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Obesity

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Obesity

Post  MattinglyDoug on Wed Feb 17, 2010 6:14 am

Facts concerning Obesity

Many Americans are at increased health risk because they are obese. The U.S.
Surgeon General, in a 1988 report on nutrition and health, estimated that
one-fourth of adult Americans are overweight. Obesity is a known risk
factor for chronic diseases including heart disease, diabetes, high blood
pressure, stroke, and some forms of cancer. Everyone needs a certain amount
of body fat for stored energy, heat insulation, shock absorption, and other
functions. As a rule, women have more fat than men. Doctors generally agree
that men with more than 25 percent body fat and women with more than 30
percent body fat are obese. Precisely measuring a person's body fat,
however, is not easy. The most accurate method is to weigh a person
underwater - a procedure limited to laboratories with sophisticated
equipment. There are two simpler methods for estimating body fat, but they
can yield inaccurate results if done by an inexperienced person or if done
on someone with severe obesity. One is to measure skinfold thickness in
several parts of the body. The second involves sending a harmless amount of
electric current through a person's body (bioelectric impedance analysis).
Both methods are commonly used in health clubs and in commercial weight-
loss programs, but results should be viewed skeptically.

Because measuring a person's body fat is tricky, doctors often rely on
other means to diagnose obesity. Two widely used measurements are weight-
for-height tables and body mass index. While both measurements have their
limitations, they are reliable indicators that someone may have a weight
problem. They are easy to calculate and require no special equipment.

One problem with using weight-for-height tables is that doctors disagree
over which is the best table to use. Many versions are available, all with
different weight ranges. Some tables take a person's frame size, age, and
sex into account; others do not. A limitation of all weight-for-height
tables is that they do not distinguish excess fat from muscle. A very
muscular person may appear obese, according to the tables, when he or she
is not. Still, weight-for-height tables can be used as general guidelines.

Doctors are concerned with not only how much fat a person has but where the
fat is on the body. Women typically collect fat in their hips and buttocks,
giving their figures a "pear" shape. Men, on the other and, usually build
up fat around their bellies, giving them more of an "apple" shape. This is
not a hard and fast rule, though. Some men are pear-shaped and some women
become apple-shaped, especially after menopause. People whose fat is
concentrated mostly in the abdomen are more likely to develop many of the
health problems associated with obesity. In scientific terms, obesity
occurs when a person's calorie intake exceeds the amount of energy he or
she burns. What causes this imbalance between consuming and burning
calories is unclear. Evidence suggests that obesity often has more than one
cause. Genetic, environmental, psychological, and other factors all may
play a part.

Genetic Factors

Obesity tends to run in families, suggesting that it may have a genetic
cause. However, family members share not only genes but also diet and
lifestyle habits that may contribute to obesity. Separating these lifestyle
factors from genetic ones is often difficult. Still, growing evidence
points to heredity as a strong determining factor of obesity. In one study
of adults who were adopted as children, researchers found that the
subjects' adult weights were closer to their biological parents' weights
than their adoptive parents'. The environment provided by the adoptive
family apparently had less influence on the development of obesity than the
person's genetic makeup.

Environmental Factors

Although genes are an important factor in many cases of obesity, a person's
environment also plays a significant part. Environment includes lifestyle
behaviors such as what a person eats and how active he or she is. Americans
tend to have high-fat diets, often putting taste and convenience ahead of
nutritional content when choosing meals. Most Americans also don't get
enough exercise.

People can't change their genetic makeup, of course, but they can change
what they eat and how active they are. Some people have been able to lose
weight and keep it off by:

Learning how to choose more nutritious meals that are lower in
fat.
Learning to recognize environmental cues (such as enticing smells)
that may make them want to eat when they are not hungry.
Becoming more physically active.

Psychological Factors

Psychological factors also may influence eating habits. Many people eat in
response to negative emotions such as boredom, sadness, or anger.

While most overweight people have no more psychological disturbance than
normalweight people, about 30 percent of the people who seek treatment for
serious weight problems have difficulties with binge eating. During a
binge eating episode, people eat large amounts of food while feeling they
can't control how much they are eating. Those with the most severe binge
eating problems are considered to have binge eating disorder. These people
may have more difficulty losing weight and keeping the weight off than
people without binge eating problems. Some will need special help, such as
counseling or medication, to control their binge eating before they can
successfully manage their weight.

Other Causes of Obesity

Some rare illnesses can cause obesity. These include hypothyroidism,
Cushing's syndrome, depression, and certain neurologic problems that can
lead to overeating. Certain drugs, such as steroids and some
antidepressants, may cause excessive weight gain. A doctor can determine if
a patient has any of these conditions, which are believed to be responsible
for only about 1 percent of all cases of obesity.

Obesity is not just a cosmetic problem. It's a health hazard. Someone who
is 40 percent overweight is twice as likely to die prematurely as an
average-weight person. (This effect is seen after 10 to 30 years of being
obese.)

Obesity has been linked to several serious medical conditions, including
diabetes, heart disease, high blood pressure, and stroke. It is also
associated with higher rates of certain types of cancer. Obese men are more
likely than nonobese men to die from cancer of the colon, rectum, and
prostate. Obese women are more likely than nonobese women to die from
cancer of the gallbladder, breast, uterus, cervix, and ovaries.

Other diseases and health problems linked to obesity include:

Gallbladder disease and gallstones.
Osteoarthritis, a disease in which the joints deteriorate,
possibly as a result of excess weight on the joints.
Gout, another disease affecting the joints
Pulmonary (breathing) problems, including sleep apnea, in which
a person can stop breathing for a short time during sleep.

Doctors generally agree that the more obese a person is, the more likely he
or she is to have health problems.

Psychological and Social Effects

One of the most painful aspects of obesity may be the emotional suffering
it causes. American society places great emphasis on physical appearance,
often equating attractiveness with slimness, especially in women. The
messages, intended or not, make overweight people feel unattractive. Many
people assume that obese people are gluttonous, lazy, or both. However,
more and more evidence contradicts this assumption. Obese people often face
prejudice or discrimination at work, at school, while looking for a job,
and in social situations. Feelings of rejection, shame, or depression are
common.

Doctors generally agree that people who are 20 percent or more overweight,
especially the severely obese person, can gain significant health benefits
from weight loss.

Many obesity experts believe that people who are less than 20 percent above
their healthy weight should try to lose weight if they have any of the
following risk factors.

Risk Factors:

Family history of certain chronic diseases. People with close
relatives who have had heart disease or diabetes are more likely
to develop these problems if they are obese.
Pre-existing medical conditions. High blood pressure, high
cholesterol levels, or high blood sugar levels are all warning
signs of some obesity-associated diseases.
"Apple" shape. People whose weight is concentrated around
their abdomens may be at greater risk of heart disease, diabetes,
or cancer than people of the same weight who are pear-shaped.

Fortunately, even a modest weight loss of 10 to 20 pounds can bring
significant health improvements, such as lowering one's blood pressure and
cholesterol levels.

The method of treatment will depend on how obese a person is. Factors such
as an individual's overall health and motivation to lose weight are also
important considerations. Treatment may include a combination of diet,
exercise, and behavior modification. In some cases of severe obesity,
gastrointestinal surgery may be recommended.

MattinglyDoug

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