Let's Talk About Obesity

肥胖生活并不总是那么容易;除此之外，您还可能会遇到的健康并发症，我们的社会放在个人谁是超重的一个巨大的耻辱。你可能会觉得尴尬或羞愧。但是，我们在HealthCentral来这里是为了告诉你，你不应该有这样的感觉。对于初学者来说，你是不是从单打独斗远。生活在这种条件的感觉或其他人的数以百万计已经感觉到就像你现在做的。我们和他们，在这里为您服务。单就这个页面，你会发现现实和肥胖的挑战，最好的治疗方法，乐于助人的生活方式的改变一起，和所有的重要信息，帮助您不只是管理，但茁壮成长。我们相信你已经得到了很多的问题......我们在这里为大家解答。

什么是肥胖，无论如何？

首先，让我们来谈谈肥胖isn’t。It’s not a character flaw, a sign of laziness, or evidence of a lack of control. It’s not a reason to feel shamed or be made the punch line of a joke. Just like1型糖尿病要么多发性硬化症, obesity is a disease—and a difficult-to-control one, at that.

那就是当你的身体积聚和储存过量的脂肪会出现一个合法的医疗条件。取决于一个人的身高和体重，肥胖被分为几类，其中包括1类，2类和3类。

3类有时也称为“严重”或“极端”肥胖。（术语“病态肥胖”现在被认为是过时和过于诬蔑翻译：不要用它来形容自己或他人。）

Contrary to popular thought, people don’t choose to develop obesity; most people don’t wake up one morning and think, “Hey, today is a good day to become overweight to the point where it might damage my health and well-being.” Obesity is a result of a complex back-and-forth interplay of biological, psychological, and environmental triggers.

是的，营养和锻炼的事，但每过一年，研究人员揭示了越来越多的可能的影响因素，从缺乏睡眠对各种流行的药物，以肠道细菌，甚至儿时的耳部感染。

虽然整个社会似乎有那些通过模因肥胖笑话没问题取笑，事实是，肥胖是现在我国的规范。根据新的研究发表在新英格兰医学杂志, 40% of the U.S. population is currently living with obesity and that number is projected to rise to nearly half of the American population by the year 2030. Contributing to eight of the 10 leading causes of death in the U.S., obesity is a public health epidemic—and there's nothing funny about that.

是什么原因导致肥胖的发生吗？

在最基本的层面，肥胖在热量摄入和支出不平衡的结果：当你消耗更多的热量比你消耗通过锻炼和日常生活活动，创建所谓的“正能量平衡” - 您的身体有在更多的燃料时间比它可以使用。如果继续下去，它可能会导致体重增加，可能还有肥胖。

但还有更多工作，不仅仅是这个充满挑战的情况下，“哎呀，我吃了太多的炸薯条。”也不能肥胖症遗传学完全归咎于，正如经常的情况。

专家认为，环境对我们身边每天都保持巨大支配着我们吃什么样的社会，经济，文化，甚至是物理因素，我们是多么的消费，如何迅速或低效我们燃烧它关闭。

这里有一些最common culprits believed to be behind the obesity epidemic:

An Obesogenic Environment

专家认为，环境因素的星座可能是负责，部分信息，以提示我们不是需要每天吃更多的热量。总之，他们创造所谓的致胖，肥胖或促进，环境。其中一些功能包括：

• 对吃零食移位。这些热量往往是除了我们的饭菜，这意味着我们不能弥补那个下午3点通过在晚餐吃得少的芯片袋。
• Mushrooming portion sizes。A typical fast food beverage in the 1950s was seven ounces. Today's drinks are often 42 ounces. Meanwhile, hamburgers and fry portions have tripled in size.
• 超加工食品普及。我们谈论的糖果，饼干，薯片，苏打 - 所有这些都以某种方式设法是calorically高但营养缺乏。
• 从家常菜渐行渐远。More than half of our calories come from outside the home. These dishes tend to be higher in fat and sugar than home-cooked food.
• 有针对性的营销。如果你在网上购物一定低于健康的零食，对同类产品有针对性的广告将开始在你的社交媒体饲料弹出。在有针对性的营销的另一种形式，公司，使快餐，汽水，和其他加工食品已知集中在黑人和西班牙裔社区营销力度。
• 进入汽车和公共交通。Driving everywhere means there’s no need to walk, and walking burns calories. Less calorie-burn while eating the same amount of food raises the odds of weight gain.

