What Is Obesity?
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Medically reviewed by Isabel Casimiro, MD
Obesity is a common condition that occurs when your body has an excessive number and size of fat cells. A number of factors can lead to obesity, including your family history, genetics, eating patterns, and activity levels. In the United States, about three in four adults over the age of 20 have a weight that healthcare providers consider overweight or obese. Among children and adolescents, obesity is prevalent in 20% of cases.
Healthcare providers diagnose obesity using a measurement known as body mass index (BMI). It's worth noting that BMI is a biased and outdated metric that uses your weight and height to make assumptions about your body fat and your overall health. This measurement has several flaws and doesn't factor in your body composition, ethnicity, sex, race, and age. Despite these flaws, the medical community still uses BMI because it’s a quick way to analyze health data.
If you receive a diagnosis for obesity, it's important to know that the condition is reversible and that several prevention and treatment options exist to help you improve your symptoms. Your exact treatment plan will depend on the severity of your condition and your overall health, but may include lifestyle changes, medication, and sometimes, surgery.
Symptoms
The most common symptom of obesity is a larger amount of adipose tissue (or, body fat) in the body. Obesity may cause extra body fat accumulation in any part of your body, but commonly starts around your waist.
Symptoms of obesity can also vary from person to person but may include:
Skin irritation if skin folds rub together
Body aches
Lower self-esteem
Causes
Obesity occurs when your body accumulates a larger amount of fat cells when you consume more energy (or, calories) than you need. When your body has more energy from food than it needs, an energy imbalance occurs. As a result, your body then stores the excess energy from your food as body fat. The increase in body fat thereby boosts your risk of developing obesity.
Risk Factors
Several factors affect how your body uses and stores energy. The following factors increase your risk of obesity:
Eating foods that are high in energy, such as sweets, fried foods, and processed foods
Not moving your body enough or participating in physical activity or exercise
Residing in an area without proper access to nutritious food or outdoor spaces to walk
Taking medications such as antidepressants, beta-blockers, and hormonal birth control
Having a family history of obesity or conditions that affect your metabolism
Living with health conditions such as metabolic syndrome or polycystic ovary syndrome (PCOS)
Experiencing excessive amounts of stress
Getting less sleep than your body needs to recover from daily activities and stressors
Diagnosis
Healthcare providers diagnose obesity using a tool called the body mass index (BMI). Providers calculate BMI solely based on your height and weight. BMI is an imperfect tool, as it does not take into account any other health factors.
You can calculate your own BMI by using the following formula: divide your weight by your squared height, and multiply that sum by 703. However, the Centers for Disease Control and Prevention (CDC) offers a free BMI calculator that may be easier to use. BMI charts categorize weight by using the following measurements:
Obese: A BMI of 30 or higher
Overweight: A BMI between 25 and 29.9
Healthy weight: A BMI between 18.5 and 24.9
Underweight: A BMI of 18.4 or lower
In addition to BMI, healthcare providers may also consider your waist circumference (or, the measurement around your waist). Research suggests that a larger amount of adipose tissue (body fat) around your abdomen may increase your risk of chronic health conditions like heart disease or diabetes. Your provider may tell you that you're at risk for these conditions if your waist circumference falls in these measurements:
40 inches or more for people assigned male at birth
35 inches or more for people assigned female at birth
Treatment
Fortunately, obesity is treatable and can be reversed. The goal of treatment is to reduce obesity by decreasing body fat and maintaining a lower weight. Your healthcare provider may recommend a combination of treatments, such as lifestyle changes, medications, surgery, or medical devices.
Lifestyle Changes
For many people who live with obesity, lifestyle changes are usually the first line of treatment. Lifestyle changes refer to the ways that you can alter how your body uses and stores energy from food. It's worth noting that lifestyle changes are most effective when you use more than one of these changes together:
Developing a more nutritious eating plan: Meet with a nutritionist or dietician to develop an eating plan based on how many calories and nutrients your body needs
Engaging in more physical activity: Healthcare providers recommend at least 150 minutes of moderate-to-intense physical activity each week
Considering weight-loss counseling: This program pairs you with a weight-loss specialist so you can meet at least 14 times over 6 months to monitor your condition and receive support during treatment
Monitoring your eating and exercise habits: Keeping track of your lifestyle changes by tracking your food intake or exercise sessions has been found to be an effective weight loss tool
Medications
When lifestyle changes alone are not effective, your healthcare provider may likely recommend adding medication to your treatment plan. Obesity drugs work in different ways to help you feel less hungry. Some of the medications also change how your body absorbs fats from your diet. It's important to use obesity medications in conjunction with lifestyle changes.
