‘Life is so much better at a healthy weight’
Causes of obesity
Complications of obesity
Diagnosing obesity
Introduction
obesityprevention
Obesitysymptoms
See what the doctor sees with Map of Medicine
Surgery
Treating obesity

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Obesity

'Life is so much better at a healthy weight'

[Original article on NHS Choices website]

Husband and wife Brendan and Debbie Byrne lost a combined total of 9st 6lb by binning takeaways in favour of a healthy diet.

The Byrne’s family diet used to comprise Chinese takeaways, kebabs, pizzas and little else. Debbie and Brendan, who live in Essex with their children, knew it wasn’t ideal.

“When you both work full-time, it’s hard to find time to cook,” she says. “Brendan and I had struggled with our weight for years. I could see that the children were gaining weight, too.”

By early 2006, Debbie and Brendan, who both work for the police force, each weighed 16st 4lb. On a visit to his GP, Brendan was told that his blood pressure was too high. Meanwhile, Debbie’s self-esteem was at an all-time low because of her weight, and she was on medication for depression.

“When we heard about Brendan’s blood pressure, we knew we really had to act,” she says. “Our eldest daughter, Rhiannon, is 21. She was 12st 5lb, around 21lb overweight.”

Their eldest son Liam and youngest child Ciaran, 13, could also have benefited from losing few pounds, says Debbie. “I didn’t want the children to grow up facing the same health problems as us.”

When a friend recommended local slimming classes, Debbie immediately booked a slot for herself and Brendan. “It was quite daunting at first,” says Debbie. “But we soon both found the classes an enormous support.”

A consultant provided advice on diet and exercise at the weekly meetings, and group members were encouraged to share their experiences.

“At home, I started cooking with less fat,” says Debbie. “I changed from white bread to wholemeal, and we started eating lots more fruit.”

A food system devised by the slimming club consisted of a diet full of fresh fruit, vegetables, fish and lean meat. Dieters are also allowed occasional treats, small indulgences for which you plan ahead. By August 2006, Debbie had lost three stone and Brendan four.

“There’s flexibility in the diet, and that was important for the children,” says Debbie. “They could see the good it was doing us.”

Rhiannon, Liam and Ciaran had also started to lose weight. Along with weight loss came an energy boost. The family started running together, and Debbie even joined a gym.

By May 2007, Debbie had reached her target weight of 10st 2lb and had dropped five dress sizes, from a 20 to a 10. Brendan had also reached his target of 12st 10lb. Daughter Rhiannon had lost 21lb, reaching 11st, and Ciaran and Niall had also lost pounds.

“It’s so good to know that the children’s weight is under control,” says Debbie. “Weight loss has also done wonders for my self-esteem, and I’m no longer reliant on antidepressants. Brendan’s blood pressure has dropped to a normal level, too.

“Life is so much better at a healthy weight. You feel great, and people see you differently. I only wish I’d done this years ago.”

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Published Date: 2014-06-05 10:33:03Z
Last Review Date: 2014-04-06 00:00:00Z
Next Review Date: 2016-04-06 00:00:00Z

Classification: Getting active,Healthy eating,Obesity

NHS Choices Syndication

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/conditions/articles/obesity/causes

Obesity

Causes of obesity

[Original article on NHS Choices website]

Obesity is generally caused by eating too much and moving too little.

If you consume high amounts of energy from your diet, particularly from fat and sugars, but do not burn off the energy through exercise and physical activity, much of the surplus energy is then stored by the body as fat.

Calories

The energy value of food is measured in units called calories. The average physically active man needs about 2,500 calories a day to maintain a healthy weight, and the average physically active woman needs about 2,000 a day.

This may sound high, but it can be easy to reach this limit if you eat certain types of food. For example, eating a large takeaway hamburger, fries and a milkshake can total 1,500 calories – and that’s just one meal.

Another problem is that many people are not physically active, so lots of the calories they consume end up being stored in the body as fat.

Poor diet

Obesity does not happen overnight. It develops gradually over time, as a result of poor diet and lifestyle choices, such as:

eating large amounts of processed or fast food that is high in fat and sugar
drinking too much alcohol – alcohol contains a lot of calories, and people who drink heavily are often overweight
eating out a lot – you may be tempted to also have a starter or dessert in a restaurant, and the food can be higher in fat and sugar
eating larger portions than you need – you may be encouraged to eat too much if your friends or relatives are also eating large portions
drinking too many sugary drinks – including soft drinks and fruit juice
comfort eating – if you feel depressed or have low self-esteem, you may eat to make yourself feel better

Unhealthy eating habits tend to run in families, as you learn bad eating habits from your parents when you are young and continue them into adulthood.

Lack of physical activity

Lack of physical activity is another important factor related to obesity. Many people have jobs that involve sitting at a desk for most of the day. They also rely on their cars, rather than walking or cycling.

When people relax, they tend to watch TV, browse the internet or play computer games, and rarely take regular exercise.

If you are not active enough, you do not use the energy provided by the food you eat, and the extra energy you consume is stored by the body as fat.

The Department of Health recommends adults do at least 150 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week. This doesn’t need to be done in one go, but can be broken into smaller periods. For example, you could exercise for 30 minutes a day for five days.

If you are obese and trying to lose weight, you may need to do more exercise than this. It may help to start off slowly and gradually increase the amount of exercise you do each week.

Read more about the physical activity guidelines for adults.

Genetics

Some people claim there is no point in trying to lose weight because “it runs in my family” or “it’s in my genes”.

While there are some rare genetic conditions that can cause obesity, such as Prader-Willi syndrome, there is no reason why most people cannot lose weight.

It may be true that certain genetic traits inherited from your parents – such as having a large appetite – may make losing weight more difficult, but it certainly doesn’t make it impossible.

In many cases, obesity is more to do with environmental factors, such as poor eating habits learned during childhood.

Medical reasons

In some cases, underlying medical conditions may contribute to weight gain. These include:

an underactive thyroid gland (hypothyroidism) – where your thyroid gland does not produce enough hormones
Cushing’s syndrome – a rare disorder that causes the over-production of steroid hormones

However, if conditions such as these are properly diagnosed and treated they should pose less of a barrier to weight loss.

Certain medicines, including some corticosteroids, medications for epilepsy and diabetes, and some medications used to treat mental illness – including antidepressants and medicines for schizophrenia – can contribute to weight gain. Weight gain can also sometimes be a side effect of stopping smoking.

