The primary health risks related to obesity are heart disease, hypertension (high blood pressure), diabetes and musculoskeletal disorders. The connection between diabetes and obesity is particularly strong. Those who are obese are more likely to have blood vessel disorders and are less likely to exercise. Being overweight or obese increases the stress on joints, especially in the knees, hips and ankles, which can result in degenerative problems in these joints.
Part of the reason it’s hard to lose weight is that people can’t just stop eating the way they can stop smoking. Food is readily available for many people, and it tends to be high in calories, fat and sugar, all of which add pounds. Food is also a big part of family and social activities, and it’s very hard to not eat when everyone else is eating. Most people are also genetically programmed to gain or maintain body weight, which was a survival advantage in the past when food was not as readily available.
The body mass index (BMI) is what most doctors use to determine if a patient is overweight or obese. The BMI is a mathematical comparison of a person’s height and weight; it indicates how much of the total body weight is fat. A BMI between 18.5 and 24.9 is considered to be a “normal” weight. A person is overweight if the BMI is 25 to 29.9 and obese if the BMI is 30 or above. The BMI can be deceptive in those who are very muscular because muscle weighs more than fat.
Unlike weight-loss programs such as Weight Watchers, medical weight loss includes some other strategies than just diets and education about food. A medical evaluation is a very important part of the process because it can identify specific risk areas, such as insulin resistance (pre-diabetes) or high blood pressure. Laboratory and diagnostic testing can indicate other health problems. Most medical weight-loss programs include consultations with both the medical provider, dietitian and some include support groups with trained mediators.
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