Because of these risks, it is
important to lose weight even if you do not feel bad now. It is hard to change
eating habits and exercise habits. But you can do it if you make a plan.
How do you know if you are obese?
You can use a
measurement called a body mass index, or BMI, to decide whether your weight is
dangerous to your health. The BMI is a combination of your height and weight.
If you have a BMI of 30 or higher, your extra weight is putting your health in
danger. If you are Asian, your health may be at risk with a BMI of 27.5 or
higher.
Where you carry your
body fat may be as important as how many extra pounds you have. People who
carry too much fat around the middle, rather than around the hips, are more
likely to have health problems. In women, a
waist size of 35 in (88 cm)
or more raises the chance for disease. In men, a waist size of
40 in (101 cm) or more raises
the chance for disease.1 In Asian people, health
problems are seen with a smaller waist size. In Asian women, a waist size of
32 in (80 cm) or more raises
the chance for disease. In Asian men, a waist size of
36 in (90 cm) or more raises
the chance for disease.2
What causes obesity?
When you take in more
calories than you burn off, you gain weight. How you eat, how active you are,
and other things affect how your body uses calories and whether you gain
weight.
If your family members are obese, you may have inherited
a tendency to gain weight. And your family also helps form your eating and
lifestyle habits, which can lead to obesity.
Also, our busy lives
make it harder to plan and cook healthy meals. For many of us, it's easier to
reach for prepared foods, go out to eat, or go to the drive-through. But these
foods are often high in fat and calories. Portions are often too large. Work
schedules, long commutes, and other commitments also cut into the time we have
for physical activity.
There is no quick fix to being overweight.
To lose weight, you must burn more calories than you take in.
You've tried diets, but you always gain the weight back. What can you do?
Focus on health, not diets.
Diets are hard to stay on and usually do not work in the long run. It is very
hard to stay with a diet that includes lots of big changes in your eating
habits.
Instead of a diet, focus on lifestyle changes that will
improve your health and achieve the right balance of energy and calories. To
lose weight, you need to burn more calories than you take in. You can do it by
eating healthy foods in reasonable amounts and becoming more active. And you
need to do it every day.
Little steps mean a lot. Losing just
10 lb (4.5 kg) can make a
difference in your health.
When you stray from your plan, do not get upset. Figure out what got you
off track and how you can fix it.
How can you stay on your plan for change?
It is
hard to change habits. You have to be ready. Make sure this is the right time
for you. Are you ready to make a plan and stay on it? Do you have the support
of your family and friends? Do you know what your first steps will be? Becoming
healthier and staying that way is a lifelong effort.
Most people
have more success when they make small changes, one step at a time. For
example, you might eat an extra piece of fruit, walk 10 minutes more, or add
more vegetables to your meals.
Studies show that people who keep
track of what they eat are better at losing weight. Keep a notebook where you
can write down everything you eat and drink each day. You may be surprised to
see how much you are eating. Use a calorie counter to add up your calories.
(You can find calorie counters online and at bookstores.)
As you
keep track of calories, look at whether you skip meals, when you eat, how often
you eat out, and how many fruits and vegetables you eat. This will help you see
patterns that you may want to change.
You may want to write down
the amount of physical activity you've had each day and compare the calories
you burned to those you took in. Use the
Interactive Tool: Calories Burned to see how many
calories you burn through daily activities.
Can you take medicines or have surgery?
Surgery
and medicines do not work by themselves. Most people also need to make changes
in what they eat and how active they are.
Before your doctor will
prescribe medicines or surgery, he or she will probably want you to work on
diet and activity for at least 6 months. Even if your doctor gives you
medicines or recommends surgery, you will need to keep your new healthy habits
for the rest of your life.
Obesity is a
complex disease for which no single cause or cure exists. You gain weight when
you take in more calories than you burn off. But obesity is influenced by many
other factors, also, including your family history, the type of work you do,
your race, and
your environment.
Overeating is easy in
our culture today. Portions at fast-food and other restaurants are
"super-sized" to the point that one meal can provide an entire day's worth of
calories. Food is also a focal point of social activity. Gatherings of family
and friends, work events, and holidays are usually centered around food. And
eating can be a comfort when you are depressed or stressed.
