December 28, 2006

Obesity

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The most important part of being a normal weight isn't looking a certain way - it's feeling good and staying healthy. Having too much body fat can be harmful to the body in many ways.

The good news is that it's never too late to make changes in eating and exercise habits to control your weight, and those changes don't have to be as big as you might think. So if you or someone you know is obese or overweight, this article can give you information and tips for dealing with the problem by adopting a healthier lifestyle.

Being obese and being overweight are not exactly the same thing. An obese person has a large amount of extra body fat, not just a few extra pounds. People who are obese are very overweight and at risk for serious health problems.

To determine if someone is obese, doctors and other health care professionals often use a measurement called body mass index (BMI). First, a doctor measures a person's height and weight. Then the doctor uses these numbers to calculate another number, the BMI.
Once the doctor has calculated a child's or teen's BMI, he or she will plot this number on a specific chart to see how it compares to other people of the same age and gender. A person with a BMI above the 95th percentile (meaning the BMI is greater than that of 95% of people of the same age and gender) is generally considered overweight. A person with a BMI between the 85th and 95th percentiles typically is considered at risk for overweight. Obesity is the term used for extreme overweight. There are some exceptions to this formula, though. For instance, someone who is very muscular (like a bodybuilder) may have a high BMI without being obese because the excess weight is from extra muscle, not fat.


Causes
People gain weight when the body takes in more calories than it burns off. Those extra calories are stored as fat. The amount of weight gain that leads to obesity doesn't happen in a few weeks or months. Because being obese is more than just being a few pounds overweight, people who are obese have usually been getting more calories than they need for years.


Genes - small parts of the DNA that people inherit from their parents and that determine traits like hair or eye color - can play an important role in this weight gain. Some of your genes tell your body how to metabolize food and how to use extra calories or stored fat. Some people burn calories faster or slower than others do because of their genes.

Obesity can run in families, but just how much is due to genes is hard to determine. Many families eat the same foods, have the same habits (like snacking in front of the TV), and tend to think alike when it comes to weight issues (like urging children to eat a lot at dinner so they can grow "big and strong"). All of these situations can contribute to weight gain, so it can be difficult to figure out if a person is born with a tendency to be obese or overweight or learns eating and exercise habits that lead to weight gain. In most cases, weight problems arise from a combination of habits and genetic factors. Certain illnesses, like thyroid gland problems or unusual genetic disorders, are uncommon causes for people gaining weight.

Sometimes emotions can fuel obesity as well. People tend to eat more when they are upset, anxious, sad, stressed out, or even bored. Then after they eat too much, they may feel bad about it and eat more to deal with those bad feelings, creating a tough cycle to break.
One of the most important factors in weight gain is a sedentary lifestyle. People are much less active today than they used to be, with televisions, computers, and video games filling their spare time. Cars dominate our lives, and fewer people walk or ride bikes to get somewhere. As lives become busier, there is less time to cook healthy meals, so more and more people eat at restaurants, grab takeout food, or buy quick foods at the grocery store or food market to heat up at home. All of these can contain lots more fat and calories than meals prepared from fresh foods at home.


Risk Factor
The number of people who are obese is rising. About 1.2 billion people in the world are overweight and at least 300 million of them are obese, even though obesity is one of the 10 most preventable health risks, according to the World Health Organization. In the United States, more than 97 million adults - that's more than half - are overweight and almost one in five adults is obese. Among teenagers and kids 6 years and older, more than 15% are overweight - that's more than three times the number of young people who were overweight in the 1970s. At least 300,000 deaths every year in the United States can be linked to obesity.
In the United States, women are slightly more at risk for becoming obese than men. Race and ethnicity also can be factors - in adolescents, obesity is more common among Mexican Americans and African Americans.


Effects
Obesity is bad news for both body and mind. Not only does it make a person feel tired and uncomfortable, it can wear down joints and put extra stress on other parts of the body. When a person is carrying extra weight, it's harder to keep up with friends, play sports, or just walk between classes at school. It is also associated with breathing problems such as
asthma and sleep apnea and problems with hips and knee joints that may require surgery.
There can be more serious consequences as well. Obesity in young people can cause illnesses that once were thought to be problems only for adults, such as
hypertension (high blood pressure), high cholesterol levels, liver disease, and type 2 diabetes, a disease in which the body has trouble converting food to energy, resulting in high blood sugar levels. As they get older, people who are obese are more likely to develop heart disease, congestive heart failure, bladder problems, and, in women, problems with the reproductive system. Obesity also can lead to stroke, greater risk for certain cancers such as breast or colon cancer, and even death.
In addition to other potential problems, people who are obese are more likely to be depressed. That can start a vicious cycle: When people are overweight, they may feel sad or even angry and eat to make themselves feel better. Then they feel worse for eating again. And when someone's feeling depressed, that person is less likely to go out and exercise.


Prevention
The best way to avoid these health problems is to maintain a healthy weight. And the keys to healthy weight are regular exercise and good eating habits.
To stay active, try to exercise 30 to 60 minutes every day. Your exercise doesn't have to be hard core, either. Walking, swimming, and stretching are all good ways to burn calories and help you stay fit. Try these activities to get moving:
Go outside for a walk.
Take the stairs instead of the elevator.
Walk or bike to places (such as school or a friend's house) instead of driving.
If you have to drive somewhere, park farther away than you need to and walk the extra distance.
Tackle those household chores, such as vacuuming, washing the car, or cleaning the bathroom - they all burn calories.
Alternate activities so you don't get bored: Try running, biking, skating - the possibilities are endless.
Limit your time watching TV or playing video games; even reading a book burns more energy.
Go dancing - it can burn more than 300 calories an hour!
Eating well doesn't mean dieting over and over again to lose a few pounds. Instead, try to make healthy choices every day:
Soft drinks, fruit juices, and sports drinks are loaded with sugar; drink fat-free or low-fat milk or water instead.
Eat at least five servings of fruit and vegetables a day.
Avoid fast-food restaurants. If you can't, try to pick healthier choices like grilled chicken or salads, and stick to regular servings - don't supersize!
If you want a snack, try carrot sticks, a piece of fruit, or a piece of whole-grain toast instead of processed foods like chips and crackers, which can be loaded with fat and calories.
Eat when you're hungry, not when you're bored or because you can't think of anything else to do.
Eat a healthy breakfast every day.
Don't eat meals or snacks while watching TV because you'll probably end up eating more than you intend to.
Pay attention to the portion sizes of what you eat.


Treatments
Before you start trying to lose weight, talk to a doctor, a parent, or a registered dietitian. With their help, you can come up with a safe plan, based on eating well and exercising. Remember that teenagers need to keep eating regularly. Don't starve yourself because you won't get the nutrients you need to grow and develop normally.
You may also want to keep a food and activity journal. Keep track of what you eat, when you exercise, and how you feel. Changes can take time, but seeing your progress in writing will help you stick to your plan. You might also want to consider attending a support group; check your local hospital or the health section of a newspaper for groups that meet near you. Above all, surround yourself with friends and family who will be there for you and help you tackle these important changes in your life.

Adapted from Nemours Foundation