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Published Date: 2014-06-25 09:02:03Z
Last Review Date: 2014-06-02 00:00:00Z
Next Review Date: 2016-06-02 00:00:00Z

Classification: Carbohydrates,Fruit and vegetables,Obesity,Weight gain,Weight management

NHS Choices Syndication

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/conditions/articles/obesity/complications

Obesity

Complications of obesity

[Original article on NHS Choices website]

Obesity can cause a number of further problems, from difficulties with daily activities to serious health conditions.

Some of the day-to-day problems that can be caused by obesity include:

breathlessness
increased sweating
snoring
difficulty doing physical activity
feeling very tired a lot of the time
joint and back pain
low confidence and self-esteem
feeling isolated

You may also find that some of the psychological problems associated with being obese affect your relationships with family members and friends, and may lead to depression.

Further health problems

Being obese can also increase your risk of many potentially serious health conditions, including:

type 2 diabetes – a condition that causes a person’s blood sugar level to become too high
high blood pressure
high cholesterol and atherosclerosis (where fatty deposits narrow your arteries), which can lead to coronary heart disease and stroke
asthma
metabolic syndrome – a combination of diabetes, high blood pressure and obesity
several types of cancer, including bowel cancer, breast cancer and womb cancer
gastro-oesophageal reflux disease (GORD) – where stomach acid leaks out of the stomach and into the oesophagus (gullet)
gallstones – small stones, usually made of cholesterol, that form in the gallbladder
reduced fertility
osteoarthritis – a condition involving pain and stiffness in your joints
sleep apnoea – a condition that causes interrupted breathing during sleep, which can lead to daytime sleepiness with an increased risk of road traffic accidents, as well as a greater risk of diabetes, high blood pressure and heart disease
liver disease and kidney disease
pregnancy complications, such as gestational diabetes or pre-eclampsia (when a woman experiences a potentially dangerous rise in blood pressure during pregnancy)

Obesity reduces life expectancy by an average of 3 to 10 years, depending on how severe the problem is. It’s estimated that being overweight or obese contributes to at least 1 in every 13 deaths in Europe.

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Published Date: 2014-06-05 14:14:23Z
Last Review Date: 2014-06-02 00:00:00Z
Next Review Date: 2016-06-02 00:00:00Z

Classification: Obesity

NHS Choices Syndication

Representations

/conditions/articles/obesity/diagnosis

Obesity

Diagnosing obesity

[Original article on NHS Choices website]

Body mass index (BMI) is widely used as a simple and reliable way of finding out if you are overweight or obese.

BMI measures whether you’re a healthy weight for your height.

For most adults, having a BMI of 18.5 to 24.9 means you are considered to be a healthy weight. A person with a BMI of 25 to 29.9 is considered to be overweight, and someone with a BMI over 30 is considered to be obese.

However, while BMI is a useful measurement for most people, it is not accurate for everyone.

For example, the normal BMI scores may not be accurate if you are very muscular, because muscle can add extra pounds and may mean you have a high BMI when you are not an unhealthy weight. In such cases, it may be more helpful to use your waist circumference as a better guide (see below).

What is considered a healthy BMI is also influenced by your ethnic background. The scores mentioned above generally apply to people with a white Caucasian background. If you are from an ethnic minority background, the threshold for being considered overweight or obese may be lower.

BMI should not be used to work out if a child is a healthy weight, as their bodies are still developing. If you want to find out whether your child is overweight, speak to your GP.

Visiting your GP

If you are overweight or obese, visit your GP for advice about losing weight safely and to find out if you have an increased risk of health problems.

Your GP may ask about:

your lifestyle – particularly your diet and how much physical activity you do, and also whether you smoke and how much alcohol you drink
any possible underlying causes for your obesity – for example, if you are taking medication or have a medical condition that may contribute to weight gain
how you feel about being overweight – for example, if you are feeling depressed
how motivated you are to lose weight
your family history – as obesity and other health conditions, such as diabetes, are often more common in families

As well as calculating your BMI, your GP may perform tests to determine if you are at increased risk of health complications because of your weight. These could include:

measuring your blood pressure
measuring your glucose (sugar) and cholesterol levels in a blood sample
measuring your waist circumference (the distance around your waist)

People with very large waists (generally, 94cm or more in men and 80cm or more in women) are more likely to develop obesity-related health problems.

Your GP may also take your ethnicity into account, as these can affect your risk of certain conditions. For example, some people of Asian, African or Afro-Caribbean ethnicity may be at increased risk of high blood pressure (hypertension). Healthy waist measurements can also be different for people from different ethnic backgrounds.

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Published Date: 2014-06-05 14:02:42Z
Last Review Date: 2014-06-02 00:00:00Z
Next Review Date: 2016-06-02 00:00:00Z

Classification: Obesity,Weight gain,Weight management

NHS Choices Syndication

Representations

/conditions/articles/obesity/introduction

Obesity

Introduction

[Original article on NHS Choices website]

Obesity is a term used to describe somebody who is very overweight, with a lot of body fat.

It’s a common problem, estimated to affect around one in every four adults and around one in every five children aged 10 to 11 in the UK.

Defining obesity

There are many ways in which a person’s health in relation to their weight can be classified, but the most widely used method is body mass index (BMI).

BMI is a measure of whether you’re a healthy weight for your height. You can use the BMI healthy weight calculator to work out your score.

For most adults:

a BMI of 25 to 29.9 means you are considered overweight
a BMI of 30 to 39.9 means you are considered obese
a BMI of 40 or above means you are considered severely obese

BMI is not used to definitively diagnose obesity – as people who are very muscular sometimes have a high BMI, without excess fat – but for most people, it can be a useful indication of whether they may be overweight.

A better measure of excess fat is waist circumference, and can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9).

Generally, men with a waist circumference of 94cm or more and women with a waist circumference of 80cm or more are more likely to develop obesity-related health problems.

Risks of obesity

Taking steps to tackle obesity is important because, in addition to causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions, such as:

type 2 diabetes
coronary heart disease
some types of cancer, such as breast cancer and bowel cancer
stroke

Obesity can also affect your quality of life and lead to psychological problems, such as low self-esteem or depression.

Read more about the complications of obesity.

Causes of obesity

Obesity is generally caused by consuming more calories – particularly those in fatty and sugary foods – than you burn off through physical activity. The excess energy is then stored by the body as fat.

Obesity is an increasingly common problem, because many modern lifestyles often promote eating excessive amounts of cheap, high-calorie food and spending a lot of time sitting at desks, on sofas or in cars.

