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OBESITY

Overview

Obesity is a common, serious, and costly chronic disease of adults and children. It is serious because it is associated with poorer mental health outcomes and reduced quality of life.
Obesity can lead to type two diabetes, heart, disease, stroke, and some cancers.

Causes/Risk Factors

Obesity happens when an individual‘s weight is higher than what is considered healthy for his or her height. While genetics and social determinants of health (SDOH) can play a part in an individual being overweight/obese, many factors, such as excessive eating, physical inactivity and inadequate sleep contribute to Obesity.

Symptoms

Body mass index (BMI) is often used to diagnose obesity. To calculate BMI, multiply weight in pounds by 703, divide by height in inches and then divide again by height in inches. Or divide weight in kilograms by height in meters squared.

Diagnosis

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity
Asians with BMI of 23 or higher may have an increased risk of health problems.

Many doctors also measure a person's waist circumference to help guide treatment decisions. Weight-related health problems are more common in men with a waist circumference over 40 inches (102 centimeters) and in women with a waist measurement over 35 inches (89 centimeters).
Side note: a waist circumference of over 35in increases a woman’s risk of diabetes.

Treatment/Prevention

Treatment and prevention is largely geared toward lifestyle modification such as dietary changes and exercise. Weight loss surgery and some medications have also proven efficient in weight loss.

Dietary Changes

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:
* Cutting calories. 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.
* Feeling full on less. Some foods — such as desserts, candies, fats and processed foods — contain a lot 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.
* Making healthier choices. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole grains. 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.
* Restricting certain foods. Certain diets limit the amount of a particular food group, such as high-carbohydrate or full-fat foods. Ask your doctor which diet plans are effective and which might be helpful for you. Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended. Limiting these drinks or eliminating them altogether is a good place to start cutting calories.
* Meal replacements. These plans suggest replacing 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. But these diets likely won't teach you how to change your overall lifestyle. So you may have to stay on the diet if you want to keep your weight off.

Exercise
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* Exercise. 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. You probably will need to gradually increase the amount you exercise as your endurance and fitness improve.
* Keep moving. Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Park farther from store entrances and take the stairs instead of the elevator. A pedometer can track how many steps you take over the course of a day. Many people try to reach 10,000 steps every day. Gradually increase the number of steps you take daily to reach that goal.

The most commonly used medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of obesity include:
* Bupropion-naltrexone (Contrave)
* Liraglutide (Saxenda)
* Orlistat (Alli, Xenical)
* Phentermine-topiramate (Qsymia)

Common weight-loss surgeries include:
* Adjustable gastric banding. In this procedure, an inflatable band separates the stomach into two pouches. The surgeon pulls the band tight, like a belt, to create a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently.
* Gastric bypass surgery. In gastric bypass (Roux-en-Y), the surgeon creates a small pouch at the top of the 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 the stomach.
* Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It's a less complicated surgery than gastric bypass

Complication

Reference

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