Obesity is defined as a medical condition marked by accumulation of excess fat in your body. The word comes from the Latin word "obesus," which roughly translates to "to eat."1 Obesity can be divided into two primary categories, based on how it occurs:
• Exogenous obesity: This type of obesity is caused by eating more food than the body needs. Excess calories are converted into fat, leading to weight gain.2
• Endogenous obesity: A type of obesity caused by a genetic malfunction or a problem in hormonal production that results in weight gain.3
Obese people are generally at risk of developing life-threatening complications and diseases. Furthermore, an obese woman going through a pregnancy can develop additional complications apart from the ones normally associated with obesity, which ultimately affects the health of the fetus as well.
This guide aims to educate you on obesity: the alarming statistics in the United States, how this condition wreaks havoc on your body and what you can do to prevent or reverse it.
Overweight Versus Obese: What Is the Difference Between Them?
You may have heard the words "overweight" and "obese" used interchangeably, but what exactly is the difference between them? The answer lies in their body mass index (BMI) classification. According to the BMI table, the overweight category has an index of 25 to 29.9.The obese category on the other hand, has an index of 30 or higher.
In essence, obese people are heavier than overweight people. It's possible that you can be overweight, but still have a generally healthy body. Being overweight simply means that you have excess pounds above your ideal weight.4
Furthermore, there's a very small chance that you can be obese, yet do not have the health risks associated with it. The Harvard Medical School classifies this rare occurrence as "metabolically healthy obesity." People who fall under this category usually have a high BMI with a large waistline, but have normal sensitivity to insulin, and normal blood sugar, blood pressure and cholesterol levels.5
However, if you're obese yet metabolically healthy, that doesn't mean you are immune to the negative effects of obesity forever. The condition is not permanent, and you may soon feel obesity-related complications, especially as you age. Instead, you should strive to achieve a healthy weight so that you can avoid possible health complications in the future.6
Note: For your reference, a BMI table can be found below.
Adult Obesity in America Is Growing Every Year, and Shows No Signs of Slowing Down
Adult obesity in the United States is a growing concern. The Centers for Disease Control and Prevention (CDC) estimates that around 26.5 percent of all American adults are now considered obese.7 Due to the prevalence, it's now believed that 1 in every 5 deaths are obesity-related.8
According to the Journal of American Medicinal Association (JAMA), 48.1 percent of non-Hispanic African-Americans are obese, making them the ethnicity with the highest obesity population. This is followed by Hispanics (42.5 percent), non-Hispanic Caucasians (34.5 percent) and non-Hispanic Asians (11.7 percent). Overall, 40.2 percent of middle aged adults (40 to 59 years old) in the U.S. are obese.9
Economic and educational factors play a large role in obesity among adults. According to the National Center for Health Statistics (NHCS), obesity among men is similar in all income levels, but the rate is slightly higher at higher income levels, and that education level has no significant influence in developing obesity.
