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This is a combination drug of naltrexone (an opioid antagonist) and bupropion HCL (an antidepressant medication that is an inhibitor of the reuptake of dopamine and norepinephrine). The main side effects observed with this medication are nausea, constipation, and headaches. The medication is contraindicated in patients with uncontrolled hypertension or a history of seizures.
Obesity is measured by various means, but the most common methods used are Body Mass Index (BMI) and Waist Circumference. There is no perfect method to measuring obesity, however these two indicators are most commonly used by clinicians as a tool to diagnose weight.
Measuring your waist circumference. Fat stored around your waist, sometimes called visceral fat or abdominal fat, may further increase your risk of diseases, such as diabetes and heart disease. Women with a waist measurement (circumference) of more than 35 inches (80 centimeters, or cm) and men with a waist measurement of more than 40 inches (102 cm) may have more health risks than do people with smaller waist measurements. Like the BMI measurement, your waist circumference should be checked at least once a year.
It’s never too late to get healthy and improve your quality of life. For some older adults, this means losing weight. But what is the best diet plan for seniors? And how do you start an exercise program if you’ve never been active?
I also visited Tic Gums in White Marsh, Maryland, a company that engineers textures into food products. Texture hasn’t received the attention that flavor has, noted Greg Andon, Tic’s boyish and ebullient president, whose family has run the company for three generations. The result, he said, is that even people in the food industry don’t have an adequate vocabulary for it. “They know what flavor you’re referring to when you say ‘forest floor,’ but all they can say about texture is ‘Can you make it more creamy?’ ” So Tic is inventing a vocabulary, breaking textures down according to properties such as “mouth coating” and “mouth clearing.” Wielding an arsenal of some 20 different “gums”—edible ingredients mostly found in tree sap, seeds, and other plant matter—Tic’s researchers can make low-fat foods taste, well, creamier; give the same full body that sugared drinks offer to sugar-free beverages; counter chalkiness and gloopiness; and help orchestrate the timing of flavor bursts. (Such approaches have nothing in common with the ill-fated Olestra, a fat-like compound engineered to pass undigested through the body, and billed in the late 1990s as a fat substitute in snack foods. It was made notorious by widespread anecdotal complaints of cramps and loose bowels, though studies seemed to contradict those claims.)
Several areas of research are exploring mechanisms that link obesity and cancer (29, 46). One research area involves understanding the role of the microbes that live in the human gastrointestinal tract (collectively called the gut microbiota, or microbiome) in both type 2 diabetes and obesity. Both conditions are associated with dysbiosis, an imbalance in the collection of these microbes. For example, the gut microbiomes of obese people are different from, and less diverse than, those of non-obese people. Imbalances in the gut microbiota are associated with inflammation, altered metabolism, and genotoxicity, which may in turn be related to cancer. Experiments in mice show that the microbiome may influence the efficacy of some types of cancer treatment, particular immunotherapy (47, 48). Researchers are beginning to think about ways to change the microbiota of cancer patients to improve their outcomes.
Although strength training programs have been shown to reduce body weight significantly (and increase muscle mass), convincing overweight clients to eat properly is even more important in helping them lose fat. Consult a registered dietician and use the information in chapter 10 that discusses food selection and substitutions for heart-healthy eating to help your overweight clients attain a more desirable bodyweight. Also, encourage them to drink lots of water before, during, and after workouts, especially in hot and humid weather or in training areas without ideal air circulation. Suggest that they wear loose clothing to decrease chafing and dress in layers so that they can remove articles to avoid overheating (Flood and Constance 2002).
You don’t have to run a marathon to be active in your golden years. In fact, small changes — such as walking 30 minutes a day or taking a low-impact fitness class at your local gym or senior center — can lead to big health rewards.
Experts believe if the current trends continue by 2015 approximately 2.3 billion adults will be overweight and more than 700 million will be obese. The scale of the obesity problem has a number of serious consequences for individuals and government health systems.
23. Yeh S, Wu SY, Levine DM, et al. Quality of life and stimulation of weight gain after treatment with megestrol acetate: correlation between cytokine levels and nutritional status, appetite in geriatric patients with wasting syndrome. J Nutr Health Aging 2000; 4:246–51 [PubMed]
If you think you may be obese, and especially if you’re concerned about weight-related health problems, see your doctor or health care provider. You and your provider can evaluate your health risks and discuss weight-loss options.
Talk to your doctor to learn more about the benefits and risks of each type of surgery. Possible complications include bleeding, infection, internal rupture of sutures, or even death. Read gastric bypass surgery for more information.
Surgery. In general, weight-loss surgery (called bariatric surgery) may be considered if your BMI is 40 or greater, or your BMI is 30-35 or greater and you have at least one medical condition directly related to obesity. In addition, you must have participated in a structured weight loss program without success.
Aim for roughly 30 grams at each meal, and more if you tend to crave carb-rich foods. “In my practice, I notice that dietary patterns tend to shift somewhat with age, and as people get older, the calories that were once spent on lean protein might now be spent on carbohydrates or fats.” Not only does adequate protein help support muscle growth and repair (which, when coupled with resistance training, will help increase metabolic rate and overall calorie burn), but it’s also more satiating than carbs and fats, meaning you’ll be less likely to reach for unhealthy snacks, says Bowerman. (You can drink your protein with these 20 protein-packed smoothie recipes.)
Clearly, this is not the way to do it. In order to lose 5-10% of your body weight over a six-month period you must, by definition, stick to the diet for six months. Since most of us will stop dieting after one or two months, we need help in order to see the results we desire most.
Hoping to gain some firsthand insight into the issue while in L.A., I drove away from the wholesome-food-happy, affluent, and mostly trim communities of the northwestern part of the city, and into East L.A. The largely Hispanic population there was nonaffluent and visibly plagued by obesity. On one street, I saw a parade of young children heading home from school. Perhaps a quarter of them were significantly overweight; several walked with a slow, waddling gait.
Body mass index is closely related to body fat percentage but is much easier to measure. Therefore, it is used by many primary-care providers to identify obesity. The greater your BMI, the higher your risk of developing health problems related to excess weight.
Ironically, weight loss itself, particularly rapid weight loss or loss of a large amount of weight, can actually increase your chances of developing gallstones. Modest, slow weight loss of about 1 pound a week is less likely to cause gallstones.

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Jump up ^ Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB (23 June 2011). “Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men”. The New England Journal of Medicine (Meta-analysis). 364 (25): 2392–404. doi:10.1056/NEJMoa1014296. PMC 3151731 . PMID 21696306.
There were other factors that made the legislation possible, including a legislature determined to address the rising economic costs of obesity and support from Ms. Bachelet, a socialist who also happens to be trained as a pediatrician.
Obesity can lead to social stigmatization and disadvantages in employment.[200] When compared to their normal weight counterparts, obese workers on average have higher rates of absenteeism from work and take more disability leave, thus increasing costs for employers and decreasing productivity.[209] A study examining Duke University employees found that people with a BMI over 40 kg/m2 filed twice as many workers’ compensation claims as those whose BMI was 18.5–24.9 kg/m2. They also had more than 12 times as many lost work days. The most common injuries in this group were due to falls and lifting, thus affecting the lower extremities, wrists or hands, and backs.[210] The Alabama State Employees’ Insurance Board approved a controversial plan to charge obese workers $25 a month for health insurance that would otherwise be free unless they take steps to lose weight and improve their health. These measures started in January 2010 and apply to those state workers whose BMI exceeds 35 kg/m2 and who fail to make improvements in their health after one year.[211]
BMI is the tool most commonly used to estimate and screen for overweight and obesity in adults and children. BMI is defined as weight in kilograms divided by height in meters squared. For most people, BMI is related to the amount of fat in their bodies, which can raise the risk of many health problems. A health care professional can determine if a person’s health may be at risk because of his or her weight.
A randomized, double-blind trial conducted in Denmark among 24 hospitalized patients compared differences in total nutrient intake between a diet that included a standard (4.2 kJ/ml) commercial liquid supplement and a diet incorporating a nutrient-dense (6.3 kJ/ml) supplement.17 The products were offered in addition to the regular hospital diet. Both diets increased total daily energy and protein intake, with no significant difference between the diets. Poor compliance, occurring in one-third to one-half of patients, was evident during the first two to three days of supplementation.
There is an “obesity paradox” raging in the medical community. You may be surprised to hear this hot debate revolves around an unlikely group: our elders. Childhood and young adulthood obesity seem to always be in the headlines. But what about people ages 65 and older? Thanks to some new research, the debate of obesity in older people has been thrust into the medical spotlight.