Also,
people are less active than ever. Some people hate to exercise and others may
not have the time. And many of the conveniences we use, such as elevators,
cars, and the remote control for the television, cut activity out of our lives.
Even making small changes—like walking your dog—can make a
difference. Letting the dog out the door burns 2 calories. Walking the dog for
30 minutes burns 125 calories. Taking the car to a car wash uses 18 calories.
Washing and waxing it yourself burns 300.
Use this interactive
tool to find out how many calories you burn with typical daily activities and
exercise:
Other things can affect our weight, such as
family history or genetics. If one of your parents is
obese, you are 3 times as likely to be obese as someone with parents of healthy
weight.3
Your family's and friends'
lifestyles can also affect your weight. If your family or friends eat a lot of
high-fat or snack foods, eat at irregular times, and skip meals, you probably
will too. And if they are not physically active, you may not be either.
Other things influence your weight and whether you are physically active,
including:
Low self-esteem. Being
overweight or obese may lower your
self-esteem and lead to eating as a way to comfort
yourself. Repeated failure at dieting also can affect your self-esteem and make
it even harder to lose weight.
Emotional concerns. Emotional
stress,
anxiety, or illnesses such as
depression or chronic pain can lead to overeating.
Some people eat to calm themselves, to avoid dealing with unpleasant tasks or
situations, or to dampen negative emotions.
Trauma. Distressing events, such as childhood sexual,
physical, or emotional abuse; loss of a parent during childhood; or marital or
family problems, can contribute to overeating.
Alcohol. Alcohol (beer and mixed drinks)
is very high in calories.
Medicines or medical conditions. Some
medical conditions and medicines may also cause weight gain. Examples include
having
Cushing's syndrome or
hypothyroidism or taking certain antidepressants or
corticosteroids.
Health Risks of Obesity
How
obesity affects your health depends on many things,
including your age, gender, where you carry your body fat, and how physically
active you are.
Where you carry
body fat is important. If fat builds up mostly around your stomach (sometimes
called apple-shaped), you are at greater risk for type 2 diabetes, high blood
pressure,
high cholesterol, and coronary artery disease than
people who are lean or people with fat around the hips (sometimes called
pear-shaped).
To make big changes in your
lifestyle, you have to be committed. Ask yourself if this is the right time.
Are you ready to make a well thought-out plan and stay with it? Do you have the
support of your family and friends? Have you talked with your doctor, and do
you know what your first steps will be?
Ask your doctor to help
you:
Identify things that cause you to gain weight.
Identify any medicines you are taking that may make it harder for
you to lose weight.
Make lifestyle changes instead of
dieting.
Your doctor may recommend the following professionals to
help you make changes:
A
registered dietitian can help you determine how many
calories you need and how best to get them.
An exercise specialist
or personal trainer can help you plan a safe and effective exercise
program.
A
counselor or
psychiatrist can help if you have an emotional problem
such as
depression or
anxiety, have experienced sexual or physical abuse,
have family problems, or abuse drugs or alcohol.
When you are ready to start making changes, do not take on
too much too soon. Anything you can do today that was healthier than yesterday
is a step in the right direction.
Set small goals. Your goals
should be specific, within your reach, and flexible enough to break once in a
while. A goal to be more active and eat better is too general. Instead, make a
plan to be active 3 to 4 times per week. Perhaps start with a goal of walking
for 15 minutes 3 times a week, and then increase it to 4 times a week. When you
reach this goal and it has become routine, set a new one. But realize that you
may have setbacks now and then—these do not mean that you have failed.
Think about a time that you were successful in making a change, and
remember what motivated you. Try to draw on a similar motivation, and set
small, realistic goals. Experiencing success, no matter how small, is
important. Each time you meet one of your goals, set another one.
Using a pedometer or step counter can help you set goals and be more
active. For more information, see:
If you don't think you are ready for making changes, try to
pick a date in the future. Make an appointment to see your doctor and discuss
whether that time is right for you. In the meantime, think about how you can
fit changes into your life.
Exams and Tests
Along with a regular medical
checkup, you may have some tests to check on your health.
Your doctor
will check your blood pressure, ask about any medicines you are taking, and
discuss your medical history and your family's medical history. He or she will
ask how active you are, whether you drink alcohol (and how much), your history
of weight gain, and how often you have tried to lose weight.