On the other hand, women who have lower incomes tend to develop obesity more than women who have higher incomes.10 From a national perspective, the 10 most obese states in America are:11
Obesity Percentage: 35.9
✓ West Virginia
Obesity Percentage: 35.7
Obesity Percentage: 35.5
Obesity Percentage: 34.9
Obesity Percentage: 33.5
Obesity Percentage: 33
Obesity Percentage: 32.7
Obesity Percentage: 32.6
✓ North Dakota
Obesity Percentage: 32.2
✓ South Carolina
Obesity Percentage: 32.1
Childhood Obesity in America Is Growing Rapidly as Well
Unfortunately, much like adult obesity, childhood obesity in America is also becoming more prevalent. This is because many parents believe their kids are average in size, but are actually obese. In addition, they may have difficulties speaking to their children about their growing weight, so the parents put it off until problems begin to show.12
The CDC estimates that in children and adolescents 2 to 19 years old, 17 percent are obese, or a total of 12.7 million children. Below is a list of ethnicities with the highest childhood obesity rates:13
• Hispanics (21.9 percent)
• Non-Hispanic African-Americans (19.5 percent)
• Non-Hispanic Caucasians (14.7 percent)
• Non-Hispanic Asians (8.6 percent)
Obese kids generally develop the same symptoms as obese adults (which will be discussed later). In addition, they are more prone to developing nonalcoholic fatty liver disease (NAFLD), a condition where fat deposits build up in the liver, leading to damage in the future.14
Morbid Obesity: A More Severe Form of Obesity
Morbid obesity is a serious health condition that needs to be addressed promptly. Its main characteristic is a BMI higher than 40 (or 100 pounds heavier than the ideal weight15), which can result in more severe health complications.16 In the United States, morbid obesity is a growing problem. It's estimated that more than 15.5 million citizens are morbidly obese, and that number is expected to grow higher in the coming years.17
The causes for this condition are very much the same for people who are obese, such as genetics, environment, eating habits, possible mental disorders and underlying medical conditions.18 Health complications that can arise are virtually the same as well. Morbidly obese people may develop diabetes, hypertension, heart disease, stroke and cancer.19
The Various Causes of Obesity
There are many factors that can cause obesity, from lifestyle choices and hereditary conditions, to hormonal imbalances. Learn the common causes below.
Sitting down too much is a main cause of obesity. If you don't get adequate exercise and you consume more calories than needed, the excess amount becomes stored as fat, leading to weight gain.
Poor Dietary Choices
Another big factor that can increase your risk of obesity is the kinds of foods you eat. A diet high in processed and sugary foods can greatly increase your BMI. Alcoholic beverages contain lots of calories as well, so if you are a frequent heavy drinker, you'll gain weight faster.20
Eating out in restaurants is another reason for weight gain. Many restaurant meals, especially fast foods, contain lots of calories, harmful fat and sugar that can make you gain weight. If you add sugary drinks such as sodas to your meal, the calories add up even more.21
Currently, there are four genetic disorders associated with obesity:
• Prader-Willi syndrome: A condition marked by weak muscle tone, poor growth and delayed development. It also causes an insatiable appetite during childhood.22
• Bardet-Biedl syndrome: This condition causes abnormal weight gain, along with a host of vision problems, cognitive difficulties and abnormalities in the genitals. Children with this condition may have extra fingers during birth as well.23
• Alström syndrome: Defining symptoms of this condition include gradual loss of vision and hearing, cardiac muscle weakness and enlargement, type 2 diabetes, obesity and a short stature. This is caused by a mutation in the ALMS1 gene.24
• Cohen syndrome: Also known as the Pepper syndrome, its main symptoms include intellectual disability, small head size and weak muscle tone. Obesity can develop during late childhood or adolescence, which affects the lower torso only — the arms and legs remain normal.25
In addition, obesity seems to have a hereditary connection, but this is not fully understood. Your chances of developing obesity are higher if one or both your parents are obese — not only due to genetic reasons, but due to your family's lifestyle choices as well.26
Certain types of medicines such as antipsychotics, antidepressants, antiepileptics, corticosteroids and antihyperglycemics can cause you to gain weight if used long-term. If you're using any of them right now to treat a certain medical condition, consult with your doctor to find an alternative that will not affect your weight.27
In some people, certain emotions trigger hunger. Boredom, sadness and stress are just a few examples that can cause a person to eat more than they need to. While most obese people typically experience the same type of psychological disturbances as that of normal-weight people, it's estimated that 30 percent of those who seek treatment for obesity have psychological problems in controlling their binge eating.28
Environment and Economic Factors