There are also some underlying health conditions that can occasionally contribute to weight gain, such as an underactive thyroid gland (hypothyroidism), although conditions such as this don’t usually cause weight problems if they are effectively controlled with medication.

Treating obesity

The best way to treat obesity is to eat a healthy, reduced-calorie diet and to exercise regularly. To do this you should:

eat a balanced, calorie-controlled diet as recommended by your GP or weight loss management health professional (such as a dietitian)
join a local weight loss group
take up activities such as fast walking, jogging, swimming or tennis for 150-300 minutes a week
eat slowly and avoid situations where you know you could be tempted to overeat

You may also benefit from psychological support from a trained healthcare professional, to help change the way you think about food and eating.

If lifestyle changes alone don’t help you lose weight, a medication called orlistat may be recommended. If taken correctly, this medication works by reducing the amount of the fat you absorb during digestion. Your GP will know whether orlistat is suitable for you.

In rare cases, weight loss surgery may be recommended.

Outlook

There is no “quick fix” for obesity. Weight loss programmes take time and commitment, but they work best when people are able to complete the programmes fully and are offered advice about maintaining the weight loss achieved.

Regularly monitoring your weight, setting realistic goals and involving your friends and family with your attempts to lose weight can also help.

Remember that even losing what seems like a small amount of weight (such as 3% or more of your original body weight), and maintaining this for life, can significantly reduce your risk of obesity-related complications like diabetes and heart disease.

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Obesity

Introduction

Losing weight: how your GP can help

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A GP talks about visiting your doctor to get help with losing weight. He describes how you’ll be assessed and given an individually tailored weight loss plan. Elinor, who had health problems caused by her weight, explains why she asked her GP for help instead of choosing to follow a commercial diet.

Media last reviewed: 30/04/2013

Next review due: 30/04/2015

Couch to 5K

If it’s been a long since you did any exercise, you should check out the NHS Choices Couch to 5K running plan.

It’s made up of podcasts delivered over the course of nine weeks and has been specifically designed for absolute beginners.

You first start running for short periods of time and as the plan progresses, gradually increase the amount.

When the nine weeks ends, you should be able to run for 30 minutes non-stop, which for most people is around five kilometres.

Defining obesity

There are many ways in which a person’s health in relation to their weight can be classified, but the most widely used method is body mass index (BMI).

BMI is a measure of whether you’re a healthy weight for your height. You can use the BMI healthy weight calculator to work out your score.

For most adults:

a BMI of 25 to 29.9 means you are considered overweight
a BMI of 30 to 39.9 means you are considered obese
a BMI of 40 or above means you are considered severely obese

A better measure of excess fat is waist circumference, and can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9).

Generally, men with a waist circumference of 94cm or more and women with a waist circumference of 80cm or more are more likely to develop obesity-related health problems.

Risks of obesity

Taking steps to tackle obesity is important because, in addition to causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions, such as:

type 2 diabetes
coronary heart disease
some types of cancer, such as breast cancer and bowel cancer
stroke

Obesity can also affect your quality of life and lead to psychological problems, such as low self-esteem or depression.

Read more about the complications of obesity.

Causes of obesity

Treating obesity

The best way to treat obesity is to eat a healthy, reduced-calorie diet and to exercise regularly. To do this you should:

eat a balanced, calorie-controlled diet as recommended by your GP or weight loss management health professional (such as a dietitian)
join a local weight loss group
take up activities such as fast walking, jogging, swimming or tennis for 150-300 minutes a week
eat slowly and avoid situations where you know you could be tempted to overeat

You may also benefit from psychological support from a trained healthcare professional, to help change the way you think about food and eating.

In rare cases, weight loss surgery may be recommended.

Outlook

Regularly monitoring your weight, setting realistic goals and involving your friends and family with your attempts to lose weight can also help.

Page last reviewed: 03/06/2014

Next review due: 03/06/2016

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Comments

The 9 comments about ‘Obesity’ posted are personal views. Any information they give has not been checked and may not be accurate.

evo25uk said on 20 March 2014

I had always been thin until I moved in with my partner. Since then I have put on 5 stone! As I stopped smoking at the beginning of this year, losing weight is not the priority it might otherwise be for my doctor.
Since I stopped smoking I have also suffered from breathlessness. Not when I exercise but when I am walking around my flat. This has now been accompanied with dizziness thatais almost constant. I’m not sure if this is related to my weigh but it does affect my day to day activities.
When exercising, which I am doing daily, I have a breathing pattern you would expect, slightly quicker but nothing of concern yet walking from one room to another leaves me struggling for breathe, so I am umsure whether the weight gain has caused my breathlessness.
I too suffer from depression and have recently changed medication. The result from this has done me wonders. I have my motivation to lose weight back and am looking forward to returning to work. I know that losing weight is my responsibility and am looking forward to feeling comfortable with myself again.
I can only thank my doctors for their determination to make me feel more positive about life.

CEJ135 said on 11 March 2014

I think doctors need to realise that obesity isn’t just about eating badly and not exercising, they need to look into the mental health of the obese people. I am morbidly obese and, even though I know all the risks to my health, I continue overeating because my depression makes me have no motivation to do anything about it and it boosts my mood (albeit temporarily). I know all about healthy eating, I know the foods and portion sizes I should be having. I just don’t do it. Not through choice but because my own mind stops me.

Ondat said on 25 February 2014

I think there’s some useful, practical information on this site. But for people like me, knowledge wasn’t the issue. i used food and overeating to cope with life, without really even realising I was doing it, while having an almost encyclopaedic knowledge of everything food, weight and health- related.

The more I overate and the larger I became, the larger I became, the more I struggled with low self esteem and the more I ate. I would constantly plan to lose the weight in the belief that this would be the key to happiness, but when I was successful at losing weight and still wasn’t happy, I’d sabotage myself and overeat again. I went on eating binges, and was so ashamed of my behaviour that most of my eating was in secret.

I think that overeating for some people is a compulsion over which we have, despite years of trying, no control. I see overeating or using food as similar to using alcohol for an alcoholic or drugs for an addict.

When I finally admitted to myself that my problem was food, I was lucky enough to find a self help group called Overeaters Anonymous (OA). In the same way that Alcoholics Anonymous helps alcoholics stop using alcohol, in OA we support eachother to tackle our food problems. It’s not a diet and calories club and won’t tell you what to eat. There are meetings in most cities and they have a GB website if you want to find out more.

