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- Obesity is the state of excess adipose tissue, frequently characterized in adults by body mass index (BMI), body weight (kg)/(body height [m2]), of ≥30 kg/m2.
- Obesity is associated with negative health outcomes (1), and the concurrent presence of abdominal obesity increases the risk of morbidity and mortality.
- System(s) affected: endocrine/metabolic, cardiac, respiratory, gastrointestinal, musculoskeletal, dermatologic, mental health
- Synonym(s): overweight; adiposity
Note: Underweight BMI (≤18) is associated with an increased risk of mortality. The most likely explanation is that this is a secondary effect; severe chronic conditions can cause anorexia and weight loss.
- Predominant age: Incidence rises in the early 20s.
- Predominant sex: female > male
- Mean prevalence of obesity among adults is 35% in the United States (2,3).
- Overweight: 40% of men and 25% of women
- Obese: 20% of men and 25% of women
- Pediatric obesity is defined as have a BMI at ≥95th percentile, as by age and sex specific WHO or CDC growth curves.
- Obesity during adolescence and young adulthood is strongly associated with obesity in adulthood.
Etiology and Pathophysiology
- Obesity is caused by an imbalance among food intake, absorption, and energy expenditure.
- Underlying organic causes include psychiatric disturbances, hypothyroidism, hypothalamic disorders, insulinoma, and Cushing syndrome.
- Medications can contribute to obesity, including corticosteroids, neuroleptics (particularly atypical antipsychotics), and antidepressants.
- Genetic syndromes such as Prader-Willi and Bardet-Biedl are found in a minority of people with obesity.
- Studies are insufficiently powered to isolate specific genes as independent predictors of obesity.
- Parental obesity
- Sedentary lifestyle
- Consumption of calorie-dense food
- Low socioeconomic status
- >2 hours per day of television viewing
- Encourage at least 1 hour of daily exercise, limited television viewing, and moderation in portion size.
- Avoid calorie-dense and nutrient-poor foods such as sweetened beverages and processed foods.