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JAMA Patient Page
April 9, 2003


JAMA. 2003;289(14):1880. doi:10.1001/jama.289.14.1775

Obesity is a medical problem. Persons who are overweight or obese (severely overweight) are much more likely to have health problems than persons who maintain a healthy weight. Taking in more calories (a measure of energy supplied by food or drink) than your body needs results in weight gain. Large portion sizes, easy access to foods with poor nutritional value, and sedentary (inactive) lifestyles are common factors leading to obesity. There is now a standard way to measure overweight, obesity, or severe morbid) obesity, based on height and weight. This standard, the body mass index (BMI), is calculated by dividing the weight in kilograms (2.2 pounds per kilogram) by the square of the height in meters (39.37 inches per meter). A BMI of 25 or more is considered overweight; 30 or more is considered obesity; and 40 or more, morbid obesity.

The April 9, 2003, issue of JAMA is a theme issue on the topic of obesity.

Losing just 10% of your excess body weight has been shown to have good effects on your health. Slow weight loss (about 2 pounds per week) is most effective in keeping off the extra weight for the long term. Making simple lifestyle changes such as decreasing portion sizes, limiting snacks, eating a healthy diet (emphasizing fruits, vegetables, and whole-grain foods), and exercising regularly are lifelong ways to maintain a healthy weight. Consult your doctor for specific recommendations.

Medical complications of obesity

  • Diabetes

  • High blood pressure

  • Osteoarthritis

  • High blood cholesterol

  • Gastroesophageal reflux disease (severe heartburn, also called GERD)

  • Back pain

  • Increased risk for heart disease

Benefits of regular exercise

  • Improved cardiovascular fitness

  • Decreased risk of developing diabetes

  • Lower blood pressure

  • Better control of high blood pressure or diabetes for those who already have them

  • Beneficial effects on osteoarthritis, back pain, and depression

  • Stress reduction

  • Improved mood and energy levels

  • Weight loss

Bariatric surgery

For morbid obesity (extreme overweight), an operation to restrict the size of the stomach may be recommended. This is called bariatric surgery and may be offered as a treatment for extremely obese persons or obese individuals with medical complications of obesity. Bariatric operations are major surgery and have risks as well as possible benefits.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA ’s Web site at http://www.jama.com. They are available in English and Spanish. A Patient Page on bariatric surgery was published in the December 11, 2002, issue; one on obesity was published in the October 27, 1999, issue; one on healthful eating was published in the October 6,1999, issue; and one on weight management was published in the January 20, 1999, issue.

The JAMA Patient Page is a public service of JAMA . The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

Sources: Centers for Disease Control and Prevention, Office of the Surgeon General, US Department of Health and Human Services