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DEFINITION: Many confuse the terms obesity and overweight.Overweight is an excess amount of weight that includes all tissues such as, muscle, bone, fat, and water. Obesity is the oldest metabolic disorder. It is a chronic disease which is defined as one who is 20% over ideal body weight. Excess weight must be fat weight; not muscle or excess water weight. Most people who are overweight are also obese.

There are many ways to find out if one is obese. The first and the oldest way is the idea of the height-weight tables. These tables give one's "ideal" weight for their height. insurance companies developed the first height and weight table in 1908. Its original purpose was to determine insurance rates based on life expectancy studies. In 1942, Metropolitan Life Insurance Company introduced the terms "ideal weights for men and women". The term "desirable weight for height" was introduced in 1959.

This is a very controversial method of diagnosing obesity. There are controversal issues concerning which height and weight table best fits the health issues of the population. These tables don't give weights to which an individuals is the healthies or looks his/her best. A women who is 5 foot 3 inches may weight 140 lbs and have a percent body fat of 18% will be considered obese by these height and weight tables. Many doctors and other health experts are trying to do away with using the height-weight table.

There is an indirect method called densitometry. This method first weigh individuals in air then in water. From these measurements, density is calculated. Using formulas we can determine the amount of fat in the body.

Another indirect method is called hydrometry in which we can measure the total body water by injecting the subject with a diluting substance.

Calculating body mass index (BMI) is another way of diagnosing obesity. It considers one's body fat instead of body weight. If one's body mass index in greater than 24 kg/m2 they're consider obese. To calculate BMI, multiply weight (lbs.) by 703. Then divide it by the square of height in inches. (example: (130 lbs. * 703)/ (62*62 inches) ).

And finally, the last method I will mention is the most used to diagnose obesity; body composition. Body composition is calculating an individual's body fat percentage. There are different assessments to use to calculate body composition.

With the use of calipers to measure certain skinfolds on the body we can determine one's fat percentage. This is the most precise when tested against other methods. The technician folds the skin from designated areas on the body. Some of these areas are the quadricep, tricep, and subscapular region. The technician pinches the skin and uses the caliper to measure it. The fat under the skin is an estimate of fat percentage.

This method uses an instrument which sends an electrical signal through the body. This electrical current detects the amount of water in the body. The more water there is in the body, the more lean body tissue. This measurement isn't as reliable as the above.

This is probably the most reliable measure of estimating body composition. An individuals' body density can be measured using hydrostatic weighing. The individual is submerged in water and he/she blows out to get rid of as much air as possible in the lungs (total lung volume). Also, the water that is displaced is measured. Though this method is quite accurate, it is timely and not very convenient.

Determinine the circumference of the waist at its smallest point and the circumference of the hip at its widest point. Calculate the ratio between the two. The recommended waist hip ratio for women is below .95 and for men it is .85. The wait ratio is a good indicator to classify people as either "apple" shape (android) or "pear" shape (gynoid). If a person has a high wait to hip ratio, then they are more likely to be android. Android people carry most of their weight in the abdominal region. Lower wait to hip ratios indicates more of a gynoid shape; most of the weight in the buttocks and hip area.

Looking at yourself naked in the mirror is usually a good indicator for estimating obesity. If you look fat, then you probably are fat.

If one can pinch more than an inch, this is a good indication that there is much excessive fat.

Put a ruler against the abdomen while lying flat on your back. If the ruler has a slope then there is excessive fat, if the ruler doesn't have a slope then there isn't.

There are many causes of obesity. Many think that obesity is only caused from overeating and not exercising. Yes, this is one of the major causes of it but there are others. Obesity is a disease. For many people this disease is hereditary. If one's parents are obese then their probability of becoming obese is quite high. There was a study done of 800 Danish adoptees. They found that there was no relation between body weight of the adopted children and adopted parents. However, there was a close relationship between the children and their biological parents.

