Obesity

What is obesity?

Obesity means your body mass index (BMI) is greater than 30. Your
healthcare provider will use your height and weight to measure your BMI.

What are the risks of obesity?

Obesity can cause many health problems, including injuries or physical disability.

Diabetes (high blood sugar level)
High blood pressure or high cholesterol
Heart disease
Stroke
Gallbladder or liver disease
Cancer of the colon, breast, prostate, liver, or kidney
Sleep apnea
Arthritis or gout

What do I need to know about screening?

Screening is done to check for health conditions before you have signs or symptoms. If you are 35 to 70 years old, your blood sugar level may be checked every 3 years for signs of prediabetes or diabetes. Your healthcare provider will check your blood pressure at each visit. High blood pressure can lead to a stroke or other problems. Your provider may check for signs of heart disease, cancer, or other health problems.

How is obesity treated?

The goal of treatment is to help you lose weight so your health will improve. Even a small decrease in BMI can reduce the risk for many health problems. Your healthcare provider will help you set a weight-loss goal.

Lifestyle changes are the first step in treating obesity. These include making healthy food choices and getting regular physical activity. Your healthcare provider may suggest a weight-loss program that involves coaching, education, and therapy.
Medicine may help you lose weight when it is used with healthy foods and physical -
activity.
Surgery can help you lose weight if you are very obese and have other health problems. There are several types of weight-loss surgery. Ask your healthcare provider for more
information.

How can I be successful at losing weight?

Set small, realistic goals. An example of a small goal is to walk for 20 minutes 5 days a week. Another goal is to lose 5% of your body weight.
Tell friends, family members, and coworkers about your goals and ask for their support. Ask a friend to lose weight with you, or join a weight-loss support group.
Identify foods or triggers that may cause you to overeat, and find ways to avoid them. Remove tempting high-calorie foods from your home and workplace. Place a bowl of fresh fruit on your kitchen counter. If stress causes you to eat, then find other ways to cope with stress. A counselor or therapist may be able to help you.
Keep a diary to track what you eat and drink. Also write down how many minutes of physical activity you do each day. Weigh yourself once a week and record it in your diary.

What eating changes should I make?

You will need to eat 500 to 1,000 fewer calories each day than you currently eat to lose 1 to 2 pounds a week. The following changes will help you cut calories:

Eat smaller portions. Use small plates, no larger than 9 inches in diameter. Fill your plate half full of fruits and vegetables. Measure your food using measuring cups until you know what a serving size looks like.
Eat 3 meals and 1 or 2 snacks each day. Plan your meals in advance. Cook and eat at home most of the time. Eat slowly. Do not skip meals. Skipping meals can lead to overeating later in the day. This can make it harder for you to lose weight. Talk with a dietitian to help you make a meal plan and schedule that is right for you.
Eat fruits and vegetables at every meal. They are low in calories and high in fiber, which makes you feel full. Do not add butter, margarine, or cream sauce to vegetables. Use herbs to season steamed vegetables.
Eat less fat and fewer fried foods. Eat more baked or grilled chicken and fish. These protein sources are lower in calories and fat than red meat. Limit fast food. Dress your salads with olive oil and vinegar instead of bottled dressing.
Limit the amount of sugar you cat. Do not drink sugary beverages. Limit alcohol.

What activity changes should I make?

Physical activity is good for your body in many ways. It helps you bum calories and build strong muscles. It decreases stress and depression, and improves your mood. It can also help you sleep better. Talk to your healthcare provider before you begin an exercise program.

Exercise for at least 30 minutes 5 days a week. Start slowly. Set aside time each day for physical activity that you enjoy and that is convenient for you. It is best to do both weight training and an activity that increases your heart rate, such as walking, bicycling, or swimming.
Find ways to be more active. Do yard work and housecleaning. Walk up the stairs
instead of using elevators. Spend your leisure time going to events that require walking, such as outdoor festivals or fairs. This extra physical activity can help you lose weight and keep it off.

When should I seek immediate care?

You have a severe headache, confusion, or difficulty speaking.
You have weakness on one side of your body.
You have chest pain, sweating, or shortness of breath at rest.

When should I call my doctor?

You have symptoms of gallbladder or liver disease, such as pain in your upper abdomen.
You have knee or hip pain and discomfort while walking.
You have symptoms of diabetes, such as intense hunger and thirst, and frequent urination.
You have symptoms of sleep apnea, such as snoring or daytime sleepiness.
You have questions or concerns about your condition or care.\

Weight Management

Why is important to manage my weight?

