can lead to angina (chest pain), palpitations (abnormal heart beat rhythm) and sometimes sudden death.
  
  
• Depression: You may feel bad about the way you look, and sad about yourself and your life. You may stop doing the things that you enjoy, and feel like your life will never get better.
  
  
• Diabetes: This a disease in which the blood sugar levels are higher than normal. With obesity, your cells cannot take in sugar from your blood stream as they should. Having diabetes increases your risk of kidney disease, blindness, and other medical problems.
  
  
• High blood pressure: Having high blood pressure means that the pressure in your blood vessels is raised. This makes your heart work harder. Over time, your heart can weaken, and you may have heart failure. High blood pressure can hurt your eyes and kidneys.
  
  
• High cholesterol: With high cholesterol, you have too much fat in your blood. Having too much fat in your blood increases your risk of heart disease and stroke.
  
  
• Cancer: This is a condition in which cells grow wrongly, and too fast. Obesity increases the risk of getting kidney, esophagus (food pipe) and colon (bowel) cancer. In women, the risk of getting uterine (womb) and breast cancer are also higher.
  
  
• Stroke: A stroke happens when blood vessels that carry oxygen to your brain get narrow and blocked. Blood clots may also travel to your brain, causing part of your brain to die. This can make you lose feeling and movement in body areas, and change how you think, talk and act. A stroke can also cause death.
  
  
• Breathing and other problems: People who are obese may store extra fat around the neck. This can cause breathing problems, such as asthma and sleep apnea. Asthma is a disease where your airway gets narrow, making it hard for you to breathe. Sleep apnea is when you stop breathing for short periods of time while asleep. Sleep apnea can cause headaches, make you feel tired during the day, and it may lead to heart failure. Being obese can also cause arthritis or urinary incontinence (urinating when you do not want to).

What can I do to help decrease my weight, and lower my risk of getting medical problems?

• Change your diet: Eating 500 fewer calories a day can lead to a weight loss of about one pound a week. Whole wheat rolls or sandwiches, salads, fish, and lean meat are healthy food choices. There are many kinds of diets. Ask your caregiver which diet is best for you, and for more information about it.
  
  
  • Low-fat diet: With this diet, a small amount of your calories come from fat. Fast food (such as hamburgers) from take-out restaurants often contain a lot of fat. Avoid eating fast food. Choose low-fat foods that are not fried.
    
    
  • Low-carbohydrate diet: With this diet, a small amount of your calories come from carbohydrates. Carbohydrates are found in foods such as breads and cereals.
    
    
  • High-protein diet: With this diet, more of your calories come from protein. Protein is found in foods such as meat, fish, eggs and nuts. This diet may help you feel full longer than usual.
  
  
• Get enough exercise: Physical activity and exercise help burn extra calories. Exercising strengthens your heart, decreases your risk of getting medical problems, and may help you lose weight and keep the weight loss over time. Caregivers may tell you to walk 30 to 45 minutes, three days a week. Do not start exercising until you talk to your caregiver.
  
  
• Stop smoking: If you smoke, it is never too late to quit. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

How is obesity treated?

Caregivers may suggest one or more if the following treatments:

• Behavioral modification: This therapy helps you change the habits that may have led to your obesity. You may become more aware of why you are obese. You may need to set some goals and keep track of what you are eating. You may want to meet with a mental health caregiver to help you change your habits.
  
  
• Medicine: If diet and exercise have not helped you lose weight, your caregiver may suggest medicine. Medicine may help you lose weight when it is used with diet and exercise. You may also need other medicines to treat health problems that may have come because of obesity. Ask your caregiver for more information about your medicines.
  
  
  • Appetite suppressant: This medicine helps you feel full, so you want to eat less.
    
    
  • Lipase inhibitor: This medicine is also called a fat blocker. It blocks your body from taking in the fat that you eat.
  
  
• Surgery: If you are morbidly obese and cannot lose weight by yourself, your caregiver may suggest surgery. Bariatric surgery is surgery that may help you lose weight. Losing weight can help decrease your risk of getting diabetes, heart disease and other medical problems. After surgery, you will need to follow a special diet. You may also need to take vitamins. Ask your caregiver for more information about surgery that is used to treat obesity.
  
  
  • Gastroplasty: A band or staples are used to make your stomach smaller. This limits the amount of food you can eat at one time. An adjustable band may be used, which allows your caregiver to reduce the size of your stomach without doing surgery again.
    
    
  • Gastric bypass: Your stomach is made smaller, which reduces how much food you can eat before feeling full. Your stomach opening is connected past the first part of your bowel, which decreases the amount of calories taken into your body.

What are the risks of being obese?

• Without treatment, you are at higher risk for diabetes, high blood pressure, and high blood cholesterol levels. These problems can lead to dangerous medical conditions such as blindness, kidney damage, and stroke. You are at greater risk of having a heart attack or getting cancer if you are obese. These problems can be life-threatening.
  
  
• Even after treatment, you may gain weight again. Obesity medicines may cause side effects, such as flatus (gas), leaking stool, and having to use the bathroom suddenly and more often. With surgery, you may lose blood or get an infection. You may not lose enough weight to decrease your risk factors. Your caregiver may need to do surgery a second time. Ask your caregiver for more information about the risks of having and being treated for obesity.

What can I do to prevent gaining more weight?

Talk to your caregiver. Follow a diet and exercise plan. Write down what and how much you are eating, and how much you exercise. Weigh yourself once a week and write it down to show your caregiver at follow-up visits. Visit your caregiver for support. Ask your caregiver for help choosing the best foods to help you stay at a healthy weight.

Where can I get support and more information?

Having obesity may make you feel bad about yourself. You may find it hard to make the changes that are needed to lose weight. This is normal. You may want to join a support group with others who are obese. You can talk to them about your feelings about being obese. Ask your caregiver about support groups in your area. Contact the following:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

When should I call my caregiver?

Call your caregiver if:

• You have diarrhea (loose bowel movements).
  
  
• You have headaches or you feel dizzy.
  
  
• You feel like your heart is beating much faster than usual.
  
  
• You have concerns or questions about obesity, or other medical problems.

When should I seek immediate care?

Seek immediate help or call 911 if:

• You have a rash, hives, swelling, itchy skin, or trouble breathing after starting a new medicine.
  
  
• After starting a new medicine, you have abdominal pain, yellow skin, dark-colored urine or light-colored stools.
  
  
• After starting a new medicine, you have blood in your urine or new back pain.
  
  
• You feel like you cannot cope with your life any more.
  
  
• You have sudden and new abdominal pain. You may also feel sick and vomit (throw up).
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand
  
  
• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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