Understanding Obesity & Severe Obesity

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Understanding Obesity& Severe Obesity

Understanding Obesity& Severe ObesityYou may have questions about obesity.This brochure can help answer thosequestions. On the following pages, youwill learn what obesity is and how itdiffers from excess weight. You willalso learn about the causes and healthconcerns of obesity. Finally, you willread about the importance of weightmanagement and explore treatmentoptions. This brochure is meant to bean introduction about obesity.For more information, please visit:ObesityAction.org.Please note, the contents of this brochure are nota substitute for medical advice. Please be sure toconsult a healthcare provider before starting anyobesity management program.2

what is Obesity& Severe Obesity?Obesity is a treatable disease that is aworldwide health concern associated withhaving an excess amount of body fat. It iscaused by genetic and environmental factorsand can be difficult to control through dietingalone. Obesity is diagnosed by a healthcareprovider and is classified as having a bodymass index (BMI) of 30 or greater. Nearly 40percent of Americans have obesity.Obesity IS A disease. A worldwide health concern. Caused by many factors. Treatable and manageable.Obesity Is not Your fault. Yours to manage alone. Just about food. Cured by a miracle treatment.Body mass index (bmi)Body fat is hard to measure directly.So it is often measured by body massindex (BMI). BMI measures weight related toheight. It is a common way to measure bodyfat and is one tool healthcare providers usewhen talking about weight.To find your BMI, please see the BMI chart inthe back of this brochure on page 22 or pleasevisit the OAC website at: ObesityAction.org.BMI is not a percentage of body fat. BMI isonly part of a diagnosis of obesity. Ask yourhealthcare provider for other ways ofdetermining obesity.3

How weight is categorizedWeight Categories Based on BMIUnderWeight 18.5HealthyWeightOverweightObesity18.5-24.9 25.0-29.9 30.0-39.9SevereObesity 40OverweightHaving a BMI in the overweight range (25.029.9) is a health concern. Excess weight ishard on your body. It can lead to other healthproblems including obesity. People who havea BMI in the overweight range and have otherhealth problems (such as type 2 diabetes orheart disease) need to see their healthcareprovider for treatment options.ObesityObesity is a disease where a person’s weightis in an unhealthy range (BMI of 30.0-39.9). Itis a disease that can lead to other healthproblems. Talk with your healthcare providerto better understand and treat obesity.Severe ObesitySomeone who is more than 100 pounds overtheir healthy body weight (BMI greater than40) has severe obesity. Severe obesity has thegreatest risk of other health problems. Peoplewith severe obesity need to see theirhealthcare provider for treatment options.4

Causes of obesityBetter understanding the causes of obesity canhelp you better treat obesity. Talk with yourhealthcare provider about your daily habits,medical history and family medical history todetermine the best treatment plan for you. Obesity is a complicated disease. Obesity has more than one cause. Obesity is not just about food. Obesity is not someone’s fault.Psychological Factors Weight management can bechallenging if troubled bystress and other concerns. You need to work on theseissues to be successful withyour weight management.Energy In/Energy Out An imbalance of calories inand calories burned maycause weight gain. Long daily commutes anddesk jobs make it harder toget physical activity. Not all communities have safespaces to run, bike or walk. Small bouts of increasedphysical activity throughoutthe day can be beneficial.5

Sleep Deprivation Some studies show a linkbetween how much peoplesleep and how much peopleweigh. In general, people who do notget enough sleep may weighmore than people who do.Appetite Signals Hormones Your body has hormones(chemicals in your body thatcontrol function and activityof tissues and organs) thathelp let you know if you arehungry or full. The hormones that signalhunger and fullness do notalways work correctly inpeople with obesity.Genetic Factors Genes in your body candetermine if you are morelikely to have obesity. Having these genes is not areason to give up on losingweight. Weight-loss as smallas 5 percent can improve youroverall health.6

Prescription Medications Some prescriptionmedications can cause weightgain of up to several poundseach month. Do not stop takingmedications you think mightbe causing weight gain, butspeak with your healthcareprovider about othermedication options.Environmental Factors We are surrounded bytelevision ads, billboards andimages that promote theconsumption of foods andbeverages that are high incalories and fat. Some neighborhoods havelittle or no access to fresh,healthy foods.7

What are the risksAssociated with obesity?Excess weight can be hard on your wholebody. More than 50 health problems arerelated to excess weight and obesity. Thesehealth problems are diseases and conditionsthat can decrease your quality of life and arecommonly called obesity-related conditions.It is important to talk with your healthcareprovider about these conditions.The moreweight you carry,the more likely youare to developobesity-relatedconditions.Not everyonewith obesity willdevelop everyobesity-relatedcondition.Finding andtreating healthconditions earlyis best for youroverall health.Weight-loss assmall as 5-10%can reduce theeffects ofobesity-relatedconditions.For more information on obesity-relatedconditions, please see the “RelatedConditions” section of the OAC website:8ObesityAction.org

