Overweight and Obesity: Prevalence, Causes, Risk Factors, Signs, Diagnosis, and Treatment

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Weight that is higher than what is considered as a healthy weight for a certain height is described as overweight or obese.

Overweight and obesity are increasingly common conditions in the world. In 2016, over 1.9 billion adults, aged 18 years and older, were overweight – of these, over 650 million were obese. Obesity is a serious medical condition that can cause complications, such as high blood pressure, high blood cholesterol, heart disease, diabetes, sleep disorders, and certain types of cancers.

Treatment depends on the cause and severity of your condition, and whether you have complications. Treatments include lifestyle changes, increased physical activity, and medications.

In this article, we take an in-depth look into overweight and obesity, including its causes, risk factors, signs and symptoms, treatment, and more.

What Does Overweight and Obesity Mean?

Overweight and obesity are defined as excessive or abnormal fat accumulation that may impair health. Body Mass Index (BMI) is used as a screening tool for overweight or obesity. 

To use the table below, find the appropriate height in the left-hand column labeled ‘Height’. Then, move across to a given weight. The number at the top of the column is the BMI at that specific height and weight. Note that pounds have been rounded off.

(source: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.htm)

For adults, the World Health Organization (WHO) defines overweight and obesity as follows:

  • Overweight BMI. Overweight is a BMI greater than or equal to 25
  • Obesity BMI. Obesity is a BMI greater than or equal to 30

For children, age needs to be considered when defining overweight and obesity. 

For children under 5 years old, WHO defines overweight and obesity as follows:

  • Overweight is weight-for-height greater than 2 standard deviations above WHO Child Growth Standards median
  • Obesity is weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median 

For children between 5 – 19 years old, WHO defines overweight and obesity as follows:

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  • Overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median
  • Obesity is greater than 2 standard deviations above the WHO Growth Reference median

Overweight and Obesity in the Philippines

“The prevalence of overweight and obese is observed to be higher than the national estimate across all population groups in the 80 highly-urbanized cities (HUCs) in the National Capital Region (NCR),” Dr. Imelda Angeles-Agdeppa, Scientist II, Officer-in-Charge, Office of the Deputy Director and Chief Science Research Specialist of the Department of Science and Technology – Food and Nutrition Research Institute (DOST-FNRI) said during the Dissemination Forum on the Expanded National Nutrition Survey (ENNS) Year 1 Results at the Dusit Thani Manila on August 20, 2019.

Preschool Children. The prevalence for overweight and obese at the national level was 4.0% among preschool children, 0 – 59 months old, based on the Child Growth Standard (CGS). 

School-age Children. Among school-age children, between the ages of 5 – 10 years old, the prevalence of overweight and obese at the national level more than doubled among preschool children at 11.6% or about 1 in every 10 school-age children, based on the World Health Organization (WHO) Growth Reference body mass index (BMI) for-age.

Adolescents. Based on BMI-for-age, about 1 in every 5 adolescents in Makati (23.6%), Mandaluyong (19.7%), Manila (19.2%), San Juan (18.4%), Caloocan (17.6%) and Las Piñas (16.3%) were overweight/obese and these were significantly higher then the national prevalence of 11.6% or 1 in every 10.

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Adults and Elderly. At the national level, 28.8% are overweight and 9.6% are obese among adults, 20-59 years old, based on BMI.

Elderly. Among elderly, aged 60 years old and above, the prevalence of overweight was 24.7% and obese is 6.3% at the national level.

Overweight and Obesity Causes

Energy imbalances, some genetic or endocrine medical conditions, and certain medications are known to cause overweight or obesity. 

  • Energy Imbalances

Energy imbalances can cause overweight and obesity. An energy imbalance means that your energy IN doesn’t equal your energy OUT – this energy is measured in calories. Energy IN is the number of calories that you get from food and drinks. On the other hand, Energy OUT is the number of calories that your body uses for things such as digesting, breathing, body temperature regulation, and being physically active. 

Over time, overweight and obesity develop when you take in more calories than you use, or when Energy IN is more than your Energy OUT. This type of energy imbalance can cause your body to store fat. 

  • Medical Conditions

Some genetic syndromes, endocrine disorders, and other medical conditions can cause overweight or obesity. 