Without being on a diet, I’ve lost a lot of weight in OA, but have gained so much more than that – a programme that helps me live life sanely and happily without turning to excess food for comfort. My head is no longer obsessed with eating, diets, bdoy image. It’s a relief to be with so many others who’ve suffered alone for many years. Anyone with a desire to stop eating compulsively is welcome at any meeting.

hhmmmmm said on 05 February 2014

Incredibly out of date information that will not help people much

I would argue can your doctor help you? The evidence suggests not because we are still overweight and they prescribe calorie controlled diets with more exercise ignoring the dozens of studies showing those diets don’t work. And why would they? Reducing calories on the recommended diets make people hungry and miserable and exercising makes people even hungrier and the body compensates by slowing down metabolism.

If calorie controlled diets fail to work over the long term (the figures from meta analysis of diet studies over the past 15 show about 2% of people have long term significant weight loss on calorie restricted diets over the course of at least 18 months or 2 years they have no significant loss, often they will gain weight.

If you start to realise the clinically proven to work diets see and target excessive consumption of refined carbohydrate and sugar, then you see a problem you can do something about it by managing that. It causes both excessive consumption of calories and chronically high insulin levels which drive fat storage (and a number of other problems).

Try paleo (which has worked wonders for me) with a focus on non-starchy vegetable and meat, fish, poultry and eggs or low-moderate carb diet such as The Zone diet or even a ketogenic diet which have consistently shown in many numerous long and short term diet studies to be both more effective at long term weight loss and better at reducing risk factors for heart disease and diabetes than low calorie and particularly low fat diets and the long term success rates of these diets are 1 in 2, not 1 in 50 as is the case with the diets most (not all) doctors prescribe and as written out here.

If 1 in 50 was the success rate for other medical treatment, we’d be questioning the sanity of it.

It is also worth mentioning these were often the diets prescribed to lose weight by doctors before the 60s/70s.

izzy33 said on 21 July 2013

8 weeks ago i had a bmi of 28.8 and 32% body fat – so not obese but certainly overweight – i got weighed today and i now have a bmi of 27.3 and 17.7% body fat. I’ve lost around 2 stone in fat and gained around 1 stone in muscle mass. This has been through the paleo diet and lots of exercise (walking, local gym membership, cycling). i recommend these steps as they certainly worked for me (although of course this diet won’t work for everyone, and you shouldn’t try to run before you can walk!) – i am also a great believer in having a positive, can-do attitude – go on – you can do it!!

jennyrobson85 said on 21 May 2013

BMI is an extremely unreliable way of assessing obesity – muscle weighs more than fat! Fat percentage is a much better way of checking healthy body weight.

Rache1972 said on 18 January 2013

I agree silva82. I myself have recently been diagnosed with pcos and have lost over 8 stone by going to a slimming club. However I cannot get any further treatment until I lose more weight, to which I asked how much and how as now I haven’t lost any weight since March 2012, the answer just keep trying!

silva82 said on 26 July 2012

Its all well and good to explain what obesity is, how many people are obese in uk and what damage obesity does to us!

But what actual physical and emotional support does the nhs actually offer?

Does being referred to a dietician really help? iv been there! And no it did nothing for me, I would like to think that most people in 2012 will know what foods to eat and what not to eat!

I have pcos and have suffered from obesity all my life and not once have I been given any help from my gp!

I have had to deal with periods lasting 6 months embarrassing facial hair and being obese and the best advice my gp was able to give me was “oh dear you have to lose weight and come back in a few months to check progress” well thanks ! tell me something I didn’t know!

NHS say there is a huge obesity problem, here’s an idea……. actually do something to help obese people!

a country like the uk should have weekly support both physical and emotional, access to exercise classes for free (or even based on a small donation by the obese person) in every hospital.

does any one else agree?

andyjones1247 said on 14 June 2012

I was obese at 22st in jan 2012 and I reduced my food consumption and added excercises daily and now 6 months on I am down to 17st it’s all about will power and all these excuses I.e. ” I have a slow metabolism”, ” I don’t eat a lot”, etc etc are all just excuses ( yes I’ve used them all ) but now I realise it’s me and only me that can change ” yes you guessed it me” so come on people dedication and not giving up, changes don’t come overnight but they will come of you stick with it and don’t give up!

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Obesity

Introduction

Losing weight: how your GP can help

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Viewing video content in NHS Choices

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Media last reviewed: 30/04/2013

Next review due: 30/04/2015

Couch to 5K

If it’s been a long since you did any exercise, you should check out the NHS Choices Couch to 5K running plan.

It’s made up of podcasts delivered over the course of nine weeks and has been specifically designed for absolute beginners.

You first start running for short periods of time and as the plan progresses, gradually increase the amount.

When the nine weeks ends, you should be able to run for 30 minutes non-stop, which for most people is around five kilometres.

Defining obesity

There are many ways in which a person’s health in relation to their weight can be classified, but the most widely used method is body mass index (BMI).

BMI is a measure of whether you’re a healthy weight for your height. You can use the BMI healthy weight calculator to work out your score.

For most adults:

a BMI of 25 to 29.9 means you are considered overweight
a BMI of 30 to 39.9 means you are considered obese
a BMI of 40 or above means you are considered severely obese

A better measure of excess fat is waist circumference, and can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9).

Generally, men with a waist circumference of 94cm or more and women with a waist circumference of 80cm or more are more likely to develop obesity-related health problems.

Risks of obesity

Taking steps to tackle obesity is important because, in addition to causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions, such as:

type 2 diabetes
coronary heart disease
some types of cancer, such as breast cancer and bowel cancer
stroke

Obesity can also affect your quality of life and lead to psychological problems, such as low self-esteem or depression.

Read more about the complications of obesity.

Causes of obesity

Treating obesity

The best way to treat obesity is to eat a healthy, reduced-calorie diet and to exercise regularly. To do this you should:

eat a balanced, calorie-controlled diet as recommended by your GP or weight loss management health professional (such as a dietitian)
join a local weight loss group
take up activities such as fast walking, jogging, swimming or tennis for 150-300 minutes a week
eat slowly and avoid situations where you know you could be tempted to overeat

You may also benefit from psychological support from a trained healthcare professional, to help change the way you think about food and eating.

In rare cases, weight loss surgery may be recommended.

Outlook

Regularly monitoring your weight, setting realistic goals and involving your friends and family with your attempts to lose weight can also help.

Page last reviewed: 03/06/2014

Next review due: 03/06/2016

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Comments

The 9 comments about ‘Obesity’ posted are personal views. Any information they give has not been checked and may not be accurate.

evo25uk said on 20 March 2014

CEJ135 said on 11 March 2014

Ondat said on 25 February 2014

hhmmmmm said on 05 February 2014

Incredibly out of date information that will not help people much

If 1 in 50 was the success rate for other medical treatment, we’d be questioning the sanity of it.