Being overweight increases your risk of health conditions such as heart disease, high blood pressure, type 2 diabetes, and certain types of cancer. It can also increase your risk for osteoarthritis, sleep apnea, and other respiratory problems. Aim for a slow, steady weight loss. Even a small amount of weight loss can lower your risk of health problems.

What are the risks of being overweight?

Extra weight can cause many health problems, including the following:

Diabetes (high blood sugar level)
High blood pressure or high cholesterol
Heart disease
Stroke
Gallbladder or liver disease
Cancer of the colon, breast, prostate, liver, or kidney
Sleep apnea
Arthritis or gout

What do I need to know about screening?

How do I lose weight safely?

A safe and healthy way to lose weight is to eat fewer calories and get regular exercise.

You can lose up about I pound a week by decreasing the number of calories you eat by 500 calories each day. You can decrease calories by eating smaller portion sizes or by cutting out high-calorie foods. Read labels to find out how many calories are in the foods you eat.
You can also burn calories with exercise such as walking, swimming, or biking. You will be more likely to keep weight off if you make these changes part of your lifestyle. Exercise at least 30 minutes per day on most days of the week. You can also fit in more physical activity by taking the stairs instead of the elevator or parking farther away from stores. Ask your healthcare provider about the best exercise plan for you.

What is a healthy meal plan that can help me manage my weight?

A healthy meal plan includes a variety of foods, contains fewer calories, and helps you stay healthy. A healthy meal plan includes the following:

Eat whole-grain foods more often. A healthy meal plan should contain fiber. Fiber is the part of grains, fruits, and vegetables that is not broken down by your body. Wholegrain foods are healthy and provide extra fiber in your diet. Some examples of wholegrain foods are whole-wheat breads and pastas, oatmeal, brown rice, and bulgur.
Eat a variety of vegetables every day. Include dark, leafy greens such as spinach, kale, collard greens, and mustard greens. Eat yellow and orange vegetables such as carrots, sweet potatoes, and winter squash.
Eat a variety of fruits every day. Choose fresh or canned fruit (canned in its own juice or light syrup) instead of juice. Fruit juice has very little or no fiber.
Eat low-fat dairy foods. Drink fat-free (skim) milk or I% milk. Eat fat-free yogurt and low-fat cottage cheese. Try low-fat cheeses such as mozzarella and other reduced-fat cheeses.
Choose meat and other protein foods that are low in fat. Choose beans or other legumes such as split peas or lentils. Choose fish, skinless poultry (chicken or turkey), or lean cuts of red meat (beef or pork). Before you cook meat or poultry, cut off any visible fat.
Use less fat and oil. Try baking foods instead of frying them. Add less fat, such as margarine, sour cream, regular salad dressing and mayonnaise to foods. Eat fewer high fat foods. Some examples of high-fat foods include french fries, doughnuts, ice cream, and cakes.
Eat fewer sweets. Limit foods and drinks that are high in sugar. This includes candy, cookies, regular soda, and sweetened drinks.

What are some ways I can decrease calories?

Eat smaller portions.
- - Use a small plate with smaller servings.
  - Do not eat second helpings.
  - When you eat at a restaurant, ask for a box and place half of your meal in the box before you eat.
  - Share an entrée with someone else.
Replace high-calorie snacks with healthy, low-caloric snacks.
- - Choose fresh fruit, vegetables, fat-free rice cakes, or air-popped popcorn instead of potato chips, nuts, or chocolate.
  - Choose water or calorie-free drinks instead of soda or sweetened drinks.
Do not shop for groceries when you are hungry. You may be more likely to make unhealthy food choices. Take a grocery list of healthy foods and shop after you have eaten.
Eat regular meals. Do not skip meals. Skipping meals can lead to overeating later in the day. This can make it harder for you to lose weight. Eat a healthy snack in place of a meal if you do not have time to eat a regular meal. Talk with a dietitian to help you create a meal plan and schedule that is right for you.

What other things should I consider as I try to lose weight?

Be aware of situations that may give you the urge to overeat, such as eating while watching television. Find ways to avoid these situations. For example, read a book, go for a walk, or do crafts.
Meet with a weight loss support group or friends who are also trying to lose weight. This may help you stay motivated to continue working on your weight loss goals.

Heart Healthy Diet

What is a heart healthy diet?