Calorie Quality

Not all calories are created equal. What we mean by that is that 100 calories of almonds don’t affect your weight in the same way as 100 calories of nachos. Your body has to work harder to digest foods that are rich in fiber and protein than it does to digest refined carbohydrates, such as white bread, pasta, and candy. Researchers call this the “thermic effect” of food.

在发表的一项研究美国临床营养学杂志, subjects ate the same diet with the same number of calories for six weeks with one exception: when it came to grains, one group incorporated whole grains (brown rice, whole wheat bread, and oats) while the other ate refined grains like white bread. Those people in the whole grain group burned nearly 100 more calories per day, simply due to thermic effect.

遗传学

According to the Obesity Medicine Association, genetics increase the odds of obesity by anywhere from 40% to 70%, and there are more than 200 genes known to be strongly associated with the disease. If these genes are not working properly, it's important to understand that while they raise the risk of developing obesity, they by no means guarantee it. For the vast majority of people, when it comes to your weight, your fate is truly in your hands. Genes may also interact with the environment to increase or decrease one’s odds of gaining an unhealthy amount of weight.

药物

处方药的洗衣清单已与体重增加，包括类固醇，抗抑郁药，激素避孕药，药物治疗糖尿病，双相情感障碍，失眠，高血压，癫痫发作，癫痫和多个链接。

睡觉

嗡嗡代谢和均衡的饥饿荷尔蒙是的，当我们登录足够Zzzzs所发生的健康促进作用的一群之中。适当的睡眠有助于平衡，使我们感到饥饿或全（分别生长素和瘦素）激素。

睡眠过少和生长素翱翔，驾驶你吃得更多。更何况，后来熬夜给你更多的时间来吃饭，这也有助于体重增加。在具有里程碑意义的护士健康研究，跟随68000中年美国妇女为16岁，谁睡了五个小时或更少的女性分别为15％，更容易患上肥胖症与那些谁睡7小时的睡眠进行比较。

Does Obesity Put Me at Risk for Other Conditions?

肥胖rarely occurs in a bubble. While some people may be obese and have no serious co-existing medical conditions, they are the exception. As the second leading cause of preventable death in the U.S., obesity is a serious public health concern with far-reaching implications and reams of studies have linked it with more than 200 chronic diseases. Here are a few:

Heart Disease

Carrying around excess amounts of weight can put pressure on the heart, forcing it to work harder to send blood throughout the body. Individuals who are overweight or have obesity also tend to have conditions that independently raise the risk for心脏病, such as elevated cholesterol and high blood pressure.

2型糖尿病

在this increasingly common condition, a person’s blood sugar levels become chronically elevated. Up to 90% of adults with2型糖尿病carry extra weight or have obesity, perhaps because excess weight causes cells to become more resistant to a hormone called insulin, which is responsible for ferrying sugar from blood to muscle and fat cells, where it can be used for energy. With insulin resistance, sugar remains in the blood for an inappropriate amount of time, creating inflammation. Complications of high blood sugar include heart disease, stroke, kidney disease, amputation, and blindness.

Depression

The psychological impact of obesity may contribute to萧条，特别是女性。在澳大利亚的一项研究中，研究人员比较了48000多名抑郁症患者与没有它的近30万数据的数据。他们发现，个人谁有肥胖率45％更容易患抑郁症与那些谁有一个健康的身体质量指数进行比较。（身体质量指数被定义为一个人的公斤由它们身高米的平方除以体重）的链接可能是由于遗传变异，携带额外的重量，或其他因素的社会耻辱。

Cancer

截至都达到了惊人的40％cancers与肥胖有关。医生们发现肥胖与这些癌症之间的连接：

• 结肠和直肠
• Breast (specifically, in post-menopausal women)
• 食管
• Gall bladder
• 肾
• 肝
• Ovarian
• 胰腺
• Thyroid

当癌症细胞在身体的一部分生长异常或外的控制的方式发生。我们并不确切地知道为什么肥胖甚至只是携带额外的重量，似乎推动癌症发病率，但是一种理论是，脂肪细胞会释放荷尔蒙，影响这个异常细胞的生长。不良的饮食习惯和/或缺乏体力活动也助长癌症风险。

英年早逝

据发表在最近的一项研究国际肥胖杂志，谁拥有肥胖现场5.6至7.6近年来比正常体重的人的人少。那些谁拥有重度肥胖者可以活到8.1至10.3年代少了。

…和更多

睡眠障碍和反酸，腰痛，关节炎，和引起的过大的应力等并发症一起被放置在骨骼和关节，也由肥胖引起的。

How Do Doctors Diagnose Obesity?

