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Nih causes of weight gain and obesity and strategies and help losing weight


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NIH comprehensive report on causes of weight gain, and strategies to deal with obesity and overweight.

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Nih causes of weight gain and obesity and strategies and help losing weight

  1. 1. Understanding AdultOverweight and ObesityU.S. Department of Healthand Human ServicesWIN Weight-control Information NetworkWhen we eat more calories than we burn, ourbodies store this extra energy as fat. While a fewextra pounds may not seem like a big deal, theycan increase your chances of having high bloodpressure and high blood sugar. These conditionsmay lead to serious health problems, includingheart disease, stroke, type 2 diabetes, andcertain cancers.Today, more than two-thirds of adults in the UnitedStates are considered to be overweight or obese.More than one-third of adults have obesity. Thisfact sheet will help you find out if you may be atrisk of developing weight-related health problems.It will also explain how overweight and obesity aretreated and give you ideas for improving yourhealth at any weight.How can I tell if I am at a normal weight?Body mass index (BMI) is one way to tell whetheryou are at a normal weight, overweight, or obese. TheBMI measures your weight in relation to your height.The BMI table on the next page will help you tofind your BMI score. Find your height in inchesin the left column labeled “Height.” Move acrossthe row to your weight. The number at the top ofthe column is the BMI for that height and weight.Pounds are rounded off. You may also go to theResources section at the end of this booklet for alink to an online tool for measuring BMI.A BMI of 18.5 to 24.9 is in the normal range.A person with a BMI of 25 to 29.9 is consideredoverweight, and someone with a BMI of 30 orgreater is considered obese.However, because BMI doesn’t measure actualbody fat, a person who is very muscular, like abodybuilder, may have a high BMI without havinga lot of body fat. Please review your findings withyour health care provider if your BMI is outsideof the normal range.Why do people gain weight?Our bodies need calories (energy) to keep us aliveand active. But to maintain weight we need tobalance the energy we take in with the energy weuse. When a person eats and drinks more caloriesthan he or she burns, the energy balance tips towardweight gain, overweight, and obesity. The tippingDoes my body shape matter?Health care providers are concerned not onlywith how much body fat a person has, butwhere the fat is located on the body.„„ Women tend to collect fat in their hips andbuttocks, giving them a “pear” shape.„„ Men usually build up fat around theirbellies, giving them more of an “apple”shape.„„ Of course, some men are pear-shaped andsome women are apple-shaped, especiallyafter menopause.Extra fat around your midsection may putyou at greater risk for type 2 diabetes, heartdisease, and other health problems—even ifyou have a normal weight. Your provider canhelp you assess your risk.(continued on page 3)
  2. 2. Table1.BodyMassIndexTableTousethetable,findtheappropriateheightintheleft-handcolumnlabeledHeight.Moveacrosstoagivenweight(inpounds).ThenumberatthetopofthecolumnistheBMIatthatheightandweight.Poundshavebeenroundedoff.NormalOverweightObeseExtremeObesityBMI192021222324252627282930313233343536373839404142434445464748495051525354Height(inches)BodyWeight(pounds)589196100105110115119124129134138143148153158162167172177181186191196201205210215220224229234239244248253258599499104109114119124128133138143148153158163168173178183188193198203208212217222227232237242247252257262267609710210711211812312813313814314815315816316817417918418919419920420921522022523023524024525025526126627127661100106111116122127132137143148153158164169174180185190195201206211217222227232238243248254259264269275280285621041091151201261311361421471531581641691751801861911962022072132182242292352402462512562622672732782842892956310711311812413013514114615215816316917518018619119720320821422022523123724224825425926527027828228729329930464110116122128134140145151157163169174180186192197204209215221227232238244250256262267273279285291296302308314651141201261321381441501561621681741801861921982042102162222282342402462522582642702762822882943003063123183246611812413013614214815516116717317918619219820421021622322923524124725326026627227828429129730330931532232833467121127134140146153159166172178185191198204211217223230236242249255261268274280287293299306312319325331338344681251311381441511581641711771841901972032102162232302362432492562622692762822892953023083153223283353413483546912813514214915516216917618218919620320921622323023624325025726327027728429129730431131832433133834535135836570132139146153160167174181188195202209216222229236243250257264271278285292299306313320327334341348355362369376711361431501571651721791861932002082152222292362432502572652722792862933013083153223293383433513583653723793867214014715416216917718419119920621322122823524225025826527227928729430230931632433133834635336136837538339039773144151159166174182189197204212219227235242250257265272280288295302310318325333340348355363371378386393401408741481551631711791861942022102182252332412492562642722802872953033113193263343423503583653733813893964044124207515216016817618419220020821622423224024825626427227928729530331131932733534335135936737538339139940741542343176156164172180189197205213221230238246254263271279287295304312320328336344353361369377385394402410418426435443Source:AdaptedfromClinicalGuidelinesontheIdentification,Evaluation,andTreatmentofOverweightandObesityinAdults.TheEvidenceReport.NIHPublicationNo.98-4083:NationalHeart,Lung,andBloodInstitute;1998.
