New treatments could be in the pipeline to give obese people a full feeling after eating just a small meal, researchers said.
Experts have identified two cell proteins that relax the stomach and help it expand to accommodate large meals.
By targeting the protein receptors, they hope to be able to develop drugs which make people feel "full up" quicker.
Dr Brian King, senior lecturer at University College London (UCL), said the targeted therapies - in the form of a pill - were a long way off but the research was an exciting step.
"This offers a new way forward for people who are looking to find an effective way for weight control," he said.
"This is a growing problem and so people need as much help as possible."
Dr King and his colleague, Dr Andrea Townsend-Nicholson, published their latest research in the Journal of Pharmacology and Experimental Therapeutics.
The study explores the basis of relaxation of the gut at a molecular level.
The authors identify two protein receptors - P2Y1 and P2Y11 - involved in fast and slow relaxation of the gut.
The study was carried out on guinea pigs, but the proteins are also present in the human gut. Future research will look at the human form of the P2Y11 protein receptor.
Tuesday, March 11, 2008
Herbal Remedies:
The use of herbs is a time-honored approach to strengthening the body and treating disease. The following have been used traditionally to treat obesity:
Guggul (Commiphora mukul): This is a popular herb used in Ayurveda. Guggul is frequently recommended by Ayurveda practitioners for weight control in addition to use in lowering cholesterol. In clinical trials, intake of guggul derivatives regularly for three months results in four times the weight loss compared to placebo.
Licorice (Glycyrrhiza glabra): Licorice root strengthens the adrenal glands, thus helping to sustain a regulated blood-sugar level and reduce cravings for sweets. Licorice tastes sweet.
Dose: Take a cup of licorice daily, one week out of every month for up to three months.
Triphala (Emblica officinalis): Effective Laxative which takes away fats from body & reduces weight. It is said to promote normal appetite, good digestion, increase red blood cells and hemoglobin. It has strong purifying and antioxidant qualities as well as reducing the overall water content in the body tissues.
Aloe Vera (Aloe barbadensis): Aloe vera juice improves digestion and cleanses the digestive tract.
Garcinia Cambogia: Garcinia slows down the enzyme process that is responsible for producing fat within the body's cells. As a result, the process of thermogenesis is accelerated. The active ingredient in Garcinia cambogia, hydroxy-citric acid, has been shown to help reduce appetite by maintaining blood sugar levels in the body. It also helps promote the conversion of blood sugar into glycogen rather than fat.
People who are overweight almost always have an excess of ama in their bodies. Getting rid of the body of its ama is a primary strategy of Ayurvedic treatment. The following herbs and compounds are effective in reducing ama:
Triphala (a combination of Amalaki, Vibhitaki, and Haritaki) detoxifies the whole body and improves digestion and assimilation.
Guggulu - Take this in combination with triphala
Guggul (Commiphora mukul): This is a popular herb used in Ayurveda. Guggul is frequently recommended by Ayurveda practitioners for weight control in addition to use in lowering cholesterol. In clinical trials, intake of guggul derivatives regularly for three months results in four times the weight loss compared to placebo.
Licorice (Glycyrrhiza glabra): Licorice root strengthens the adrenal glands, thus helping to sustain a regulated blood-sugar level and reduce cravings for sweets. Licorice tastes sweet.
Dose: Take a cup of licorice daily, one week out of every month for up to three months.
Triphala (Emblica officinalis): Effective Laxative which takes away fats from body & reduces weight. It is said to promote normal appetite, good digestion, increase red blood cells and hemoglobin. It has strong purifying and antioxidant qualities as well as reducing the overall water content in the body tissues.
Aloe Vera (Aloe barbadensis): Aloe vera juice improves digestion and cleanses the digestive tract.
Garcinia Cambogia: Garcinia slows down the enzyme process that is responsible for producing fat within the body's cells. As a result, the process of thermogenesis is accelerated. The active ingredient in Garcinia cambogia, hydroxy-citric acid, has been shown to help reduce appetite by maintaining blood sugar levels in the body. It also helps promote the conversion of blood sugar into glycogen rather than fat.
People who are overweight almost always have an excess of ama in their bodies. Getting rid of the body of its ama is a primary strategy of Ayurvedic treatment. The following herbs and compounds are effective in reducing ama:
Triphala (a combination of Amalaki, Vibhitaki, and Haritaki) detoxifies the whole body and improves digestion and assimilation.
Guggulu - Take this in combination with triphala
Alternative Medicine for Obesity
The Obesity Cause
To understand The Obesity Prevention and Curing Protocol, you should first get familiar with The Obesity Cause
Now, I assume that you know something about what is causing Obesity, so we can continue with the Obesity program.
Obesity Diet
Let's start with most simple part of this program: Obesity diet. When it comes to diet, it is very important to avoid eating Toxins and Foods that Kill. Please follow those links and learn what are The Toxins I am talking about and what are those " Foods that Kill". Now, important part of your diet should also be Water Cure. Please, become familiar with Water Cure. Your Diet should contain: Foods That Heal, Vegetable juices, Fats that Heal, Unrefined Sea Salt. Also, try to understand food tolerance. You can not find the right Obesity diet, unless you fully understand and learn about food tolerance.
