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Overweight and Obesity

What Are Overweight and Obesity?

Overweight and obesity are common conditions in the United States that are defined as the increase in size and amount of fat cells in the body. Overweight and obesity are caused by many factors including behaviors like eating patterns, lack of sleep or physical activity, and some medicines, as well as genetics and family history. Obesity is a chronic health condition that raises the risk for heart disease — the leading cause of death in the United States — and is linked to many other health problems, including type 2 diabetes and cancer.

Nearly 3 in 4 adults age 20 or older in the United States have either overweight or obesity. Nearly 1 in 5 children and teens ages 2 to 19 years have obesity. Overweight and obesity can lead to serious health issues for people of all ages.

Healthcare providers use body mass index (BMI) to screen for overweight and obesity in adults. BMI is a measure of body fat based on height and weight and is defined as the body mass (in kilograms) divided by the square of the body height (in meters) and expressed in units of kg/m². Your provider may talk to you about overweight and obesity if your BMI shows that your weight is above average for your height. But there is more to obesity than BMI.

Unhealthy lifestyle habits, such as not getting enough physical activity and eating high-calorie, low-nutrient foods and beverages, can raise your risk of overweight and obesity. Some people find that their weight goes up when they start taking medicine for another health condition such as diabetes, depression, or high blood pressure. Talk to your provider before you consider stopping any medicine you are taking for another condition that you think is also impacting your weight.

Lifestyle changes that can reduce weight include following a heart-healthy eating plan lower in calories and unhealthy saturated fats and increasing physical activity. The Food and Drug Administration (FDA) has also approved medicines and other treatments for weight loss. Surgery may also be a treatment option but is not available for everyone.

Symptoms and Diagnosis

There are no specific symptoms of overweight and obesity. Your healthcare provider may diagnose overweight and obesity based on your medical history and high body mass index (BMI). Your provider may also order tests to rule out other medical conditions.

Body mass index

Your BMI is a measure of body fat based on your weight and height. It is important to know that body mass index is a screening tool and does not necessarily diagnose body fatness. Other related measures, such as waist circumference, are used to evaluate a person’s health and risk of overweight and obesity.

BMI categories for adults

For adults:

Underweight is a BMI of less than 18.5

Healthy weight is a BMI of 18.5 to 24.9

Overweight is a BMI of 25 to 29.9

Obesity is a BMI of 30 or above

BMI categories for children

For children, height and weight are shown in percentiles. A child’s BMI percentile is calculated by comparing the child’s BMI to growth charts for children who are the same age and sex.

Underweight is a BMI below the 5th percentile.

Healthy weight is a BMI between the 5th and the 85th percentile.

Overweight is a BMI between the 85th percentile and the 95th percentile.

Obesity is a BMI in or above the 95th percentile.

The U.S. Preventive Services Task Force recommends that providers screen for obesity in children beginning at age 6.

Unhealthy body fat distribution

To better understand the health risks that overweight and obesity may pose to a specific person providers can measure the person’s distribution of body fat. You may have a normal BMI but if you have a large waist circumference, you may have more fat in your abdomen than elsewhere.

For men, an unhealthy waist circumference is greater than 40 inches.

For women, an unhealthy waist circumference is greater than 35 inches.

Fatty tissue is found in different parts of your body. Fatty tissue produces hormone, cushions your joints, and stores energy.

However, depending on where the fatty tissue is found, it may do more harm than good. Fatty tissue found inside your abdomen is called visceral or abdominal fat. We do not know what causes the body to create and store visceral fat. But we do know that this type of fat interferes with your body’s endocrine and immune systems. It also promotes inflammation and contributes to obesity-related complications, including heart disease and diabetes.

Talk to your healthcare provider about your BMI results and body fat distribution and what steps you may need to take to reach a healthy weight.

Testing for causes of overweight and obesity

Sometimes other medical conditions or medicines that you take may lead to overweight and obesity. These conditions or medicines may disrupt the delicate balance of hormones that control how we use and store energy. Your provider may order blood tests to rule out one of these conditions.

Cushing’s syndrome is a disorder that happens when your body makes too much of the stress hormone cortisol.

