Understanding Extreme Obesity and What You Can Do

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Too much weight can take a toll on your body, especially your heart. The good news is that there are steps you can take to get healthier — and even losing a little body weight can start you on the right path.  

Why lose weight?

Less risk of heart disease, less diabetes and cancer. Metabolic improvements start to occur when people with extreme obesity lose about 10% of their body weight.  

Losing weight can reduce your risk of heart disease and stroke as well as risk factors such as high blood pressure, glucose (blood sugar) and sleep apnea. It can also help lower your total cholesterol, triglycerides and raise “good” cholesterol — also known as HDL.

Understanding extreme obesity

A healthy body mass index range is from 18.5 to 25 kg/m2. If your BMI is 40 or higher, you are considered extremely obese (or morbidly obese.) BMI in children is determined using a different BMI calculator from the CDC.

A woman is extremely obese if she’s 5 feet, 4 inches tall and weighs 235 pounds, making her BMI 40.3 kg/m2. To reach a healthy BMI of 24.8, she would have to lose 90 pounds to reach a weight of 145 pounds.

A man is extremely obese if he’s 6 feet, 2 inches tall and weighs 315 pounds, making his BMI 40.4 kg/m2. To reach a healthy BMI of 25.0, he would need to lose 120 pounds to reach a weight of 195 pounds.  

Health care professionals use BMI to define severe obesity rather than a certain number of pounds or a set weight limit, because BMI factors weight in relation to height.

How to get healthier

If you’re extremely obese, taking action to lose weight and improve your health may seem overwhelming. You may have had trouble losing weight or maintaining your weight loss, been diagnosed with medical problems and endured the social stigma of obesity.

If you’re extremely obese, you should become more active, but do not to start a vigorous workout program without getting physician advice. You should also wait until you’ve lost about 10% of your body weight.

You can continue the level of physical activity that you’re already doing but check with your health care professional before increasing it. Some people with extreme obesity may have health issues such as arthritis or heart disease that could limit or even be worsened by exercise. 

Treatment options

Talk to your doctor about the health benefits and the risks of treatment options for extreme obesity:

  1. Change your diet. You may be referred to a dietician who can help you with a plan to lose one to two pounds per week. To lose weight, you have to reduce the number of calories you consume. Start by tracking everything you eat.

    You need to reduce your calories by 500 calories per day to lose about a one pound a week or cut 1,000 calories a day to lose about two pounds a week. 

  2. Consider adding physical activity after reaching a minimum of a 10% weight-loss goal.  

  3. Medication.  Some people can benefit from medication to help with weight loss for extreme obesity. Keep in mind that medication can be expensive and have side effects.

  4. Surgery.  If changing your diet, getting more physical activity and taking medication haven’t helped you lose enough weight, bariatric or “metabolic” surgery may be an option. The American Heart Association recommends surgery for those who are healthy enough for the procedure and have been unsuccessful with lifestyle changes and medication. Risks can include infections and potentially dangerous blood clots soon after the operation. There also are concerns about getting the right amount of vitamins and minerals long-term.

Get the social or medical support you need

Although some people can modify their lifestyle and lose weight on their own, many need extra help. A social support system can help encourage your progress and keep you on track. Decide what support best fits your needs — either a weight-loss support group or one-on-one therapy.

Some people with extreme obesity suffer from depression. Talk to your health care professional about the best treatment, as some anti-depressant medications can cause weight gain.


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