A heart healthy diet is an eating plan low in unhealthy fats and sodium (salt). The plan is high in healthy fats and fiber. A heart healthy diet helps improve your cholesterol levels and lowers your risk for heart disease and stroke. A dietitian will teach you how to read and understand food labels.

What diet guidelines should I follow?

Choose foods that contain healthy fats.
- - Unsaturated fats include monounsaturated and polyunsaturated fats. Unsaturated fat is found in foods such as soybean, canola, olive, com, and safflower oils. It is also found in soft tub margarine that is made with liquid vegetable oil.
  - Omega-3 fat is found in certain fish, such as salmon, tuna, and trout, and in
    walnuts and flaxseed. Eat fish high in omega-3 fats at least 2 times a week.
Get 20 to 30 grams of fiber each day. Fruits, vegetables, whole-grain foods, and legumes (cooked beans) are good sources of fiber.
Limit or do not have unhealthy fats.
- - Cholesterol is found in animal foods, such as eggs and lobster, and in dairy
    products made from whole milk. Limit cholesterol to less than 200 mg each day.
  - Saturated fat is found in meats, such as bacon and hamburger. It is also found in chicken or turkey skin, whole milk, and butter. Limit saturated fat to less than 7%of your total daily calories.
  - Trans fat is found in packaged foods, such as potato chips and cookies. It is also in hard margarine, some fried foods, and shortening. Do not eat foods that contain trans fats.
Limit sodium as directed. You may be told to limit sodium to 2,000 to 2,300 mg each day. Choose low-sodium or no-salt-added foods. Add little or no salt to food you prepare. Use herbs and spices in place of salt.

What can I include in my heart healthy plan?

Ask your dietitian or healthcare provider how many servings to have from each of the following food groups:

Grains:
- - Whole-wheat breads, cereals, and pastas, and brown rice
  - Low-fat, low-sodium crackers and chips
Vegetables:
- - Broccoli, green beans, green peas, and spinach
  - Collards, kale, and lima beans
  - Carrots, sweet potatoes, tomatoes, and peppers
  - Canned vegetables with no salt added
Fruits:
- - Bananas, peaches, pears, and pineapple
  - Grapes, raisins, and dates
  - Oranges, tangerines, grapefruit, orange juice, and grapefruit juice
  - Apricots, mangoes, melons, and papaya
  - Raspberries and strawberries
  - Canned fruit with no added sugar
Low-fat dairy:
- - Nonfat (skim) milk, l % milk, and low-fat almond, cashew, or soy milks fortified with calcium
  - Low-fat cheese, regular or frozen yogurt, and cottage cheese
Meats and proteins:
- - Lean cuts of beef and pork (loin, leg, round), skinless chicken and turkey
  - Legumes, soy products, egg whites, or nuts

What should I limit or not include in my heart healthy plan?

Unhealthy fats and oils:
- - Whole or 2% milk, cream cheese, sour cream, or cheese
  - High-fat cuts of beef (T-bone steaks, ribs), chicken or turkey with skin, and organ meats such as liver
  - Butter, stick margarine, shortening, and cooking oils such as coconut or palm oil
Foods and liquids high in sodium:
- - Packaged foods, such as frozen dinners, cookies, macaroni and cheese, and
    cereals with more than 300 mg of sodium per serving
  - Vegetables with added sodium, such as instant potatoes, vegetables with added sauces, or regular canned vegetables
  - Cured or smoked meats, such as hot dogs, bacon, and sausage
  - High-sodium ketchup, barbecue sauce, salad dressing, pickles, olives, soy sauce, or miso
Foods and liquids high in sugar:
- - Candy, cake, cookies, pies, or doughnuts
  - Soft drinks (soda), sports drinks, or sweetened tea
  - Canned or dry mixes for cakes, soups, sauces, or gravies

What other guidelines should I follow for a healthy heart?

Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
Limit or do not drink alcohol as directed. Alcohol can damage your heart and raise your blood pressure. Your healthcare provider may give you specific daily and weekly limits. The general recommended limit is 1 drink a day for women 21 or older and for men 65 or older. Do not have more than 3 drinks in a day or 7 in a week. The recommended limit is 2 drinks a day for men 21 to 64 years of age. Do not have more than 4 drinks in a day or 14 in a week. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1 ½ ounces of liquor.
Exercise regularly. Exercise can help you maintain a healthy weight and improve your blood pressure and cholesterol levels. Regular exercise can also decrease your risk for heart problems. Ask your healthcare provider about the best exercise plan for you. Do not start an exercise program without asking your healthcare provider.