Hypothyroidism is a condition in which your body does not produce enough thyroid hormone. This slows down your body’s use of energy (food), called metabolism.

Polycystic ovary syndrome (PCOS) is a condition that affects the ovaries and results in hormone imbalance. PCOS can also be ruled out using ultrasound, a test where sound waves are used to create images of organs.

Talk with your provider if you start gaining or losing weight when you take prescribed medicines.

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Prevention

You and your child should each see a healthcare provider once a year to monitor changes in body mass index (BMI). Your provider or your child’s pediatrician may recommend lifestyle changes if BMI regularly increases. This is to prevent you or your child from developing overweight or obesity.

What factors contribute to a healthy or unhealthy weight?

Many factors can contribute to a person’s weight.

These include your:

Behavior or lifestyle habits, such as lack of physical activity, sedentary behaviors, a poor diet, and poor sleep habits

Environment, such as where you live and the lifestyle habits within your family

Economic factors that can influence the foods that you can afford and other lifestyle habits

Family history and genetics

Metabolism (the way your body converts food into energy)

Additionally, people from communities with fewer resources, who have food insecurity, or who face other similar issues tend to have a higher risk of developing obesity. NHLBI-funded research found that unhealthy lifestyle habits can worsen the risk of obesity in people who have a genetic risk of obesity. You cannot change some of these factors; for example, the genes you inherit from your parents that determine how tall you are. But you can replace unhealthy habits with healthy ones.

What healthy habits prevent overweight and obesity?

If your BMI indicates you are getting close to being overweight or if you have certain risk factors, your provider may recommend you adopt healthy lifestyle changes to prevent overweight and obesity. Such changes may include healthy eating, being physically active, maintaining a healthy weight, managing stress, and getting enough good-quality sleep.

Causes and Risk Factors

What causes overweight and obesity?

Overweight and obesity can develop over time when you consume more calories than you use. This is also described as an energy imbalance: when your energy in (calories) does not equal your energy out (calories your body uses for things such as breathing, digesting food, and being physically active).

Your body uses certain nutrients, such as carbohydrates or sugars, proteins, and fats, from the foods you eat to make and store energy.

Food is turned into energy for immediate use to power routine daily body functions and physical activity.

Food is stored as energy for future use by your body. Sugars are stored as glycogen in the liver and muscles. Fats are stored mainly as triglycerides in fatty tissue.

An energy imbalance causes your body to store more fat than can be used now or in the future. But your risk of developing overweight or obesity is determined by more than how much you eat. It also includes the types and amount of food and drinks you consume each day, your level of physical activity (such as whether you sit at an office desk or are on your feet all day), and how much good-quality sleep you get each night.

All of these factors, as well as many others, can contribute to weight gain.
What raises the risk of overweight and obesity?

There are many risk factors for overweight and obesity. Some are individual factors like knowledge, skills, and behaviors. Others are in your environment, such as school, workplace, and neighborhood. Additionally, food industry practices and marketing as well as social and cultural norms and values can also impact your risk.

You may not be able to change all of your risk factors for overweight or obesity. But knowing your risk is important to help you take steps to reaching a healthy weight and lowering your risk for obesity-related health problems, such as heart disease.

Lack of physical activity

Lack of physical activity, combined with high amounts of TV, computer, video game, or other screen time has been associated with a high body mass index (BMI). Most adults need at least 150 minutes of aerobic activity a week. It is also recommended that adults do muscle-strengthening activities for major muscle groups on 2 or more days each week, as these activities give additional health benefits. Children should get 60 minutes of aerobic activity each day.

Unhealthy eating behaviors

Some unhealthy eating behaviors can increase your risk for overweight and obesity.

Eating more calories than you use: The number of calories you need will vary based on your sex, age, and physical activity level. Find daily calorie needs or goals for adults as part the DASH Eating Plan.

Eating too much saturated fat: According to the Dietary Guidelines for Americans, the amount of saturated fat in your daily diet should be no more than 10% of your total calories. For a 2,000-calorie diet, that’s about 200 calories or about 22 grams of saturated fat.

Eating foods high in added sugar: On a daily basis, try to limit the amount of added sugar in your diet to no more than 10% of your calories.