Certain environmental or economic factors come into play regarding weight gain. For example, financial problems can cause you to purchase ready-to-eat, processed food more frequently than healthy, organic food. Other times, lack of facilities to exercise or safety issues in your neighborhood can increase your risk of obesity.29
Obesity Symptoms to Watch Out For
BMI is the main indicator used to identify obesity by calculating whether a person has a normal weight relative to their height. To compute for the BMI, your weight (in kilograms) is divided by the square of your height (in meters). Note however, that BMI does not indicate the overall health of your body. It is only used to help indicate your weight status.30
The table below shows how the BMI is computed for adults:31
|BMI||Weight Status Category|
✓ Below 18.5
Weight Status Category: Underweight
✓ 18.5 to 24.9
Weight Status Category: Normal or healthy weight
✓ 25.0 to 29.9
Weight Status Category: Overweight
✓ 30.0 and above
Weight Status Category: Obese
Children and teenagers can compute for their BMI as well, but the results are expressed differently. Once they have their BMI, it is expressed in percentile using a graph or a percentile calculator. Their results will be compared to children of their own age (BMI-for-age) who participated in national surveys during the period of 1963 to 1965 and 1988 to 1994. This is because young people are still growing, thus their height and weight may fluctuate. The table below is used for interpreting results in children:32
|Weight Status Category||Percentile Range|
Percentile Range: Less than the 5th percentile
✓ Normal or healthy weight
Percentile Range: 5th percentile to less than the 85th percentile
Percentile Range: 85th to less than the 95th percentile
Percentile Range: Equal or greater than the 95th percentile
In addition to having a high BMI, obesity can cause issues such as:33
✓ Increased sweating
✓ Inability to cope with sudden physical activity
✓ Feeling tired every day
✓ Low confidence and self-esteem
✓ Feeling isolated
Furthermore, obesity can cause internal changes in your body that you may not notice right away, but are nonetheless potentially harmful to your health. High blood pressure and fat blocking your arteries (high cholesterol) can occur, increasing your risk of heart attack and stroke.34 In other cases, type 2 diabetes may appear alongside obesity. Its main symptoms include increased thirstiness, extreme fatigue and increased urination during nighttime.35
The Detrimental Effects of Obesity on Your Body and Their Symptoms
Obesity is a health concern that should be addressed right away, because it can cause various complications, many of which are serious. Below is a list of potential complications that can arise due to obesity, as well as their symptoms.
Type 2 Diabetes
Most people who are obese develop type 2 diabetes, a condition wherein your body has higher levels of blood sugar (glucose) than the normal, healthy range, due to insulin resistance. Insulin is a substance produced by your pancreas to help keep your blood sugar levels in the normal range. But if you have type 2 diabetes, your pancreas can't produce enough insulin to keep up with your body's demand, resulting in higher blood sugar levels.36
The condition can cause various symptoms, such as frequent urination, fatigue, recurrent infections and headaches. If you develop any of these symptoms, have yourself tested for diabetes right away.37
Obesity drastically increases your risk of developing coronary heart disease, which is the buildup of plaque in your arteries. If the plaque severely limits the flow of blood to your heart, a heart attack can happen. Telltale symptoms of a heart attack include chest pain, shortness of breath and palpitations.38
Furthermore, obesity can cause you to develop high blood pressure, which is also known as hypertension. In this condition, the force of the blood flow is too high, increasing your heart's workload to the point of artery damage. If you suspect that you have high blood pressure, have yourself tested. If the results are higher than 140/90, you most likely have high blood pressure.39
Gallstones are hard, crystal-like deposits created inside your gallbladder. They're typically made from the excess of one of these three substances: cholesterol, bile or bilirubin (discarded red blood cells). In the case of obesity, the stones are usually made from cholesterol, and their sizes can vary, from a grain of sand to the size of a golf ball.40
Gallstones do not usually cause symptoms if they do not cause a blockage in the pancreatic duct. However, if stones do get stuck, they cause a very noticeable pain in the gallbladder, which can last several hours. This occurs usually after a heavy meal when the gallbladder releases bile into the small intestines. Nausea, fever, tea-colored urine and yellow skin or eyes are other symptoms you should watch out for as well.41
It's been observed that higher amounts of body fat can contribute to various forms of cancer. The connection isn't clear, but doctors believe that low-level inflammation caused by obesity can gradually damage your DNA over time, leading to cancer. It's also suggested that fat cells produce hormones that lead to cell proliferation. The following types of cancer have been linked to obesity:42
✓ Endometrial cancer: Overweight and obese women are two to four times more likely to develop endometrial cancer compared to women who have normal weight.
