Obesity is an increased percentage of total body fat compared with normal. Overweight is increased body weight relative to height. Both have important effects on health.
Body mass index (BMI) is one way to see whether someone is overweight. The formula for BMI is BMI = (weight in pounds) × 703/(height in inches) × (height in inches). Women 19 to 35 years old should have a BMI of 19 to 25, and women older than 35, of 21 to 27.
Skinfold measurements are used to determine relative obesity. Waist and hip size are used to determine body fat distribution. Females with a body fat content higher than 33% are obese. An increased waist-to-hip ratio is a risk factor for diabetes and heart disease.
Obesity is caused by eating too many calories for the physical activities performed. Why certain people gain too much weight isn’t known. Genetics (parents passing on a tendency to gain weight to children), psychological reasons (eating when stressed), culture, and society (people are encouraged to eat too much) may play a role.
A women with a BMI higher than 25 is overweight; a woman with a BMI of 30 or higher is obese; and a woman with a BMI of 40 or more is severely obese. Being overweight increases the chances of having serious health problems, such as high blood pressure, diabetes, and coronary artery disease. It strains arthritic joints and causes shortness of breath and tiredness.
The health care provider will do a physical examination (weight, BMI, blood pressure) and take a medical history. The health care provider may use calipers (a tool that measures thickness) to find the amount of body fat. Blood and urine tests may also be done as part of the medical evaluation to rule out medical disorders that can also cause excess weight.
Diet, exercise, medicines, and surgery are all used. A registered dietitian and doctors can help plan a good low-fat, low-calorie diet. Exercise is very effective, and an individualized supervised program helps prevent complications. Few drugs (such as amphetamines, orlistat, lorcaserin, phentermine, diethylpropion, and the combination of bupropion and naltrexone) are available for weight loss, and they cause side effects. They should be tried only after diet and exercise and only under direct supervison of the health care provider.
Morbidly obese women (more than 100% above ideal body weight or with a BMI higher than 40) who had no success with other methods may consider surgery, such as gastric bypass, lap band, or vertical band gastroplasty (stomach stapling).
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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