It is also worth mentioning these were often the diets prescribed to lose weight by doctors before the 60s/70s.

izzy33 said on 21 July 2013

jennyrobson85 said on 21 May 2013

BMI is an extremely unreliable way of assessing obesity – muscle weighs more than fat! Fat percentage is a much better way of checking healthy body weight.

Rache1972 said on 18 January 2013

silva82 said on 26 July 2012

Its all well and good to explain what obesity is, how many people are obese in uk and what damage obesity does to us!

But what actual physical and emotional support does the nhs actually offer?

Does being referred to a dietician really help? iv been there! And no it did nothing for me, I would like to think that most people in 2012 will know what foods to eat and what not to eat!

I have pcos and have suffered from obesity all my life and not once have I been given any help from my gp!

NHS say there is a huge obesity problem, here’s an idea……. actually do something to help obese people!

a country like the uk should have weekly support both physical and emotional, access to exercise classes for free (or even based on a small donation by the obese person) in every hospital.

does any one else agree?

andyjones1247 said on 14 June 2012

Useful links

NHS Choices links

External links

Overweight and pregnant

Being very overweight can cause problems in pregnancy. Find out the risks and what you can do

Very overweight children: advice for parents

Practical advice for parents of very overweight children including tips on healthy eating and suitable physical activity

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important

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Obesity

See what the doctor sees with Map of Medicine

[Original article on NHS Choices website]

The Map of Medicine is used by doctors throughout the NHS to determine the best treatment options for their patients. NHS Choices offers everyone in England exclusive and free access to this cutting-edge internet resource, which lets you see exactly what your doctor sees.

The information in the Map has been approved by the UK’s leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: obesity in adults

Map of Medicine: obesity in children

Useful Links

Published Date: 2011-09-11 17:53:00Z
Last Review Date: 2010-02-25 00:00:00Z
Next Review Date: 2012-02-25 00:00:00Z

Classification: Obesity

Weight loss surgery – NHS Choices

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Weight loss surgery

Overview
weight-loss-surgery Map of Medicine

Introduction

Understanding BMI results in adults

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Find out how to calculate your body mass index (BMI) and interpret the results correctly.

Media last reviewed: 04/03/2014

Next review due: 04/03/2016

Body mass index and obesity

The most widely used method of seeing if you are a healthy weight is to calculate your body mass index (BMI). This is your weight in kilograms divided by your height in metres squared:

If your BMI is 25-29.9, you are over the ideal weight for your height (overweight).
If your BMI is 30-39.9, you are obese.
If your BMI is over 40, you are very obese (known as morbidly obese).

BMI does not provide an accurate assessment of weight in all circumstances, such as in people who are very muscular or children going through a sudden growth spurt.

‘My gastric band surgery’

Vicky talks about the changes she had to make to her diet before and after weight loss surgery, and what it’s like living with a gastric band

Weight loss surgery, also called bariatric surgery, is used as a last resort to treat people who are dangerously obese (carrying an abnormally excessive amount of body fat).

This type of surgery is only available on the NHS to treat people with potentially life-threatening obesity when other treatments, such as lifestyle changes, haven’t worked.

Potentially life-threatening obesity is defined as:

having a body mass index (BMI) of 40 or above
having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes or high blood pressure

For people who meet the above criteria, weight loss surgery has proved to be effective in significantly and quickly reducing excess body fat.

The National Institute for Health and Care Excellence (NICE) is currently considering lowering the threshold for weight loss surgery to a BMI of over 30 for people who have recently been diagnosed with type 2 diabetes.

However, it is always recommended that you try to lose weight through a healthy, calorie-controlled diet and increased exercise before you consider weight loss surgery, as surgery carries a risk of complications and requires a significant change in lifestyle afterwards.

Due to these associated risks, most surgeons, whether they are working privately or for the NHS, would only consider a person for surgery if there was a clinical need, and not just for cosmetic reasons.

Read more about who can use weight loss surgery.

Availability of weight loss surgery

Even if you are eligible for weight loss surgery, the demand for this surgery on the NHS is currently higher than the supply in many areas of the country. Therefore, there may be a considerable waiting list.

Weight loss surgery is also available privately. Prices are around:

£5,000-8,000 for gastric banding
£9,500-15,000 for gastric bypass surgery

An increasing number of people are seeking treatment abroad as costs for private treatment are often cheaper in other countries, but this option should be considered carefully. For more information, see planned treatment abroad.

Types of weight loss surgery

The two most widely used types of weight loss surgery are:

gastric band, where a band is used to reduce the size of the stomach so a smaller amount of food is required to make you feel full
gastric bypass, where your digestive system is re-routed past most of your stomach so you digest less food and it takes much less food to make you feel full

Several other surgical techniques may be recommended in certain circumstances.

Read more about how weight loss surgery is performed.

Life after weight loss surgery

Weight loss surgery can achieve often impressive results in the amount of weight lost, but it should not be seen as a magic cure for obesity.

People who have had weight loss surgery will need to stick to a rigorous and lifelong plan afterwards to avoid putting weight back on or long-term complications.

This plan will include:

a carefully controlled diet
regular exercise

The rapid weight loss may cause relationship problems, for example with a partner who is also obese, and it may lead to unwanted loose folds of skin, which may need further surgery to correct.

Also, many people with mental health problems, such as depression or anxiety, find that these problems do not automatically improve because they have lost weight.

It is important to have realistic expectations about what life after weight loss surgery will be like.

Read more about life after weight loss surgery.

Risks

As with all types of surgery, weight loss surgery carries the risk of complications, some of which are serious and potentially fatal, such as:

internal bleeding
a blood clot inside the leg (deep vein thrombosis)
a blood clot or other blockage inside the lungs (pulmonary embolism)

A 2014 American review of over 157,000 patients found the overall risk of death, within 30 days of having any kind of weight loss surgery, is around 1 in 1000. The risk of death after having a gastric bypass was slightly higher.

However, certain risk factors, such as high blood pressure or a BMI of 50 or above, increase the risk of complications.

Read more about risks of weight loss surgery.

Results

As long as a person is willing and able to stick to their agreed plan afterwards, surgery can effectively reduce their weight and treat conditions associated with obesity, such as diabetes.

Recent research carried out in America found that on average:

people with a gastric band will lose around half their excess body weight
people with a gastric bypass will lose around two-thirds of their excess body weight

Both techniques also lead to a considerable improvement (and sometimes a complete cure) of obesity-related conditions, such as diabetes or high blood pressure.