Take some time to implement and learn all what you have read here, and then continue reading further.
Body Cleansing (Obesity)
Now, let's start with body cleansing. Body cleansing is extremely important part of every prevention and curing program. You are guessing: "Dietary changes you made are also a form of cleansing." But, most people need more then this, especially when it comes to liver health. Body Cleansing is even important for children. Our internal organs can hold a lot toxins, and sometimes, it is impossible to get those toxins out, without doing cleansing. Our liver can contain hundreds of intrahepatic stones. Those stones will block bile flow, and affect the bases of your health, your digestion. Another problem are parasites. You must learn as much as possible about parasites. And, don't forget also dental toxins.
Let start with cleansing program. You are suppose to do cleansing in this order:
Bowel cleanse with parasite cleanse
Dental cleanup (if you can afford it)
Kidney Cleanse and
Liver cleanse.
Body Cleansing for Adults:
Bowel cleanse and Parasite cleanse !
Dental cleanup - dental work may be one cofactor of your disease: amalgam, root canal, nickel crowns, cavitations (pocket inside jaw bone left after extraction of the wisdom and molar teeth )
Kidney cleanse
Liver cleanse and Gallbladder cleanse -liver flush!
Make sure you visit those pages and get more info. Dental cleanup can take many years. If you have a lot of dental metal, do not rush to replace it all at once.
Bowel cleanse should be done at least once a year.
Liver cleanse is a procedure that, for best results, should be repeated at least 6 - 10 times, every 2 or 3 weeks.
Kidney cleanse is simple and cheap, many herbs can be used to cleanse kidneys. If you have no kidney stones, even Water Cure could be enough!
Body Cleansing for kids:
Parasites cleanse
Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse:
Liver Cleanse - flush
Physical Activity (Obesity)
Physical Activity helps cleansing, it brings balance and relieves stress.
Psycho-physical activities will help you balance your body and will help you relief accumulated stress. You will have to find a form of exercise that suit you. I will just give you a few examples:
Mini Trampoline jumping - rebounding!
Meditation
Walk or jog in the nature : Forest, Mountain , river / sea / lake side, beach ... fishing, photo-safari, rowing, riding, golf, ...
Tai Chi, Chi Gong, Meditation ...
Yoga - Hatha, Meditation, Chinese Yoga ...
Martial Arts: Karate, Judo, Kung Fu, Teakwood, Budokai, Uechi, Aikido ...
Dancing, Aerobics, Gymnastics, Stretching ...
Swimming in non-chlorinated water ! ( Best in minerals rich water - Ocean ! )
Weight lifting, ....
Do not exhaust yourself !
Do not exercise with full stomach ! (You may take a walk!)
Do not hurt yourself !
Sweating (Obesity)
Sweating is powerful way to cleanse your body from accumulated toxins.
examples:
- exercise with a lot of clothes
- Sauna
- drink warm tea in a hot room ...
- eat CAYENNE pepper! ...
It is known that some modern industrial toxins and pesticides can leave your body only through sweat glands!
Psychotherapy and Spiritual Therapy
Human body is not just this what we can se. There is more to it. To treat other level of us, to treat soul and to treat mind and unconscious parts of us, I suggest you Hellinger's therapy.
To understand The Obesity Prevention and Curing Protocol, you should first get familiar with The Obesity Cause
Now, I assume that you know something about what is causing Obesity, so we can continue with the Obesity program.
Obesity Diet
Let's start with most simple part of this program: Obesity diet. When it comes to diet, it is very important to avoid eating Toxins and Foods that Kill. Please follow those links and learn what are The Toxins I am talking about and what are those " Foods that Kill". Now, important part of your diet should also be Water Cure. Please, become familiar with Water Cure. Your Diet should contain: Foods That Heal, Vegetable juices, Fats that Heal, Unrefined Sea Salt. Also, try to understand food tolerance. You can not find the right Obesity diet, unless you fully understand and learn about food tolerance.
Take some time to implement and learn all what you have read here, and then continue reading further.
Body Cleansing (Obesity)
Now, let's start with body cleansing. Body cleansing is extremely important part of every prevention and curing program. You are guessing: "Dietary changes you made are also a form of cleansing." But, most people need more then this, especially when it comes to liver health. Body Cleansing is even important for children. Our internal organs can hold a lot toxins, and sometimes, it is impossible to get those toxins out, without doing cleansing. Our liver can contain hundreds of intrahepatic stones. Those stones will block bile flow, and affect the bases of your health, your digestion. Another problem are parasites. You must learn as much as possible about parasites. And, don't forget also dental toxins.
Let start with cleansing program. You are suppose to do cleansing in this order:
Bowel cleanse with parasite cleanse
Dental cleanup (if you can afford it)
Kidney Cleanse and
Liver cleanse.
Body Cleansing for Adults:
Bowel cleanse and Parasite cleanse !
Dental cleanup - dental work may be one cofactor of your disease: amalgam, root canal, nickel crowns, cavitations (pocket inside jaw bone left after extraction of the wisdom and molar teeth )
Kidney cleanse
Liver cleanse and Gallbladder cleanse -liver flush!