  3. 3. 3point at which the calories coming in and the caloriesgoing out become out of balance and lead to weightgain may differ from one person to another.What other factors are involved?Your genes, the world around you, and otherfactors may all affect weight gain. Learn how toaddress these factors in the section “How can Iimprove my health?”FamilyResearch shows that obesity tends to run infamilies, suggesting that genes may contributeto obesity. Families also share diet and lifestylehabits that may affect weight. However, it ispossible to manage your weight even if obesityis common in your family.(continued from page 1)The World around YouWhere people live, play, and work may also stronglyaffect their weight. Consider the fact that obesityrates were lower 30 years ago. Since that time, ourgenetic make-up hasn’t changed, but our world has.The world around us affects access to healthy foodsand places to walk and be active in many ways:■■ Many people drive rather than walk.■■ Living in areas without sidewalks or safeplaces to exercise may make it tough to bemore active.■■ Many people eat out or get takeout insteadof cooking, which may lead to eating morecalories.■■ Most vending machines do not offer low-calorie, low-fat snacks.Overweight and obesity affect people in all incomeranges. But people who live in low-income areasmay face even greater barriers to eating healthyfoods and being active than other people. High-calorie processed foods often cost less than healthieroptions, such as fruits and vegetables. There alsomay be few safe, free, or low-cost places nearby tobe active on a regular basis. These factors maycontribute to weight gain.CultureA person’s culture may also affect weight:■■ Some cultures have foods with a lot of fat orsugar, making it hard to manage weight.■■ Family events at which people eat largeamounts of food may make it tough tocontrol portions.SleepResearch suggests that lack of sleep is linked tooverweight and obesity. Recent studies have foundthat sleeping less may make it harder to lose weight.In these studies, adults who were trying to loseweight and who slept less ate more calories andsnacked more.For more on how obesity and sleep are related,see the Resources section at the end of this factsheet for a link to the WIN fact sheet Do YouKnow Some of the Health Risks of Being Overweight?MedicineCertain drugs may cause weight gain. Steroids andsome drugs to treat depression or other mental health
  4. 4. 4problems may make you burn calories more slowlyor feel hungry. Be sure your health care providerknows all the medicines you are taking (includingover-the-counter drugs and dietary supplements).He or she may suggest another medicine that hasless effect on weight.Whatproblemsarelinkedtoexcessweight?Weighing too much may increase the risk for severalhealth problems. It also may contribute to emotionaland social problems.Health RisksType 2 diabetes, heart disease, high blood pressure,stroke, kidney disease, and certain cancers are someof the diseases linked to excess weight. Obese menare more likely than other men to develop cancerof the colon, rectum, or prostate. Obese women aremore likely than other women to develop cancerof the breast (after menopause), gallbladder, uterus,or cervix. Cancer of the esophagus (the tube thatcarries food and liquids to the stomach) may alsobe linked to obesity.Other diseases and health problems linked toexcess weight include■■ breathing problems, including sleep apnea■■ fatty liver disease (also called nonalcoholicsteatohepatitis or NASH)1■■ gallbladder disease and gallstones■■ pregnancy problems, such as gestationaldiabetes (high blood sugar during pregnancy),high blood pressure, and increased risk forcesarean section (C-section)Emotional and Social EffectsExcess weight may also contribute to emotionalsuffering. Physical beauty and how a person looksare highly valued in society. People who may notfit society’s view of beauty because of their weightmay be seen as less attractive.1 For more information on NASH, see the listing in theResources section for the National Digestive DiseasesInformation Clearinghouse.Also, because some people in our culture may viewa person with obesity as lacking willpower, peoplewith obesity may face limited options in the jobmarket, at school, and in social situations. Theymay feel rejected, ashamed, or depressed.Who should lose weight?Health care providers generally agree that peoplewho are considered to be obese (have a BMI of 30or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9),experts recommend that you avoid gaining any extraweight. If you are overweight and have other riskfactors (see below), losing weight may reduce theserisks. Experts recommend you try to lose weight ifyou have two or more of the following:■■ Family history of certain chronic diseases. If youhave close relatives who have had diseases suchas heart disease or diabetes, you may be morelikely to develop these problems.■■ Pre-existing medical problems. High bloodpressure, high LDL (bad) cholesterol levels,low HDL (good) cholesterol levels, hightriglycerides, and high blood sugar (prediabetesor diabetes) are all warning signs of some diseaseslinked to obesity.■■ Large waist size. Men who have waist sizesgreater than 40 inches and women who havewaist sizes greater than 35 inches are at higherrisk of diabetes, unhealthy blood fats (highcholesterol and triglycerides), high bloodpressure, and heart disease.Fortunately, losing even a small amount of weightcan help improve your health. This weight lossmay lower your blood pressure and improve otherrisk factors.For example, research shows that people at high riskfor type 2 diabetes who lose a modest amount ofweight and increase their physical activity mayprevent or delay type 2 diabetes. For moreinformation, see the listing in the Resources sectionfor the National Diabetes Education Program.