在2013年，美国医学协会正式认可肥胖病。这是一个巨大的进步在很多医生和患者的眼睛，因为它担当了宣布国家，肥胖不是个人的选择，而是一个复杂的，合法的健康状况。

认识到肥胖作为一种疾病也很重要，因为这意味着，如癌症，克罗恩氏病等广泛接受的医疗条件，医疗服务提供者可以写处方治疗。

How to Calculate BMI

When diagnosing, most doctors and medical organizations use a measure called Body Mass Index (BMI) to determine whether a person has obesity or not. BMI is calculated via the following mathematic equation (Warning: You’ll likely need to use anonline conversion tool, as it utilizes the international system of units):

Weight (in kilograms) / Height (in meters) squared = BMI

For adults…

• BMI of 25.0 to 29.9 = overweight
• 的30 BMI或多个=肥胖

为了把在角度来看，一个女人谁是5'4” ，重达175被认为是肥胖（30 BMI）。这同样适用于一个5'9” 男人谁重204磅（30.3 BMI）。

肥胖is further divided by class:

• 类1 = 30.0 34.9 BMI
• Class 2 = BMI of 35.0 to 39.9
• Class 3, or severe obesity = BMI ≥40.0

Arguments exist both for and against using BMI as a diagnostic tool. Those in favor of using it appreciate the fact that it’s a fast, easy, no-cost calculation, and say it offers a quick but reliable snapshot of a person’s risk.

Opponents feel it may be a misleading measurement, either incorrectly categorizing some people having obesity, as it doesn’t take muscle mass or body frame into account (in athletic individuals or those with highly muscular builds, for instance) or, more dangerously, classifying some people as healthy simply because they have a "normal" BMI, when in fact they may be at risk for weight-related health conditions due to哪里他们携带自己的脂肪。

People who carry their weight around the belly ("apple" body types), for instance, are at increased risk for cardiovascular disease over those who carry more weight around their hips ("pear" type), even if they have a medically acceptable BMI. Belly fat is more worrisome when it comes to the effects of obesity.

有些人认为，一个更进步的诊断工具大概占身体不只是多余的脂肪，但引起的体脂不良健康效应的存在（见上文）。

什么是肥胖最好的治疗？

If you think obesity seems like a complicated disease, its treatments are equally complex. Physiologically speaking, it’s difficult to lose a significant amount of weight and keep it off. “Eat less and move more” is great advice when you have 10 pounds to shed; less so when you need to unload 50 or more. (In fact, while exercise is vital for weight maintenance, research suggests it's less effective in helping people to lose large amounts, unless you're work out at a super-intense level.)

所以，是的，斗争是真实的。准备好了一些令人鼓舞的消息？失去的只有3％至5％的重量和维护亏损有可能带来关于健康的重要改进的动力。您可以稳定血糖水平，降低你患2型糖尿病的风险，等等。删除更重要的是有助于改善心脏健康，并可能足以减少服药你把各种相关的慢性疾病的剂量。

考虑到这一点，检查出的治疗策略专家目前采用以帮助人们对抗肥胖，他们的成功几率。

改变生活方式

这一类通常包括旨在帮助人们减肥的努力消耗更少的热量和增加体力活动。如果你与医疗服务提供者的工作，他或她可能会建议增加来帮助你留在轨道改变行为的工具，如设置具体的，可实现的目标;保持食物和锻炼杂志;和深挖掘，了解环境线索提示你不健康的方式吃。

％的人谁将会使用生活方式的改变达到他们的减肥目标：2％至5％

Prescriptive Nutritional Interventions

A step beyond lifestyle medication, this category involves specific, prescribed behavioral modifications tailored to the individual’s unique environmental and genetic risk factors, with the goal of creating some sort of weight-loss advantage. Possibilities include (but are not limited to):

• 素食者的饮食
• 治疗碳水化合物减少（也称为酮饮食）

Percent of people who will reach their weight-loss goal using prescriptive nutritional interventions: 5% to 10%