Make sure you visit those pages and get more info. Dental cleanup can take many years. If you have a lot of dental metal, do not rush to replace it all at once.
Bowel cleanse should be done at least once a year.
Liver cleanse is a procedure that, for best results, should be repeated at least 6 - 10 times, every 2 or 3 weeks.
Kidney cleanse is simple and cheap, many herbs can be used to cleanse kidneys. If you have no kidney stones, even Water Cure could be enough!
Body Cleansing for kids:
Parasites cleanse
Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse:
Liver Cleanse - flush
Physical Activity (Obesity)
Physical Activity helps cleansing, it brings balance and relieves stress.
Psycho-physical activities will help you balance your body and will help you relief accumulated stress. You will have to find a form of exercise that suit you. I will just give you a few examples:
Mini Trampoline jumping - rebounding!
Meditation
Walk or jog in the nature : Forest, Mountain , river / sea / lake side, beach ... fishing, photo-safari, rowing, riding, golf, ...
Tai Chi, Chi Gong, Meditation ...
Yoga - Hatha, Meditation, Chinese Yoga ...
Martial Arts: Karate, Judo, Kung Fu, Teakwood, Budokai, Uechi, Aikido ...
Dancing, Aerobics, Gymnastics, Stretching ...
Swimming in non-chlorinated water ! ( Best in minerals rich water - Ocean ! )
Weight lifting, ....
Do not exhaust yourself !
Do not exercise with full stomach ! (You may take a walk!)
Do not hurt yourself !
Sweating (Obesity)
Sweating is powerful way to cleanse your body from accumulated toxins.
examples:
- exercise with a lot of clothes
- Sauna
- drink warm tea in a hot room ...
- eat CAYENNE pepper! ...
It is known that some modern industrial toxins and pesticides can leave your body only through sweat glands!
Psychotherapy and Spiritual Therapy
Human body is not just this what we can se. There is more to it. To treat other level of us, to treat soul and to treat mind and unconscious parts of us, I suggest you Hellinger's therapy.
Save Child from Obesity
Helping Your Child Be a Healthy Weight
When children are overweight, it's best to focus on becoming healthy rather than on losing weight. Here are some tips for helping your child maintain a healthy weight:
Create a Safe Environment
Make your home a safe environment in terms of food. Only have foods and beverages that are healthy. This means getting rid of all the junk food, soda and juice. Ideally, your child should only drink milk and water. Keep fruits and vegetables easily accessible for healthy snacks.
Creating a safe environment also ensures that the entire family is eating right, not just your child who may have a weight problem. This makes it easier for parents because you don't have to say "no" to unhealthy foods if they aren't around. Parents need to buy and prepare the right foods, making all meals eaten in the home healthy.
Be a Positive Role Model
Children eat what their parents eat so, you need to set a good example and eat the same foods you want your child to eat. Your attitudes, beliefs and behaviors around food are passed down to your children in both explicit and implicit ways.
There needs to be conscious parenting around food. Make a point to convey that fruits, vegetables and whole grains are yummy and be careful not to emphasize a craving for sweets or salty snacks. Studies show that parents' presence at mealtime leads to kids eating healthier meals. And, in terms of preventing obesity, it's important to understand that the exposures you give your children will influence what they eat.
Set Limits
One of the most important things you can do for your child is to set limits. Parents must be the gatekeepers. This is the case for all dangerous behaviors, including overeating. Children need their parents to set limits for them. You cannot expect your child to self-limit how much he or she eats.
Restrict Sweetened Beverages
Children should not drink soda, juice or other sweetened beverages. Beverages with sugar are essentially wasted calories. While high in calories, sweetened beverages do little to fill up your child.
Limit Television
Specifically, children under 2 years of age should not watch any television. Children over 2 should only watch one to two hours a day. Studies have shown that limiting television is an important part of helping children lose weight and be more active. Also crucial is not eating in front of the television.
Use Positive Messages and Rewards.
Children benefit from setting attainable goals that are celebrated with inexpensive, non-food and age-appropriate rewards. When children have a reward to work toward, they are more likely to succeed. The best reward you can give a child is time with the parent. Rewards can include taking your child to the park or to see or rent a movie. Praise also is extremely important, even non-verbal praise such as a thumbs up. For teenagers, getting a music CD or movie ticket or getting to spend special time with a friend are great rewards.
Help Your Child be Active.
The key to children and physical activity is that it has to be fun. To find the activities children really enjoy, you have to expose them to many different activities. And, as with adults, your child's favorite activities will likely change over time.
Some kids like doing the same thing over and over. They like the structure that doing the same activity provides. But most children need constant exposure to a variety of activities or they'll get bored.
It's best to expose your child to many different activities -- from biking to swimming to team sports to walking with mom or dad to skateboarding to dance class. Let them tell you what they like and what they want to do. And, for almost all kids, activity works best if they are doing it with someone else, especially a parent.
When children are overweight, it's best to focus on becoming healthy rather than on losing weight. Here are some tips for helping your child maintain a healthy weight:
Create a Safe Environment
Make your home a safe environment in terms of food. Only have foods and beverages that are healthy. This means getting rid of all the junk food, soda and juice. Ideally, your child should only drink milk and water. Keep fruits and vegetables easily accessible for healthy snacks.