Read more about the results of weight loss surgery.

Page last reviewed: 05/11/2012

Next review due: 05/11/2014

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Comments

The 15 comments about ‘Introduction’ posted are personal views. Any information they give has not been checked and may not be accurate.

Lubelle81 said on 09 July 2014

I just discovered I have PCOS.. The weight started packing on when I was 19.. I’m 32 now.. I got very lucky to have one son..But this uncontrollable weight gain is too much it’s depressing, every time I travel to work I want to jump in front of a train.. I talked this over with my GP, I begged him for a gastric bypass but instead he told me to get a dietitian and enter a gym, I don’t want to be difficult but I choose to work as a cleaner to replace going to a gym.. Besides swallowing painkillers as if I was eating skittles, How else can I explain to my GP 12 years of Pain, and Depression is enough for me, I settle for a Gastric Bypass??

Chezzybaby said on 15 March 2014

I had a gastric bypass on 23rd October 2013 and 5 months on and I am 6 stone 2llb lighter and have not looked back, providing you stick with what the hospital tell you and take ur medication and eat what they say you should be fine. Iv yoyo dieted for years battled with my weight iv researched thus operation to help me reach the right decision . The only part of the journey I didn’t really like was having to have injections in my tummy for two weeks twice a day, but it was all go after they were finished. And I do not regret it one bit. Everyone is different but this op had mentally changed my whole outlook on food and drink, I no longer crave chocolate and diet Pepsi which was my downfall before. Good luck to you all considering to have the bypass xx

cirelondiel said on 07 January 2014

I need help.
I am 22 years old, 5”10 size 26/28 and around 25/26 stone. As a child I was always bigger than the other children in school.
I have been on a diet most of my life even when I was small. relentlessly bullied all the way through school and still even now remarks and taunts are made. exercise is hard as I had a accident a few years ago and have nerve damage in the base of my spine and a curvature in the top. manic depression and anxiety disorders and a history of self harming and several attempts on my own life. I am seriously considering surgery but I need as much help and advice as you can give me.
Any advice or words of wisdom will be greatly appreciated.

cirelondiel said on 07 January 2014

GastricBypassSufferer said on 10 December 2013

As someone who has to live with a mother who has had the gastric bypass operation, I think people should be made aware of what the side effects are to having this surgery and how Gastric Surgery can be detrimental to your own health because what the surgeons tell patients before hand is not a reality and the operation should be banned under some sort of misselling in my opinion.

Firstly as a result of having a cut and shut of the digestive system, the food consumed is never digested properly, you will not absorb all the nutrition you need from the food which will ultimately be bad for your own health but as the food passes through in a undigested/incorrectly digested state, what goes down the loo, stinks.

I really cant emphasis enough just how bad this smell is and over time this smell will follow you around everywhere like an unchanged nappy!

Likewise your gaseous emissions or flatulence will also smell an order of magnitude worse than before surgery and you will always be planning to be around a toilet as you have far less control over your bowels as a result. If an app existed where you can see every public toilet on the planet, gastric bypass recipients will almost certainly download it. Secondly, if you choose to have this operation, you will become very ashamed of this smell (which is a negative effect on your already fragile mental health) and will spend massive amounts on air-freshener and perfumes. This means anyone else living in the home if they have not already, will develop breathing problems including asthma as a results of the copious amounts of artificial smells deployed in the building. The smell for me is so bad it triggers massive coughing sessions and as a result I have developed permanent ringing in my ears and a hernia from the excessive coughing caused ultimately by this surgery. This excessive use of air freshener is bad for everyone’s health but the I doubt the Gastric Surgeons have thought that fair ahead!

GastricBypassSufferer said on 10 December 2013

Part 2.

Thirdly as a taxpayer I dont see this Gastric Surgery recipient having changed what they eat contrary to the “careful eligibility checks” carried out by the NHS before hand. My mother still continues to pig out on doughnuts and other junk fund, which suggests to me obesity may be have some element of mental health issues after all what is comfort eating if its not eating in search of missing nutrients from the diet? Likewise I think its also worth pointing out most obese people are seriously deficient in Vitamin D, and studies show your weight will drop off when your get your levels up to 200nmol/L, so if you want a cheaper less invasive alternative, get your Dr to check your Vit D levels and get them up, at least to 100nmol/L, as Vit D helps your body repair itself, your taste for healthy food will increase until you crave eating healthy food and shun sugary foods. Some fatty foods are healthy because fat soluble vitamins need fat to be stored in, so when you eat some joints of meat, you will getting the fat soluble vitamins the animal has naturally built up so you will benefit from a a natural form of vitamin delivery.

So to anyone considering this surgery, its painful, and will leave you smelling and behaving like an incontinent for the rest of your life. And ask yourself do you really want that? At least check out the Vit D route for 1 year before hand as the science backs up my claims, but it also means the UK’s GDP will decline as a Vit D is a lot less expensive than questionable surgery.

BigIsBack said on 09 November 2013

Reading the experiences of everyone else here that somehow resembles my own experience I come to the conclusion that patients are not in the heart of the NHS ethos.

I really hope that the NHS will help every patient enjoy a healthier life.

Soul Surfer said on 10 October 2013

I am a 34 year old female. I have always suffered from weight problems and tried all the diets that are around. I managed to shed some weight when I was younger, however now is so difficult. Recently, I have been diagnosed with low thyroid function and I am taking hormone treatment to regulate that. My current BMI is 33.9 (I weigh 98 Kilos) – height 5.7. I have also been diagnosed with hypertension and I am asthmatic. I am just worried that things might just get worse as I get older. I wonder whether the NHS can make exceptions when just BMI is not 35 or above. I do certainly have the High blood pressure which is considered a serious health condition. Does anyone know if these exceptions exist?

H from Bedford said on 27 August 2013

I had a gastric bypass last year and I would urge anybody who has had problems with their doctor to try and see another doctor perhaps even another doctor at the same practice. It is scary going to the doctors but all doctors vary and it is always worth getting a second opinion. Princess Teacake – I do understand what its like – I would stress your family history of diabetes when you see the doctor – really hope it works out.