药物治疗

美国食品和药物管理局已批准的减肥和慢性体重管理几种药物。你需要一个BMI大于30有资格获得处方，虽然与那些BMI大于27，以及一个体重相关的健康并发症有资格为好，即使他们不是技术上的肥胖。

药物的几个例子包括：

• Alli (Orlistat)- This drug works by blocking the absorption of dietary fat. When taken, about 30% less fat is absorbed from food and eliminated in the stool.
• Ozempic（司美鲁肽）- 到2021年已被用于治疗糖尿病，这种药物有望成为适用于肥胖，属于一类药物GLP-1受体激动剂，并研究表明，它可以帮助一些人失去了重量高达20％。
• Suprenza（芬特明）- 在大脑中食欲浸湿，这刺激神经递质的目标。

药物治疗requires medical supervision and is used in combination with nutrition and lifestyle changes.

％的人谁将会使用药物治疗达到他们的减肥目标：5％至20％

Endoscopic Procedures

术语“内窥镜”是指医生使用一个小的，灵活的仪器通过你的嘴，进入你的肠道。一旦进入，许多方法中的一个可以用来帮助减少食物的摄入。这些措施包括胃内水球，而这正是它听起来是这样的：气球在胃中，在那里它占用的空间来降低食欲和鼓励病人消耗较小的部分膨胀。在endoscopic suturing, tiny stitches are sewn into the inside of the stomach, making a person feel fuller on less food.

On the upside, endoscopic procedures are done on a same-day, outpatient basis, and are less invasive than surgery (meaning fewer risks). On the downside, they are not yet covered by insurance, so you can expect to pay $5,000 to $8,000 out of pocket.

Percent of people who will reach their weight-loss goal using these endoscopic methods: 10% to 20%

Metabolic Surgery (a.k.a. bariatric surgery)

This is the treatment category with the most risk but also greatest success rate. Surgery is usually reserved for people with a BMI higher than 40, or a BMI over 35 along with an obesity-related health condition. It has the potential to not just drastically reduce your weight, but to also help manage, improve or even reverse more than 40 obesity-related conditions, including heart disease, sleep apnea, high cholesterol, certain cancers, and more. In some trials, 70% of patients who undergo surgery show remission of type 2 diabetes within a few days.

几类代谢手术包括：

• 胃旁路手术- 外科医生，创建了一种新的，更小的胃，然后直接将其连接到小肠。第一步骤减少，可以（在一个时间约二至六个盎司）被舒适地消耗的食物的量，和所述第二步骤防止主体从吸收如，因为它会否则多少卡路里。
• 胃套（又名垂直胃切除术）- 像胃绕道手术，这限制多少人可以吃。不同于胃旁路，胃的约80％被除去。“套筒”，也有调节食欲的激素有很大的影响，所以人们一般只是觉得手术后那么饿了。

保险公司一般做cover metabolic surgery, so long as you meet the proper criteria.

Percent of people who will reach their weight-loss goal using bariatric surgical methods: 20% to 40%

什么是生命像肥胖的人？

在dividuals affected by excess weight and obesity are on the receiving end of unwarranted disapproval and shaming by others in the workplace, in the dating world, at their doctor’s office, when dining out, at the gym, or just at the corner store, as other customers assess and judge their purchases. Studies have concluded that weight stigma is as pervasive as racial stigma.

The effects of being treated as unworthy of respect or love can be emotionally haunting and physically and psychologically dangerous. Poor self-esteem, depression, and even suicidal thoughts have all been widely reported in individuals affected by obesity.

重量偏差也影响如何以及是否一个人选择获得医疗保健服务。例如，有研究表明，女性肥胖往往会忽略预防保健的约会和日常妇科癌症筛检。原因包括希望避免与谁曾表达了对他们的体重或给出不请自来的减肥建议持否定态度提供商交互;担心被要求穿上过小礼服或坐在一个太小的检查表;不希望被测量;你明白了吧。其结果是一个超级无益的22条军规，导致那些谁需要医疗帮助的最避免。

讽刺的是，一些治疗比较成功的形式，如手术，本身就是耻辱。没有人会指责患有乳腺癌的女人需要一个乳房切除术，然而这对选举的人接受手术代谢听力共同应对。（“哇，什么是失败的。她不能在她自己失去它。”）

尽管如此，社会正慢慢向前的理解，肥胖是一种疾病，而不是一种生活方式的选择移动。用恭敬的语言（“person with obesity“ 代替 ”obese person“）是在朝着正确的方向迈出的重要一步，和令人兴奋的工作正在有关于公共健康政策和治疗的创新来完成。

如果你是肥胖的生活，找了一个多学科的减肥团队（他们往往附属于大学）可以帮助你想出一个策略，把你的身体的控制权。通过这些球队之一，你将有机会获得医生，心理学家，营养学家，健身专家和其他专家谁希望能帮助你，免判定。

Where Can I Find My Obesity Communities?