Treatment for
obesity will be most successful if you create a
long-term plan with your doctor. A reasonable goal might be to begin making
lifestyle changes by increasing physical activity and limiting calories.
Your initial goal should be to improve your health, not to achieve an
ideal weight. Although the “formula” for weight loss—to burn more calories than
you take in—is not complicated, it is often hard to achieve and maintain. Along
with lifestyle changes, medicines and surgery may be options for some people.
The treatment you need depends on your level of obesity, your overall health,
and your motivation to lose weight.
Health guidelines suggest
that people should make lifestyle changes for at least 6 months before trying
medicines or surgery. Your doctor may suggest medicines and surgery earlier if
you also have conditions such as
coronary artery disease or
type 2 diabetes.1
Medicines for obesity work in different ways. Depending on the medicine,
they make you feel full sooner, limit your body's ability to absorb fat, or
control binge eating. Surgery is used to reduce the size of the stomach and
limit how many calories are absorbed by the
intestines.
Your doctor may also
suggest
counseling. If you use food to cope with depression,
loneliness, anxiety, or boredom, you need to learn new skills to deal with
those feelings.
Initial treatment
Before you begin treatment,
decide if you are ready to make the lifestyle changes needed to lose weight.
Losing weight and maintaining weight loss can be hard. And it may be hard to
find the motivation if you have lost and regained weight several times. Think
about successes that you had before and how you were able to achieve them.
If you are not ready to make the changes to lose weight, your
doctor may suggest that you set a goal to not gain any more weight or set a
date in the future to think again about this decision.
If you are
ready, your doctor may suggest losing 10% of your weight at a rate of
1 lb (0.45 kg) to
2 lb (0.9 kg) a week as your
first target. Research shows that a 10% weight loss can improve your
health.1 It is better that you maintain a small amount
of loss rather than lose a lot of weight fast and gain it back.
Changing eating habits: Eating fewer calories
while increasing activity is the best way to lose weight. For most adults, a
low-calorie diet of 1,200 to 1,500 calories a day for
women and 1,500 to 1,800 calories a day for men is recommended for weight
loss.
Research shows that limiting calories—not the types of
foods you eat—causes more weight loss. For example, cutting only carbohydrate
or fat will not cause any more weight loss than a healthful and balanced
low-calorie diet.3
Rather than focusing
on a particular type of diet, try to eat healthier foods. Don't try to restrict
the foods you love. Eat less of them. Eat smaller portions.
For
some people, a
very low-calorie diet may be considered, but generally
it is not recommended. A very low-calorie diet should only be conducted under
close medical supervision. Over the long term, a low-calorie diet and a very
low-calorie diet have similar results.3, 4
Research on
low-carbohydrate diets, such as the Atkins plan, show that weight loss is more
likely to result from eating fewer calories and staying with the diet for a
long time rather than cutting out the carbohydrate.5
A
dietitian can show you how to make healthy changes in
your diet by helping you:
Plan your meals, which helps you eat regular
meals and a balanced, nutritious diet. It can also save you money when
shopping. See a
meal planning form(What is a PDF document?).
Cut fat from your diet, especially by substituting healthy monounsaturated
fat for saturated fat. To do this, you will need to understand the difference
in types of fat.
Increasing activity: Physical
activity helps you burn more calories. One of the best ways to increase your
activity is by walking. It is an activity that most people can do safely and
routinely alone or with family members, friends, coworkers, or pets. And it is
easy to work into a daily schedule.
Keep track of your steps with
a step counter or pedometer. If you have a desk job, you may be surprised to
see how little you move in a typical day. Wearing the step counter will
motivate you to accumulate more steps during the day. Start with a goal of
increasing your steps by 2,000 steps a day and work up to 10,000 to 12,000. For
more information, see:
Overall, experts recommend doing either of these things
to get and stay healthy:6
Do
moderate activity for at least 2½ hours a week.
Moderate activity is equal to a brisk walk, cycling about 10 to 12 miles per
hour (mph), sailing, or shooting baskets. You notice your heart beating faster
with this kind of activity.
Do
vigorous activity for at least 1¼ hours a week.
Vigorous activity is equal to jogging, cycling at least 12 mph, cross-country
skiing, or playing a basketball game. You breathe rapidly and your heart beats
much faster with this kind of activity.