Not getting enough good-quality sleep

Research has shown a link between poor sleep — not getting enough sleep or not getting enough good-quality sleep — and a high BMI. Regularly getting less than 7 hours of sleep per night can affect the hormones that control hunger urges. In other words, not getting good-quality sleep can make us more likely to overeat or not recognize our body’s signals that we are full.

High amounts of stress

Long-term and even short-term stress can affect the brain and trigger your body to make hormones, such as cortisol, that control energy balances and hunger urges. These hormone changes can make you eat more and store more fat.

Health conditions

Some conditions, such as metabolic syndrome and polycystic ovary syndrome, cause people to gain weight. These medical conditions must be treated for a person’s weight to come close to or into normal range.

Genetics

Some people are predisposed to being heavier. Researchers have found at least 15 genes that influence obesity. Studies show that genetics may play a more important role in people with obesity than in people who are overweight. For people with a genetic high risk for obesity, making healthy lifestyle changes can help lower that risk.

Medicines

Some medicines cause weight gain by disrupting the chemical signals that tell your brain you are hungry.

These include:

Antidepressants

Antipsychotics

Beta-blockers, which are used to treat high blood pressure

Birth control

Glucocorticoids, which are often used to treat autoimmune disease

Insulin, which is a hormone taken to control blood sugar levels in people with diabetes

Talk to your provider if you notice weight gain while you are using one of these medicines. Ask whether there are other forms of the same medicine or other medicines that can treat your medical condition but have less of an effect on your weight.

Your environment

Your environment can contribute to unhealthy eating and a lack of physical activity. Your environment includes all of the parts where you live and work — your home, buildings in which you work or shop, streets, and open spaces. The types of restaurants and the amount of green space you have can contribute to overweight and obesity.

Studies have shown that access to sidewalks and green spaces can help people be more physically active, and grocery stores and farmers markets can help people eat healthier. On the other hand, people living in neighborhoods with more fast food restaurants and inaccessible or no sidewalks or bike paths are more likely to be overweight or obese.

Treatment

If you are diagnosed with overweight or obesity, you and your healthcare provider will work together to develop a treatment plan. Your plan will likely include reducing the number of calories you eat each day, getting more physical activity, and adopting lifelong healthy lifestyle changes.

The goal of your treatment plan is to reduce your risk of obesity-related complications and improve your quality of life. Depending on your body mass index (BMI) and other health conditions you have, your provider may also talk to you about dietary or nutritional counseling, behavioral weight-loss treatment programs, medicines, or surgery. The obesity screening, counseling, and weight-loss programs may be covered by your insurance.
Healthy lifestyle changes

To help you aim for and maintain a healthy weight, your provider may recommend that you adopt lifelong healthy lifestyle changes. A 5% to 10% weight loss can significantly improve your health and quality of life.

Choose heart-healthy foods. It’s important to eat the right number of calories to maintain a healthy weight. If you need to lose weight, try to reduce your total daily calories gradually. Use the DASH Eating Plan to find out your daily calorie needs and to set goals.

Get regular physical activity. Many health benefits are associated with physical activity and getting the recommended amount of physical activity needed each week. Before starting any exercise program, ask your provider about what level of physical activity is right for you.

Get enough good-quality sleep. Research has shown a relationship between lack of sleep and obesity that begins as early as infancy. Experts recommend 7 to 8 hours of sleep per night for adults.

Behavioral weight-loss programs

Research has shown that there are areas of your brain that respond to pleasure. A chemical messenger is released whenever this part of the brain is stimulated by something we enjoy, such as eating food. The stimulation makes us feel good. Research shows that these connections may be stronger in some people than in others, which may explain why some people have a harder time losing weight.

Individual or group behavioral weight-loss programs are run by people who understand these brain connections. In these programs, one or more trained healthcare professionals, such as a registered dietitian and nutritionist (RDN), psychologist, or exercise physiologist, will work with you to develop a customized weight-loss plan. The plan will likely include a reduced-calorie diet, physical activity goals, and behavioral strategies to help you make and maintain these lifestyle changes.

Your weight-loss specialist usually reviews or modifies your goals every 6 months, based on your progress and overall health.