Creating a safe environment also ensures that the entire family is eating right, not just your child who may have a weight problem. This makes it easier for parents because you don't have to say "no" to unhealthy foods if they aren't around. Parents need to buy and prepare the right foods, making all meals eaten in the home healthy.
Be a Positive Role Model
Children eat what their parents eat so, you need to set a good example and eat the same foods you want your child to eat. Your attitudes, beliefs and behaviors around food are passed down to your children in both explicit and implicit ways.
There needs to be conscious parenting around food. Make a point to convey that fruits, vegetables and whole grains are yummy and be careful not to emphasize a craving for sweets or salty snacks. Studies show that parents' presence at mealtime leads to kids eating healthier meals. And, in terms of preventing obesity, it's important to understand that the exposures you give your children will influence what they eat.
Set Limits
One of the most important things you can do for your child is to set limits. Parents must be the gatekeepers. This is the case for all dangerous behaviors, including overeating. Children need their parents to set limits for them. You cannot expect your child to self-limit how much he or she eats.
Restrict Sweetened Beverages
Children should not drink soda, juice or other sweetened beverages. Beverages with sugar are essentially wasted calories. While high in calories, sweetened beverages do little to fill up your child.
Limit Television
Specifically, children under 2 years of age should not watch any television. Children over 2 should only watch one to two hours a day. Studies have shown that limiting television is an important part of helping children lose weight and be more active. Also crucial is not eating in front of the television.
Use Positive Messages and Rewards.
Children benefit from setting attainable goals that are celebrated with inexpensive, non-food and age-appropriate rewards. When children have a reward to work toward, they are more likely to succeed. The best reward you can give a child is time with the parent. Rewards can include taking your child to the park or to see or rent a movie. Praise also is extremely important, even non-verbal praise such as a thumbs up. For teenagers, getting a music CD or movie ticket or getting to spend special time with a friend are great rewards.
Help Your Child be Active.
The key to children and physical activity is that it has to be fun. To find the activities children really enjoy, you have to expose them to many different activities. And, as with adults, your child's favorite activities will likely change over time.
Some kids like doing the same thing over and over. They like the structure that doing the same activity provides. But most children need constant exposure to a variety of activities or they'll get bored.
It's best to expose your child to many different activities -- from biking to swimming to team sports to walking with mom or dad to skateboarding to dance class. Let them tell you what they like and what they want to do. And, for almost all kids, activity works best if they are doing it with someone else, especially a parent.
Childhood Obesity Treatment
For some children, especially if they are still growing taller, it's more important to stabilize weight and allow them to grow into their weight. Overweight children who are still growing do not necessarily need to lose weight but simply maintain so that they can grow into their weight. The earlier a child is identified as being overweight or at risk the easier it is to treat. Because it's hard to permanently change dietary and exercise habits, it's essential to do something sooner rather than later.
Obese children need a thorough medical evaluation by a pediatrician or family doctor to assess their family history as well as their diet and exercise routines. First, the doctor will check for genetic and biochemical disorders related to obesity, such as Prader-Willi Syndrome and other genetic disorders, and hypothyroidism, and other hormonal disorders.
Diet and Activity Changes
The main way to treat obesity in children is to help them eat a healthy diet and encourage them to be physically active. In some instances, medication and even surgery may be considered depending on how overweight a child is and how much the weight is impacting his or her health.
Since losing weight is so difficult, it is very important that parents support their child while he or she makes difficult lifestyle changes. Lasting weight loss only occurs when the whole family participates.
Surgery
UCSF Children's Hospital has begun to evaluate the use of bariatric surgery to treat teens with severe weight problems.
Obese children need a thorough medical evaluation by a pediatrician or family doctor to assess their family history as well as their diet and exercise routines. First, the doctor will check for genetic and biochemical disorders related to obesity, such as Prader-Willi Syndrome and other genetic disorders, and hypothyroidism, and other hormonal disorders.
Diet and Activity Changes
The main way to treat obesity in children is to help them eat a healthy diet and encourage them to be physically active. In some instances, medication and even surgery may be considered depending on how overweight a child is and how much the weight is impacting his or her health.
Since losing weight is so difficult, it is very important that parents support their child while he or she makes difficult lifestyle changes. Lasting weight loss only occurs when the whole family participates.
Surgery
UCSF Children's Hospital has begun to evaluate the use of bariatric surgery to treat teens with severe weight problems.
Diet Therapy
Lifestyle modifications such as increasing physical activity and decreasing calorie intake are recommended instead of "dieting." Crash diets should definitely be avoided. The best approach to changing your diet is to talk to your doctor to find out what is best for you. Your doctor can provide you with dietary guidelines or refer you to a dietician for further help. Dietary guidelines will differ for each person depending on height, weight, concurrent health conditions, and desired amount of weight loss. A diet must be established that will allow for weight loss and be easy to comply with. Maintenance of your program is the key to keeping the pounds off.
Exercising is important to any good weight loss program. An aerobic exercise program reduces weight regardless of any changes you make in your diet. Adding 45 minutes of aerobic exercise a day is the equivalent of losing 400-800 Calories depending on your intensity. Minimally, that would result in losing one pound per week. Even if you can only exercise three times per week, that would still help you lose almost 2 pounds per month or 20 pounds over a year! Remember that this is without any changes in your diet. Dropping 500 Calories a day from your diet (the equivalent of one large French fries) will double your results.
