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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.
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.
-
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.
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.
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