When you are choosing a behavioral weight-loss program, you may want to consider whether the program:

Offers the service of multiple professionals, such as registered dietitians, doctors, nurses, psychologists, and exercise physiologists

Provides goals that have been customized for you and that consider things such as the types of food you like, your schedule, your physical fitness, and your overall health

Provides individual or group counseling to help you change your eating patterns and personal unhealthy habits

Teaches long-term strategies to deal with problems that can lead to future weight gain, such as stress or slipping back into unhealthy habits

Other things to consider when selecting a program include:

How many people have successfully completed the program

The average weight loss for people who finish the program

Possible side effects or risks

Fees or costs for additional items, such as dietary supplements

Medicine

When healthy lifestyle changes are not enough, your provider may treat overweight and obesity with medicines. The Food and Drug Administration (FDA) has approved several medicines for weight loss or management. These medicines target different parts of your body.

Brain: Several medicines change the way the brain regulates the urge to eat, reducing your appetite. These include liraglutide, which is now approved for both children and adults age 12 or older with obesity. Other medicines that work in a similar way are naltrexone/bupropion, diethylpropion, and phendimetrazine. Setmelanotide is used to treat rare genetic conditions that cause obesity and increases resting metabolism.

Gastrointestinal tract: Orlistat blocks your intestines from absorbing fat from foods in your diet.

Pancreas: Semaglutide is an injectable medicine that works by helping the pancreas release the right amount of insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues, where it is used for energy. The injections also work by slowing the movement of food through the stomach and may reduce appetite and cause weight loss.

Weight-loss medicines are not recommended as a single treatment for weight loss. These medicines can help you lose weight but should be combined with lifestyle changes for greater and longer-lasting weight loss.

Tell your provider about all the medicines you take, because some of these medicines should not be used if you have certain conditions or are taking certain other medicines. Also, these medicines may have side effects. Talk to your provider if you are pregnant, planning to get pregnant, breastfeeding, or have a family history of cardiovascular conditions, such as high blood pressure, heart attack, or stroke.
Devices

The FDA has approved three weight-loss devices for adults. About half the people who undergo procedures to implant these devices lose at least 5% of their initial body weight as a result of the devices.

Gastric balloons are placed in the stomach via a swallowable capsule attached to a thin catheter or via an endoscope (a long flexible tube with a small camera and a light at the end). Then, depending on the device, the balloons may be filled with gas or liquid (such as salt water) and sealed. Later, they are removed.

Gastric bands are surgically implanted around the stomach, limiting the amount of food a person can eat at one time and increasing digestion time. This helps people eat less.

Gastric emptying systems include a tube placed in the stomach via an endoscope and a port that lies against the skin of the abdomen. The tube drains a portion of the stomach contents into a container 20 to 30 minutes after meals. The device is removed when the patient reaches their goal weight.

Your doctor will monitor you for pain, vitamin deficiencies, anemia, persistent nausea and vomiting, intolerance to solid food, and failure to lose weight. These complications can be treated if they occur.
Surgery

Some people do not lose weight by making healthy lifestyle changes or taking medicines. If your BMI is 35 or greater and you are at risk for obesity-related complications, you may be eligible for surgery if you develop obesity-related complications.

Types of weight-loss (also called bariatric) surgeries are listed below.

Gastrectomy: A big portion of the stomach is removed to reduce the amount of food that you can eat.

Gastric banding: The gastric band mentioned above is placed around the upper part of the stomach. This creates a smaller stomach.

Gastric bypass surgery: A small part of the stomach is connected to the middle part of the intestine, bypassing the first part of intestine. This reduces the amount of food that you can eat and the amount of fat your body can take in and store.

Talk to your doctor to learn more about the benefits and risks of each type of surgery. All surgeries carry some type of risk of possible complications, including bleeding, infection, or even death.

Medications for Obesity

The medications listed below are related to or used in the treatment of this condition.