Obesity is Linked to More Than50 DisordersThe Most Common Obesity-RelatedConditions Include: High blood pressure High cholesterol Type 2 diabetes Heart disease Stroke Gallbladder disease Osteoarthritis Sleep apnea Respiratory problems Fatty Liver disease Venous disease Acid reflux Menstrual irregularities and infertility13 Types of Obesity-RelatedCancers Include: Meningioma (brain tissue and spinal cord) Thyroid Adenocarcinoma of the esophagus Multiple myeloma (blood cells) Breast (post-menopausal women) Liver Kidney Gallbladder Upper stomach Pancreatic Colon and rectal Uterine Ovarian9

What are the societal effectsof obesity & severe obesity?Obesity can impact your life in ways beyondphysical health. Our culture focuses on bodysize and appearance. When combined withmisunderstanding and negative attitudes byothers, discrimination and bias occurs. As partof daily life, this bias and discrimination canlead to a decreased quality of life andemotional pain.10

Effects at Home & Among FriendsFamily and friends are not always supportive.They may not understand the causes and risksof obesity. They might also fail to support youin your decision to manage your weight.Effects at WorkEmployees with obesity are often viewed aslazy or less competent. Sometimes they areseen as undisciplined, less ambitious or lessproductive. They also face lower wages andare less likely to be hired or promoted.Effects in Healthcare SettingsPatients with obesity and severe obesity canface discrimination in healthcare settings.This can lead to much greater healthproblems. People faced with this situationoften delay seeing their healthcareprovider. Some may cancel appointmentsor not seek treatment at all.11

WHAT TREATMENT OPTIONSSHOULD BE CONSIDERED?Treatment plans are made for each individual.Your plan will likely not be the same as forothers sitting in the waiting room. But earlytreatment is best for everyone. Always talkwith your healthcare provider before startinga weight management program. Manytreatment options are available and acombination is often used to manage obesity.Your healthcare providers play amajor role in your weightmanagement journey. They helpyou manage your weight and guideyou with tools, resources and support. Thispartnership can make all the difference.You do not need to manage your weightalone. Visit Obesity Care Providers poweredby the OAC to find an Obesity Care Providerin your area: ObesityCareProviders.com12

With ObesityCareProviders.com, finding the rightobesity care provider is a click away.SEARCH BY SPECIALTY Bariatric Surgeon Dietitian Nurse Practitioner Physician Physician AssistantGET HELPFUL TIPSPrepare for your next appointment with: Valuable tips on what to bring duringyour consultation Questions to ask your healthcare providerin order to have an honest conversationabout your weight and healthFILTER BY LOCATIONConvenience is key. Use your zip code to do a quick search. Find healthcare providers near you.Visit ObesityCareProviders.com today!13

Lifestyle modificationsYour everyday choices are your behaviors.They include everything from sleeping towhat you have for lunch and if you take thestairs or the elevator. They fit together likepuzzle pieces to form your lifestyle. A healthylifestyle can look like this:Seeing yourhealthcareprovider.Getting afull nightof sleep.Keeping afood journal.Joining theOACCommunity.Choosinghealthyfoods.Taking walkswith yourfamily.Focusing on manageable modifications toimprove your health is the goal. Do notbecome discouraged. Healthy is a lifestyle,not a size. Weight-loss as small as 5-10percent can improve your overall health. It willtake time and you may face set-backs, but thehealth benefits are significant.14

Physical Activity ModificationsPhysical activity is keywhen managing obesity. Itis best to start simple andkeep it manageable. Take awalk around the block afterdinner or park far awayfrom the store. These areeasy ways to make physicalactivity part of your day.Make sure to speak withyour healthcare providerbefore starting anyexercise program.When making an exercise and physicalactivity plan, remember to: Make it simple. Make it realistic. Make it happen. Make it fun.Nutrition ModificationsChanging your eating habits can be hard. Weare surrounded by convenience foods high infat and calories and low in nutritional value.Knowing which foods to pick for a healthydiet can be hard as well. There are optionsto help.Non-clinical and clinical (medical) weightmanagement options are ways to gethelp and learn more about nutritionand healthy eating.15

weight management OptionsNon-Clinical Weight Management OptionsNon-clinical weight management programscan be self-managed. They can also beoffered by someone other than a healthcareprovider. These programs range from booksand websites to chain weight-loss programsor support groups. Finding the right optionfor you is important. Take time to read aboutseveral and talk about them with yourhealthcare provider. The success of anyoption takes a commitment to your goal ofimproving your health.People with severe obesity havegreater health risks. Clinical weightmanagement programs and bariatricsurgery are options for treatment.Talk with your healthcare provider aboutthese options.16