Instead, dropping pounds can often feel harder than ever. After all, that stiff back that keeps you from bounding out of bed in the morning can make it less inspiring to go to the gym, a busy schedule can prompt you to eat on the run, and those 10 pounds you gained in your 40s can become an extra 20 pounds in your 50s and, well, you get the idea. (Want to lose weight but are short on time? Then check out Fit in 10, the new fitness program that only takes 10 minutes.)
van Geel M, Vedder P, Tanilon J. Are overweight and obese youths more often bullied by their peers? A meta-analysis on the correlation between weight status and bullying. Int J Obes (Lond). 2014;38(10):1263–1267.
Beers, Mark H., MD, and Robert Berkow, MD, editors. “Nutritional Disorders: Obesity.” Section 1, Chapter 5. In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.
The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. Reducing your weight by 10% can decrease your chance of developing heart disease.
You should visit your health care provider periodically to monitor for possible complications, which if left untreated can be life-threatening. Your doctor may do any of the following to monitor your condition.
Weight loss occurs when more calories are expended than are consumed. Healthy animals can experience weight loss, but in a geriatric cat, a subtle decrease in weight can also be the first indication of illness. For example, cats with small intestinal disease may lose weight before exhibiting anorexia, vomiting, or diarrhea. Unfortunately, weight changes in older cats are often attributed merely to aging, so clients may not seek veterinary care or veterinarians may inadvertently delay a diagnostic workup until marked weight loss is evident or additional clinical signs arise. Starting with a detailed history, work your way through a complete workup in these patients.
Mauro Russo, managing director at Ferrero, the maker of the Kinder Surprise, said the law had been erroneously applied to their product because the toy is an intrinsic part of the treat, not a “promotional gadget,” as described by the legislation, that seeks to stimulate sales. He also disputed the notion that the product is unhealthy, noting that each egg contains 110 calories and that few consumers purchase more than one or two a year. “Kinder Surprise’s impact on obesity is very marginal,” he said.
“From a nutritional perspective, starting at age 30, our metabolic rate (meaning the calories we need) declines by 10 percent per decade,” explains Roberts. It comes down to the number of calories consumed versus the number of calories burned. Remember: You don’t want to break down lean body mass; you only want to burn stored body fat.
IsagenixHealth.net is your one-stop platform for learning about the science behind Isagenix products. With regular articles from our Research and Science Team and the Scientific Advisory Board, you can stay abreast of the latest evidence-based updates about weight management, healthy aging, and energy and performance. Keeping up with us is easy — bookmark our page, subscribe via email or RSS, like our Facebook Page, or follow us on Twitter. For more information about Isagenix, visit www.isagenix.com.
Obese people often have increased blood levels of insulin and insulin-like growth factor-1 (IGF-1). (This condition, known as hyperinsulinemia or insulin resistance, precedes the development of type 2 diabetes.) High levels of insulin and IGF-1 may promote the development of colon, kidney, prostate, and endometrial cancers (29).
Participating in a non-clinical program or commercially operated program is another form of treatment for obesity. Some programs may be commercially operated, such as a privately owned weight-loss chain. Counselors, books, Web sites or support groups are all ways you can be involved in a non-clinical weight-loss program.
Talk to your doctor if you notice weight gain while you are using one of these medicines. Ask if 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. Do not stop taking the medicine without talking to your doctor.
Making healthier choices. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein — such as beans, lentils and soy — and lean meats. If you like fish, try to include fish twice a week. Limit salt and added sugar. Stick with low-fat dairy products. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as olive, canola and nut oils.
JoAnn Manson, MD, chief of preventive medicine at Harvard University’s Brigham and Women’s Hospital, and her Harvard colleagues took a look at last year’s CDC findings soon after they were published. They excluded smokers and people who might have already been ill when enrolled in the trial.
“The epidemic of obesity is so clear and harmful to the whole population, including the political elite, and no country is succeeding to control it without regulation of the food environment,” he said. “Doing nothing is no longer an option.”
The next step for Pilkington is to conduct a survey to examine any health-promoting features at various workplaces, and the barriers to and enablers of new programs aimed at improving workers’ health.
It’s possible to eat healthy produce on a limited budget. “Frozen fruits and vegetables can be cheaper and sometimes even healthier than fresh, depending where they’re shipped from,” Campbell says. Canned produce can be OK, she says, if there’s no added salt.
Results from the National Health and Nutrition Examination Survey (NHANES) showed that in 2011–2014, nearly 70% of U.S. adults age 20 years or older were overweight or obese and more than one-third (36.5%) were obese (3). In 1988–1994, by contrast, only 56% of adults aged 20 years or older were overweight or obese.
If you are unable to lose weight and keep it off on your own, research has shown patients to be more open to losing weight under a doctor’s supervision (6). Consider working with your primary care physician and asking for referrals to a dietitian, psychologist and even a personal trainer to assist in your efforts.
Future trials need to address specific exercise training modalities, calcium, Vitamin D and protein supplementation, and/or prescribing anti-resorptive therapy (e.g. in patients with low BMD to start with) during active weight loss. Trials specifically designed to investigate the complex interplay between exercise, caloric restriction, weight loss, diet composition, hormones, growth factors, and inflammatory markers are also needed. Finally, trials need to have adequate sample size with appropriate controls, and long follow-up periods needed to determine how best to achieve sustained lifestyle change associated with optimal health outcomes in frail, obese older adults. With the 65+ age group representing the fastest growing segment of the population, and with a high prevalence of obesity, these studies should become a priority for public health research.
To measure obesity, researchers commonly use a scale known as the body mass index (BMI). BMI is calculated by dividing a person’s weight (in kilograms) by their height (in meters) squared (commonly expressed as kg/m2). BMI provides a more accurate measure of obesity than weight alone, and for most people it is a fairly good (although indirect) indicator of body fatness. 
For those who don’t have the time to make it to support groups, there are now many free or low-cost apps available for the iPhone, iPad, or Android, which help determine and track calories, nutrition, and calorie expenditure. Try LoseIt!, Weight Watchers Mobile, Restaurant Nutrition, 40:30:30, Diet Point, Noom Weight Loss Coach, FitBit, Fooducate, Diet Assistance, Calorie Counter PRO MyNet Diary, Amwell, MyFitnessPal, or 7-Minute Workout.
Losing 5 to 10 percent of your weight may lower your chances of developing heart disease. If you weigh 200 pounds, this means losing as little as 10 pounds. Weight loss may improve blood pressure, cholesterol levels, and blood flow.
Medication adverse effects (Table 21,17,18) are common but often overlooked causative factors.17 Polypharmacy has been shown to interfere with taste and can cause anorexia.19 In addition, a variety of social factors are associated with unintentional weight loss and include poverty, alcoholism, isolation, financial constraints, and other barriers to obtaining food (e.g., impairment in activities of daily living, lack of assistance in grocery shopping or preparing meals).1 In 16% to 28% of patients, no readily identifiable cause for unintentional weight loss is determined.11–16
A study done in Sweden compared the rates of diabetes and hypertension in two groups of obese patients: those who underwent surgery and those who didn’t. Each group had similar body weight at baseline (the start of the study). At two years, diabetes and high blood pressure were lower in the patients treated with surgery.

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Body mass index (BMI) is used to determine if you or your child are underweight, healthy, or overweight or obese. Children are underweight if their BMI is below the 5th percentile, healthy weight if their BMI is between the 5th to less than the 85th percentile, overweight if their BMI is the 85th percentile to less than the 95th percentile, and obese if their BMI is the 95th percentile or above. Adults are underweight if their BMI is below 18.5, healthy weight if their BMI is 18.5 to 24.9, overweight if their BMI is 25 to 29.9, and obese if their BMI is 30 or above. *A child’s BMI percentile is calculated by comparing your child’s BMI to growth charts for children who are the same age and sex as your child.
Qsymia (combination of phentermine and topiramate) was approved by the FDA in 2012. It is only approved for those with a BMI greater than 27 with weight-related conditions. When combined with diet and exercise, studies have shown that half of the participants lost 10% of their body weight and four-fifths lost 5% (which equates to 12 pounds in a 227 pound person). Topiramate is associated with a high risk of birth defects such as cleft lip and palate. Phentermine (an appetite suppressant) was one of the ingredients in fen-phen and is associated with an elevation in heart rate. Because of these potentially serious side effects, Qsymia is only available through mail order. Other side effects include tingling, dizziness, alterations in taste, insomnia, dry mouth, and constipation.
BMI is a useful measure of overweight and obesity. It is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.
Obesity is increasing around the world. High body mass index now ranks with major global health problems such as childhood and maternal under-nutrition, high blood pressure, high cholesterol, unsafe sex, iron deficiency, smoking, alcohol and unsafe water in total global burden of disease.
Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.
But when his wife, Elena Acosta, signed up for a diabetes prevention program at the local YMCA, Acosta had no choice but to participate too. “Whatever I have to eat during this program, you’re eating too,” she told him.