PrincessTeacake said on 28 May 2013

I am writing this to ask for help. I’m a female, aged 24, and currently weigh in at 21.7stone with my height being 5.8. Well I have always had an issue with my weight being a size 12/14 at school then size 16-18 at college. And now rest at a size 22-24. I am very insecure and very depressed about my weight. I have been to the doctors many of times to be told I’m not big enough. Well I’m pretty sure 21stone is more then enough! I hate the way I look so much I don’t even let my fiancé see me in the nude. I hate being like this, it’s always been a big issue. I have depression and anxiety and I’m worried I’m going to get diabetes soon as my auntie and mum currently have it. I have tried many diets, slimming tablets and even going to the gym 3 days a week but my weight barely comes off. Most I’ve lost is 1stone and a half but had a bad day and my depression got the better of me and I put it back on In a matter of a few weeks. I’m In this viscous circle and I can’t get out. What does it take for me to get a gastric bypass on the NHS??? I pay my taxes! I don’t want to be thin to be a model or just like everyone else I want to be thin to be healthy to get my confidence back to wake up everyday and not cry!

fussie said on 25 May 2013

Dear mysticalpickle. I read your post with real compassion your frustration and desperation are so evident. I wanted GB surgery but was encouraged by my family to try other methods as we lost a family friend in the operating room having this procedure. I tried many things as you have but I persevered with Lighter Life and now I am so glad I did, some packs were OK but generally I had to think of it at nutrition. Ultimately, all I was doing was eating what I could have done after surgery and the counsellor was fantastic helping me to make the changes I wanted in both my diet and lifestyle and enabling me to start thinking about me and food differently. I know that being morbidly obese is a lonely place but the support of the group and the management group that I still attend every now and then is worth it. I am so proud that I own the responsibility of my weight loss and it is mine alone not dependant on an NHS budget or a GP opinion, Weight management isn’t about what you eat it is about how we use food for a variety of reason. I wish you all the luck in the world with weight loss but please don’t let the GP door closing stop you from doing what you need to do,

mysticalpickle said on 21 May 2013

Hi, im a 40 yr old mum, im 5ft 7, i now weigh 20stone. I suffer with Fibromyalgia, severe depression/ migraines, i have a wheat and glutten issue( some diet foods make me worse) Ive had an acl recon, ive damaged ligamemnts in one ankle, I suffer with Achillies tendonopothy on both feet/ankles, i suffer with plantar facilitus on both feet and ganglion syst on one foot which can not be removed, its hard to breath at times, I also have ligament damage on one of the shoulders and carple tunnel damage in one of my wrists after a car accident. my sciatica is in overdrive. I do not claim disability as i am not disabled enough lol I can not walk unaided, im sick of taking pills, i can not attend a gym due to the above conditions, i have tried 5 diets( cambridge, lighter life, slimming world, weightwatchers and diet chef) i am not working , not because I am not qualified or dont have the incentive, but medical conditions stop me and companies wont epmploy insurance risks or obese( fact). I have begged for help from my gp in the past, and they suggest the normal.(gym and healthy food) I dont smoke, dont do drugs nor do i drink. My mental and emotional state are so low, its hard to see myself live the rest of my life like this. I have 2 children and want to be around for them, grandkids etc to enjoy my life and etc. i dont have a personal life, everything is sooo painful, i desperatly need some help. Having read the types of op, bypass, band etc , i read about the balloon too. which is similar to the band but can be altered to fix the need of each person. im going up and up in weight, and its hard for us over weighties to keep weight off through daily routine. I have no friends for support and family is miles away. Can anyone suggest something, im not after sympathy or a magic wand, but i just cant get me wobbly bits off. Im quite scared to go back to my GP. Would i be a good candidate for these procedures? surely having a better lif, healthier life is better than struggles

nata1ie said on 08 May 2013

Im 32 5′ 3" and a bmi of 53 since i had my daughter when i was a size 10 ive suffered from extreme lower back pains which made me put the weight on as i can hardly walk with the amount of pain im in i dont leave the house as apart from the pain, ive gained a phobiia that everyones looking and laughing at me.
Ive tried excercise to get my weight down but because of the pain i cant do it so i asked my doctor for weight loss surgery and he refused im at a loss why did he refuse when im obviously needing the help !! I just dont know where to turn anymore, if this comment gets read then plz help me xx

Marina3 said on 05 October 2012

I am 18 years old, 5"3 and 105kilos. My BMI is 41. I have always been big in my life due to many bad experiences during my early life. I have been to my doctor today to discuss my weight, they just told me what I have already been trying to do since I was 14. I have done every diet possibly, hypnosis (didn’t work), calorie controlled diets, non carb diets, all have not worked. I have quite an active life style. Yet I also suffer with Asthma. My weight can extremly make me depressed and stop me from doing what I want to do. I really need medical help now, Please.

gilboandco27 said on 07 August 2012

Why can’t my 21 year old Son have the gastric band fitted when he is over 28 stones and lives in his bedroom all of the time because he is so afraid of what people think of him. Does he have to wait untill he has a heart attack, diabetes or a stroke. He fits all of the criteria and also his mental health now because of the fear of going out of the house. I had the gastric band fitted 7 years ago now and I lost 11 stones and kept it off. I wonder if anyone will respond to this letter?

Useful links

NHS Choices links

External links

NICE: obesity

Lose weight

Weight loss resources to help you lose weight healthily, including the NHS 12-week diet and exercise plan

‘Is weight loss surgery right for me?’

Find out whether weight loss surgery, including gastric band and gastric bypass, is right for you, and how it would affect your diet and lifestyle

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Obesity

Treating obesity

[Original article on NHS Choices website]

If you are obese, speak to your GP for advice about losing weight safely.

Your GP can advise you on the type of diet you should be following and how you can much exercise you should do.

They can also let you know about other services, such as:

local weight loss groups – these could be provided by the NHS or may be commercial services you have to pay for
exercise on prescription – where you are referred to a local active health team for a number of sessions under the supervision of a qualified trainer

If you have underlying problems associated with obesity, such as polycystic ovary syndrome (PCOS), high blood pressure, diabetes or obstructive sleep apnoea, your GP may recommend further tests or specific treatment. In some cases, they may refer you to a specialist.

Read more about how your GP can help you lose weight.

Diet

While there is no single rule that applies to everybody, most obese people are advised to reduce the energy intake from their diet by 600 calories a day.

The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices.

A healthy diet should consist of:

plenty of fruit and vegetables
plenty of potatoes, bread, rice, pasta and other starchy foods (ideally you should choose wholegrain varieties)
some milk and dairy foods
some meat, fish, eggs, beans and other non-dairy sources of protein
just small amounts of food and drinks that are high in fat and sugar

Try to avoid foods containing high levels of salt as these can raise your blood pressure, which can be dangerous in people who are already obese. Read some tips for a lower-salt diet.