Drug name	Rating	Rx/OTC	Preg	CSA	Alcohol
phentermine	8.6	Rx	X	4	X
bupropion / naltrexone	6.6	Rx	X	N	X
Contrave	6.6	Rx	X	N	X
liraglutide	7.5	Rx	C	N	X
Saxenda	7.5	Rx	C	N	X
tirzepatide	8.8	Rx		N	X
semaglutide	7.5	Rx		N	X
phentermine / topiramate	7.7	Rx	X	4	X
Adipex-P	8.9	Rx	X	4	X
Qsymia	7.6	Rx	X	4	X
Wegovy	7.5	Rx		N	X
Mounjaro	8.9	Rx		N	X
orlistat	7.4	Rx/OTC	X	N
Zepbound	8.9	Rx		N	X
topiramate Off-label	7.3	Rx	D	N	X
diethylpropion	8.7	Rx	B	4	X
phendimetrazine	8.2	Rx	C	3	X
Xenical	8.2	Rx	X	N
Alli	6.1	OTC	X	N
bupropion Off-label	7.3	Rx	C	N	X
Lomaira	8.1	Rx	X	4	X
benzphetamine	7.6	Rx	X	3	X
chorionic gonadotropin (hcg) Off-label	6.6	Rx	X	N
desvenlafaxine Off-label	8.1	Rx	C	N	X
Bontril PDM	6.0	Rx	C	3	X
methamphetamine	9.2	Rx	C	2	X
amphetamine	10	Rx	C	2	X
Imcivree	9.0	Rx		N
methylphenidate Off-label	6.0	Rx	C	2	X
Pregnyl Off-label	9.0	Rx	X	N
setmelanotide	9.0	Rx		N
Atti-Plex P		Rx	X	4	X
cimetidine Off-label		Rx/OTC	B	N	X
dulaglutide Off-label		Rx	C	N	X
Evekeo		Rx	C	2	X
fenfluramine		Rx	C	4	X

Legend
Rating	For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Off-label	This medication may not be approved by the FDA for the treatment of this condition.
Rx	Prescription only.
OTC	Over-the-counter.
Rx/OTC	Prescription or Over-the-counter.

Pregnancy Category		Controlled Substances Act (CSA) Schedule		Alcohol
B	Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.	U	CSA Schedule is unknown.	X	Interacts with Alcohol.
C	Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.	N	Is not subject to the Controlled Substances Act.

Management

Reaching and maintaining weight loss for the long term is challenging. It is important that you continue your treatment plan and adopt heart-healthy lifestyle changes you can keep up for the rest of your life. This will help prevent obesity-related complications.
Tips for managing overweight and obesity

Changing lifestyle habits takes time and patience. Follow these tips to help maintain the healthy lifestyle changes your healthcare provider recommended to aim for a healthy weight.

Use an app on your phone or a journal to record your daily food intake and physical activity. Talk about your goals and your progress with your provider.

Weigh yourself every day. Daily weighing has been shown to help with initial weight loss as well as long-term weight loss for many people.

Set specific goals. An example of a specific goal is to “walk 30 minutes, 5 days a week” or “eat a serving of vegetables with each meal.” Be realistic about your time and abilities.

Set doable goals that don’t change too much at once. When starting a new lifestyle, try to avoid changing too much at once. Slow changes lead to success. Remember, quick weight loss methods do not provide lasting results.

Learn from your slips. Don’t worry if work, the weather, or your family causes you to have an occasional slip. Remember that changing your lifestyle is a long-term process. Find out what triggered the slip and restart your eating and physical activity plan.

Celebrate your success. Reward yourself along the way as you meet your goals. Instead of eating out to celebrate your success, try a night at the movies, shopping for workout clothes, a visit to the library or bookstore, or a hike.

Identify temptations. Learn what environments or social activities, such as watching TV or going out with friends, may be keeping you from meeting your goals. Once you have identified the issues, use creative strategies to help keep you on track.

Plan regular physical activity with a friend. Find a fun activity that you both enjoy, such as Zumba, jogging, biking, or swimming. You are more likely to stick with that activity if you and a friend have committed to it together.

How does obesity affect your health?

Overweight and obesity can directly cause a variety of health problems and indirectly make other health issues more likely to occur. The good news is that losing 5% to 10% of your body weight has meaningful health benefits.