It's fine to be active in blocks of 10 minutes or more
throughout your day and week. You can choose to do one or both types of
activity.
Talk with your doctor before
starting a fitness program. If you have arthritis, you
will need to find an activity that does not stress your joints.
For more information on exercise and fitness, see the topic
Fitness.
Staying with it:Stress, family, your environment, and other influences can affect your
progress. If you stray from your plan one day, get back on track the next
day.
Research shows that people who keep track of what they eat
and drink each day have more success at losing weight. Start a
food journal(What is a PDF document?), and record everything you eat and drink. Pay attention to
portion sizes and use a calorie counter to check calories. You can find a
calorie counter at a bookstore or online (see www.caloriecontrol.org or
www.nutritiondata.com). People often convince themselves that they don't
overeat. Documenting your daily food intake can be eye-opening.
Track your daily activity. Use the
Interactive Tool: Calories Burned calculator to learn
how many calories you use, or use a pedometer to record the number of steps you
take.
Understand the connection between stress and eating: Decide whether you eat to calm yourself.
Have you noticed a change in your eating
or weight since a change occurred in your lifestyle or stress
level?
Do you eat when you are not hungry or when you are
full?
Do you eat (or cook) to avoid dealing with a stressful
situation?
Do you find food very soothing?
Do you use
food as a reward?
If you eat to relieve stress, stop and think
about what is really bothering you and how you could deal with it.
Change what you are doing. Take a short
walk down the hall or around the block.
Call a
friend.
If you are truly hungry, reach for a healthy meal or snack.
Focus on the experience of eating, and enjoy your food.
Remove temptations, and think before eating: If you have easy access to a lot of high-fat,
high-sugar, tasty foods, it is tempting to eat them. Take a look at your
environment, and see what causes you to eat more than you need.
Do you sometimes eat without thinking? If
so, give your food the attention it deserves. Try eating only at the kitchen
table. Avoid eating in front of the television or the computer, at your desk,
or while driving your car. Be aware of what you do while you are preparing
food. Do you snack on ingredients as you make dinner? Chew gum while you cook
so that you will not be tempted to snack on the ingredients.
Do
you eat whatever is most available because you don't plan ahead? Make it a
habit to pack a healthy lunch and snacks the night before.
Snack
from a plate, not from the package. Plan your snacks just like your meals.
Is eating a positive, pleasurable experience for you? Take some
time to relax before a meal so that you can eat slowly and enjoy it. Eat your
meals with others and make your mealtime enjoyable.
Do you try to
ignore feelings of hunger and skip meals? This can lead to overeating or eating
a high-fat snack later on. Plan for meals and snacks to eat at times when you
know you will be hungry. The goal is to eat when you are hungry and not eat
when you are not hungry.
Avoid straying from your plan: Isolated slips are normal, but try these tips to stay with your
plan.
Think ahead about situations that may be
hard, and visualize how you will deal with them. For example, if you're going
to a friend's house to watch a movie, remind yourself that snack food may be
served. Bring healthy foods to eat, such as raw vegetables or low-fat
crackers.
Plan for special occasions and situations. Sometimes
social situations, such as holidays, parties, and travel, will entice you to
eat more. Eat a healthy snack, such as low-fat yogurt or fruit before these
meals. It will help you have the willpower to make healthier choices.
See your doctor after 6
months to check your progress. Some people stop losing weight around this time,
because their bodies adjust to fewer calories, and their motivation starts to
slip.
At this point your doctor may want you to increase your
activity and revisit the dietitian to make further changes in your diet. Your
goals may switch from losing more weight to keeping the weight off. Staying
active is very important for maintaining weight loss.
If you have
lost weight but gained it back, don't be discouraged. It is not uncommon to try
several times before weight comes off and stays off. Talk to your doctor about
starting again. It may be helpful to work with others who are trying to lose
weight in a structured program.
If you cannot keep weight off or
have not managed to lose
1 lb (0.5 kg) a week, your
doctor may want you to add medicines. Weight-loss drugs generally are used
along with eating changes and exercise. Use of medicine without lifestyle
changes is not likely to have long-term success. Medicines for weight loss
include
sibutramine,
orlistat, and
phentermine.
If you do
not lose weight, continue to gain weight, or have lost weight several times
only to regain it, or if your doctor is concerned about a
related health problem, you might need to try
medicines or surgery.