Energy Expenditure: As was mentioned, obesity is caused from overeating and not expending this excess energy. We must try to maintain the energy balance equation; ENERGY IN = ENERGY OUT. If the energy taken in isn't expended then it goes to storage as fat. Inactivity is another concern for obese individuals. Those who overeat also tend not to exercise. Inactivity is a result of our social and economic conditions which have eliminated the need for physical work. Exercising uses excess energy or "fat" that we have stored.

Metabolism and obesity: Obesity isn't caused just from overeating and inactivity. Some obese individuals may have a metabolic disorder in which there is structural error in metabolism which causes an increase in fat to be formed when no overeating takes place. There is another disorder in which the part of the nervous mechanism that regulates food intake malfunctions and leads to overeating. Such disorders are hypothyroidism, Cushings syndrome, depression, and certain neurologic problems. Drugs such as steroids and some antidepressants, may cause excessive weight gain. These conditions account for about 1% of obesity.

Many times obesity is causes by genetics. Evidence points to heredity as a strong determining factor of obesity. Obesity often runs in families. It's not only the genes that is inherited from family, but also diet and lifestyle habits that can contribute to obesity. Studies have shown that even children who are adopted, have similar weights to their biological parents, not their adopted parents.

Environment also plays a huge part in many cases of obesity. Environment includes lifestyle behaviors such as what and how much a person eats and how active he/she is. Today, people tend to have high fat diets. People claim they are too busy to cook or look for nutritional meals. They eat whatever is fast and convenient. Most people also don't get enough exercise. Many say they're too tire after work or they just simply don't have the time. People can't change their genetic makeup, but they can change their eating and exercise habits.

There are psychological factors that may influence eating habits. Many people eat during times of boredom, sadness, depression, anger, and other negative emotions. Most obese individuals don't have any more psychological disturbances than normal weight people. However, about 30% of people who seek treatment for weight problems have a hard time with binge eating. During binge eating, people eat a large amount of food while not feeling in control of how much they are eating. People with binge eating disorders have a harder time losing weight than those who don' have this disorder.

Obesity is a huge health problem, not just a cosmetic problem. An obese individual who is 40% overweight is twice as likely to die prematurely as an average-weight individual. Obesity is also linked to severe health risks.

Obesity is a serious disease. Not only does it affect obese individuals physically, but also emotionally. Nobody wants to be fat. In today's society it is "unattractive" to be fat. Fat people are thought to be lazy, gluttons, and even sometimes dirty. Obese individuals often face prejudice and discrimination at work, school, and in public. Obese individuals often feel shameful, rejected, and most of all depressed.

Childhood obesity is more common than we think. About 25-30% of children are obese. A child has an 80% risk of becoming obese if his/her parents are; compared to only 10% risk if the parents aren't obese. Obese adolescents are at a very high risk of becoming obese adults.

Family History

High-fat diet of average american diet

High-calorie diet (snacks)

Inactivity

Children today spend much of their time indoors watching telelvision and playing video games. The activity levels of children is decreasing more and more. Besides their inactivity, children are also eating more. Kids are "hung-up" on high fat foods like McDonald's. Kids are always eating snacks throughout the day. These snacks don't usually consist of apples and bananas, but usually cup cakes, chips, or cookies.

In the past 20 years, childhood obesity has increase 54% among 6-11 year olds. Overweight and obese childen deal with both psychological and physical stresses. However, overweight children don't have to become overweight adults. Here are a few things parents can do to help their children avoid future weight problem:

Parents should make nutritious meals and snacks as well as exercise as a whole family. This way the child will feel included in a total family effort and the focus will be on health and not just the one isolated problem. In general, weight loss is not recommended for most children. Most of the time the child's weight becomes appropriate for their height. If a child must lose weight, the recommended loss shouldn't exceed 1 lb. per month. Children should never be put on a low calorie, deprivation diet.

Treatments for obesity include strict low calorie diets, exercise, medication, and surgery. Depending on ones' severity of this disease is what is recommended for treatment.

