Overweight and Obesity

Obesity means a person has too much body fat. When a person eats more calories than they need, and doesn’t exercise enough, their body starts to gain weight. If their body weight is at least 20% higher than it should be, they are considered obese.

The most common way to determine if a person is overweight is by comparing the patient’s height and weight with weight charts (Body Mass Index or BMI). The BMI can be a useful way to measure whether a person is overweight, but it may not be the only way to determine the person’s body fat. Measuring their waist size, the difference between the waist and the hips, or measuring the skin-fold thickness at the back of the upper arm and other areas of the body can also help measure whether a person is overweight. To check your own BMI go tohttp://www.nhlbisupport.com/bmi.

Obesity is a problem worldwide. In 1980 14% of the adult population in the US was obese, by 2000 the number increased to 31%. Eating too much and not exercising enough are not the only things causing men and women to gain weight. Other factors include:

  • Age – as you get older your body’s way to burn calories (metabolism) slows down. If a person doesn’t eat less, they don’t burn the calories and they gain weight.
  • Genetics – being overweight and being thin tends to run in families.
  • Gender – women tend to be more overweight because their metabolism slows after menopause. Men also burn more energy at rest (resting metabolic rate).
  • Lifestyle behaviors – what a person eats and their physical activity.
  • Medications – certain drugs, such as steroids and some antidepressants, may cause a person to gain weight.
  • Psychological factors – feelings of sadness, anger, and being bored can cause a person to eat to feel better. Some people also have a disorder where they are afraid of gaining weight (anorexia), or they eat a lot and then go and throw it up so they don’t gain weight (bulimia).

Being overweight can also negatively affect the body in the following ways:

  • High blood pressure, heart disease, high cholesterol, high triglycerides
  • Type 2 Diabetes, insulin resistance, menstrual disorders
  • Low back pain, some types of arthritis
  • Skin – stretch marks, discoloration (particularly around the neck)
  • Lungs – sleep apnea, asthma, the feeling of being out of breath
  • Throat, stomach, intestines, etc-reflux disease (GERD), fatty liver
  • Slowed sexual development in males, some pregnancy problems, not able to hold urine
  • Stroke, severe headaches, pain and numbness in the outer surface of the thigh.

Childhood obesity

Not all children who carry extra pounds are overweight or obese. Some children have larger than average body frames. Body fat varies at different stages of growth. Using a growth chart, the doctor determines the child’s percentage based on how they compare with other children of the same sex and age.

Obesity is now the most widespread medical problem affecting children and adolescents in the U.S. and other developing countries. According to the American Obesity Association, about 15% of children 12-19 years old and children 6-11 years old are obese in the U.S., and the numbers are expected to continue to increase.

Obesity increases the child’s risk of many health, emotional, and social problems. Although there are some genetic and hormonal causes in childhood obesity, most of the time overeating and not getting enough exercise is the primary case. Many factors can increase a child’s risk of becoming overweight:

  • Diet – eating high calorie and fast foods; drinking soft drinks, candy and desserts.
  • Lack of exercise
  • Family history
  • Psychological factors
  • Family factors – foods purchased that are easy to give a child (like cookies, chips).
  • Low income backgrounds

Childhood obesity can cause problems in the child’s overall health, and include:

  • Type 2 diabetes
  • Metabolic syndrome
  • High cholesterol and high blood pressure
  • Asthma and other breathing problems
  • Sleep disorders
  • Early puberty or menstruation from hormone imbalances
  • Low self-esteem and bullying
  • Behavior and learning problems
  • Depression.

Treatment

For treatment to be successful, life-long behavioral changes must be made, not just dieting or exercising for several weeks. People who go on and off a diet tend to regain the weight and may develop more health problems. Behavior should focus on:

  • What the person eats, and how much they eat:
    • Choose foods high in fiber and nutrients such as whole grains; select lean meats and fish; eat colorful fruits and vegetables.
    • Limit soft drinks. One 12 ounce can of cola has 3 ½ Tablespoons of sugar.
    • Limit fast foods, pre-packaged foods and meals, and sweets.
    • Eat slowly.
    • Eat smaller portions.
  • Understanding why the person may want to always eat (habits, or behavior issues).
  • How they spend their time, such as:
    • Limit TV, video game and computer time to 2 hours or less per day.
    • Participate in some form of physical activity every day.
  • If you skip a meal, you’ll probably eat more during the day.
  • Not enough sleep may cause feelings of hunger, difficulty learning and behavior problems. Preschool children need 10-12 hours of sleep per night. Older children need about 9 hours.

Our dietitians have experience in helping individuals and their families with obesity. Please call (865) 546-3998 for a personal dietary evaluation and plan. We also have a pediatric weight management program called Bee Fit 4 Kids.

Other Resources include:

Websites:

Please see http://www.beefit4kids.com for further information on the weight management program our practice now offers.

http://www.eatright.org (The American Dietetic Association-wonderful ideas; how to pack a lunch, etc.)

http://www.diabetes.org (The American Diabetes Association-this site has terrific low-fat, low-sugar recipes and even tips on eating out)

http://www.etch.com (East Tennessee Children’s Hospital-lots of good nutrition information plus the schedule of Healthy Kids classes)

http://www.dole5aday.com (A fun site for kids to learn about fruit and vegetables, healthy eating, recipes, games, etc.)