obesity
(ō-bē'sĭt-ē 
)
(ō-bes'ĭt-ē)
[ obese ]
- A body mass index of >30 kg/m2, an unhealthy accumulation of body fat. In adults, damaging effects of excess weight are seen when the body mass index exceeds 25 kg/m2. A person 5'7‵ tall and weighing more than 191 lb would be obese by this stand ard.SYN: adiposis; adiposity; corpulence; liposis; weight.
SEE: body mass index for table.
Etiology: Obesity is the end result of an imbalance between food eaten and energy expended, but the underlying causes are more complex. Genetic, hormonal, and neurological influences all contribute to weight gain and loss. In addition, some medications (such as tricyclic antidepressants, insulin, and sulfonylurea agents) may cause patients to gain weight.Treatment: Attempts to lose weight are often unsuccessful, but mild caloric restriction, an increase in physical activity, and supportive therapies all have a role. Medications to enhance weight loss (such as liraglutide, orlistat, and phentermine) can sometimes produce weight losses of several kilograms. However, some weight loss agents (such as amphetamines or amphetamine-like agents) have unacceptable side effects (such as cardiac valvular injuries with fenfluramine/phentermine, addiction with other anorexiants). Surgical remedies (“bariatric” surgery) are readily available and can result in sustained weight loss accompanied by remission of type 2 diabetes mellitus and hypertension.Diet: Caloric intake should be less than maintenance requirements, but all essential nutrients must be included in any weight-loss regimen. Severe caloric restriction is unhealthy and should be avoided unless undertaken under strict supervision. For many patients of average size and activity, consumption of 1200 to 1600 calories a day will result in gradual loss of weight. Most fad diets provide temporary results at best.Exercise: Dietary changes should be accompanied by a complementary program of regular exercise. Exercise improves adherence to weight loss diets and consumes stored fat. For many people 35 minutes of low-level exercise performed daily (either in one long workout session or in several shorter intermittent sessions) will aid weight loss and improve other cardiovascular risk factors. Exercise programs may be hazardous for some patients; professional supervision may be recommended for some people who start an exercise program, e.g., people with a history of heart or lung disease, arthritis, or diabetes mellitus.Patient Care: The U.S. Preventive Services Task Force and other promoters of public health recommend that clinicians screen all adults for obesity and offer incentive behavioral counseling to obese adults. Patients who are overweight should be screened for conditions worsened by obesity, e.g., hypertension, diabetes mellitus, and hyperlipidemia. Health care professionals can aid patients in making permanent life-style changes by discussing diet and exercise, being familiar with various eating plans, and by providing patients with a list of local weight loss centers. The patient's feelings about weight and body image should be explored to understand the individual's motivations. People who diet and exercise for health reasons tend to be the most successful. Family support is also important.
Obesity is the most common metabolic/nutritional disease in the U.S., with more than 65% of the adult population being overweight. Obesity is more common in women, minorities, and the poor. The obese have an increased risk of developing diabetes mellitus, hypertension, heart disease, stroke, fatal cancers, and other illnesses. Obese people may also suffer psychologically and socially.
acquired o.Obesity that results primarily from environmental rather than genetic causes. It can be most clearly identified in identical twins one of whom is of normal weight and the other markedly overweight
adult-onset o.Obesity first appearing in the adult years. SYN: Recent obesity .
and roid o.Obesity in which fat is located largely in the waist and abdomen. It is associated with an increased risk of heart disease, hypertension, and diabetes. People with and roid obesity are often described as having an apple-shaped body. SYN: abdominal obesity .
developmental o.Juvenile obesity
endogenous o.Obesity associated with some metabolic or endocrine abnormality.
exogenous o.Obesity due to an excessive intake of food.
gluteal-femoral o.Obesity in which fat deposits are located primarily below the waist in the hips and thighs. The health risks of gluteal-femoral fat appear to be less than those associated with abdominal obesity. SYN: gynecoid obesity .
gynecoid o.Gluteal-femoral obesity.
hypothalamic o.Obesity resulting from dysfunction of the hypothalamus, esp. the appetite-regulating center.
iatrogenic o.Obesity that is caused or worsened by prescription medications or other treatments.
juvenile o.Obesity that occurs before adulthood. It is associated with an increased risk of obesity in adulthood. SYN: developmental obesity .
About one third of American children and 15% of teenagers are overweight or obese. A variety of factors contributes to childhood obesity, including learned patterns of behavior, genetics, a decreased emphasis on physical activity and exercise, and access to inexpensive, calorically dense fast foods (typically rich in fats and sugars but limited in fiber, vitamins, minerals, and other essential nutrients). School nurses, pediatricians, and other health care professionals who provide care to children should help educate children about healthy food choices and portion sizes and the need to increase activity and decrease caloric intake. Parents should be taught to avoid overfeeding infants and to familiarize themselves with nutritional needs and optimum growth rates. The overweight child should be assisted in keeping a record of what, where, and when he/she eats to help identify situations that lead to overeating. Unhealthy weight loss behaviors, such as fad diets or purging, are discouraged. Children and teens benefit from weight loss support programs. Snacks should consist of foods such as raw vegetables rather than cookies, cand ies, or sugary drinks. Families that exercise together (as by walking, hiking, biking, swimming) provide children with interest in, knowledge of, and practice in activities that help to maintain desired weight levels.
morbid o.1Having a body mass index >40. Approx. 5% of Americans 20 years and older are morbidly obese. 22. Having a BMI >95 or 99% of the population (expert opinion varies). SYN: severe obesity .
SEE: illus..
sarcopenic o.Obesity combined with reduced skeletal muscle mass and impaired muscle function.