Weight-loss medicines are not prescribed
alone. Diet changes and physical activity are needed for keeping weight off
long-term. Without these, when medicine is stopped, weight will return.
Medicines for weight loss include
sibutramine,
orlistat, and
phentermine. These drugs work by making you feel full
sooner, lowering your appetite, or limiting the amount of fat your body can
absorb.
Your doctor may suggest surgery if you have not been able
to lose weight with other treatments and you are at high risk for developing
other health problems because of your weight.
If your
body mass index is over 40 or if it is 35 or higher
and you have a serious medical problem that is made worse by your weight, one
of the following surgeries may be an option:
A modest weight loss of
4.4 lb (2 kg) to
9.7 lb (4.4 kg) resulted in a
significant lowering of blood pressure.7
People with
asthma who lost an average of
31.3 lb (14.2 kg) over 1 year
showed improved lung function and overall health, and with weight loss, the
number of severe asthma episodes (exacerbations) and oral
corticosteroid courses were reduced.8
People with type 2 diabetes who lost weight had
lower blood sugar levels and were able to use less medicine to lower their
blood sugar levels.3
Sustained weight loss
prevented new cases of type 2 diabetes in people who were obese.3
People
with obstructive
sleep apnea who lost as little as 10% of their weight
improved their sleep patterns and had less daytime sleepiness.3
Weight-Loss Programs and Strategies
What helps one
person lose weight may not work for you. You need to find the right balance of
eating and physical activity that you can keep doing or a program that works
with your lifestyle.
A recent study suggests that the type of
diet you follow is less important than choosing one that you can stay with.
Most diets or programs can help you lose weight at first. But you will lose
more and have more health benefits if you can keep with it for a longer time.
Find what
works best for you. If you do not have time to cook and hate to prepare meals,
a program that offers meal replacement bars or shakes may be better for you. Or
if you like to prepare meals, finding a plan that includes daily menus and
recipes may be best.
Get family and friends involved to provide
support. Talk to them about why you are changing your diet and physical
activity and how important losing weight is to you. Ask them to help by doing
exercises and having meals with you, even if they may be eating something
different.
Identify obstacles to losing weight. Look at your food
journal and try to find things that cause you to overeat, such as stress or
depression.
Remove food temptations such as high-calorie snacks,
and replace them with healthier foods such as fruit and low-fat
yogurt.
Plan your meals and snacks ahead of time. This
provides a road map for how you will make changes and helps you set goals,
track your progress, and reward yourself.
Make healthy fast-food,
restaurant, and convenience-food choices to maintain your diet when eating out.
Keep unhealthy food out of the house.
Eat before
you go grocery shopping. This can lower your tendency to buy foods that aren't
good for you and can help you avoid impulse shopping (buying things you do not
need, just because you see them).
Commercial weight-loss programs
Many commercial weight-loss programs (such as
Weight Watchers or Lifesteps) and self-help or support groups (such as
Overeaters Anonymous) are available. The quality and effectiveness of these
programs vary widely, from reputable obesity clinics associated with hospitals
to quick weight-loss schemes that may even harm your health with untested
“miracle” products.
More research is needed to prove whether
these programs are effective or any better than a self-directed
program.9 But some people do better when they have a
structured plan to follow or can participate with a group of people.
When
considering a commercial weight-loss program, ask
questions about the staff's qualifications and whether counseling is offered.
Be aware that the advertising strategies for weight-loss programs and products,
such as using celebrities and "before and after" pictures, are usually
unrealistic.
Most weight-loss medicines for
obesity work by making you feel less hungry or making
you feel full sooner. They are used together with diet and exercise.
Sibutramine (Meridia) is a prescription
medicine that makes you feel full sooner.
Orlistat (Xenical)
is a prescription medicine that prevents some of the fat calories you eat from
being absorbed in your intestines. Also, orlistat (Alli) is available
over the counter. Alli contains half of the medicine
that is in Xenical.
Phentermine suppresses your appetite. It is approved
only for short-term use.
What to Think About
Phentermine is no longer
marketed in Europe because of a possible link with heart and lung
problems.
Medicine alone is not as effective as when combined with
diet or activity. Most of the results reported in research are for a
combination of medicine, diet, and activity.