Clinical Weight Management OptionsA physician who specializes in obesitymedicine (ABOM Certified*) can offer you aclinical weight management program.Additional healthcare providers may be partof your program. Nurses, nurse practitionersand physician assistants may help with routinemonitoring. Registered dietitians may giveyou healthy eating tips and menus.Psychologists may talk with you about stressin your life and how your eating is impacted.These programs focus a great deal on lifestylechanges, but might also include FDAapproved medicines for chronic weightmanagement. Routine visits with all teamproviders is important for success.Your schologistPhysicianASSISTANTNursePractitioner*An American Board of Obesity Medicine (ABOM)Certified physician has completed a certification processand is committed to providing effective, science-basedweight management care. They recognize the need fora comprehensive approach that considers themultiple factors contributing to obesity as wellas the variety of treatment options.17

Medical Weight Management &Bariatric Surgery OptionsSome prescription medications help withweight-loss. Your healthcare provider maywant them in your treatment plan. Yourprovider will tell you about the risks andbenefits. These prescription medications workin combination with lifestyle modifications.Currently, there are several FDA-approvedmedications for chronic weight management.Chronic Weight Management Medications:Some healthcare providers may useprescription medicines usually given to treatother diseases for the treatment of obesity.For more information on medicalweight management, please visit theOAC website at: ObesityAction.org18

Bariatric Surgery and DevicesBariatric surgery is a safe and effectiveprocedure to treat obesity and severe obesity.Surgery is primarily used to treat patients witha BMI greater than 35 when you have at leastone obesity-related condition such as type 2diabetes or high blood pressure or a BMIgreater than 40 without obesity-relatedconditions. With some surgeries or devices,procedures may be performed on those witha BMI as low as 30.Bariatric surgery is also commonly called“the treatment of obesity and severe obesitysurgery.” Please note for the purpose of thisbrochure, we’ll refer to it as “bariatricsurgery.” Bariatric surgery helps in weight-lossby limiting the amount of food your stomachcan hold.Device procedures for weight-loss can limitthe amount of food the stomach can hold,make you feel full with smaller amounts offood or by aspirating food following meals.Bariatric devices are not a permanentchange and are removed at a timedetermined by your healthcare provider.19

Surgery and device procedures are notmiracle cures. Following these procedures,you must make lifestyle modificationsincluding healthy eating and increasedphysical activity. You will need a supportsystem, and be willing to follow all directionsfrom your healthcare provider. Your healthcareprovider will help you decide if one of theseprocedures is part of your treatment. Severaltypes of bariatric surgery and device implantsare available.Be sure to talk with your providerabout all risks and any FDA warningsbefore any medical procedure.Bariatric Surgery Options: Sleeve Gastrectomy Roux en-Y Gastric Bypass Biliopancreatic Diversionwith Duodenal SwitchBariatric Device Options: Adjustable Gastric Banding (LAP-BAND ) Aspire Assist Gastric Balloon Neuromodulation (VBLOC )Deciding to have surgery is not simple, butyou do not make the decision alone. Yoursurgeon will help you decide. You need tobalance the health concerns of severe obesitywith the potential risks of surgery. Thistreatment option is a tool that is part of along-term plan to lose and manage yourweight. Overall lifestyle changes are key formaintaining a healthy quality of lifeafter surgery.20

If bariatric surgery is an option, you will likelybe sent to see a psychologist. It is a normalpart of surgery preparation. Together, the twoof you will work to be ready for surgery. Ateam of providers will be part of your carefollowing surgery. The team will likely includea dietitian, exercise therapist andpsychologist. They will get to know you andare part of your support system.To learn more about bariatric surgery, pleasevisit the “Obesity Treatments” section of theOAC website: ObesityAction.orggaining access to treatmentwith your insurance providerPeople affected by obesity count on theirinsurance provider. They help you have safeand effective medical treatment. Working withyour provider is not always easy. You canexperience problems and delays. The mostcommon problem is repeated claim denials.All of this can become physically andemotionally draining.The OAC designed Working with Your Insurance Provider: A Guide to Seeking Weightloss Surgery to help. It focuses on coveragefor bariatric surgery. To view this brochure,please visit the “Access to Care” page on theOAC website: ObesityAction.org21

3232425252627282930313233170Underweight Less than mal 18.5 - 24.9212122232324252526272829303132333435180Weight in 344464749250Overweight 25 - 73839404142434546474950525355575961310Obesity 30 - 3656769727476390Severe Obesity Greater than 354565859616365676971737678400BMI CHARTObesityAction.orgHeight

Obesity Obesity is a disease where a person’s weight is in an unhealthy range (BMI of 30.0-39.9). It is a disease that can lead to other health problems. Talk with your healthcare provider to better understand and treat obesity. Severe Obesity Someone who is more than 100 pounds over their

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