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'''Obesity''' is when a person's weight is higher than the ''healthy weight range'' advised by public health bodies, and higher than the ''overweight'' range. The [[Centers for Disease Control and Prevention|CDC]] regards a [[body mass index|Body Mass Index]] of 30 or higher in adults as obesity.<ref name="definition">{{Cite web|url=https://www.cdc.gov/obesity/adult/defining.html | title = Defining Adult Overweight and Obesity | last = | first = | authorlink = | date = 2021-06-07 | website = Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref> One in 3 people in the [[United States]] have obesity.<ref name="health" /> Obesity is considered a health problem because it has been linked to a number of serious, chronic dieases including heart disease, type 2 [[diabetes]] and certain types of cancers.<ref name="health">{{Cite web|url=https://www.cdc.gov/obesity/about-obesity/why-it-matters.html | title = Why It Matters | last = | first = | authorlink = | date = 2021-03-01 | website = Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref> ==Signs and symptoms== ==Treatment== ==ME/CFS== Obesity is not considered a [[:Category:Triggers and risk factors|trigger or risk factor]] for ME/CFS, and is not a sign or symptom of ME/CFS. Obesity is a [[differential diagnosis]] for ME/CFS and it can cause [[fatigue]]; clinicians are advised to consider this along with other symptoms, test results, and a personal history (e.g. whether symptoms began suddenly or any recent weight change).<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19= Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref><ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 =Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols| journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02| url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf}}</ref> According to the US ME/CFS Clinician Coalition, obesity is a potential comorbidity in people with ME/CFS, although it is not listed as a common comorbidity in either the [[Canadian Consensus Criteria]] or the [[International Consensus Criteria]].<ref name="UScoalition2020">{{Cite web | title = Diagnosing and Treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last=U.S. ME/CFS Clinician Coalition |edition=2 | date = July 2020 | url= https://bridgesandpathways.org.au/wp-content/uploads/2021/02/DiagnosingAndTreatingMECFSV2_USCoalition_2020.pdf | pages = 4}}</ref> ===Weight changes in ME/CFS === Medications taken for some ME/CFS symptoms can increase weight, particularly: *[[amitriptyline]] and other [[:Category:Tricyclic antidepressants|tricyclic antidepressants]], which are often used for [[pain]], especially in [[Fibromyalgia]], or for [[sleep dysfunction]] *[[quetiapine]], which may be used off-label for sleep problems *[[Lyrica]] (pregabelin) which is commonly used for pain<ref name="canadianconsensus-CCC" /> Marked [[weight loss]] or [[weight gain]] can also be a result of the [[neuroendocrine symptoms]] in some people with ME/CFS, or result from changed behaviors caused by [[reactive depression]], which is relatively common in ME/CFS.<ref name="canadianconsensus-CCC" /> ===Exercise === The [[exercise intolerance]] caused by ME/CFS means that many patients are unable to do as much physical activity as they would like to. Physical activity and a [[healthy, balanced diet]] are the main ways to prevent and reduce obesity.<ref name="management">{{Cite web|url=https://www.cdc.gov/obesity/strategies/index.html | title = Strategies to Prevent & Manage Obesity {{!}} Overweight & Obesity | last = | first = | authorlink = | date = 2021-04-09 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref> ==Severe obesity== The CDC's [[Fukuda criteria]] for [[chronic fatigue syndrome]] (1994), which was retired in 2017, did exclude patients with '''severe obesity''', which they defined as a BMI of 45 or greater, from a diagnosis of ME/CFS. Understanding of ME/CFS has changed considerably and it is no longer regarded as primarily a "fatigue" illness, but as a complex multi-systemic neurological disease, with [[post-exertional malaise]] rather than [[chronic fatigue]] as the hallmark symptom.<br> The CDC does not suggest obesity as a [[differential diagnosis]] for ME/CFS and does not list it as a common comorbidity. The phyiscal examination suggestions do not refer to weight or BMI values, although they may be assessed as part of routine practice or in identifying other existing conditions.