Obesity

Obesity Overview

Obesity is a complex disease in which excess body fat has accumulated to an extent that it may have negative effects on a persons health. Obesity isn’t just a cosmetic concern. It is a medical problem that increases the risk of developing other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers. There are many reasons why some people have difficulty avoiding obesity. Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices.

A body mass index (BMI) over 25 is considered overweight, and over 30 is obese. The issue has grown to epidemic proportions, according to the world health organizations (WHO) over 4 million deaths occur each year as a result of being overweight or obese. Rates of overweight and obesity continue to grow in adults and children. From 1975 to 2016, the prevalence of overweight or obese children and adolescents aged 5–19 years increased more than four-fold from 4% to 18% globally.

Obesity is common. The CDC estimates that the prevalence of obesity was 42.4% of Americans 20 years old and older had obesity in 2017 to 2018. According to the center for disease control (CDC) factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat. Also, BMI doesn’t distinguish between excess fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals. Despite these limitations, BMI continues to be widely used as a way to measure body size.

Symptoms of Obesity

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.

BMI	Weight status classification
Below 18.5 or under	Underweight
18.5 to 24.9	Normal weight
25.0 to 29.9	Overweight
30.0 to 35	Class 1 Obesity
35.0 to 40	Class 2 Obesity
40.0 and higher	Class 3 Obesity (extreme, or severe obesity)

For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.

Causes of Obesity

There are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Most Americans’ diets are too high in calories, often from fast food and high-calorie beverages. Patients with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.

Eating more calories than you burn in daily activity and exercise, on a long-term basis, can lead to obesity. Over time, these extra calories add up, turns into fat and cause weight gain. But it’s not always just about calories in and calories out, or having a sedentary lifestyle. While those are indeed causes of obesity, some causes you cannot control.

Following are some of the specific causes of Obesity:

Genetics, which can affect how the body processes food into energy and how fat is stored
Aging which can lead to less muscle mass and a slower metabolic rate, making it easier to gain weight
Insomnia or not getting enough sleep which can lead to hormonal changes that make you feel hungrier and crave certain high-calorie foods.
Pregnancy, as weight gained during pregnancy may be difficult to lose and might eventually lead to obesity

Following are some of the health conditions can also lead to weight gain, which may lead to obesity:

Polycystic ovary syndrome (PCOS) a condition that causes an imbalance of female reproductive hormones.
Prader-Willi syndrome, a rare condition present at birth that causes excessive hunger
Cushing syndrome a condition caused by having high cortisol (the stress hormone) levels in the system.
Hyperparathyroidism (underactive thyroid), a condition in which the thyroid gland doesn’t produce enough of certain important hormones.
Osteoarthritis (OA) and other conditions that cause pain that may lead to reduced activity.

Risk Factors of Obesity

Obesity results from complex mix of factors and combination of causes. Following are some of the known risk factors of developing obesity:

Family Inheritance and Influences

The genes a person inherits from his or her parents may affect the amount of body fat you store, and where that fat is distributed in the body. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise. Obesity tends to run in families, it is and inherited disorder. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.

Lifestyle Choices

Unhealthy diet: A diet that’s high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.
Liquid calories: People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages, such as sugared soft drinks, can contribute to significant weight gain also.
Inactivity: If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet and phone screens is a sedentary activity. The number of hours you spend in front of a screen is highly associated with weight gain.

Certain Diseases and Medications

In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.

Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

Social and Economic Conditions

Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight, you’re more likely to develop obesity if you have friends or relatives with obesity.

Age

Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs, and can make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.

Other Factors

Pregnancy: Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women. Breast-feeding may be the best option to lose the weight gained during pregnancy.
Quitting smoking: Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. In the long run, however, quitting smoking is still a greater benefit to your health than is continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.
Lack of sleep: Not getting enough sleep or getting too much sleep can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
Stress: Many external factors that affect your mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.
Microbiome: Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.
Previous attempts to lose weight: Previous attempts of weight loss followed by rapid weight regain may contribute to further weight gain. This phenomenon, sometimes called yo-yo dieting, can slow your metabolism.

Even if you have one or more of these risk factors, it doesn’t mean that you’re destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavioral changes.

Complications of Obesity

Patients with obesity are more likely to develop a number of complications and potentially serious health problems, including the following:

Heart disease and strokes: Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
Type 2 diabetes. Obesity can affect the way your body uses insulin to control blood sugar levels. This raises your risk of insulin resistance and diabetes.
Certain cancers: Obesity may increase your risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
Digestive problems: Obesity increases the likelihood that you’ll develop heartburn, gallbladder disease and liver problems.
Gynecological and sexual problems: Obesity may cause infertility and irregular periods in women. Obesity also can cause erectile dysfunction in men.
Sleep apnea: People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
Osteoarthritis: Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.
Severe COVID-19 symptoms: Obesity increases the risk of developing severe symptoms if you become infected with SARS-CoV-2 the virus that causes coronavirus disease 2019 (COVID-19). Patients who have severe cases of SARS-CoV-2 may require treatment in intensive care units or even ventilator (mechanical assistance) to breathe.

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