Obesity may cause the following complications:

Metabolic syndrome

Type 2 diabetes

Heart and blood vessel diseases, such as high blood pressure, heart attack, and stroke

High blood cholesterol

Respiratory problems, including asthma, sleep apnea, and obesity hypoventilation syndrome

Higher risk of serious illness from SARS-CoV-2, the virus that causes COVID-19

Back pain

Non-alcoholic fatty liver disease (NAFLD)

Osteoarthritis, especially in weight-bearing joints such as the knees, because extra weight can damage the cartilage and bone

Urinary incontinence, which happens when pelvic muscles that are weakened from chronic (long-term) obesity can no longer help maintain bladder control

Gallbladder disease

Depression or other mental health conditions

Cancers, such as pancreatic, colon, breast, and liver cancers

Take care of your mental health

Overweight and obesity can lead to depression or self-esteem issues for people of all ages but especially in children and teens. Obesity and overweight may also lead to or be a sign of an eating disorder.

Talk to your or your child’s provider or a professional counselor. Sometimes a history of childhood trauma, such as emotional neglect, divorce, or substance abuse, is contributing to overweight and obesity. It is important to get professional help for these issues to help you or your child reach and maintain a healthy weight. If you are depressed, your provider may recommend medicines or other treatments that can help.

Support from family and friends can also help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.

Childhood Obesity

Childhood obesity is an increasingly serious problem in the United States. Nearly 1 in 5 children have obesity. Children with obesity are more likely to develop other serious health problems, including heart disease and type 2 diabetes. They are also more likely to suffer from anxiety, depression, and low self-esteem.

Obesity affects children from different backgrounds differently. About 1 in 4 Hispanic and non-Hispanic Black children have obesity. This is a challenge for parents, because addressing their child’s weight often means making lifestyle changes for the whole family.
Prevention

All children should visit a healthcare provider every year for wellness check-ups that include monitoring of weight and calculation of body mass index (BMI) percentiles.

Some of the best ways to prevent childhood obesity are to:

Choose and prepare healthy foods that are lower in fat and have less calories.

Get regular physical activity. Your children should get at least 60 minutes of daily physical activity.

Reduce screen time. Try to limit screen time at home to 2 hours or less each day.

Get enough good-quality sleep.

Risk Factors

Researchers agree that children inherit genes, the blueprints for our bodies, that make them more likely to have obesity. However, that genetic risk does not account for the increase in childhood obesity seen in recent years. A child’s community also has an impact on their weight, as the community can affect a family’s ability to make healthy choices. For example, fresh fruits and vegetables may be difficult to get, roads without sidewalks may make it unsafe to walk for exercise, or healthy meal choices in schools may be unavailable.

Most parents, however, do have some control over other risk factors that increase a child’s risk of having obesity.

These include:

Eating a high-calorie, low-nutrient diet

Not getting enough good-quality sleep

Too much screen time

Too little physical activity

Personal or family stress or trauma

BMI for children

BMI is used to determine whether your child’s weight fits the criteria for overweight or obesity. It is compared with growth charts for children who are the same age and sex as your child.

Underweight is a BMI below the 5th percentile.

Healthy weight is a BMI between the 5th to the 85th percentile.

Overweight is a BMI between the 85th percentile and the 95th percentile.

Obesity is a BMI in the 95th percentile or above.

Treatment

Your child’s provider will monitor your child’s BMI and overall health during regular visits. They may talk to you about healthy lifestyle changes you can make as a family. If your child’s weight does not respond to those, your child’s provider may recommend medicine.

The good news for parents is that childhood obesity is reversible. Even small decreases in weight can have a positive impact on current health and future risk of health problems. The key is to learn the basics of maintaining a healthy weight, seek out resources in your community, and get both medical and mental health care for your child as needed.

Obesity and Women's Health

Women are slightly more likely (40%) than men (35%) to have obesity. Obesity specifically affects some different aspects of women’s health.

Fertility: Women who have obesity are more likely to have problems getting pregnant than are women who are at a healthy weight.

Lifetime hormonal changes: Obesity changes reproductive hormone levels as women age.

Polycystic ovary syndrome (PCOS): PCOS is the most common hormone disorder among women of childbearing age (between about age 15 and 45). Most women with PCOS also have obesity.

Disease risk: Women with obesity are more likely to have heart disease, diabetes, and breast cancer than are women without obesity.

