OBESITY

Possible Cause

Although there are genetic 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. Obesity usually results from a combination of causes and contributing factors, including:

• Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use.
• Unhealthy diet and eating habits. Having a diet that's high in calories, lacking in fruits and vegetables, full of fast food, missing breakfast, and laden with high-calorie beverages and oversized portions all contribute to weight gain.
• Pregnancy. During pregnancy, a woman's weight necessarily increases. 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.
• Lack of sleep. Too little 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.
• Certain medications 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, corticosteroids and beta blockers.
• Medical problems Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.

Risk Factors

A number of factors can increase your risk of having knee problems:

• Genetics Your genes may affect the amount of body fat you store and its distribution. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercise. Even when someone has a genetic predisposition, environmental factors ultimately make you gain more weight.
• Family lifestyle Obesity tends to run in families. That's not just because of genetics. Family members tend to have similar eating, lifestyle and activity habits. If one or both of your parents are obese, your risk of being obese is increased.
• Inactivity If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you burn off through exercise and normal daily activities.
• Unhealthy diet and eating habits A diet that's high in calories, lacking in fruits and vegetables, full of fast food, missing breakfast, and laden with high-calorie beverages and oversized portions contributes to weight gain.
• Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain that the person becomes obese. In the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke.
• Pregnancy. During pregnancy, a woman's weight necessarily increases. 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.
• Lack of sleep. Not getting enough sleep or getting too much sleep at night 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.
• Certain medications. 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.
• 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. This 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 control what you eat and consciously become more physically active as you age, you'll likely gain weight.
• Social and economic issues. Certain social and economic issues may be linked to obesity. You may not have a healthy cooking trend at home or you may not be able to afford healthy food items. In addition, the people you spend time with may influence your weight — you're more likely to become obese if you have obese friends or relatives.
• Medical problems. Obesity can rarely be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. Even if you have one or more of these Risk Factors, it doesn't mean that you're destined to become obese. You can counter them through diet, physical activity and exercise, and behavior changes.

Complications

If you're obese, you're more likely to develop a number of potentially serious health problems, including:

• High triglycerides and low high-density lipoprotein (HDL) cholesterol.
• Type 2 diabetes.
• High blood pressure.
• Metabolic syndrome — a combination of high blood sugar, high blood pressure, high triglycerides and low HDL cholesterol.
• Heart disease.
• Stroke.
• Cancer, including cancer of the uterus, cervix, endometrium, ovaries, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
• Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts.
• Gallbladder disease.
• Gynecologic problems, such as infertility and irregular periods.
• Erectile dysfunction and sexual health issues.
• Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver and can cause inflammation or scarring.
• Osteoarthritis.
• Skin conditions, including poor wound healing.

Quality of life When you're obese, your overall quality of life may be lower, too. You may not be able to do things you'd normally enjoy as easily as you'd like, such as participating in enjoyable activities. You may avoid public places. Obese people may even encounter discrimination. Other weight-related issues that may affect your quality of life include:

• Depression
• Disability
• Sexual problems
• Shame and guilt
• Social isolation
• Lower work achievement

Care and Treatment

The steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

• Exercise regularly You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
• Eat healthy meals and snacks Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. You can still enjoy small amounts of high-fat, high-calorie foods as an infrequent treat. Just be sure to choose foods that promote a healthy weight and good health most of the time.
• Know and avoid the food traps that cause you to eat Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you're feeling and how hungry you are. After a while, you should see patterns emerge. You can plan ahead and develop strategies for handling these types of situations and stay in control of your eating behaviors.
• Monitor your weight regularly People who weigh themselves at least once a week are more successful in keeping off excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gains before they become big problems.
• Be consistent Sticking to your healthy-weight plan during the week, on the weekends, and amidst vacation and holidays as much as possible increases your chances of long-term success.

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