  5. 5. 5How are overweight and obesity treated?The best way to control your weight may dependon how much excess weight you have, your overallhealth, and how ready you are to change your eatingand physical activity habits. In some cases, if lifestylechanges do not lead to enough weight loss to improveyour health, doctors may recommend additionaltreatment, including weight-loss drugs.In some cases of extreme obesity, doctors mayrecommend bariatric surgery. For more informationon bariatric surgery, see the WIN fact sheet BariatricSurgery for Severe Obesity, listed in the Resourcessection.How can I improve my health?Although you cannot change your genes, you canwork on changing your eating habits, levels ofphysical activity, and other factors. Try the ideasbelow.Get regular physical activityTry these tips for starting or maintaining anexercise program:■■ Get at least 150 minutes (2 ½ hours) ofmoderately intense aerobic activity eachweek that raises your heart rate and makesyou sweat. Brisk walking, biking (with ahelmet), swimming, and playing tennis orbasketball are fun choices that you can dowith others for support.■■ You can spread the 150 minutes out in shortspurts over the week. Do house or yard choresbriskly, walk the dog at a quick pace, or danceto your favorite music for at least 10 minutesat a time.■■ Aim for 300 minutes (5 hours) of aerobicactivity a week to prevent gradual weightgain in adulthood. If you are at a healthyweight now but used to be overweight or obese,experts encourage 60 to 90 minutes of exercisea day to keep the weight off.Most adults don’t need to see their doctor beforestarting a physical activity program. However,those who should see a doctor include menolder than 40 and women older than 50 whoplan a vigorous program or who have either aserious health condition or risk factors for aserious health condition.Eat betterEating healthy foods has vital health benefits, too,including weight loss. To start eating better, trythese tips:■■ Eat the rainbow. Make half of what’s on yourplate fruit and vegetables.■■ Replace refined grains with whole grains, likeoatmeal, whole wheat bread, and brown rice.■■ Get your protein from healthy sources, likeseafood, lean meats, poultry, eggs, beans,unsalted nuts, and seeds.■■ Instead of sugary drinks, choose unsweetenedtea, low-fat milk, or water.Remember, weight control is a lifelong effort.Starting now with small steps may improve yourhealth. A healthy eating plan and regular physicalactivity can be steps to a healthier you.
  6. 6. 6ResearchThe National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)conducts and supports a broad range of basic and clinical obesity research. Moreinformationaboutobesityresearchisavailableat in clinical trials can play a more active role in their own health care,gain access to new research treatments before they are widely available, andhelp others by contributing to medical research. For more information, visit Reading from the Weight-control Information NetworkFor more information on topics related to healthy eating, barriers to physicalactivity,portion control,and eating and physical activity myths,refer to these WINpublications.All are available online at■■ Active at Any Size explains the benefits of regular physical activity and describesactivities that people who are overweight or obese can enjoy safely.■■ Bariatric Surgery for Severe Obesity explains how this operation on the stomachand/or intestines helps patients with extreme obesity to lose weight. Patients mayuse this fact sheet to talk about this option with their health care providers.■■ Do You Know Some of the Health Risks of Being Overweight? explains theharmful effects of being overweight and the benefits of losing weight.■■ Weight Loss for Life discusses the benefits of weight loss and helps readersplan for healthy eating and regular physical activity.This brochure also comparesdifferent types of weight-loss programs to help readers choose programs that arebest for them.Additional Resources■■ 2008 Physical Activity Guidelines for Americans■■ Body Mass Index Online CalculatorNational Heart, Lung, and Blood Institute■■ Dietary Guidelines for Americans, 2010■■ National Diabetes Education Program■■ National Digestive Diseases Information ClearinghouseInformation on NASH■■ National Kidney Disease Education Programhttp://nkdep.nih.govWeight-controlInformation Network1 WIN WayBethesda, MD 20892–3665Phone: 202–828–1025Toll-free number: 1–877–946–4627Fax: 202–828–1028Email: win@info.niddk.nih.govInternet: Weight-control InformationNetwork (WIN) is a nationalinformation service of the NationalInstitute of Diabetes and Digestiveand Kidney Diseases (NIDDK), partof the National Institutes of Health(NIH). WIN provides the generalpublic, health professionals, and themedia with science-based, up-to-date,culturally relevant materials and tips.Topics include healthy eating, barriersto physical activity, portion control, andeating and physical activity myths.Publications produced by WIN arecarefully reviewed by both NIDDKscientists and outside experts. This factsheet was also reviewed by Delia SmithWest, Ph.D., Professor, University ofArkansas for Medical Sciences.Inclusion of resources is for informationonly and does not imply endorsementby NIDDK or WIN.This publication is not copyrighted.WIN encourages you to copy and shareas many copies as desired.This publication is also available at, page 3: Sierra Faye MitchellPhoto, page 5: Centers for DiseaseControl and Prevention/Amanda MillsNIH Publication No. 06–3680November 2008Updated December 2012NIH…Turning Discovery Into Health®