Obesity

What is obesity?

Obesity is a disease that means having too much body fat. It is different from being overweight, which means weighing too much. Both terms mean that your weight is greater than what's considered healthy for your height.

Body Mass Index (BMI) measures how much you weigh compared to how tall you are. An adult who has a BMI of 30 or more is considered to have obesity. Severe obesity is having a BMI of 40 or higher. Obesity increases your risk for many other diseases and health problems, especially if the extra body fat is carried around the waist.

What raises your risk of obesity?

Obesity happens over time from taking in more calories (through food and drinks) than used up from physical activity and daily living. Your body stores the extra calories as fat. The right balance between calories and activity is different for everyone.

There are many different factors that can affect your body weight. Certain medicines or medical conditions may affect your weight. Other factors include your:

• Genetic makeup
• Eating habits
• Sex
• Race or ethnicity
• Physical activity level

How is obesity diagnosed?

To find out if you have obesity, your health care provider may:

• Ask about your health history, which may include reviewing your weight history, weight-loss efforts, and how physically active you are.
• Do a physical exam, which may include checking your height, weight, and vital signs, as well as listening to your heart and lungs.
• Order blood tests or other imaging tests, which may include checking any known health problems, as well as for other weight-related diseases and health conditions.
• Calculate your BMI, to check your risk for certain diseases. The higher your BMI, the higher your risk. BMI does not distinguish between fat, muscle, and bone mass. It may also overestimate body fat in athletes or those with a muscular build, or underestimate body fat in older persons, or others who have lost muscle.
• Check your waist size, since a large waistline, with more body fat around your abdomen (belly) rather than your hips, increases your risk for weight-related health problems.

What health problems can obesity cause?

Having a larger body size can make your heart work harder, put extra pressure on your joints, and may increase your risk for many health conditions, including:

• Type 2 diabetes.
• Heart disease.
• High blood pressure.
• Stroke.
• Metabolic syndrome.
• Osteoarthritis.
• Sleep apnea.
• Pregnancy problems.
• Fertility problems.
• Some cancers.

If you have obesity, losing even 5 to 10% of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds.

What are the treatments for obesity?

Treatment plans for obesity may depend on your overall weight, other health conditions, and your willingness to participate in a weight-loss plan.

Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight. They may refer you to other providers that specialize in nutrition or weight loss to help you make realistic goals and provide support.

Possible treatments may include:

• Dietary changes and exercise goals to help you learn how to adopt healthy nutrition, exercise, and lifestyle changes to lose weight safely and keep it off long term.
• Counseling or support groups can give you encouragement and help you understand what's behind weight changes.
• Weight-loss medicines to treat obesity.
• Weight loss procedures or surgery if you have severe obesity or serious obesity-related health problems and have not been able to lose enough weight.

A healthy lifestyle that includes healthy eating patterns and regular physical activity can help you lose weight and lower your chance of developing complications related to obesity.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Obesity in Children

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Children grow at different rates, so it isn't always easy to know when a child has obesity or is overweight. Ask your health care provider to check whether your child's weight and height are in a healthy range.

If a weight-loss program is necessary, involve the whole family in healthy habits so your child doesn't feel singled out. Encourage healthy eating by:

• Serving more fruits and vegetables
• Buying fewer soft drinks and high-fat, high-calorie snack foods
• Making sure your child eats breakfast every day
• Eating fast food less often
• Not using food as a reward

Physical activity is also very important. Kids need about 60 minutes each day. It does not have to happen all at once. Several short periods of activity during the day are just as good.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Pancreas Transplantation

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. A pancreas transplant is surgery to place a healthy pancreas from a donor into a person with a diseased pancreas. It is mostly done for people with severe type 1 diabetes. It can allow them to give up insulin shots. An experimental procedure called islet cell transplantation transplants only the parts of the pancreas that make insulin.

People who have transplants must take drugs to keep their body from rejecting the new pancreas for the rest of their lives. They must also have regular follow-up care. Because of the risks, it is not a common treatment for type 1 diabetes.

Peripheral Arterial Disease

Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis. This happens when plaque builds up on the walls of the arteries that supply blood to the arms and legs. Plaque is a substance made up of fat and cholesterol. It causes the arteries to narrow or become blocked. This can reduce or stop blood flow, usually to the legs. If severe enough, blocked blood flow can cause tissue death and can sometimes lead to amputation of the foot or leg.

The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke.

