Misconceptions about obesity are common. For example, many individuals consider that if obese people simply use extra willpower to eat less and exercise more, they'll easily reach and stay at a healthy, normal weight.
Even those that struggle with obesity may consider this, despite the incontrovertible fact that repeated personal experience often tells them otherwise. The increasing prevalence of obesity—which now affects only 42 percent of individuals on this country—is further evidence that it's a posh, difficult disease (see “Defining Obesity”).
Misplaced bias
Dr. Stanford suggests that to begin, don't seek advice from other people or yourself as “fat,” but see yourself as an obese person. Prejudice and stigma against obese people is widespread, often attributable to the assumption that poor decisions and lack of motivation are the one causes. But as is true for a lot of diseases, many interconnected aspects play a job, says Dr. Stanford.
A serious problem is the “obesity-promoting” environment we've all been living in for the past few many years. One aspect is the constant exposure to and prepared access to jumbo-sized portions of highly processed foods, which now make up greater than half of Americans' meals. Loaded with fat, salt and sugar, these tempting foods are easy to go down quickly – and all those extra calories are sometimes stored as fat. Another is lack of physical activity, which makes it difficult to keep up a healthy weight.
Definition of obesityThe official definition of obesity is a body mass index (BMI) of 30 or more (see /BMI to calculate your individual). But BMI, an indirect estimate of body fat based on height and weight, is just not based on science. Many experts consider waist circumference a greater method to assess the health risks of excess body fat. A waist circumference of 35 inches (in women) or 40 inches (in men) indicates high risk. 
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But other lifestyle and health issues may contribute to thwarting weight gain and weight reduction efforts, says Dr. Stanford. Here are a few of the principal culprits:
Lack of sufficient sleep. Too little sleep — especially six or fewer hours per night — is a known contributor to weight gain. While sleep disorders resembling insomnia may be blamed, a fixation with screens — computers, smartphones and televisions — often prevents us from getting enough shut-eye.
Depression, anxiety and stress. These common mental health issues can motivate you to exercise and prepare healthy meals. They may trigger emotional eating, which frequently results in overeating of high-calorie foods.
Prescription drugs. According to a recent study by the CDC, about one in five people take prescribed drugs that could cause weight gain. These include certain medications used to treat diabetes, hypertension, depression, and muscle pain or inflammation.
All of those aspects – together with genetics – affect metabolism, which is controlled by the hypothalamus. This brain region, which controls many body functions resembling temperature control and appetite, also serves to maintain body weight inside a narrow range, or “set point.” This signifies that obese people often regain the load they lost—their brains work against them to return to their previous, heavier weight, explains Dr. Stanford.
what are you able to do
This doesn't mean that obese people cannot shed some pounds. But they often require a more nuanced, personalized approach that goes beyond food regimen and exercise, possibly weight-loss drugs or surgery. Dr. Stanford, who treats patients on the Massachusetts General Hospital Vet Center, never prescribes a selected food regimen. Instead, she advises people to give attention to eating lean protein, whole grains, fruit and veggies and find their “soulmate” exercise — something they'll enjoy on daily basis. She also helps them address other lifestyle issues that may affect weight: getting enough sleep, treating mental health issues, and switching weight-gain medications when possible. To discover a physician near you who makes a speciality of obesity treatment, the Obesity Action Coalition maintains a searchable directory here. https://obesitycareproviders.com.
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