Weight training and calisthenics also help you to reduce weight not by direct loss but by decreasing fatty tissue and increasing lean body mass. This will increase your metabolism and burn more calories while at rest.
Obese patients should start slowly with low-intensity walking or swimming and advance intensity as tolerated. If you have cardiovascular disease or other conditions that may make exercise very difficult, talk to your physician before you begin.
Exercising is important to any good weight loss program. An aerobic exercise program reduces weight regardless of any changes you make in your diet. Adding 45 minutes of aerobic exercise a day is the equivalent of losing 400-800 Calories depending on your intensity. Minimally, that would result in losing one pound per week. Even if you can only exercise three times per week, that would still help you lose almost 2 pounds per month or 20 pounds over a year! Remember that this is without any changes in your diet. Dropping 500 Calories a day from your diet (the equivalent of one large French fries) will double your results.
Weight training and calisthenics also help you to reduce weight not by direct loss but by decreasing fatty tissue and increasing lean body mass. This will increase your metabolism and burn more calories while at rest.
Obese patients should start slowly with low-intensity walking or swimming and advance intensity as tolerated. If you have cardiovascular disease or other conditions that may make exercise very difficult, talk to your physician before you begin.
How is Obesity treated
The FDA is calling the nation?s obesity problem an ?epidemic? and released a report in 2004 with goals and actions focusing on a campaign entitled, ?Calories Count.? Recommended actions include:
enhancing the food label to display calorie count more prominently and to use meaningful serving sizes
initiating a consumer education campaign focusing on the "Calories Count" message
encouraging restaurants to provide nutritional information to consumers
stepping up enforcement actions concerning accuracy of food labels
revising FDA guidance for developing drugs to treat obesity
working cooperatively with other government agencies, non-profits, industry, and academia on obesity research
Obesity is associated with increased morbidity and mortality. Weight loss reduces risk factors for complications associated with the excess weight, including diabetes and cardiovascular diseases. There are several treatment options for the management of overweight and obese individuals, including diet therapy, changes in physical activity, behavioral therapy, drug therapy, surgery and a combination of these.
The initial goal of weight loss therapy is to decrease body weight by about 10%. Once this goal is met, then further weight loss can be attempted. This weight loss will not occur overnight, but you can see a difference over mere weeks if you stay with your program. Once the weight is lost, maintenance of the loss needs to be implemented to ensure that the weight stays off.
enhancing the food label to display calorie count more prominently and to use meaningful serving sizes
initiating a consumer education campaign focusing on the "Calories Count" message
encouraging restaurants to provide nutritional information to consumers
stepping up enforcement actions concerning accuracy of food labels
revising FDA guidance for developing drugs to treat obesity
working cooperatively with other government agencies, non-profits, industry, and academia on obesity research
Obesity is associated with increased morbidity and mortality. Weight loss reduces risk factors for complications associated with the excess weight, including diabetes and cardiovascular diseases. There are several treatment options for the management of overweight and obese individuals, including diet therapy, changes in physical activity, behavioral therapy, drug therapy, surgery and a combination of these.
The initial goal of weight loss therapy is to decrease body weight by about 10%. Once this goal is met, then further weight loss can be attempted. This weight loss will not occur overnight, but you can see a difference over mere weeks if you stay with your program. Once the weight is lost, maintenance of the loss needs to be implemented to ensure that the weight stays off.
Weight-loss surgery
If you're among those who have tried and can't lose the excess weight that's causing your health problems, weight-loss (bariatric) surgery may be an option. Weight-loss surgery may be considered if:
Your body mass index (BMI) is 40 or higher
Your BMI is 35 to 39.9, and you have a serious weight-related health problem such as diabetes or high blood pressure
Gastric bypass surgery, which changes the anatomy of your digestive system to limit the amount of food you can eat and digest, is the favored weight-loss surgery in the United States.
In gastric bypass (Roux-en-Y gastric bypass) the surgeon creates a small pouch at the top of the stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of the stomach. The stomach continues to make digestive juices to help break down food. So the portion of the intestines still attached to the stomach is reattached farther down. This allows the digestive juices to flow to the small intestine. Weight loss is achieved by restricting the amount of food that the stomach can hold and to a lesser extent by reducing the amount of calories that are absorbed.
When appropriate, weight-loss surgery can result in dramatic improvements in weight and health. Within the first two years, you can expect to lose 50 percent to 60 percent of your excess weight. Those people who follow dietary and exercise recommendations tend to keep most of that weight off long term.
Weight-loss surgery does have side effects, however. Complications such as pneumonia, blood clots and infection can occur with any type of surgery. Rapid weight loss can result in gallstones; a hernia or weakness, which may require surgery to correct, may develop at the site of your incision. Gastric bypass can also cause dumping syndrome, a condition in which stomach contents move too quickly through the small intestine, causing nausea, vomiting, diarrhea, dizziness and sweating.