Pregnancy risks and complications

Having obesity can affect your health and increase the risk of complications during pregnancy and childbirth. Having obesity before pregnancy or gaining too much weight during pregnancy can raise the risk of preterm birth and a baby that is larger than gestational age (larger than they should be at that week of pregnancy). This can lead to problems during delivery for the mother and baby. It can also affect the future health of your child. Talk to your provider about how much weight you should plan to gain during your pregnancy. They can help you set a goal based on your pre-pregnancy BMI.

Several health problems are more common in pregnant women who have obesity. They can cause serious complications during pregnancy.

Gestational diabetes is typically diagnosed after 20 weeks of pregnancy or close to delivery. It makes it hard for your body to properly break down and store energy from food, causing high levels of glucose in your blood. This can affect both you and your developing baby.

Gestational hypertension is high blood pressure that starts during the second half of pregnancy.

Preeclampsia is a combination of high blood pressure during pregnancy with signs that your organs are not working well, such as high protein levels in your urine. It can lead to life-threatening seizures.

Obstructive sleep apnea happens when your throat muscles relax and you temporarily stop breathing while sleeping. This disrupts your brain’s healthy sleep rhythms and can leave you exhausted upon waking. It can be fatal if severe and not treated.

Your provider will monitor you closely during pregnancy. You should also watch for warning signs of problems, such as high blood pressure, during and after pregnancy. Some warning signs are a worsening headache, overwhelming tiredness, dizziness, trouble breathing, chest or belly pain, swelling, or nausea. If you feel like something is wrong, get medical care right away.

Obesity Hypoventilation Syndrome

What is obesity hypoventilation syndrome?

Obesity hypoventilation syndrome, also known as Pickwickian syndrome, is a breathing disorder that affects some people who have been diagnosed with obesity. Normally, you exhale carbon dioxide, a by-product of breaking down food for energy. Obesity hypoventilation syndrome causes you to have too much carbon dioxide and too little oxygen in your blood. Without treatment, it can lead to serious and even life-threatening health problems.
How do you get it?

Having overweight or obesity increases your risk of developing obesity hypoventilation syndrome. Most people who have obesity hypoventilation syndrome also have sleep apnea.

It is not clear why obesity hypoventilation syndrome affects some people who have obesity and not others. Extra fat on your neck, chest, or across your abdomen can make it difficult to breathe deeply and may produce hormone that affect your body’s breathing patterns. You may also have a problem with the way your brain controls your breathing.
What are the symptoms?

Common symptoms include:

Breathlessness

Daytime sluggishness or sleepiness, especially if you also have sleep apnea

Dizziness

Fatigue, or extreme tiredness

Headaches

In addition to the above symptoms, you or a loved one may notice you often snore loudly, choke or gasp, or have trouble breathing at night. Your symptoms may get worse over time.
How is it diagnosed?

If your healthcare provider suspects that you have obesity hypoventilation syndrome, they will:

Perform a physical exam

Measure your weight and height

Calculate your body mass index (BMI)

Measure your waist and neck circumference

Additional tests might include lung tests to measure the amount of oxygen in your body or how well your lungs are working. You may also need a sleep study if your provider thinks you may have sleep apnea.
How is it treated?

If you are diagnosed with obesity hypoventilation syndrome, your provider may recommend healthy lifestyle changes, such as getting to and maintaining a healthy weight and being physically active. You may also need a continuous positive airway pressure (CPAP) machine or other breathing device at night to help keep your airways open and increase blood oxygen levels. Other treatments may include weight-loss surgery or medicines.

If you have been prescribed a CPAP machine, use it as instructed and continue with your provider’s recommended healthy lifestyle changes to prevent complications. Tell your provider about new symptoms, such as swelling around your ankles, chest pain, lightheadedness, or wheezing. Talk to your provider if you will be flying or need surgery, because these situations can increase your risk for serious complications.

Resources

MyPlate.gov

Healthfinder.gov Get tips on how to eat healthy on a budget, plan ahead to save time, and eat healthy away from home.

Nutrition Education Explore materials about menu labeling and the Nutrition Facts label.

Start Simple with MyPlate App Meet healthy eating goals one at a time! Use this easy-to-use app to get started.

Foodsafety.gov Learn more about how to keep food safe to eat.

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