There are also wide economic gaps between older adults in different racial/ethnic groups. While just 8 percent of non-Hispanic whites ages 65 and older lived in poverty in 2014, the comparable figure for Latinos was 18 percent, and for African Americans, it was 19 percent.
Get excited about reading again with fun and interesting tips from our experts, including The M.D., our dietitians, and our fitness expert. In our health library, you will find all of the information you need to achieve your goals of making a healthy lifestyle change. So, start reading and start losing!
Obesity is a serious health problem that can cause multiple medical complications and impair an individual’s quality of life. In older adults, being obese can exacerbate age-related decline in physical function and lead to frailty. Furthermore, older adult who are overweight or obese have an increased risk for developing chronic diseases, joint pain and limited mobility, greatly impacting how they function on a daily basis. Fortunately, there are multiple options for addressing obesity, including residential weight loss programs, that can help older adults achieve and maintain a healthy weight. With proper nutrition and the implementation of regular physical activity, older adults can get their weight problems under control.
I suffer with Crohn’s & im trying to lose 30 lbs… I’m 5’4 almost 50 & always fluctuating between 180-195lbs. I do your chair to chair running/walking excercise but may need supplements for energy. I do take not motivated feel sluggish with low energy….Any advice is appreciated.
In addition to the rising need for nursing home slots, demand for elder care will also be fueled by a steep rise in the number of Americans living with Alzheimer’s disease, which could nearly triple by 2050 to 14 million, from 5 million in 2013.
It’s not your imagination — as the years have passed, your body has become softer and less muscular. From age 25 to age 75, body fat typically doubles, according to University of Rochester Medical Center, and your lean muscle mass decreases. This decrease in muscle mass means your body needs fewer calories to maintain your weight, but if you keep eating like you did as a younger adult, your weight will go up. If you plan to skip the gym and focus solely on controlling your food intake for your weight-loss efforts, think again. Obese seniors age 65 to 85 had the most weight-loss success when they both dieted and exercised, according to a study published in 2011 in “The New England Journal of Medicine.”
12. Uretsky S, Messerli FH, Bangalore S, Champion A, Cooper-Dehoff RM, Zhou Q, Pepine CJ: Obesity paradox in patients with hypertension and coronary artery disease. Am J Med 2007; 120: 863– 870 [PubMed]
Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic syndromes (listed above) as well as some congenital or acquired conditions: hypothyroidism, Cushing’s syndrome, growth hormone deficiency,[129] and the eating disorders: binge eating disorder and night eating syndrome.[2] However, obesity is not regarded as a psychiatric disorder, and therefore is not listed in the DSM-IVR as a psychiatric illness.[130] The risk of overweight and obesity is higher in patients with psychiatric disorders than in persons without psychiatric disorders.[131]
Diet modification incorporating patient preferences, softer food consistency to accommodate for chewing or swallowing disabilities, and assisted feeding may lead to weight gain and improved laboratory parameters; however, study results of this approach are mixed.28–30 Creating a more leisurely eating environment simulating an in-home dining experience may improve nutrition in nursing home residents.31
Preventing obesity, or losing weight if you are obese, is about having awareness of the daily choices you make. Understanding the causes and consequences of obesity is the first step towards a healthy lifestyle. The next step is up to you.
This article has presented formal programs nurses can use to help patients manage their weight along with general considerations to facilitate weight loss safely in older adults who are obese. As trusted and respected healthcare professionals, it is time for nurses to take the lead in combating the obesity epidemic.
If ever there was a time to focus on getting enough lean protein, it’s now. “There is some evidence that older adults need more protein,” says Susan Bowerman, RD, a dietitian in Los Angeles. A study at the University of Arkansas found that increasing protein intake could help older adults build muscle. That can help counteract age-related muscle loss, says Bowerman.
The World Health Assembly welcomed the report of the Commission on Ending Childhood Obesity (2016) and its 6 recommendations to address the obesogenic environment and critical periods in the life course to tackle childhood obesity. The implementation plan to guide countries in taking action to implement the recommendations of the Commission was welcomed by the World Health Assembly in 2017.
A modified diet. A reasonable weight loss goal is 1 to 2 pounds per week. This can usually be achieved by eating 500 to 1,000 fewer calories each day. Whether you concentrate on eating less fat or fewer carbohydrates is up to you. Fats have more than twice as many calories per ounce than carbohydrates or protein. If you cut out carbohydrates, you still need to limit fat intake. Choose healthy fats, such as monounsaturated and polyunsaturated oils.
It can be done. My millennial generation kids did it for me. But it was not easy. We boomers are very sure of ourselves and self-focused. Appreciating how hard it will be for my generation to change, I wrote “The Boomer Generation Diet Book.”
Three years ago, when Nicole Wilhelm, a public relations executive in Jacksonville, Florida, was in the throes of wedding planning, she visited her 68-year-old father in Lucerne Valley, California. It quickly became apparent that something was wrong, says Wilhelm.
Several tools have been developed to aid physicians in remembering the multiple etiologies of unintentional weight loss. These include the mnemonic Meals on Wheels (medication effects; emotional problems, especially depression; anorexia nervosa; alcoholism; late-life paranoia; swallowing disorders; oral factors, such as poorly fitting dentures and caries; no money; wandering and other dementia-related behaviors; hyperthyroidism, hypothyroidism, hyperparathyroidism, and hypoadrenalism; enteric problems; eating problems, such as inability to feed oneself; low-salt and low-cholesterol diet; stones; social problems, such as isolation and inability to obtain preferred foods).20 Another tool is the 9 D’s of weight loss in the elderly (dementia, dentition, depression, diarrhea, disease [acute and chronic], drugs, dysfunction [functional disability], dysgeusia, dysphagia).21
32. Levine JA, Lanningham-Foster LM, McCrady SK, Krizan AC, Olson LR, Kane PH, Jensem MD, Clark MM: Interindividual variation in posture allocation: possible role in human obesity. Science 2005; 28:307: 584– 586 [PubMed]
Many studies have seen a high BMI in people who do not get enough sleep. Some studies have seen a relationship between sleep and the way our bodies use nutrients for energy and how lack of sleep can affect hormones that control hunger urges. Visit our Sleep Deprivation and Deficiency Health Topic for more information about lack of sleep.
The results of this pilot study suggest that changes in weight, body composition, dietary intake, physical function, and insulin sensitivity following an intensive lifestyle therapy may be sustained long-term even without contact. However, this study was limited by the small sample size, high potential for selection bias, lack of a control group, and potential for under-reporting food intake. In addition, the participants who did not return for follow-up may have had outcomes that were different from those participating in this pilot study. Moreover, without a non-weight loss control group, it was not possible to separate the effects of weight loss from the aging process, per se on the variables of interest.
Obesity, however, has many causes. The reasons for the imbalance between calorie intake and consumption vary by individual. Your age, gender, genes, psychological makeup, socioeconomic, and environmental factors all may contribute.
Alcohol is full of empty calories that cause weight gain. This doesn’t mean you can’t enjoy an occasional drink or a small glass of wine with dinner, it just means that keeping alcohol intake low will help avoid going overboard on empty calories.
Being overweight or obese isn’t just a cosmetic issue. Both conditions put your health at risk and can contribute a number of diseases, including diabetes and cancer. That risk only increases in individuals who have a family history of health problems, have a sedentary lifestyle, smoke, or have an unhealthy diet.
Obesity increases the risk of diabetes and high blood pressure, the most common causes of chronic kidney disease. Recent studies suggest that even in the absence of these risks, obesity itself may promote chronic kidney disease and quicken its progress.

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The prevalence of obesity in the United States (US) is increasing in all age groups. During the past 30 years, the proportion of older adults who are obese has doubled (Patterson, Frank, Kristal, & White 2004). The increased number of obese older adults is seen both as an increase in the total number of older obese persons in our population and as an increase in the percentage of the population that is obese (Villareal, Apovian, Kushner, & Klein, 2005). In spite of the increase in obesity among older adults, it is important to note that the majority of older adults are not obese and continue to lead active and healthy lives. The goal of this article is to raise nurses’ awareness of the challenges of obesity in older adults. This article will describe the prevalence and causes of obesity among older adults, as well as the consequences of obesity in older adults. Recommendations for interventions to address obesity will be provided. Differences between two groups of older persons, those 50 to 65 years of age, and those over 65 years of age, will be addressed.
Still, plenty of older adults can benefit from losing weight, particularly if they’re obese, have weight-related chronic conditions or a poor quality of life. “If a person is overweight, they [often] feel better if they’ve lost weight,” says Dr. James Powers, a geriatrician and professor in the Vanderbilt University School of Medicine. “There’s less wear on the joints, greater endurance, greater ability to walk; to do normal activities without getting short of breath.”