Power in numbers, right? With 40% of Americans currently living with obesity, this community has no shortage of people who are right there with you. This community finds a way to encourage each other —将each other — into a healthier future. Being a part of this world may seem daunting right now, but these influencers and orgs will help you come to terms with the number on the scale, and through their own journeys, encourage you to start your own.

前肥胖有关的Instagrammers

• Stella,@stellaisstriving

遵循这是因为：她开始在567磅，她已经失去了重量的43％以上。不开刀，只是食物的变化和运动。没有特效药，只是纯粹的决心。她有挫折？当然，她的人。可是，她老是推，她每天分享每英镑丢失，一口棚的每一个汗，她每次进字令人鼓舞。

• 香农·泰勒，@shannons_story

遵循这是因为：Like most people who set off on a weight-loss journey, Shannon’s did not stick the first time around... or even the fifth. It wasn’t until he met his medical match — his gastric sleeve surgeon — that it finally clicked. He’s the epitome of the saying, if it doesn’t work the first time, try, try again. He’s now on the road to completing an Ironman, but will never forget where he came from, so he shares the inspiration for how he got from there, to here, on his feed.

• Nichole,@ pretty.n.sleeved

遵循这是因为：There is NO shame in her sleeve game. One of the best quotes on her feed could not ring more true: “Weight-loss surgery is NOT the easy way out because the surgery only works if YOU do.” Having weight-loss surgery still has its own host of hardships, and it’s not for everyone. She squashes the stigma of surgery being the scapegoat from obesity, while constantly reigniting her self-accountability to keep going.

• 迈克“Gormy”戈尔曼@gormy_goes_keto

遵循这是因为：He’s not going to sugarcoat it. It’s hard work and tough choices, every single day. But for someone who ate his way down (yes, ate his way down) from 540lbs to 205lbs, he’ll tell you it’s worth it. Gormy shares his keto lifestyle, while also spilling some life lessons about living with obesity—including the mental “weight” on your shoulders that comes along with this condition.

前肥胖有关的播客

• The Fat Guy Forum。Gormy的再次回来 - 这一次与播客，不仅记载了他300磅的重量损失，也照在其他男人有惊人的减肥旅程的焦点。他们来自每个POV生活，听他们的战术各界你会在几个小时吸（或天...）。
• 肥胖的灵丹妙药播客。两博士候选人肥胖和减肥主机这个播客中，该产品采用了减肥新产品评论，看好节目，和趋势的迷恋。他们带来的高手潜入肥胖的选择，同时也围绕这种疾病的心理和社会规范。
• 该播客燃烧脂肪。在case the name of the podcast wasn’t telling enough... this podcast aims to help you eat clean, find the workouts that are right for you, and ultimately, burn fat. Backed by hosts Dr. Lori Shemek, and health coach Omar Cumberbatch, this is the podcast you listen to when you need the knowledge about getting healthy和the encouraging daily push.

Top Obesity-Related Orgs and Support Groups

• The Obesity Society。这个非盈利性组织认为有肥胖背后一门科学 - 这不只是你的环境和生活的选择，它的化学，它是你内心。同时帮助您理解的是，他们也做了工作，创造科学为基础的治疗，以改变你的生活。
• 肥胖行动联盟。需要一个供应商对你肥胖的旅程吗?他们得到了you. Feeling like it would be best to be in a community for this process? They have one. Want to attend face-to-face or virtual conference to keep you reinvigorated? Come on down. This nonprofit has everything you need to actually be successful on your weight-loss journey.
• LEAD for Rare Obesity。这个令人难以置信的团队支持那些与肥胖的遗传性疾病，如POMC，LEPR，鲜红斑痣，和其他人，你可能只知道，如果你是其中的一个影响。作为该集团的一部分（也有许多支援小组，由LEAD内选择）让你感觉 - 也许在你的一生中第一次 - 那你的理解。