The U.S. Food and Drug Administration has approved the following drugs for weight loss and obesity treatment:
Alli (orlistat): Reduces the amount of fat your body can absorb
Qsymia (phentermine-topiramate): Lowers appetite and causes you to feel full sooner
Contrave (naltrexone-bupropion): Helps you to feel full sooner
Saxenda (liraglutide): Affects appetite and can treat type 2 diabetes
Wegovy (semaglutide): Regulates appetite and may reduce cravings
Ozempic (semaglutide) is another medication that is becoming more common. However, Ozempic has only been approved as a diabetes treatment and is not currently approved for weight loss.
Surgery
Your healthcare provider may recommend weight loss surgery if lifestyle changes and medications have not been effective in treating your condition. There are several types of surgeries available, and your provider will discuss the options that are best fit for you.
You may need surgery if you are experiencing other chronic health conditions in addition to obesity. These may include diabetes or sleep apnea. The goal of weight-loss surgery is to make your stomach smaller to help you feel full faster.
There are three main types of weight-loss surgeries, which include:
Gastric sleeve: Removes most of the stomach and leaves a small, banana-shaped section for you to digest and process food.
Gastric bypass: Staples the stomach to create a small pouch, then divides the small intestine into two sections and attaches the stomach pouch to the lower part of the small intestine
Adjustable gastric band: Places an inflatable band around the top of the stomach to make a small pouch
Devices
Finally, your healthcare provider may recommend a weight-loss device. Unlike surgery, these devices do not permanently change your stomach size. However, weight-loss devices are still considered a new treatment and more research is needed to understand their effectiveness.
If your provider recommends a weight-loss device, your options may include:
Inflatable balloon: Your healthcare provider places a balloon in the stomach and fills it with saline to take up space in the stomach and help you feel full sooner. They will remove the balloon after six months.
Gastric emptying device: Your provider places a tube from the inside of your stomach to the outside of your abdomen. After eating, you can use the tube to empty your stomach and prevent your body from absorbing about 30% of the food you just consumed.
How to Prevent Obesity
Many of the factors that lead to obesity can be changed. In most cases, obesity is reversible and even preventable. The lifestyle changes that you can use to treat obesity can also prevent the condition. To lower your risk of obesity, follow these guidelines:
Eat nutritious foods, such as fruits, vegetables, legumes, whole grains, and nuts
Avoid high-energy foods like sweets, fried foods, and processed foods
Participate in physical activity or exercise for 150 minutes each week
Manage stress with mindfulness, journaling, yoga, or other hobbies you enjoy
Focus on getting good quality sleep by avoiding caffeine and big meals before bed
Related Conditions
An excessive amount of body fat affects how your body’s other systems work. As a result, obesity can increase inflammation in your body and increase your risk of the following conditions:
Certain cancers, such as endometrial, breast, ovarian, prostate, liver, kidney, and colon
Arthritis and related conditions that cause joint pain
Infertility or trouble conceiving
Pregnancy complications such as gestational diabetes and preeclampsia
It's also important to note that some conditions can actually cause weight gain and increase your risk of obesity. Health conditions that can contribute to obesity include:
Cushing’s syndrome: Causes your body to make too much stress hormone (cortisol)
Hypothyroidism: Decreases how much thyroid hormone your body is creating, which slows down your metabolism
Polycystic ovary syndrome: Affects the functioning of your ovaries and leads to hormonal imbalances
Living With Obesity
Obesity is a chronic condition that affects many areas of your life. Fortunately, the condition is treatable. However, adhering to your treatment plan can be quite challenging at times as it may require you to make significant changes to your lifestyle habits. That said, finding support through your healthcare team and loved ones can aid your treatment.
Research shows that obesity can also affect your mental health and well-being. People with obesity are more likely to experience chronic stress, low self-esteem, and depression. This may be due to the fact that people with obesity are more likely to experience weight-related bias and stigma. If you're experiencing changes to your emotional wellness, consider seeking support from a mental health therapist or support group.
Frequently Asked Questions
How do you speed up your metabolism if you have obesity?
Your metabolism determines how your body burns calories from food for energy. Your genes can affect your metabolism, so it may not be possible to alter it. However, you can increase the number of calories your body burns by exercising, lifting weights, and getting good quality sleep.
Is obesity considered a disability?
Obesity on its own is not considered a disability by the Americans with Disabilities Act (ADA). However, obesity may lead to chronic conditions that may be included under the ADA.
How long does it take to reduce obesity?
The time it takes to treat obesity depends on each person and several other factors including the severity of the condition and your overall health. Most healthcare providers recommend making it a goal to lose 5% of your body weight in 6 months when beginning obesity treatment.
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