<ref name="differential">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/other-conditions.html | title = Other Conditions for Evaluation {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last = | first = | authorlink = | date = 2019-07-23 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref><ref name="evaluation">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html | title = Evaluation {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last = | first = | authorlink = | date = 2021-04-28 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref><ref name="comorbid">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/comorbid-conditions.html | title = Comorbid Conditions {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last = | first = | authorlink = | date = 2019-07-23 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-01-11}}</ref> == Treatment == Treating obesity does not cure [[ME/CFS]], and clinical trials for different ME/CFS treatments typically have patients in the healthy weight range. Weight loss in ME/CFS patients with obesity has not been a major focus of clinical practice or research, although clinicians are advised to address all comorbidities found.<ref name="ICC2011primer" /><ref name="canadianconsensus-CCC" /> ==Notable articles== *2007, Body mass index and fatigue severity in chronic fatigue syndrome<ref name="Schur2007">{{Cite journal | title = Body Mass Index and Fatigue Severity in Chronic Fatigue Syndrome | date = 2007-01-01|url=https://doi.org/10.1300/J092v14n01_07|journal=Journal of Chronic Fatigue Syndrome|volume=14|issue=1 | pages = 69β77 | last = Schur | first = Ellen A. | last2 = Noonan | first2 = Carolyn | last3 = Smith | first3 = Wayne R. | last4 = Goldberg | first4 = Jack | last5 = Buchwald | first5 = Dedra|doi=10.1300/J092v14n01_07|issn=1057-3321}}</ref> [https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.550.7086&rep=rep1&type=pdf (Full text)] ::In women, there was no relationship between BMI and vitality subscale or global fatigue index scores (P = 0.99 and P = 0.44). For men, vitality subscale scores significantly decreased as BMI increased (P = 0.02). ::Conclusions: In CFS patients, the prevalence of obesity was low despite risk factors for weight gain. Fatigue severity and BMI were unrelated in women with CFS, but this relationship may differ for men. *2013, Examining the impact of obesity on individuals with chronic fatigue syndrome<ref name="Flores2013">{{Cite journal | title = Examining the Impact of Obesity on Individuals with Chronic Fatigue Syndrome | date = Sep 2013|url=https://doi.org/10.1177/216507991306100705 | journal = Workplace Health & Safety|volume=61|issue=7|pages=299β307 | last = Flores | first = Samantha | authorlink = | last2 = Brown | first2 = Abigail | authorlink2 = | last3 = Adeoye | first3 = Samuel | authorlink3 = | last4 = Jason | first4 = Leonard A. | authorlink4 = Leonard Jason | last5 = Evans | first5 = Meredyth | authorlink5 = Meredyth Evans|doi=10.1177/216507991306100705|pmc=|pmid=|access-date=|issn=2165-0799|quote=|via=}}</ref> [https://journals.sagepub.com/doi/abs/10.1177/216507991306100705 (Abstract)] *2017, Obesity in adolescents with chronic fatigue syndrome: an observational study<ref name="Norris2017">{{Cite journal | title = Obesity in adolescents with chronic fatigue syndrome: an observational study | date = Jan 2017|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256402/|journal=Archives of Disease in Childhood|volume=102|issue=1|pages=35β39 | last = Norris | first = T | author-link = | last2 = Hawton | first2 = K | authorlink2 = | last3 = Hamilton-Shield | first3 = J | authorlink3 = | last4 = Crawley | first4 = E | authorlink4 = Esther Crawley|doi=10.1136/archdischild-2016-311293|pmc=5256402|pmid=27655658|access-date=|issn=0003-9888|quote=|via=}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256402/ (Full text)] ::Adolescents who had attended specialist CFS/ME services had a higher prevalence of obesity (age 13 years: 9.28%; age 16 years: 16.43%) compared with both adolescents classified as CFS/ME in ALSPAC (age 13 years: 3.72%; age 16 years: 5.46%) and those non-CFS in ALSPAC (age 13 years: 4.18%; age 16 years: 4.46%). ==See also== * [[Healthy, balanced diet]] * [[Exercise]] * [[Post-exertional malaise]] * [[Weight gain]] * [[Weight loss]] ==Learn more== *[https://www.cdc.gov/obesity/adult/defining.html Defining Adult Obesity] - CDC * ==References== {{reflist}} [[Category:Potential comorbidities]] [[Category:Diagnoses]]
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