  • Genetic Syndromes. Some genetic syndromes are associated with overweight and obesity, including Alström syndrome, Bardet-Biedl syndrome, Cohen syndrome, and Prader-Willi syndrome. 
  • Endocrine Disorders. Because the endocrine system produces hormones that help maintain energy balances in the body, endocrine disorders can cause overweight and obesity. This includes:
  • Hypothyroidism. People with hypothyroidism have low levels of thyroid hormones. These low levels are linked with decreased metabolism and weight gain, even when food intake is reduced. People with hypothyroidism also produce less body heat and do not efficiently use stored fat for energy. 
  • Cushing’s Syndrome. People with Cushing’s syndrome have high levels of glucocorticoids, such as cortisol, in the blood. High cortisol levels make the body feel like it is under chronic stress. As a result, people experience an increase in appetite and the body will store more fat. Cushing’s syndrome may develop after taking certain medications or because the body naturally produces too much cortisol. 
  • Tumors. Some tumors, such as craneopharingioma, can cause severe obesity because the tumors develop near parts of the brain that control hunger.
  • Medications. Some medications, such as antidepressants, antihyperglycemics, antiepileptics, and antipsychotics can cause weight gain and lead to overweight and obesity. Consult your doctor if you notice weight gain while you are taking one of these medications. Ask if there are other forms of the same medicine, or other medications that can treat your medical condition, but have less of an effect on your weight. Do no stop taking your medications without talking to your doctor. 

Overweight and Obesity Risk Factors

There are many risk factors for overweight and obesity. Some of these risk factors include:

  • Lack of physical activity. Lack of physical activity has been linked with a high body mass index (BMI). Healthy lifestyle changes, such as being physically active and exercising regularly can help you aim for a healthy weight. 
  • Age. The risk of unhealthy weight gain increases as you age. Often, adults who have a healthy BMI start to gain weight in young adulthood and continue to gain weight until 60 – 65 years old, when they tend to start losing weight.
  • Unhealthy eating behaviors. Some unhealthy eating behaviors can increase your risk for overweight or obesity. This includes eating more calories than you use, eating too much saturated and trans fats, and eating foods high in added sugars. 
  • Genetics and family history. Genetic studies have found that overweight and obesity can run in families, so it is possible that our DNA or genes can cause these conditions. Research studies have found that certain DNA elements are linked with obesity. 
  • Not enough sleep. Several studies have seen a high BMI in people who don’t get enough sleep. Some studies have seen a link between sleep and the way our bodies use nutrients for energy and how insufficient sleep can affect hormones that control hunger urges. 
  • Ethnicity or race. Overweight and obesity is highly prevalent in some ethnic and racial minority groups. For instances, rates of obesity in American adults are highest in blacks, followed by Hispanics, then whites. This is true for women or men. While Asian women and men have the lowest rates of unhealthy BMIs, they may have high amounts of unhealthy fat in the abdomen. 
  • High amounts of stress. Chronic stress and acute stress can affect the brain and trigger the production of hormones, such as cortisol, that control our hunger urges and energy balances. Acute stress can trigger hormone changes that make you not want to eat. If the stress becomes chronic, hormone changes can make you eat more and store more fat. 

Signs and Symptoms of Overweight and Obesity

There are no specific symptoms of overweight and obesity. 

The signs of overweight and obesity include a high body mass index (BMI) and an unhealthy body fat distribution that can be estimated by measuring your waist circumference. 

  • High BMI. A high BMI is the most common sign of overweight and obesity.
  • Unhealthy body fat distribution. Another sign of overweight and obesity is having an unhealthy body fat distribution. Having an increased waist circumference suggests that you have increased amounts of fat in your abdomen. An increased waist circumference is a sign of obesity and can increase your risk for obesity-related complications. 

Overweight and Obesity Diagnosis

Your doctor may diagnose overweight and obesity based on your medical history, physical exams that confirm you have a high BMI, and tests to rule out other medical conditions.

Overweight and Obesity Treatment

Treatment for overweight and obesity can vary depending on the cause and severity of your condition. Possible treatments include healthy lifestyle changes, medications, behavioral weight-loss treatment programs, and possibly surgery. You may also need treatments for any complications that you have. 

The Bottom Line

Overweight and obesity are increasingly common conditions in the world. In 2016, over 1.9 billion adults, aged 18 years and older, were overweight – of these, over 650 million were obese. Obesity is a serious medical condition that can cause complications, such as high blood pressure, high blood cholesterol, heart disease, diabetes, sleep disorders, and certain types of cancers. 

Treatment depends on the cause and severity of your condition, and whether you have complications. Treatments include lifestyle changes, increased physical activity, and medications.

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