The very low calorie diet is a popular treatment for obesity. It consists of a 800-1000 kcal per day and limited fat. This diet is monitored by physicians and nutritionists. Along with these very low caloried diet accompanies exercise. Patients start these exercises at a very low intensity and short durations. The patient is monitored until they are almost at their goal weight. Meanwhile, the patient must keep up the program by themselves with monthly or bi-monthly check-ups. People who go on the very low calorie diet usually gain all their weight back within 2-3 years, and sometimes more.

The problem with many people is they Yo-Yo diet. They decrease their calorie intake and lose weight. They go off the diet and gain more weight than they started off at. Another problem are fad diets such as Slim Fast and Nutri-system. These diets do help in losing weight, but keeping it off is another story.

Drugs are new to the treatment of obesity. Just recently the drug Dexfenfluramine was approved by the FDA. This drug causes a release of seratonin; a neurotransmitter in the brain from the pre-synaptic neuron. Dexfenfluramine increases the level of seratonin. It stimulates the hypothalamus; area of the brain that controls satiation, mood, sleep, and body temperature.

Dexfenfluramine is also known as REDUX. This drug is considered an anorexic drug in which is acts as an appetite suppressant. Treating obesity is a life long process in which Dexfenfluramine must be taken; in most cases. However, in the United States it is only approved for up to one year usage.

Though Dexfenfluramine does aid in losing weight, there are some disadvantages to this drug. One such condition is Primary Pulmonary Hypertension. This condition only affects about 1 in 17,000 Dexfenfluramine users. This side effect causes a shortness of breath. However, even though the user may stop the drug, this symptom may never go away. This disease may cause the patient to get a lung or hear and lung transplant. Another side effect is Dexfenfluramine has been shown to cause some damage to serotonin neurons in the brain. This damage may cause a depletion in seratonin. Low levels of seratonin cause mood disorder, sleep disorder, and depression.

Another drug is know as Fen-Phen. This drug offers a modern and healthy choise in losing weight. It works on two neurotransmitters, dopamine and seratonin. It manages hunger and helps in treating eating disorders as wll as obesity. It is also know for treating alcoholism and drug abuse.

Both these Surgeries contain a small stomach pouch of about half to one ounce with a small connection to therest of the gastrointestinal tract.

The advantage with gastric bypass is the individual will have greater weight loss. However, there are higher risks of nutrient deficiences. Besides greater weight loss there is a greater chance the individual will be able to maintain this weight reduction.

Most people who want to lose weight want to lose it as quick as possible. However, people who lose weight too fast, put the weight back on faster than they took it off. When weight is lost too fast, muscle or lean mass is lost too not just fat. When weight is regained, it is usually just fat, not the muscle you lost.

Fad diets ARE NOT the way to go. These diets aren't nutritionally balanced. Fad diets aren't the diets that people can live on for the rest of their lives. Diets should be a permanent lifestyle change. Some fad diets include liquid diets, Jenny Craig, and other such diets that are only temporarily. Besides gaining the weight back, these diets may also have effects on the individuals pschological well-being.

Exercise is the most important role in weight loss and weight management. Exercise burns energy. The more one exercises the more energy expenditure. Besides losing weight, exercise also allows us to keep our lean body mass (muscle). The individual should choose an exercise they enjoy doing and one that will increase the heart rate.

Behavior modification means changing your lifestyle that allows you to have control it. Here are a few things that behavior modification entales:

Leptin is the newest possible treatment for obesity. It hasn't been proven yet, however it has shown a significant weight loss in mice. Researchers injected the protein leptin into "fat" mice. After a few days there was significant weight loss. Though this isn't a treatment yet, perhaps someday it might even be a cure.

Chinese herbs have been around for centuries. They have been know to help relieve symptoms and even cure certain disorders and diseases. Some of these disorders include depression, pre-menstrual syndrom, headaches, and nausea. There are now herbs that can help treat overweightness and obesity. These herbs haven't been scientifically proven, but many do believe in these herbs.

Obesity is a serious disease. There are treatments for it. However, all of these treatments have side effects and no guarantee that they'll work. There isn't a cure for obesity. The only thing we can do is help modify it and learn more about.