Surgery for weight reduction isn't a miracle procedure. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after gastric bypass surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
Your body mass index (BMI) is 40 or higher
Your BMI is 35 to 39.9, and you have a serious weight-related health problem such as diabetes or high blood pressure
Gastric bypass surgery, which changes the anatomy of your digestive system to limit the amount of food you can eat and digest, is the favored weight-loss surgery in the United States.
In gastric bypass (Roux-en-Y gastric bypass) the surgeon creates a small pouch at the top of the stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of the stomach. The stomach continues to make digestive juices to help break down food. So the portion of the intestines still attached to the stomach is reattached farther down. This allows the digestive juices to flow to the small intestine. Weight loss is achieved by restricting the amount of food that the stomach can hold and to a lesser extent by reducing the amount of calories that are absorbed.
When appropriate, weight-loss surgery can result in dramatic improvements in weight and health. Within the first two years, you can expect to lose 50 percent to 60 percent of your excess weight. Those people who follow dietary and exercise recommendations tend to keep most of that weight off long term.
Weight-loss surgery does have side effects, however. Complications such as pneumonia, blood clots and infection can occur with any type of surgery. Rapid weight loss can result in gallstones; a hernia or weakness, which may require surgery to correct, may develop at the site of your incision. Gastric bypass can also cause dumping syndrome, a condition in which stomach contents move too quickly through the small intestine, causing nausea, vomiting, diarrhea, dizziness and sweating.
Surgery for weight reduction isn't a miracle procedure. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after gastric bypass surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
Weight-loss medication
Prescription weight-loss medication
It's best to lose weight through a healthy diet and regular exercise. But if you're among those who struggle to lose weight and the excess weight has produced medical problems, prescription weight-loss drugs may be able to help you.
Your doctor may consider you a candidate for medication treatment if these criteria apply:
Other methods of weight loss haven't worked for you.
Your body mass index (BMI) is greater than 27 and you have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea.
Your BMI is greater than 30.
Two prescription drugs have been approved by the Food and Drug Administration (FDA) for long-term weight loss. These drugs work in different ways and cause different side effects.
Sibutramine (Meridia). This drug changes your brain chemistry, making you feel full more quickly. Though sibutramine generally helps you lose more weight than you could through diet and exercise alone, it's no magic bullet. Studies have shown that after a year, sibutramine users lost an average of about 10 pounds more than did people simply following a low-calorie diet and taking a placebo. Side effects can include increased blood pressure, headache, dry mouth, constipation and insomnia.
Orlistat (Xenical). This drug prevents the absorption of fat in your intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is modest — about 6 pounds after one year. Side effects associated with the drug include oily and frequent bowel movements. Because orlistat blocks absorption of some nutrients, your doctor will recommend that you also take a multivitamin. The FDA has approved a reduced-strength version of orlistat (Alli) to be sold without a prescription. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
If you're among those who can benefit from weight-loss medication, you'll likely need to take it indefinitely. When drug treatment is stopped, much or all of the excess weight generally returns.
Even if you qualify for weight-loss drug therapy, the drugs might not work for you. And, if they do work, their effects tend to level off after six months of use.
It's best to lose weight through a healthy diet and regular exercise. But if you're among those who struggle to lose weight and the excess weight has produced medical problems, prescription weight-loss drugs may be able to help you.
Your doctor may consider you a candidate for medication treatment if these criteria apply:
Other methods of weight loss haven't worked for you.
Your body mass index (BMI) is greater than 27 and you have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea.
Your BMI is greater than 30.
Two prescription drugs have been approved by the Food and Drug Administration (FDA) for long-term weight loss. These drugs work in different ways and cause different side effects.
Sibutramine (Meridia). This drug changes your brain chemistry, making you feel full more quickly. Though sibutramine generally helps you lose more weight than you could through diet and exercise alone, it's no magic bullet. Studies have shown that after a year, sibutramine users lost an average of about 10 pounds more than did people simply following a low-calorie diet and taking a placebo. Side effects can include increased blood pressure, headache, dry mouth, constipation and insomnia.
Orlistat (Xenical). This drug prevents the absorption of fat in your intestines. Unabsorbed fat is eliminated in the stool. Average weight loss with orlistat is modest — about 6 pounds after one year. Side effects associated with the drug include oily and frequent bowel movements. Because orlistat blocks absorption of some nutrients, your doctor will recommend that you also take a multivitamin. The FDA has approved a reduced-strength version of orlistat (Alli) to be sold without a prescription. This medication works the same as prescription-strength orlistat and is meant only to supplement — not replace — a healthy diet and regular exercise.
If you're among those who can benefit from weight-loss medication, you'll likely need to take it indefinitely. When drug treatment is stopped, much or all of the excess weight generally returns.
Even if you qualify for weight-loss drug therapy, the drugs might not work for you. And, if they do work, their effects tend to level off after six months of use.
Physical activity & Behavior
Cutting 250 calories from your daily diet can help you lose about half a pound a week: 3,500 calories equals 1 pound of fat. But add a 30-minute brisk walk four days a week, and you can double your rate of weight loss.
The goal of exercise for weight loss is to burn more calories, although exercise offers many other benefits as well. How many calories you burn depends on the frequency, duration and intensity of your activities. One of the best ways to lose body fat is through steady aerobic exercise — such as walking — for more than 30 minutes most days of the week.