✓ Esophageal adenocarcinoma: Obese people are two times more likely to develop some form of esophageal cancer compared to normal-weight people. Extreme obesity increases the risk even further by four times.
✓ Breast cancer: Postmenopausal obese women have an increased risk of breast cancer. In addition, a 5-point increase in your BMI can already increase your risk by 12 percent.
✓ Gastric cardia cancer: This type of cancer affects the upper portion of your stomach close to the esophagus. Obesity doubles your risk of developing cancer in this area.
✓ Liver cancer: Obese men develop this condition more than women, but the risk for both genders doubles if their BMI is high.
✓ Kidney cancer: Among obese people, renal cancer is the most common type of kidney cancer that can develop. Having a high BMI doubles your risk compared to normal-weight people.
✓ Pancreatic cancer: Overweight and obese people are 1.5 times more likely to develop pancreatic cancer than people with normal weight.
✓ Colorectal cancer: The risk of developing this type of cancer among obese men and women is 30 percent more than normal-weight people.
Pain in the knees, back and hips are usually common in obese people, because the heavy weight puts extra pressure on the joints. Depending on the symptoms, the pain may be mild, or it may be so severe that it can hamper your daily activities.43
Obese and Pregnant — How Will It Affect You and Your Child?
Pregnancy can further worsen the possible health complications associated with obesity. If you're obese and pregnant, you may be at risk of the following conditions:44,45
• Blood clots: All pregnant women are at risk of developing blood clots, but obesity can increase this risk further.
• Gestational diabetes: This is a type of diabetes that develops during pregnancy. Experts are not entirely sure how it forms, but it is believed that hormones produced during pregnancy to help the baby grow block the insulin, thereby causing insulin resistance.
• Preeclampsia: This condition is essentially the development of high blood pressure during or after pregnancy. It can cause several complications to your health, such as liver and kidney failure, as well as a rare chance of stroke.
• Sleep apnea: This is a sleeping disorder wherein you suddenly stop breathing while you're sleeping. It can increase your risk of developing heart and lung disorders, as well as preeclampsia and fatigue.
Not only does obesity endanger your health, but it can affect your unborn child as well. Several obesity-related complications can arise while the child is in the womb:46
• Miscarriage and stillbirth: The risk of losing the pregnancy can increase due to obesity.
• Birth defects: The child has an increased risk of developing heart and/or neural defects when they are born.
• Macrosomia: In this condition, the baby's birth weight is higher than the expected number. As a result, it can increase the baby's risk of developing injuries, such as their shoulder getting stuck in the birth canal during delivery. It also increases their chances of developing obesity in the future.
• Premature birth: Complications caused by obesity may necessitate an early, medically-induced delivery to help save the child's life.
To lower the chances of developing complications during pregnancy, it's highly recommended that you shed the excess weight by eating healthy foods and getting regular exercise. You may consult with a doctor on which foods you can eat, and what exercises are safe to do throughout your pregnancy.
Obesity Prevention: Effective Strategies to Help You Lose Weight
Fortunately, obesity can be prevented. There are many strategies available that you can implement, but it's important to begin with creating the proper mindset first. Without the proper attitude, you may have a hard time losing weight.