Medicine does not
work for everyone. If you do not lose weight within 4 weeks of using medicine,
the medicine probably will not help you.4
Studies report that when medicine is stopped, weight is usually
regained.10
Although current weight-loss
drugs appear to be safer than previous weight-loss medicines, experts do not
know how safe or effective they are beyond 2 years of use.11
Gastric bypass surgery may
help you live longer. Some studies show that people who have weight-loss
surgery have a lower risk of dying from heart problems, diabetes, or
cancer.12
The goal of surgery is to cause
significant weight loss. This should reduce
obesity-related health problems, including type 2
diabetes and
high blood pressure.
It is important to
remember that you may still be obese or overweight after the surgery. Also,
surgery will require you to make extreme changes in how you eat, such as eating
only a few ounces of food at a time because the surgery creates a much smaller
stomach.
Getting good nutrition is also a problem. So you will
probably need to take vitamins and supplements. You will also need to avoid
high-calorie drinks, which add calories without nutrients.
Two
types of surgery are used to treat obesity. A restrictive operation (such as
stomach stapling [vertical banded gastroplasty] or adjustable gastric banding)
reduces food intake, usually by decreasing the size of the stomach. A
malabsorptive, irreversible operation (such as a Roux-en-Y gastric bypass or a
biliopancreatic diversion) makes the stomach smaller and decreases the
digestion and absorption of food.
Other types of surgery
(including intestinal bypass, jaw wiring, and liposuction) have been used to
treat obesity. None have been found to have long-term benefit in the treatment
of obesity. They are not recommended because of side effects and poor success
rates.
Roux-en-Y gastric bypass (the most commonly used). Gastric bypass surgery makes the
stomach smaller and allows food to bypass part of the small
intestine.
Biliopancreatic diversion (rarely
used). Biliopancreatic diversion changes the normal process of digestion by
making the stomach smaller and allowing food to bypass part of the small
intestine so that you absorb fewer calories.
Nutrition concerns
After surgery, you will only be
able to eat or drink very small amounts. For the first week or two, you will be
on a liquid diet. When you are able to have solid foods, they will need to be
pureed.
You will need to avoid certain foods, depending on which
type of surgery you have. Right after surgery, you may not be able to have any
liquids that contain sugar. And you may have to avoid milk.
You
will also need to learn new ways to eat. You'll need to eat very slowly and
chew your food well. If you don't make these changes, you may vomit frequently
and have pain. You may also develop nutrition problems and need to take
vitamins.
Low calcium and iron levels can be problems. Your bones
may weaken and you may develop
anemia. Your doctor may recommend calcium, iron, and
vitamin supplements.
Some people develop dumping syndrome when
they eat or drink simple sugars (found in candy, juices, ice cream, condiments,
or soft drinks). Dumping syndrome occurs when food moves too quickly through
the stomach and intestines. It can cause shaking, sweating, dizziness, rapid
heart rate, and often severe diarrhea. Foods with natural sugars found in
fruits, dairy, and vegetables do not usually cause dumping syndrome.
You will not be able to drink for 30 minutes before eating, during your
meal, and for 30 minutes after eating.
All surgeries have risks. Discuss your treatment options
with your doctor to decide what is best for you.
Most people who
have surgery to treat obesity quickly begin to lose weight. Weight loss usually
continues for about 2 years.
Risks common to all surgeries for
weight loss include an infection in the incision, a leak from the stomach into
the abdominal cavity or where the intestine is connected (resulting in an
infection called
peritonitis), and a blood clot that blocks blood flow
in the lung (pulmonary embolism). About one-third of all people who
have surgery for obesity develop
anemia or
osteoporosis.3, 13
It is important to
compare the risks of being obese with the risks of surgery.
Other Places To Get Help
Organizations
Centers for Disease Control and Prevention
(CDC)
1600 Clifton Road
Atlanta, GA 30333
Phone:
1-800-CDC-INFO (1-800-232-4636)
TDD:
1-888-232-6348
E-mail:
cdcinfo@cdc.gov
Web Address:
www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is
an agency of the U.S. Department of Health and Human Services. The CDC works
with state and local health officials and the public to achieve better health
for all people. The CDC creates the expertise, information, and tools that
people and communities need to protect their health—by promoting health,
preventing disease, injury, and disability, and being prepared for new health
threats.