Federal Dietary Guidelines for Americans. We continue to provide medical, nutritional, and other scientific expertise to the United States Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) that publish the 2015-2020 Dietary Guidelines for Americans with information about the latest science-based nutritional recommendations.
Know and avoid the food traps that cause you to eat. Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you’re feeling and how hungry you are. After a while, you should see patterns emerge. You can plan ahead and develop strategies for handling these types of situations and stay in control of your eating behaviors.
Instead, dropping pounds can often feel harder than ever. After all, that stiff back that keeps you from bounding out of bed in the morning can make it less inspiring to go to the gym, a busy schedule can prompt you to eat on the run, and those 10 pounds you gained in your 40s can become an extra 20 pounds in your 50s and, well, you get the idea. (Want to lose weight but are short on time? Then check out Fit in 10, the new fitness program that only takes 10 minutes.)
In this study, Villareal and his colleagues evaluated the of dieting and exercise in more than 100 obese seniors over a one-year period. Although weight loss alone and exercise alone improved physical function by about 12 percent and 15 percent, respectively, neither was as effective as diet and exercise together, which improved physical performance by 21 percent.
Brain. Several medicines change the way the brain regulates the urge to eat, which can help to decrease appetite. Some examples of these medicines are diethylpropion, phendimetrazine, lorcaserin, naltrexone/bupropion, and liraglutide.
When the BMI is above 25, a person is considered overweight. When it’s above 30, the person is obese. Although BMI is useful for men and women, it does have limitations. For example, BMI may overestimate body fat in individuals who have a highly muscular build such as athletes and underestimate it in people who have lost muscle (for example, those who are recovering from surgery or cancer).
Jump up ^ Weng HH, Bastian LA, Taylor DH, Moser BK, Ostbye T (2004). “Number of children associated with obesity in middle-aged women and men: results from the health and retirement study”. J Women’s Health (Larchmt) (Comparative Study). 13 (1): 85–91. doi:10.1089/154099904322836492. PMID 15006281.
Meyerhardt JA, Tepper JE, Niedzwiecki D, et al. Impact of body mass index on outcomes and treatment-related toxicity in patients with stage II and III rectal cancer: findings from Intergroup Trial 0114. Journal of Clinical Oncology 2004; 22(4):648-657.
The program should provide long-term strategies for dealing with weight problems that may come up in the future. These strategies might include things like establishing a support system and establishing a physical activity routine.
WEDNESDAY, May 17, 2017 (HealthDay News) — Older, obese adults need to shed weight, but dieting can worsen their frailty. A new study addresses this conundrum, suggesting seniors take up both aerobic and resistance exercise while slimming down.
Eat more nutritious foods that have “low energy density.” Low energy dense foods contain relatively few calories per unit weight (fewer calories in a large amount of food). Examples of low energy dense foods include vegetables, fruits, lean meat, fish, grains, and beans. For example, you can eat a large volume of celery or carrots without taking in many calories.
In a June 5 speech to the Commonwealth Club in San Francisco, Centers for Disease Control and Prevention Director Julie Gerberding reported that, in terms of controllable health factors, obesity is closing in on tobacco use as the leading cause of death in the United States, and needs to become a major priority for the U.S. healthcare system. Aggregated results from Gallup’s annual Health and Healthcare polls from 2000 to 2002*, reveal that obesity is a particularly serious problem among the “baby boomer” generation and those slightly older.
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health.
If you have or are at risk for one of the obesity health problems reviewed above and have a body mass index of 27 or more, your doctor may prescribe one of several weight loss medications.  The most effective diet pill for you would most likely fall into one of two FDA-approved categories:
Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists? You need an evaluation by a physician if you have any health problems, are currently taking or plan on taking any medicine or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet, you need an exam and follow-up visits by a doctor.
^ Jump up to: a b Bei-Fan Z (December 2002). “Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults”. Asia Pac J Clin Nutr. 11 (Suppl 8): S685–93. doi:10.1046/j.1440-6047.11.s8.9.x.; Originally printed as Zhou BF (2002). “Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults – study on optimal cut-off points of body mass index and waist circumference in Chinese adults”. Biomed. Environ. Sci. 15 (1): 83–96. PMID 12046553.
There is an “obesity paradox” raging in the medical community. You may be surprised to hear this hot debate revolves around an unlikely group: our elders. Childhood and young adulthood obesity seem to always be in the headlines. But what about people ages 65 and older? Thanks to some new research, the debate of obesity in older people has been thrust into the medical spotlight.
University of Adelaide. “Gen X obesity a major problem for healthcare, workforce: Australian study.” ScienceDaily. ScienceDaily, 27 March 2014. .
Qsymia (combination of phentermine and topiramate) was approved by the FDA in 2012. It is only approved for those with a BMI greater than 27 with weight-related conditions. When combined with diet and exercise, studies have shown that half of the participants lost 10% of their body weight and four-fifths lost 5% (which equates to 12 pounds in a 227 pound person). Topiramate is associated with a high risk of birth defects such as cleft lip and palate. Phentermine (an appetite suppressant) was one of the ingredients in fen-phen and is associated with an elevation in heart rate. Because of these potentially serious side effects, Qsymia is only available through mail order. Other side effects include tingling, dizziness, alterations in taste, insomnia, dry mouth, and constipation.
Obesity is not just a cosmetic consideration; it is harmful to one’s health. In the United States, roughly 112,000 deaths per year are directly related to obesity, and most of these deaths are in patients with a BMI over 30. For patients with a BMI over 40, life expectancy is reduced significantly. Obesity also increases the risk of developing a number of chronic diseases, including the following:
Over the next two months, her appetite improves and she gains four pounds. Her weight loss appears to have been the result of multiple factors, including social isolation, bereavement, chewing issues, decreased oral intake and possibly the use of NSAIDs. Risk factor modification appears to have been successful so you do not consider further nutritional or pharmacologic interventions at this time.
A disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency. Dyslipidemias may be manifested by elevation of the total cholesterol, the “bad” low-density lipoprotein (LDL) cholesterol and the triglyceride concentrations, and a decrease in the “good” high-density lipoprotein (HDL) cholesterol concentration in the blood. Dyslipidemia comes under consideration in many situations including diabetes, a common cause of lipidemia. For adults with diabetes, it has been recommended that the levels of LDL, HDL, and total cholesterol, and triglyceride be measured every year. Optimal LDL cholesterol levels for adults with diabetes are less than 100 mg/dL (2.60 mmol/L), optimal HDL cholesterol levels are e4qual to or greater than 40 mg/dL (1.02 mmol/L), and desirable triglyceride levels are less than 150 mg/dL (1.7 mmol/L).
Jump up ^ “Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children” (PDF). National Institute for Health and Clinical Excellence(NICE). National Health Services (NHS). 2006. Retrieved April 8, 2009.
The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the nation’s biomedical research  agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders including overweight and obesity. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.
5. Graham M, Knight B. The many causes of involuntary weight loss: a 3-step approach to the diagnosis. www.hcplive.com/general/publications/Resident-and-Staff/2006/2006-11/2006-11_04. December 22, 2009.

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Jump up ^ Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R (September 2005). “Hypogonadism and metabolic syndrome: Implications for testosterone therapy”. J. Urol. (Review). 174 (3): 827–34. doi:10.1097/01.ju.0000169490.78443.59. PMID 16093964.
Jump up ^ Flegal, Katherine M.; Kit, Brian K.; Orpana, Heather; Graubard, Barry I. (2 January 2013). “Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories”. JAMA. 309 (1): 71–82. doi:10.1001/jama.2012.113905. PMID 23280227.
Schmitz KH, Neuhouser ML, Agurs-Collins T, et al. Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. Journal of the National Cancer Institute 2013; 105(18):1344-1354.
Before we look at ways to beat the bulge, it is time to get real. Dogs are fatter than ever. It’s estimated that 53% of all dogs in the US are overweight or obese. That’s more than 40 million dogs. There are so many overweight dogs in the world that when we see a dog that is at a healthy weight, we immediately think she is too skinny and unhealthy.
PCOS is a condition that affects about 5-10 percent of women of childbearing age. Women who have PCOS are often obese, have excess hair growth, and have reproductive problems and other health issues due to high levels of hormones called androgens.
When working with obese clients, be sure that the equipment can accommodate their weight. Most manufacturers provide a weight limit in the product manual; if they do not, contact them to ascertain the weight limit for each piece of equipment that heavier clients will use. Free-weight exercises that require lifting dumbbells instead barbells from the floor to start an exercise may be easier. The width of the free-weight bar may also be too narrow to allow proper performance of exercises such as the biceps curl and back squat, indicating need to use an Olympic-size bar, which is longer. Additional consideration should be given to selecting machine equipment that will be easy for overweight clients to get into and out of, and to avoiding some floor exercises (e.g., crunches, modified push-ups, stretching) that require clients to get down and up. If arthritis or joint pain is present, consider alternating the strength training exercises with lower-impact activities such as elliptical machines and stationary cycling activities or swimming. Regardless of the equipment used or the exercises being performed, programs for overweight and obese clients should include exercises that can be performed correctly and that clients feel more comfortable performing.