Many people who have PAD don't have any symptoms. If you have symptoms, they may include:

• Pain, numbness, achiness, or heaviness in the leg muscles. This happens when walking or climbing stairs.
• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg than the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

PAD can increase your risk of heart attack, stroke, and transient ischemic attack.

Doctors diagnose PAD with a physical exam and heart and imaging tests. Treatments include lifestyle changes, medicines, and sometimes surgery. Lifestyle changes include dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.

NIH: National Heart, Lung, and Blood Institute

Peripheral Nerve Disorders

What are peripheral nerves?

Nerves are like wires that carry messages back and forth between your brain and your body. Your peripheral nerves branch off from your brain and spinal cord and connect to all parts of your body, including your muscles and organs. Peripheral nerves carry messages from your brain that control your movement, breathing, heartbeat, digestion, and more. They also carry messages from your body to your brain, so you can feel things, such as pain, heat, and cold.

What are peripheral nerve disorders?

Peripheral nerve disorders happen when one or more peripheral nerves are damaged. Damaged nerves may not carry messages correctly, or they may not work at all. As a result, you may have pain, trouble walking, or a variety of other problems, depending on which nerves are involved.

Peripheral nerve disorders are very common. There are more than 100 different types.

What causes peripheral nerve disorders?

Many things can damage nerves and lead to peripheral nerve disorders:

• Diabetes is the most common cause of peripheral nerve disorders. Most people with diabetes will develop diabetic nerve problems.
• Physical injury (trauma) that stretches, crushes, squeezes, cuts, or puts pressure on one or more nerves. Some examples of peripheral nerve disorders from physical injury include complex regional pain syndrome and brachial plexus injuries.
• Health conditions, including:
  • Certain cancers and their treatment (chemotherapy and radiation therapy).
  • Infections, such as HIV and Lyme disease.
  • Problems with blood or blood vessels.
  • Autoimmune diseases, such as rheumatoid arthritis and lupus.
  • Kidney or liver disease.
• Certain medicines.
• Contact with certain toxic substances, such as lead or mercury.
• Alcohol use disorder (AUD) and smoking.
• Vitamin imbalances, especially a lack of vitamin B12.
• Your genes, including changes in your genes or conditions that you inherit from your parents, such as Charcot-Marie-Tooth disease.

In certain cases, the cause of peripheral nerve disorder is not known.

What are the symptoms of peripheral nerve disorders?

The symptoms of peripheral nerve disorders depend on which nerves are affected, what is causing the damage, and how serious it is:

Types of nervesPossible symptoms of nerve damageMotor nerves control your muscles and all your movement, such as walking, talking, and using your hands.

• Weak or aching muscles
• Problems with balance, walking, or using your arms and hands
• Cramps or twitching muscles
• Muscle shrinking

Sensory nerves carry messages to your brain from your senses, including touch, hot and cold, and pain.

• Tingling, numbness, or pain often in the hands and feet
• Not being able to feel heat, cold, or pain, such as a cut on your foot
• Pain from even light touch

Autonomic nerves send messages to your organs to control breathing, digestion, and other body functions that happen without thinking about them.

• A heartbeat that's too fast or too slow
• Trouble swallowing
• Sweating too much or too little
• Vomiting, diarrhea, or constipation
• Problems with urination or sexual function

Symptoms may range from mild to very strong. They may develop quickly over days or slowly over months and years. But they are rarely life-threatening.

How are peripheral nerve disorders diagnosed?

To find out if you have a peripheral nerve disorder, your provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests, which may include:
  • Blood tests
  • Genetic tests
  • Nerve tests that measure:
    • Electrical activity in your nerves and muscles
    • How well your autonomic nerves are working
  • A biopsy of nerve or skin tissue
  • CT or MRI scan to see what may be pressing on your nerves

What are the treatments for peripheral nerve disorders?

It's important to treat any conditions that are causing nerve damage. In certain cases, that will allow your nerves to heal over time.

Treatment for symptoms depends on the type of peripheral nerve disorder you have, where it is, and how severe. Treatment options include:

• Braces or splints
• Over-the-counter patches and skin creams
• Prescription medicines
• Non-drug pain management, such as electrical stimulation or relaxation therapy
• Surgery to relieve pressure on a nerve

Can peripheral nerve disorders be prevented?

You can help prevent peripheral nerve disorders by:

• Managing health conditions that may cause nerve damage, especially diabetes
• Preventing falls and accidents
• Avoiding toxic substances
• Being careful to avoid repeated motions and body positions that press on your nerves
• Eating a balanced diet, exercising, limiting alcohol, and not smoking

NIH: National Institute of Neurological Disorders and Stroke