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preventive health services

Obesity

Why is this important?

Obesity is a complex health issue to address. Almost 70 percent of Americans are overweight or obese. Obesity results from a combination of causes and contributing factors, including individual factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.

People who are obese are more likely to develop heart disease, diabetes, and some cancers, as well as to die early. Losing weight can reduce the risk for illness and early death and improve overall health.

Many factors determine whether a person will become obese. Americans now live in an environment that encourages us to eat too much and discourages us from being physically active. Families, communities, employers,  government, and the medical system all have a role to play in helping people achieve and maintain a healthy weight. The number of individuals needed to reduce their body fat and eliminate a health condition such as diabetes from developing, is approximately seven individuals.

People who are obese, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including the following:

All causes of death (mortality)

  • High blood pressure (Hypertension)
  • High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Gallbladder disease
  • Osteoarthritis (a breakdown of cartilage and bone within a joint)
  • Sleep apnea and breathing problems
  • Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
  • Low quality of life
  • Mental health issues such as clinical depression, anxiety, and other mental disorders
  • Body pain and difficulty with physical functioning

In women, overweight and obesity are highest among non-Hispanic Black women about four in five, compared with about three in four percent for Hispanic women and two in three percent for non-Hispanic White women.

In men, overweight and obesity are highest among Hispanic men about four in five, compared with about three in four for non-Hispanic White men and about three in four for non-Hispanic Black men.

What are the Risks?

The experts found that the harms of screening for obesity and offering weight loss programs are small. The experts reviewed studies on the benefits and harms of intensive behavioral counseling to prevent heart disease among adults who are overweight or obese and are at increased risk for heart disease. Evidence shows that effective programs generally involve multiple sessions of face-to-face or telephone contact, spread out over several months to a year.

The main potential benefits of behavior change programs are to help obese people change their eating and physical activity behaviors, lose weight, and reduce their risk for diseases such as heart disease, high blood pressure, and diabetes. The experts found that intensive, comprehensive programs led to modest weight loss and improved risk factors for diabetes and other contributors to heart disease. The experts found little evidence, however, about the long-term effect of these programs on reducing illness and death from heart disease.

How can the MUSC healthcare team help you in planning a weight management/obesity reduction program?

When you visit your MUSC Health care team member, he or she usually weighs you and measures your height. These two numbers are used to calculate your body mass index (BMI). BMI indicates whether you are at a healthy weight or whether you are overweight or obese. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, and diabetes.

Your MUSC Health care team member also might want to measure the size of your waist (your waist circumference). This can help screen for possible health risks that develop when a person is overweight or obese. If most of your fat is around your waist rather than around your hips, you are at higher risk for heart disease and diabetes.

If your MUSC Health care team member finds that you are obese, he or she may suggest that you join a weight management program. Even modest weight loss can reduce health risks in people who are obese.

Frequently asked questions about overweight and obesity screening and counseling

What Causes Obesity?
A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT.

Energy IN is the amount of energy or calories you get from food and drinks. Energy OUT is the amount of energy your body uses for things like breathing, digesting, and being physically active.

To maintain a healthy weight, your energy IN and OUT don’t have to balance exactly every day. It’s the balance over time that helps you maintain a healthy weight.

  • The same amount of energy IN and energy OUT over time = weight stays the same
  • More energy IN than energy OUT over time = weight gain
  • More energy OUT than energy IN over time = weight loss

Overweight and obesity happen over time when you take in more calories than you use.

What are Health Behaviors for Losing Weight?
Healthy behaviors include a healthy diet pattern and regular physical activity. Energy balance of the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain. Healthy diet pattern follows the Dietary Guidelines for Americans which emphasizes eating whole grains, fruits, vegetables, lean protein, low-fat and fat-free dairy products, and drinking water. The Physical Activity Guidelines for Americans recommends adults do at least 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity, or a combination of both, along with two days of strength training per week.

Do Genes Have a Role in Obesity?
Though genetic changes in human populations occur too slowly to be responsible for the obesity epidemic studies have identified variants in several genes that may contribute to obesity by increasing hunger and food intake. Nevertheless, the variation in how people respond to the environment that promotes physical inactivity and intake of high-calorie foods suggests that genes do play a role in the development of obesity, but remain poorly understood and need greater study.

Can a Disease or Medication Influence Obesity?
Some illnesses may lead to obesity or weight gain. These may include Cushing’s disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may  also  cause  weight  gain. The science continues to emerge on the  role of other factors in energy balance and weight gain such as chemical exposures and the role of the microbiome (e.g., the role of good and bad bacteria in the gut and their influence on energy regulation).

A health care provider can help you learn more about your health habits and history in order to tell you whether behaviors, illnesses, medications, and/or psychological factors are contributing to weight gain or making weight loss hard.