Jump up ^ Corona, G; Rastrelli, G; Filippi, S; Vignozzi, L; Mannucci, E; Maggi, M (2014). “Erectile dysfunction and central obesity: an Italian perspective”. Asian Journal of Andrology. 16 (4): 581–91. doi:10.4103/1008-682X.126386. PMC 4104087 . PMID 24713832.
Obesity has a direct relationship to the development of heart disease in both men and women. This is due to the increased distribution of body fat. You are 3 times as likely to suffer from hypertension if you are obese compared to those whose weight falls within the normal range. The simple fact is that when your weight increases, so does your blood pressure.
Strokes: Being overweight or obese can lead to a buildup of plaque in your arteries. This causes blood clots to form, which can eventually reach the blood stream and then vital organs such as the brain or the heart, blocking blood flow and producing a stroke.
Jump up ^ Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH (May 2006). “Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss”. Arterioscler. Thromb. Vasc. Biol. (Review). 26 (5): 968–76. doi:10.1161/01.ATV.0000216787.85457.f3. PMID 16627822.
Calcium is also important for bone health, and above 50s are recommend to consume at least 1200mg a day. This can be a challenge, as with age often comes smaller appetites, so many people choose to take a supplement instead.
Gacci M, Sebastianelli A, Salvi M, et al. Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Multicenter Italian Report on Radical Prostatectomy (MIRROR) study. Scandinavian Journal of Urology 2014; 48(2):138-145.
Waist circumference is a less-common method used to measure obesity in an individual. This simple measurement indicates obesity and morbid obesity in adults by measuring your waist. To find your waist circumference, wrap a tape measure around the area above your hip bone and below your rib cage.

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Your waist circumference (which you can find by placing a measuring tape snugly around your waist) is a good indicator of your abdominal fat. This is another predictor of developing risk for heart disease and other illnesses. This risk increases with a waist measurement of over 40 inches in men and over 35 inches in women.
With the arrival of televisions, computers, video games, remote controls, washing machines, dish washers and other modern convenience devices, people are commonly are leading a much more sedentary lifestyle compared to their parents and grandparents.
Jump up ^ Lin BH, Guthrie J, Frazao E (1999). “Nutrient contribution of food away from home”. In Frazão E. Agriculture Information Bulletin No. 750: America’s Eating Habits: Changes and Consequences. Washington, DC: US Department of Agriculture, Economic Research Service. pp. 213–39. Archived from the original on 2012-07-08.
During the Renaissance some of the upper class began flaunting their large size, as can be seen in portraits of Henry VIII of England and Alessandro dal Borro.[15] Rubens (1577–1640) regularly depicted full-bodied women in his pictures, from which derives the term Rubenesque. These women, however, still maintained the “hourglass” shape with its relationship to fertility.[199] During the 19th century, views on obesity changed in the Western world. After centuries of obesity being synonymous with wealth and social status, slimness began to be seen as the desirable standard.[15]
Obesity, or even being overweight, increases the load placed on joints, especially the knee and hip joints. Breakdown in cartilage, resulting from the increased weight on joints, may result in pain and further functional disability (Lorig & Fries, 2006). Leveille, Wee, and Iezzoni (2005) reported that the relative risk of arthritis in people who are obese increases over time. People with arthritis are particularly vulnerable to the stress-pain-depression cycle mentioned above, in which the pain and stiffness caused by the disease leads to decreased mobility, thereby increasing stress, pain, and depression and likely decreasing quality of life (Newman, 2002). Obese older people above the age of 50 who have arthritis are more likely to say their condition limits their activities than non-obese adults in this age group (Center on an Aging Society, 2003).
Unintentional weight loss often signals serious pathology. Estimates suggest 13.3% of the population experiences unintentional weight loss, and up to 7% experiences a loss exceeding 5% of baseline weight.1 Elders are disproportionately impacted; 27% of frail elders over the age of 65 experience involuntary weight loss.2
Exercise and strength training can optimize overall health and quality of life. Lower impact activities such as walking, swimming, and bicycling are generally safe for many older adults, even those who have chronic conditions such as heart disease or high blood pressure. But the key is to start slowly. Warming up and cooling down by walking and stretching before and after each session is important to minimize any soreness or potential injury.
An association between BMI and WC with colorectal cancer is seen particularly in men. Weight gain during adult life has been consistently associated with an increased risk of breast cancer in women after menopause.
These physical effects are not the only health risks of obesity. Health also includes mental health and social and emotional well-being, all of which can also be adversely affected by obesity. It is easier to measure, record and compare physical conditions but other effects such as depression, guilt, self-blame, embarrassment (e.g. to go swimming or participate in other sports), social isolation, and in some cases even the effects of bullying or harassment, should not be ignored.
[1] How are overweight and obesity diagnosed? National Heart, Lung, and Blood Institute website. http://www.nhlbi.nih.gov/health/health-topics/topics/obe/diagnosis.html. Updated July 13, 2012. Accessed October 4, 2012.
In order to sort the types of fruit, doctors have developed a simple way to determine whether someone is an apple or a pear. The measurement is called waist-to-hip ratio. To find out a person’s waist-to-hip ratio
The true impact of overweight and obesity on mortality may be obscured by confounding factors. For example, reverse causation induced by preexisting chronic disease and inadequate control for smoking status can mask the effect of obesity through the excessive death risk caused by these low BMI–associated conditions. In some distinct diseases of the elderly, such as Alzheimer’s disease (8) or Parkinsonism (9), weight loss may precede the time of diagnosis by years, thus causing further false overrepresentation of morbidity and mortality in the low weight range.
A weight reduction every six months is more achievable, sustainable and sufficient enough to reduce the risk of associated diseases. Gradual and steady weight loss will lead to better blood sugar control, lower blood pressure, decreased cholesterol and less stress on weight-bearing joints.

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Diagnosis of obesity is made by observation and by comparing the patient’s weight to ideal weight charts. Many doctors and obesity researchers refer to the body mass index (BMI), which uses a height-weight relationship to calculate an individual’s ideal weight personal risk of developing obesity-related health problems. Physicians may also obtain direct measurements of an individual’s body fat content by using calipers to measure skin-fold thickness at the back of the upper arm and other sites. The most accurate means of measuring body fat content involves immersing a person in water and measuring relative displacement; however, this method is very impractical and is usually only used in scientific studies requiring very specific assessments. Women whose body fat exceeds 30% and men whose body fat exceeds 25% are generally considered obese.
• Organic. Cancer is the leading cause, accounting for 24% to 38% of cases (weight loss may be the only symptom of tumor burden).5 Dementia results in marked taste and smell alterations, decreasing food’s desirability. Dysphasia often accompanies severe dementia, as do centrally mediated deficits in appetite control and satiety. Other organic causes may be gastrointestinal ([GI]; nausea, vomiting, early satiety, diarrhea), endocrine (hyperthyroidism, uncontrolled diabetes), Parkinson’s disease, and chronic illness (chronic obstructive pulmonary disease, congestive heart failure).4,5
Herbal remedies, vitamins and minerals, all considered dietary supplements by the Food and Drug Administration, don’t have the same rigorous testing and labeling process as over-the-counter and prescription medications do.
Whether for you or your loved one, weight management can be challenging.  We know that having a healthy weight is good for us, but sometimes it is hard to sort through all the information out there.  Some trendy diets that seriously limit certain types of foods can be unhealthy.  It is important to keep in mind some healthy basics when changing your eating habits.  Download our tip sheet above and remember to speak to a physician before starting any new diet – especially if you have a chronic condition or are on regular medications.
Obesity and Stroke. Ischemic (clot-caused) stroke and coronary artery disease share many of the same disease processes and risk factors. A meta-analysis of 25 prospective cohort studies with 2.3 million participants demonstrated a direct, graded association between excess weight and stroke risk. Overweight increased the risk of ischemic stroke by 22 percent, and obesity increased it by 64 percent. There was no significant relationship between overweight or obesity and hemorrhagic (bleeding-caused) stroke, however. (10) A repeat analysis that statistically accounted for blood pressure, cholesterol, and diabetes weakened the associations, suggesting that these factors mediate the effect of obesity on stroke.
Just as in younger people, the prevalence of obesity has increased in the elderly. About 20 percent of people 65 and older are obese, and that is expected to continue rising as more baby boomers become senior citizens. Elevated weight is known to be associated with impairments in daily living, limitations in mobility and an increased risk for physical decline and frailty.