Even though regularly scheduled aerobic exercise is most efficient for losing fat, any extra movement helps burn calories. Lifestyle activities may be easier to fit into your day. Think about ways you can increase your physical activity throughout the day. For example, make several trips up and down stairs instead of using the elevator, or park at the far end of the lot.
If you're obese, particularly if you're unfit and have health problems, check with your doctor before starting an exercise program.
Behavior modification
To lose weight and keep it off, you need to make changes in your lifestyle. But there's more to changing your lifestyle than choosing different foods and putting more activity into your day. It also involves changing your approach to eating and activity, which means changing how you think, feel and act.
A behavior modification program — led by a psychologist, therapist or other trained professional — can help you make these lifestyle changes. Behavior modification programs may include examining your current habits to find out what factors or situations may have contributed to your excess weight. Exploring your current eating and exercise habits gives you a place to start when changing your behaviors.
Once you understand which habits are undermining your weight-loss efforts, you can take steps to create a new, healthier lifestyle. These tips can help:
Have a plan. Work out a strategy that will gradually change your habits and attitudes. Consider how often and how long you will exercise. Determine a realistic eating plan that includes plenty of water, fruits and vegetables. Write it down and choose a start date.
Set realistic goals. Weight-loss goals can be process goals, such as exercising regularly, or outcome goals, such as losing 20 pounds. Make sure process goals are realistic, specific and measurable. For example, you'll walk for 30 minutes a day, five days a week. For outcome goals, aim to lose weight at a safe pace of 1 or 2 pounds a week. Losing weight more rapidly means losing water weight or muscle tissue, rather than fat.
Avoid food triggers. Distract yourself from your desire to eat with something positive, such as calling a friend. Practice saying no to unhealthy foods and big portions. Eat when you're actually hungry — not when the clock says it's time to eat.
Keep a record. Keep a food and activity diary, so you can reinforce good habits and discover any behaviors that you may need to improve. Be sure to track other important health parameters such as blood pressure, cholesterol levels and overall fitness.
The goal of exercise for weight loss is to burn more calories, although exercise offers many other benefits as well. How many calories you burn depends on the frequency, duration and intensity of your activities. One of the best ways to lose body fat is through steady aerobic exercise — such as walking — for more than 30 minutes most days of the week.
Even though regularly scheduled aerobic exercise is most efficient for losing fat, any extra movement helps burn calories. Lifestyle activities may be easier to fit into your day. Think about ways you can increase your physical activity throughout the day. For example, make several trips up and down stairs instead of using the elevator, or park at the far end of the lot.
If you're obese, particularly if you're unfit and have health problems, check with your doctor before starting an exercise program.
Behavior modification
To lose weight and keep it off, you need to make changes in your lifestyle. But there's more to changing your lifestyle than choosing different foods and putting more activity into your day. It also involves changing your approach to eating and activity, which means changing how you think, feel and act.
A behavior modification program — led by a psychologist, therapist or other trained professional — can help you make these lifestyle changes. Behavior modification programs may include examining your current habits to find out what factors or situations may have contributed to your excess weight. Exploring your current eating and exercise habits gives you a place to start when changing your behaviors.
Once you understand which habits are undermining your weight-loss efforts, you can take steps to create a new, healthier lifestyle. These tips can help:
Have a plan. Work out a strategy that will gradually change your habits and attitudes. Consider how often and how long you will exercise. Determine a realistic eating plan that includes plenty of water, fruits and vegetables. Write it down and choose a start date.
Set realistic goals. Weight-loss goals can be process goals, such as exercising regularly, or outcome goals, such as losing 20 pounds. Make sure process goals are realistic, specific and measurable. For example, you'll walk for 30 minutes a day, five days a week. For outcome goals, aim to lose weight at a safe pace of 1 or 2 pounds a week. Losing weight more rapidly means losing water weight or muscle tissue, rather than fat.
Avoid food triggers. Distract yourself from your desire to eat with something positive, such as calling a friend. Practice saying no to unhealthy foods and big portions. Eat when you're actually hungry — not when the clock says it's time to eat.
Keep a record. Keep a food and activity diary, so you can reinforce good habits and discover any behaviors that you may need to improve. Be sure to track other important health parameters such as blood pressure, cholesterol levels and overall fitness.
Dietary changes
Adopting a new eating style that promotes weight loss must include lowering your total calorie intake. One way you can lower your calorie intake is by eating more plant-based foods — fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without giving up taste or nutrition. Cutting back on calories is easier if you focus on limiting sugar and other refined carbohydrates and some types of fat.
Ask your doctor to help you determine your calorie goals to lose weight. He or she may recommend that you also work with a dietitian or a reputable weight-loss program.
Crash diets to reduce calories aren't recommended because they can cut so many calories and nutrients that they lead to other health problems, such as vitamin deficiencies. Fasting isn't the answer, either. Most of the weight you initially lose is from water, and it's not good for your body to go without food for extended periods.