To start, you may want to seek out therapy or counseling to help you change certain behaviors that prevent you from losing weight. Trained professionals can get to the bottom of your condition, allowing them to create behavioral strategies that you can follow. In addition, joining support groups can help bolster your confidence as you start your journey towards a healthier body.47
Your Diet Is Crucial for Shedding Off Excess Pounds
A huge contributor of excess weight is poor dietary choices. You will have to eliminate foods that are bad for your health, especially those that are high in sugar and trans fat, from your diet. Here are five effective strategies you can adopt:
• Drastically Cut Back or Eliminate Sugary Foods From Your Meals
It's important that you cut back, with the goal of eliminating, sugary foods from your diet, especially those that contain fructose. This type of sugar is one of the greatest contributors to the growing obesity epidemic in America. It wreaks havoc on your health by diminishing certain digestive functions, such as your ghrelin (or hunger hormone), causing you to overeat.
Furthermore, it converts to fat more directly than any other type of sugar. And if consumed regularly, it can contribute to insulin resistance, increasing your chances of developing diabetes. To help you lose weight, it's important that you strictly limit your sugar consumption to 15 grams a day only — including fruits.
• Reduce and Eventually Avoid Grain Consumption
Alongside sugar, grains are another major contributor to weight gain. They contain gluten, an elastic compound that impedes proper absorption of nutrients from the other foods you eat. In addition, grains convert into sugar when digested, leading to excess weight. Common grain sources you should cut back on include bread, rice, potatoes and pasta.
• Increase Your Intake of Healthy Fats
As you begin to decrease your dependence on grains and sugary foods, you need to increase your intake of healthy fats. They contain specific compounds that can bring a variety of health benefits, especially if you're trying to lose weight. Healthy fats help you feel full longer, helping lower your calorie intake. They're also a good source of energy because they last longer than the energy provided by sugar. They also help you avoid increasing your cholesterol levels.
More importantly, healthy fats play an important role in nutrient absorption, because many vitamins and minerals are fat-soluble. If your body only has a small amount of healthy fat, fat-soluble nutrients aren't absorbed efficiently, making you miss out on their health benefits.
Great sources of healthy fat include coconuts and coconut oil, grass-fed meats and dairy products, raw nuts and organic-pastured egg yolks. Fish is rich in healthy fat as well, especially wild-caught salmon, anchovies and sardines. If you're consuming fish, however, be sure to purchase from reputable organic providers, because commercially harvested fish is filled with toxins.
• Eat Organic Vegetables
It's no secret that vegetables are good for your health. They're low in calories and rich in various nutrients that can help contribute to optimal health. Another main benefit of eating vegetables is their fiber content, because it can help lower your risk of certain health complications related to obesity. For example, a study showed that a high-fiber diet can help lower your risk of heart disease by 40 percent.48
In another study, researchers suggested that for every 7 grams of fiber you consume each day, your risk of developing a stroke is reduced by 7 percent.49 And similar to healthy fat, fiber helps you feel full longer, thus reducing calorie intake. In a related study, researchers specifically mentioned that fiber can benefit obese people.50
Alongside Diet, Exercise Is Key in Helping Lose Weight
While your diet is important in optimizing your health, exercise is another important weight loss strategy that you should not ignore. Not only can it help you avoid packing on excess weight by burning calories you've consumed, but it may help improve your cognitive function as well. According to one study, people who exercised regularly reported higher cognitive performance compared to those who didn't exercise as much.51
When it comes to exercising to reduce obesity, it's important to start slow and simple. The frequency and duration is more important than the intensity of the exercise. You can start with simple activities such as walking, swimming and cycling. This will help lower the stress on your knees and your other joints, so that you can get used to increased physical activity in the future.52
Try exercising four to five days a week for a total time of 30 to 60 minutes. You can break it up into smaller 10-minute sessions to allow your body to adjust. You can start slowly on the first five minutes on your first day of exercising, then gradually build up the intensity as you get better.53
Most importantly, listen to how your body responds while exercising. Due to the lack of physical activity before, you may find it hard to perform physically strenuous movements. If you feel any sort of sharp pain in your muscles, stop immediately and rest. Remember to keep yourself hydrated, because obesity tends to make you dehydrated.
Finally, you may want to seek out help from a physical therapist or a personal trainer to help create an exercise program suited to your preferred activities, so that you can enjoy exercising in the long run.54