For obese seniors, dieting and exercise together are more effective at improving physical performance and reducing frailty than either alone. Although weight loss alone and exercise alone improve physical function, neither is as effective as diet and exercise together, which improved physical performance in seniors by 21 percent.
In community-dwelling older adults, the causes of unintentional weight loss can be classified as organic or psychosocial. Multiple studies, prospective and retrospective and in inpatient and outpatient settings, have demonstrated that the most common etiologies are malignancy (19% to 36%), nonmalignant gastrointestinal disease (9% to 19%), and psychiatric conditions such as depression and dementia (9% to 24%). Overall, nonmalignant diseases are more common than malignancy.1,11–16  Etiologies are further delineated in Table 1.11–16
Searches of MEDLINE (and MEDLINE In-Process), EMBASE, CINAHL and AGELINE were conducted to identify relevant studies from 1980 to September 2009. Additional studies were identified from searching bibliographies of retrieved articles and by consulting a clinical expert in the area. We identified English-language articles that addressed risk factors, differential diagnosis, prognosis, investigation or treatment of unintentional weight loss among adults 65 years of age or older. Further details on the search can be found in Appendix 1, available at www.cmaj.ca/cgi/content/full/cmaj.101471/DC1. We excluded articles that specifically focused on weight loss associated with cancer or HIV infection. All types of articles were considered for inclusion except for case reports, editorials and meeting abstracts. All patients, regardless of where they lived, were included in the review. Two reviewers (S.S. and E.M.A or J.H-L) independently reviewed all identified citations to select relevant publications that met the inclusion criteria. In cases of doubt, full-text articles were retrieved for review and discussion.
Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. If you don’t make these other changes in your life, medication is unlikely to work.
The survey from the Robert Wood Johnson Foundation and Trust for America’s Health also found that despite first lady Michelle Obama’s best efforts, nearly one of three children and teens ages two to 19 is overweight or obese.
There are many different types of strength training exercises and a variety of equipment that can be used, including weight-training machines, dumbbells, resistance bands, medicine balls, or weighted bars.
Visscher TL, Seidell JC, Molarius A, van der Kuip D, Hofman A, Witteman JC. A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. Int J Obes Relat Metab Disord 2001; 25: 1730–1735.
Dyslipidemia related to obesity usually includes increased triglycerides, decreased HDL levels, and abnormal LDL composition and plays a major role in the development of atherosclerosis and CVD in obese individuals.F
“I never really paid attention to labels,” Patricia Sánchez, 32, an accountant and mother of two, said as she filled her shopping cart at a Santiago supermarket, with occasional help from her 7-year-old daughter. “But now they kind of force you to pay attention. And if I don’t notice, my kids do.”
In fact, more than half of boomers polled say they regularly do mental exercises such as crossword puzzles. Some also take fish oil, a type of fatty acid that some studies suggest might help prevent mental decline.
Orlistat is recommended only for people 18 years of age and over in combination with a diet and exercise regimen. People who have difficulties with the absorption of food or who are not overweight should not take orlistat. Overweight is defined by the U.S. National Institutes of Health as having a body mass index (BMI) of 27 or greater.
The results of all the scrutiny of processed food are hardly scary, although some groups and writers try to make them appear that way. The Pew Charitable Trusts’ Food Additives Project, for example, has bemoaned the fact that the FDA directly reviews only about 70 percent of the ingredients found in food, permitting the rest to pass as “generally recognized as safe” by panels of experts convened by manufacturers. But the only actual risk the project calls out on its Web site or in its publications is a quote from a Times article noting that bromine, which has been in U.S. foods for eight decades, is regarded as suspicious by many because flame retardants containing bromine have been linked to health risks. There is no conclusive evidence that bromine itself is a threat.
Certain medications. Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.
In today’s fast-paced environment, it is easy to adopt unhealthy behaviors. Behavior, in the case of obesity, relates to food choices, amount of physical activity you get and the effort to maintain your health.
Structure House offered me the opportunity to leave my chaotic world of eating and go to a safe place to build new habits that would last a lifetime. An initial four week stay and two additional visits over a one year period helped me to lose 170 pounds and learn lifelong habits to continue being healthy.    
The points in this article clearly show that in the elderly population, weight classification may not always be accurate, which is one of the difficulties encountered in older adults. This is the first hurdle encountered when trying to evaluate and treat this disease in the elderly.
Jump up ^ Borodulin K, Laatikainen T, Juolevi A, Jousilahti P (June 2008). “Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults”. Eur J Public Health (Research Support). 18 (3): 339–44. doi:10.1093/eurpub/ckm092. PMID 17875578.

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As for Anne Roberson, she says the extra weight she has long carried around on her petite frame has begun taking a toll on her joints, her sleep and her mood. On a recent morning, Roberson listened politely to Dr. Mylene Middleton Rucker, her longtime physician, during her first Medicare weight loss counseling session. Rucker suggested she eat more vegetables and less meat and encouraged her to join a local exercise class.
Obesity hypoventilation syndrome (OHS) is a condition in which an inability to breathe deeply enough and quickly enough results in a low level of oxygen and a high level of carbon dioxide in the blood.
One of the things seniors often struggle most with is flexibility, and it can be tough to know how to improve this. Yoga or Pilates are great ways to safely do this – as long as you find a teacher who understands the needs of older people.
I’ve developed a menengioma and I’ve had a smalk stroke. Finally…I’m suffering severe chronic pain from severely arthritic (bone on bone) knees and acutely painful arthritis of the lumbar spine. Alk this, pkus severe Fibromyalgia. I’ve become more and more sedentary and withdrawn, due to the pain….and can hardly walk a block. I entered a pain management program a few years ago and am following a carefully monitored program of opoid meds….without which, I’d be unable to live independently, and I’d be in a wheelchair.
In the short-term low carbohydrate diets appear better than low fat diets for weight loss.[167] In the long term; however, all types of low-carbohydrate and low-fat diets appear equally beneficial.[167][168] A 2014 review found that the heart disease and diabetes risks associated with different diets appear to be similar.[169] Promotion of the Mediterranean diets among the obese may lower the risk of heart disease.[167] Decreased intake of sweet drinks is also related to weight-loss.[167] Success rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2–20%.[170] Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child.[171] Intensive behavioral counseling is recommended in those who are both obese and have other risk factors for heart disease.[172]
Although people can control what they eat and how much they exercise, age comes with certain uncontrollable factors. For instance, you lose lean body mass as you age. “The more lean body mass we have, the higher our metabolic rate is and the more efficiently we burn calories,” says Carmen Roberts, clinical dietician specialist with Johns Hopkins Bayview Medical Center. Therefore, reduced lean body mass lowers your metabolism, thus, lowering the amount of calories needed and increasing the amount of physical activity needed.
Obesity, or even being overweight, increases the load placed on joints, especially the knee and hip joints. Breakdown in cartilage, resulting from the increased weight on joints, may result in pain and further functional disability (Lorig & Fries, 2006). Leveille, Wee, and Iezzoni (2005) reported that the relative risk of arthritis in people who are obese increases over time. People with arthritis are particularly vulnerable to the stress-pain-depression cycle mentioned above, in which the pain and stiffness caused by the disease leads to decreased mobility, thereby increasing stress, pain, and depression and likely decreasing quality of life (Newman, 2002). Obese older people above the age of 50 who have arthritis are more likely to say their condition limits their activities than non-obese adults in this age group (Center on an Aging Society, 2003).
Calculating your BMI. Your doctor will check your body mass index (BMI) determine your level of obesity. This should be done at least once a year. Your BMI also helps determine your overall health risk and what treatment may be appropriate.
Jump up ^ Nijland ML, Stam F, Seidell JC (June 2009). “Overweight in dogs, but not in cats, is related to overweight in their owners”. Public Health Nutr. 13 (1): 1–5. doi:10.1017/S136898000999022X. PMID 19545467.
Abstract Human beings are susceptible to sustained weight gain in the modern environment. Although both men and women can get fat, they get fat in different ways, and suffer different consequences. We review differences between men and women in the incidence of obesity,
^ Jump up to: a b Bei-Fan Z (December 2002). “Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults”. Asia Pac J Clin Nutr. 11 (Suppl 8): S685–93. doi:10.1046/j.1440-6047.11.s8.9.x.; Originally printed as Zhou BF (2002). “Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults – study on optimal cut-off points of body mass index and waist circumference in Chinese adults”. Biomed. Environ. Sci. 15 (1): 83–96. PMID 12046553.
For the past year, President Trump has worked with the Republican Congress to dismantle crucial parts of Obama’s legacy, including affordable health care, progressive taxation, climate-change regulation, oversight of the financial system, and immigration reform. Discussions of Medicare and Medicaid cuts surfacing in recent weeks suggest that an effort to roll back Lyndon Johnson’s Great Society might be next.