You will also need to check calorie information for each type of food and drink you consume, to make sure you do not go over your daily limit.

Some restaurants, cafés and fast food outlets provide calorie information per portion, but providing this information is not compulsory. Be careful when eating out, as some foods can quickly take you over the limit, such as burgers, fried chicken and some curries or Chinese dishes.

Diet programmes and fad diets

You should avoid fad diets that recommend unsafe practices, such as fasting (going without food for long periods of time) or cutting out entire food groups. These can make you feel ill and are not sustainable, because they don’t teach you long-term healthy eating habits.

This is not to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well for some people. A responsible diet programme should:

educate you about issues such as portion size, making changes to behaviour and healthy eating
not be overly restrictive in terms of the type of foods you can eat
be based on achieving gradual sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last

On average, people attending a lifestyle weight management programme lose around 3% of their body weight, although this varies considerably.

Read about the pros and cons of different diets.

Very low calorie diets

A very low calorie diet (VLCD) is where you consume less than 1,000 calories a day.

These diets can lead to rapid weight loss, but they are not a suitable or safe method for everyone. VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss, such as severe sleep apnoea.

VLCDs should usually not be followed for any longer than 12 weeks at a time, and they should only be adopted under the supervision of a suitably qualified healthcare professional.

Further information

For more information on diet and weight loss read about:

Exercise

Reducing the amount of calories in your diet will help you lose weight, but if you want to keep off the weight, you have to combine a calorie-controlled diet with regular exercise.

Your GP or weight loss adviser can provide an exercise plan suited to your circumstances, which will probably involve several hours of moderate-intensity physical activity a week.

Moderate-intensity physical activity is any activity that increases your heart and breathing rate, and may make you sweat, but still allows you to hold a normal conversation. Examples include:

fast walking
jogging
swimming
tennis
using a step-trainer (or similar) at the gym

Choose physical activities that you enjoy, as you are more likely to continue doing them.

You should aim to start gradually. For example, start off by doing 15 to 20 minutes of exercise five times a week and then build on it.

The Department of Health recommends most adults should do at least 150 minutes of moderate-intensity exercise every week. However, if you are obese and trying to lose weight, or have successfully lost weight and want to keep it off, you probably need to do more exercise. In most cases, up to five hours a week is recommended.

Further information

For more information on exercise, see:

Other useful strategies

Evidence has shown that weight loss can be more successful if it involves other strategies, in addition to diet and lifestyle changes. This could include things like:

setting realistic weight loss goals – even losing just 3% of your original body weight can significantly reduce your risk of obesity-related complications
eating more slowly and being mindful of what and when you are eating (for example, not being distracted by watching TV)
avoiding situations where you know you may be tempted to overeat
involving your friends and family with your weight loss efforts, as they can motivate you
monitoring your progress – for example, weigh yourself regularly and note your weight in a diary

You may also find psychological support from a trained healthcare professional helps you change the way you think about food and eating, through techniques such as cognitive behavioural therapy (CBT).

Medication

Many different types of anti-obesity medication have been tested in clinical trials, but only one has proved to be both safe and effective: orlistat.

Orlistat works by preventing around a third of the fat from the food you eat from being digested. This undigested fat is not absorbed into your body and is passed out with your faeces (stools).

This will help you avoid gaining weight, but will not necessarily cause you to lose weight. Therefore, it’s still important to stick to your recommended diet and exercise plan.

When medication is used

Orlistat is usually only recommended if you have made a significant effort to lose weight through diet, exercise or changing your lifestyle.

Even then, orlistat is only prescribed if you have:

a body mass index (BMI) of 28 or more and other conditions related to weight, such as high blood pressure
a BMI of 30 or more

Treatment with orlistat must be combined with a low-fat diet and other weight loss strategies, such as doing more exercise. If you are prescribed orlistat, you will also be offered advice and support about diet, exercise and making lifestyle changes.

Orlistat is not usually recommended for pregnant or breastfeeding women.

Dosage and duration of treatment

One orlistat capsule is taken with each main meal (up to a maximum of three capsules a day). You can take the capsule either before, during or up to one hour after each meal.

If you miss a meal or the meal does not contain any fat, you may not need to take the orlistat capsule. Your GP should explain this to you, or you can check the patient information leaflet that comes with your medication.

Treatment with orlistat should only continue beyond three months if you have lost 5% of your body weight. It usually starts to affect how you digest fat within one to two days. If orlistat has not worked after three months, it is unlikely to be an effective treatment for you.

If you have type 2 diabetes, it may take you longer to lose weight using orlistat, so your target weight loss after three months may therefore be slightly lower.

If orlistat is successful after three months, your prescription may be continued for up to a year. After that, your GP will review your condition and decide whether you should continue with orlistat.

Side effects

Common side effects of orlistat include:

fatty or oily stools
needing the toilet urgently
passing stools more frequently
oily discharge from your rectum (you may have oily spots on your underwear)
flatulence (wind)
stomach pain
headaches
upper respiratory tract infections, such as a cold

These side effects are much less likely to occur if you stick to a low-fat diet.

Women taking the oral contraceptive pill are advised to use an additional method of contraception, such as a condom, if they experience severe diarrhoea while taking orlistat. This is because the contraceptive pill may not be absorbed by your body if you have diarrhoea, so it may not be effective.

Surgery

Weight loss surgery, also called bariatric surgery, is sometimes used to treat people who are severely obese.

This type of surgery is usually only available on the NHS to treat people with severe obesity that have not responded to other measures.

Severe obesity is defined as:

having a body mass index (BMI) of 40 or above
having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes, obstructive sleep apnoea or high blood pressure

In rare cases, surgery may be recommended as the first treatment if your BMI is 50 or above.

Treating obesity in children

Treating obesity in children is based on much the same principles as treating obesity in adults – by combining a calorie-controlled diet with regular exercise.

The amount of calories your child should eat every day will depend on their age and height. Your GP should advise a recommended daily limit.

Children should ideally get at least one hour of moderately-intense exercise a day, such as running, playing football or netball.

You should restrict sedentary activities, such as watching television or playing computer games, to less than two hours a day (14 hours a week).

Referral to a specialist in treating childhood obesity may be recommended if your child develops an obesity-related complication, or there is thought to be an underlying medical condition causing the obesity.

The use of orlistat in children is only recommended in exceptional circumstances – for example, if a child is severely obese and has an obesity-related complication.

Further information:

For more information on diet and exercise in children, see:

Obesity

Obesity

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Obesity

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