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About two-thirds of the adult U.S. population is overweight.1 Almost one-third not only exceeds ideal weight, but also meets the clinical criteria for obesity. In the 1990s, rates of obesity more than doubled, and are currently rising by over 5% per year.2, 3 Excess body weight is implicated as a risk factor for many different disorders, including heart disease, diabetes, several cancers (such as breast cancer in postmenopausal women, and cancers of the uterus, colon, and kidney), prostate enlargement (BPH), female infertility, uterine fibroids, and gallstones, as well as several disorders of pregnancy, including gestational diabetes, preeclampsia, and gestational hypertension.4 The location of excess body fat may affect the amount of health risk associated with overweight. Increased abdominal fat, which can be estimated by waist size, may be especially hazardous to long-term health.5, 6
For overweight women, weight loss can significantly improve physical health. A four-year study of over 40,000 women found that weight loss in overweight women was associated with improved physical function and vitality as well as decreased bodily pain.7 The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases in overweight men and women in all age groups.8 Losing weight and keeping it off is, unfortunately, very difficult for most people.9, 10 However, repeated weight loss followed by weight regain may be unhealthy, as it has been associated with increased heart disease risk factors and bone loss in some studies.11, 12 Rather than focusing on weight loss as the most important health outcome of a change in diet or lifestyle, some doctors advocate paying more attention to overall fitness and reduction in known risk factors for heart disease and other health hazards.13
Excess body mass has the one advantage of increasing bone mass—a protection against osteoporosis. Probably because of this, researchers have been able to show that people who successfully lose weight have greater loss of bone compared with those who do not lose weight.14 People who lose weight should, therefore, pay more attention to preventing osteoporosis.
Many doctors give overweight patients a pill, a pep talk, and a pamphlet about diet and exercise, but that combination leads only to minor weight loss.15 When overweight people attend group sessions aimed at changing eating and exercise patterns, keep daily records of food intake and exercise, and eat a specific low-calorie diet the outcome is much more successful. Group sessions where participants are given information and help on how to make lifestyle changes appear to improve the chances of losing weight and keeping it off. Such changes may include shopping from a list, storing foods out of sight, keeping portion sizes under control, and avoiding fast-food restaurants.
According to most short-term studies, the effect of exercise alone (without dietary restriction) on weight loss is small,16, 17 partly because muscle mass often increases even while fat tissue is reduced,18 and perhaps because some exercising people will experience increased appetites. The long-term effect of regular exercise on weight loss is much better, and exercise appears to help people maintain weight loss.19, 20 People who have successfully maintained weight loss for over two years report continuing high levels of physical activity.21 Combining exercise with healthier eating habits results in the best short- and long-term effects on weight loss,22, 23 and should reduce the risk of many serious diseases.24, 25, 26
People who experience “weight cycling” (repetitive weight loss and gain) have a tendency toward binge eating (periods of compulsive overeating, but without the self-induced vomiting seen in bulimia), according to a review of numerous studies focusing on weight loss.27 The researchers also found an association between weight cycling and depression or poor body image. The most successful weight-loss programs (in which weight stays off, mood stays even, and no binge eating occurs) appear to use a combination of moderate caloric restriction, moderate exercise, and behavior modification, including examination and adjustment of eating habits.
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.