National Heart, Lung, and Blood Institute
(NHLBI)
P.O. Box 30105
Bethesda, MD 20824-0105
Phone:
(301) 592-8573
Fax:
(240) 629-3246
TDD:
(240) 629-3255
E-mail:
nhlbiinfo@nhlbi.nih.gov
Web Address:
www.nhlbi.nih.gov
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating:
Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
pneumonia.
Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
References
Citations
National Heart, Lung, and Blood Institute, National
Institutes of Health (2000). The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (NIH Publication No. 00-4084). Available online:
http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.
Purnell JQ (2008). Obesity. In DC Dale,
DD Federman, eds., ACP Medicine, section 3, chap. 10.
Hamilton, ON: BC Decker.
American Gastroenterological Association (2002). AGA
technical review on obesity. Gastroenterology, 123(3):
882–932. [Erratum in Gastroenterology, 123(5):
1752.
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
Bravata DM, et al. (2003). Efficacy and safety of
low-carbohydrate diets: A systematic review. JAMA,
289(14): 1837–1850.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
Stevens VJ, et al. (2001). Long-term weight loss and
changes in blood pressure: Results of the trials of hypertension prevention,
phase II. Annals of Internal Medicine 134(1):
1–11.
Stenius-Aarniala B, et al. (2000). Immediate and
long-term effects of weight reduction in obese people with asthma: Randomised
controlled study. BMJ, 320(7238):
827–832.
Tsai AG, Wadden TA, (2005). Systematic review: An
evaluation of major commercial weight loss programs in the United States.
Annals of Internal Medicine, 142(1): 56–67.
Hensrud DD (2000). Pharmacotherapy for obesity.
Medical Clinics of North America, 84(2):
463–476.
Yanovski SZ, Yanovski JA (2002). Drug therapy:
Obesity. New England Journal of Medicine, 346(8):
591–602.
Adams TD, et al. (2007). Long-term mortality after
gastric bypass surgery. JAMA, 357(8): 753–761.
U.S. Department of Health and Human Services (2008).
Bariatric Surgery for Severe Obesity (NIH Publication
No. 04-4006). Available online:
http://www.win.niddk.nih.gov/publications/gastric.htm.
Other Works Consulted
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death in overweight and obese U.S. adults 35 years of age and older.
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treatment of obesity. Annals of Internal Medicine,
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Noël PH, Pugh JA (2002). Management of overweight and
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Snow V, et al. (2005). Pharmacologic and surgical
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American College of Physicians. Annals of Internal Medicine, 142(7): 525–531.
National Heart, Lung, and Blood Institute, National
Institutes of Health (2000). The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (NIH Publication No. 00-4084). Available online:
http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.
Purnell JQ (2008). Obesity. In DC Dale,
DD Federman, eds., ACP Medicine, section 3, chap. 10.
Hamilton, ON: BC Decker.
American Gastroenterological Association (2002). AGA
technical review on obesity. Gastroenterology, 123(3):
882–932. [Erratum in Gastroenterology, 123(5):
1752.
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
Bravata DM, et al. (2003). Efficacy and safety of
low-carbohydrate diets: A systematic review. JAMA,
289(14): 1837–1850.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
Stevens VJ, et al. (2001). Long-term weight loss and
changes in blood pressure: Results of the trials of hypertension prevention,
phase II. Annals of Internal Medicine 134(1):
1–11.
Stenius-Aarniala B, et al. (2000). Immediate and
long-term effects of weight reduction in obese people with asthma: Randomised
controlled study. BMJ, 320(7238):
827–832.
Tsai AG, Wadden TA, (2005). Systematic review: An
evaluation of major commercial weight loss programs in the United States.
Annals of Internal Medicine, 142(1): 56–67.
Hensrud DD (2000). Pharmacotherapy for obesity.
Medical Clinics of North America, 84(2):
463–476.
Yanovski SZ, Yanovski JA (2002). Drug therapy:
Obesity. New England Journal of Medicine, 346(8):
591–602.
Adams TD, et al. (2007). Long-term mortality after
gastric bypass surgery. JAMA, 357(8): 753–761.
U.S. Department of Health and Human Services (2008).
Bariatric Surgery for Severe Obesity (NIH Publication
No. 04-4006). Available online:
http://www.win.niddk.nih.gov/publications/gastric.htm.
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