22. Abbott RD, Behrens GR, Sharp DS, Rodriguez BL, Burchfiel CM, Ross GW, Yano K, Curb JD: Body mass index and thromboembolic stroke in nonsmoking men in older middle age: the Honolulu Heart Program. Stroke 1994; 25: 2370– 2376 [PubMed]
Endometrial cancer: Obese and overweight women are two to about four times as likely as normal-weight women to develop endometrial cancer (cancer of the lining of the uterus), and extremely obese women are about seven times as likely to develop the more common of the two main types of this cancer (7). The risk of endometrial cancer increases with increasing weight gain in adulthood, particularly among women who have never used menopausal hormone therapy (8).

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Qsymia is the newest medication approved for weight loss. It is a combination of phentermine and extended-release topiramate. As with the other medications, it is only approved for patients who are obese (BMI >30) or overweight (BMQ >27) with one weight-related health issue. According to the FDA data, a statistically significant greater proportion of the patients taking Qsymia achieved 5% and 10% weight loss. All patients in the study were also encouraged to eat a well-balanced, reduced-calorie diet.
More recently, investigators conducted a systematic review of 89 studies on weight-related diseases and then did a statistical summary, or meta-analysis, of the data. Of the 18 weight-related diseases they studied, diabetes was at the top of the risk list: Compared with men and women in the normal weight range (BMI lower than 25), men with BMIs of 30 or higher had a sevenfold higher risk of developing type 2 diabetes, and women with BMIs of 30 or higher had a 12-fold higher risk. (4)
While the obesity health problems in this section are usually not life-threatening, they can significantly impact your quality of life.  Regarding quality of life, the Journal of Public Health published a study demonstrating that the higher your obesity level, the lower your quality of life regardless of whether or not any diseases are present (3).
Obesity may increase the risk of PCOS, but the effect is modest. However, a history of weight gain often precedes the development of the clinical features of PCOS, and following a healthy lifestyle has been shown to reduce body weight, abdominal fat, reduce testoste­rone, improve insulin resistance, and decrease hirsutism in women with PCOS.F
There were 61,317 deaths during the 10-year follow-up, with the overall risk of death highest among the study subjects who had the highest and lowest body weights, as determined by body mass index (BMI)body mass index (BMI), a ratio based on height and weight.
The Program targets large segments of the population by promoting: (1) strategies to reduce environmental barriers to healthy living, and (2) administrative policies that facilitate healthy choices.    
A 73-year-old woman presents to your clinic complaining of unintentional weight loss. She reports having lost 15 lbs (6.8 kg) over the past year. Previously, her weight was 135 lbs (61.3 kg) and now it is 120 lbs (54.5 kg). She reports that she is eating three meals per day as usual.
Most adolescents fall short of the Physical Activity Guidelines for Americans recommendation of at least 60 minutes of aerobic physical activity each day. Only 18% of students in grades 9—12 met this recommendation in 2007. Daily, quality physical education in school can help students meet the guidelines, however, in 2009 only 33% had access to and attended daily physical education classes.
Engaging in a variety of exercises, such as aerobic exercises, resistance training, and flexibility exercises is essential for healthy aging. Most older, obese adults are able to safely engage in regular physical activity; however, because fitness levels vary, a medical professional is important to determine which exercises are appropriate for an individual’s specific needs. Certain medical conditions, as well as medications, can also affect a person’s tolerance for exercise.
This study will see if personalized feedback about worksite food purchases, daily calorie goals, healthy eating, and financial incentives for healthy food purchases can help employees at Massachusetts General Hospital (MGH) prevent weight gain, reduce cardiovascular risk factors, and make healthier long-term food choices. If successful, the approach could be used by people at other worksites and food retailers to help fight the obesity epidemic. To participate, you must be an MGH employee who is 21 years or older and uses the hospital cafeteria. Visit Promoting Employee Health Through the Worksite Food Environment (ChooseWell 365) for more information and to learn how to participate in the study.
Continuing to call out Big Food on its unhealthy offerings, and loudly, is one of the best levers we have for pushing it toward healthier products—but let’s call it out intelligently, not reflexively. Executives of giant food companies may be many things, but they are not stupid. Absent action, they risk a growing public-relations disaster, the loss of their more affluent and increasingly health-conscious customers, and the threat of regulation, which will be costly to fight, even if the new rules don’t stick. Those fears are surely what’s driving much of the push toward moderately healthier fare within the industry today. But if the Pollanites convince policy makers and the health-conscious public that these foods are dangerous by virtue of not being farm-fresh, that will push Big Food in a different direction (in part by limiting the profit potential it sees in lower-fat, lower-problem-carb foods), and cause it to spend its resources in other ways.
Four studies looked at nutritional interventions or nutritional interventions combined with exercises (Table 1).17–20 All four studies were randomized trials but three were small (n < 100).17,18,20 Only one trial was blinded17 and only one used intention-to-treat analysis.18 The condition most strongly influenced by body weight is type 2 diabetes. In the Nurses’ Health Study, which followed 114,000 middle-age women for 14 years, the risk of developing diabetes was 93 times higher among women who had a body mass index (BMI) of 35 or higher at the start of the study, compared with women with BMIs lower than 22. (2) Weight gain during adulthood also increased diabetes risk, even among women with BMIs in the healthy range. The Health Professionals Follow-Up Study found a similar association in men. (3) Body Mass Index (BMI) is a mathematical calculation involving height and weight, irrespective of family history, gender, age or race. BMI is calculated by dividing a person's body weight in kilograms by their height in meters squared (weight [kg] height [m]2) or by using the conversion with pounds (lbs) and inches (in) squared as shown below, This number can be  misleading, however, for very muscular people, or for pregnant or lactating women. While it's just as possible to reach your healthy weight at 60-something as it is when you were 20-something, it might take a little longer. You might not be able to push yourself as hard as you'd like to during workouts, leading to a lower calorie-burn than you used to hit. Or, you may not be as strong as you once were, prompting you to lift lighter weights (also lowering that calorie-burn number you see on your heart rate monitor). "Keep your focus on the healthy behaviors you're adopting in order to achieve your goal, rather than your frustration if it's not happening right away," says Bowerman. If you stick to a healthy diet and exercise plan, "your weight will take care of itself over time." ^ Jump up to: a b Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL (June 2001). "Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index". Am. J. Clin. Nutr. 73 (6): 1086–93. PMID 11382664. Buying voluntary offsets can and should be a regular part of the casual environmentalist’s lifestyle, just like recycling or carpooling. In this series, we’ll explore the voluntary carbon market, how to participate and why now is the time for action. Some modifications to the WHO definitions have been made by particular organizations.[28] The surgical literature breaks down class II and III obesity into further categories whose exact values are still disputed.[29] Older people have to be careful when they implement a weight-loss plan. They key is to focus on what kind of weight you want to reduce. An article in The Online Journal of Issues in Nursing stated it’s important to hone in on minimizing muscle and bone loss. The rate of obesity also increases with age at least up to 50 or 60 years old[185] and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity.[29][186][187] A stroke happens when the flow of blood to a part of your brain stops, causing brain cells to die. The most common type of stroke, called ischemic stroke, occurs when a blood clot blocks an artery that carries blood to the brain. Another type of stroke, called hemorrhagic stroke, happens when a blood vessel in the brain bursts. "If someone does lose 20 or 30 pounds, their metabolism goes down and they start to burn fewer calories," Tsai says. "Our bodies are designed to regain weight, so it's much easier to prevent obesity than to treat it." Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education. Senior author, Malcolm J. Low, M.D., Ph.D., said "Our model demonstrates that obesity is in part a self-perpetuating disorder and the results further emphasize the importance of early intervention in childhood to try to prevent the condition whose effects can last a lifetime. Our new animal model will be used in pinpointing the reasons why most adults find it exceedingly difficult to maintain meaningful weight loss from dieting and exercise alone." Genetic: It has been determined that obesity runs in families, meaning that those who have family members with weight issues are more likely to become overweight or obese themselves. Multiple research studies have shown a genetic link, specifically in the way in which a person’s body stores and processes fat. Puhl R., Henderson K., and Brownell K. Social consequences of obesity In:Peter G. Kopelman; Ian D. Caterson; Michael J. Stock; William H. Dietz (2005). Clinical obesity in adults and children: In Adults and Children. Blackwell Publishing. pp. 29–45. ISBN 1-4051-1672-2. The U.S. Food and Drug Administration approved orlistat capsules, branded as alli, as an over-the-counter (OTC) treatment for overweight adults in February 2007. The drug had previously been approved in 1999 as a prescription weight loss aid, whose brand name is Xenical. The OTC preparation has a lower dosage than prescription Xenical. In the old spiritual, “Dem Bones,” each body part is linked to the next one in line: the thigh bone to the knee bone, the knee bone to the leg bone, and so on. But one body “part”-weight-is connected to virtually all of the others. A healthy weight sets the stage for bones, muscles, brain, heart, and others to play their parts smoothly and efficiently for many years. Regular exercise: Physical activity is important because it reduces body fat and builds muscle. Exercise also has a direct effect in preventing diseases associated with obesity, such as cardiovascular disease, type 2 diabetes, and osteoporosis. It also helps regulate unhealthy fats, improves your mood, and even promotes better sleep. Another dynamic may be at work, said Martin. Not only could the reported increases in disability reflect actual deteriorating health, but it could also reflect greater awareness of health conditions in the wake of more widespread diagnosis and treatment. Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health.[19] It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors.[20][21] BMI is closely related to both percentage body fat and total body fat.[22] In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile.[23] The reference data on which these percentiles were based date from 1963 to 1994, and thus have not been affected by the recent increases in weight.[24] BMI is defined as the subject's weight divided by the square of their height and is calculated as follows. The weight-loss program should be directed toward a slow, steady weight loss unless your doctor feels your health condition would benefit from more rapid weight loss. Expect to lose only about a pound a week after the first week or two. With many calorie-restricted diets there is an initial rapid weight loss during the first one to two weeks, but this loss is largely fluid. Shah K, Stufflebam A, Hilton TN, Sinacore DR, Klein S, Villareal DT. Diet and exercise interventions reduce intrahepatic fat content and improve insulin sensitivity in obese older adults. Obesity (Silver Spring) 2009;17:2162–2168. [PMC free article] [PubMed] Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a review and meta-analysis of prospective observational studies. Lancet 2008; 371(9612):569-578. [redirect url='https://betahosts.com/bump' sec='7']

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Jump up ^ Flegal KM, Troiano RP, Pamuk ER, Kuczmarski RJ, Campbell SM (November 1995). “The influence of smoking cessation on the prevalence of overweight in the United States”. N. Engl. J. Med. 333 (18): 1165–70. doi:10.1056/NEJM199511023331801. PMID 7565970.
Inflammatory markers in particular have received much attention since the discovery in the 1990’s that adipocytes act as an endocrine organ (Forsythe 2008). It is now widely accepted that weight gain results in adipocyte hypertrophy, which leads to an increased in obesity-related inflammatory markers such as leptin, TNF-a, IL-6, while weight loss results in a decrease in these markers (Forsythe 2008). It is also known that adipocytes are not the only source of inflammatory molecules, with macrophages and muscle also secreting these molecules (Cao 2011). The complex interplay of weight loss and exercise with inflammatory cytokines, growth factors, and regulatory pathways discussed in this review are represented in Figure 2.
To prevent losing too much muscle and bone mass when losing weight, older adults should focus on getting plenty of protein, calcium and vitamin D in their diets, Beavers says. One study found that adults between ages 52 and 75 built muscle best if they ate 1.5 grams of protein per kilogram of body weight daily – or double the Institute of Health’s recommended intake. For a 180-pound person, that’s about 120 grams, or about the amount of two chicken breasts, three eggs and one Greek yogurt.
Jump up ^ Chakravarthy MV, Booth FW (2004). “Eating, exercise, and “thrifty” genotypes: Connecting the dots toward an evolutionary understanding of modern chronic diseases”. J. Appl. Physiol. (Review). 96 (1): 3–10. doi:10.1152/japplphysiol.00757.2003. PMID 14660491.
Being significantly overweight places extra strain on all of the systems of the body, affecting them in different ways. Examples of the effects of obesity on some body systems are listed in the table below.
Through its growing sway over health-conscious consumers and policy makers, the wholesome-food movement is impeding the progress of the one segment of the food world that is actually positioned to take effective, near-term steps to reverse the obesity trend: the processed-food industry. Popular food producers, fast-food chains among them, are already applying various tricks and technologies to create less caloric and more satiating versions of their junky fare that nonetheless retain much of the appeal of the originals, and could be induced to go much further. In fact, these roundly demonized companies could do far more for the public’s health in five years than the wholesome-food movement is likely to accomplish in the next 50. But will the wholesome-food advocates let them?
According to the World Health Organization (WHO) being overweight or obese is largely preventable. To reach your ideal weight you must reach a balance of calories consumed and calories burned. According to WHO, in your diet you can:
Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking.
Obesity, or even being overweight, increases the load placed on joints, especially the knee and hip joints. Breakdown in cartilage, resulting from the increased weight on joints, may result in pain and further functional disability (Lorig & Fries, 2006). Leveille, Wee, and Iezzoni (2005) reported that the relative risk of arthritis in people who are obese increases over time. People with arthritis are particularly vulnerable to the stress-pain-depression cycle mentioned above, in which the pain and stiffness caused by the disease leads to decreased mobility, thereby increasing stress, pain, and depression and likely decreasing quality of life (Newman, 2002). Obese older people above the age of 50 who have arthritis are more likely to say their condition limits their activities than non-obese adults in this age group (Center on an Aging Society, 2003).
In the U.S., 97 million adults are overweight or obese. Being overweight significantly increases the risk of death from hypertension, dyslipidemia, type 2 diabetes, stroke, osteoarthritis, coronary heart disease, gallbladder disease, sleep apnea and respiratory problems, and endometrial, breast, prostate, and colon cancers. 
If you think you may be obese, and especially if you’re concerned about weight-related health problems, see your doctor or health care provider. You and your provider can evaluate your health risks and discuss your weight-loss options.
A baseline evaluation for unexplained, unintentional weight loss in older adults includes history, physical examination, laboratory tests, chest radiography, fecal occult blood testing, and possibly abdominal ultrasonography.
Saxenda was approved in late 2014 as a weight-loss drug in combination with physical activity and diet modifications. It is a once-a-day injection (not a pill) that mimics a hormone related to digestion and appetite control (GLP-1) that is used in the management of type 2 diabetes. It activates areas of the brain involved in appetite regulation.
Jump up ^ Rosén T, Bosaeus I, Tölli J, Lindstedt G, Bengtsson BA (1993). “Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency”. Clin. Endocrinol. 38 (1): 63–71. doi:10.1111/j.1365-2265.1993.tb00974.x. PMID 8435887.
The thrifty gene hypothesis postulates that, due to dietary scarcity during human evolution, people are prone to obesity. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would be more likely to survive famine. This tendency to store fat, however, would be maladaptive in societies with stable food supplies.[126] This theory has received various criticisms, and other evolutionarily-based theories such as the drifty gene hypothesis and the thrifty phenotype hypothesis also been proposed.[127][128]
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The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. Losing 5%-10% of your weight is proven to lower your chance of developing heart disease.
After my excursion to Whole Foods, I drive a few minutes to a Trader Joe’s, also known for an emphasis on wholesome foods. Here at the register I’m confronted with a large display of a snack food called “Inner Peas,” consisting of peas that are breaded in cornmeal and rice flour, fried in sunflower oil, and then sprinkled with salt. By weight, the snack has six times as much fat as it does protein, along with loads of carbohydrates. I can’t recall ever seeing anything at any fast-food restaurant that represents as big an obesogenic crime against the vegetable kingdom. (A spokesperson for Trader Joe’s said the company does not consider itself a “ ‘wholesome food’ grocery retailer.” Living Intentions did not respond to a request for comment.)
I’m 72, 60-80 lbs overweight. For past 20 yrs I’ve suffered from cancer, serious blood diseases for which I took heavy doses of Predisone, suffered a large DVT/PE’s which left me weakened and overweight (from steroids).
Exercise and a healthy diet are key in treating obesity. On its website, The Obesity Action Coalition writes, “modifying behaviors that contributed to developing obesity is one way to treat the disease…either alone or in conjunction with other treatments.” The educational and lobbying organization, which has more than 50,000 members, cites “increasing physical activity” and “becoming educated about the body and how to nourish it appropriately” among those actions.
The body has three types of fat tissue—white, brown, and beige—that it uses to fuel itself, regulate its temperature in response to cold, and store energy for future use. Learn about the role of each fat type in maintaining energy balance in the body.
“The numbers are disturbing,” said UC Davis School of Nursing assistant professor Debra Bakerjian. “We know that older adults over 75 are the highest consumers of health care dollars. Really focusing on the baby boom generation now to help them become more healthy is very important.”
Gallstones and gallbladder disease are additional health risks of obesity. People who are overweight or obese are at increased risk of having gallstones, which are hard pieces of stone-like material formed in the gallbladder from cholesterol and other materials. They can cause stomach or back pain.
^ Jump up to: a b Afshin A (12 June 2017). “Health Effects of Overweight and Obesity in 195 Countries over 25 Years”. New England Journal of Medicine. 377 (1): 13–27. doi:10.1056/NEJMoa1614362. PMC 5477817 . PMID 28604169.
Other reasons for not being active include relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education in schools for children.