Very low calorie liquid diets are sometimes prescribed as an intervention for seriously obese people. These mainly liquid diets, such as Medifast or Optifast, provide about 800 calories a day — most adults consume roughly 2,000 to 2,500 calories a day. While people are usually able to lose weight on these very low calorie diets, most people regain the weight just as quickly when they stop following these diets.
Over-the-counter liquid meal replacements, such as Slim-Fast, also cut calories. These plans suggest that you replace one or two meals with their products — low-calorie shakes — then eat snacks of vegetables and fruits and a healthy, balanced third meal that is low in fat and calories. This can be as effective as a traditional calorie-controlled diet.
Ask your doctor to help you determine your calorie goals to lose weight. He or she may recommend that you also work with a dietitian or a reputable weight-loss program.
Crash diets to reduce calories aren't recommended because they can cut so many calories and nutrients that they lead to other health problems, such as vitamin deficiencies. Fasting isn't the answer, either. Most of the weight you initially lose is from water, and it's not good for your body to go without food for extended periods.
Very low calorie liquid diets are sometimes prescribed as an intervention for seriously obese people. These mainly liquid diets, such as Medifast or Optifast, provide about 800 calories a day — most adults consume roughly 2,000 to 2,500 calories a day. While people are usually able to lose weight on these very low calorie diets, most people regain the weight just as quickly when they stop following these diets.
Over-the-counter liquid meal replacements, such as Slim-Fast, also cut calories. These plans suggest that you replace one or two meals with their products — low-calorie shakes — then eat snacks of vegetables and fruits and a healthy, balanced third meal that is low in fat and calories. This can be as effective as a traditional calorie-controlled diet.
Treatment-Weight loss
The main treatment for obesity is to reduce body fat by eating fewer calories and exercising more. A beneficial side effect of exercise is to increase muscle, tendon, and ligament strength, which helps to prevent injury from accidents and vigorous activity. Diet and exercise programs produce an average weight loss of approximately 8% of total body mass (excluding program drop-outs). Not all dieters are satisfied with these results, but a loss of as little as 5% of body mass can create large health benefits.[citation needed]
Much more difficult than reducing body fat is keeping it off. Eighty to ninety-five percent of those who lose 10% or more of their body mass by dieting regain all that weight back within two to five years. The body has systems that maintain its homeostasis at certain set points, including body weight.[citation needed] Therefore, keeping weight off generally requires making exercise and eating right a permanent part of a person's lifestyle. Certain nutrients, such as phenylalanine, are natural appetite suppressants which allow resetting of the body's set point for body weight.[citation needed]
Clinical protocols
In a clinical practice guideline by the American College of Physicians, the following five recommendations are made:[33]
People with a BMI of over 30 should be counseled on diet, exercise and other relevant behavioral interventions, and set a realistic goal for weight loss.
If these goals are not achieved, pharmacotherapy can be offered. The patient needs to be informed of the possibility of side-effects and the unavailability of long-term safety and efficacy data.
Drug therapy may consist of sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may be used on a selective basis. Evidence is not sufficient to recommend sertraline, topiramate, or zonisamide.
In patients with BMI > 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated. The patient needs to be aware of the potential complications.
Those requiring bariatric surgery should be referred to high-volume referral centers, as the evidence suggests that surgeons who frequently perform these procedures have fewer complications.
A clinical practice guideline by the US Preventive Services Task Force (USPSTF) concluded that the evidence is insufficient to recommend for or against routine behavioral counseling to promote a healthy diet in unselected patients in primary care settings, but that intensive behavioral dietary counseling is recommended in those with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians.[34][35]
Exercise
Exercise requires energy (calories). Calories are stored in body fat. The body breaks down its fat stores in order to provide energy during prolonged aerobic exercise. The largest muscles in the body are the leg muscles, and naturally these burn the most calories, which make walking, running, and cycling among the most effective forms of exercise for reducing body fat.
A meta-analysis of randomized controlled trials by the international Cochrane Collaboration found that "exercise combined with diet resulted in a greater weight reduction than diet alone".[36]
Dieting
Main article: Dieting
In general, dieting means eating less. Various dietary approaches have been proposed, some of which have been compared by randomized controlled trials:
A comparison of Dr. Atkins', Slim-Fast's, Weight Watchers', and Rosemary Conley's diets found no significant differences.[37]
A comparison of Atkins diet, Zone diet, Weight Watchers, and Ornish diet noted:[38]
"all 4 diets resulted in modest statistically significant weight loss at 1 year, with no statistically significant differences between diets"
"The higher discontinuation rates for the Atkins and Ornish diet groups suggest many individuals found these diets to be too extreme"
Low carbohydrate versus low fat
Main article: Medical research related to low-carbohydrate diets
Many studies have focused on diets that reduce calories via a low-carbohydrate (Atkins diet, Zone diet) diet versus a low-fat diet (LEARN diet, Ornish diet). The Nurses' Health Study, an observational cohort study, found that low carbohydrate diets based on vegetable sources of fat and protein are associated with less coronary heart disease.[39]
A meta-analysis of randomized controlled trials by the international Cochrane Collaboration in 2002 concluded[40] that fat-restricted diets are no better than calorie restricted diets in achieving long term weight loss in overweight or obese people.
A more recent meta-analysis that included randomized controlled trials published after the Cochrane review[41][42][38] found that "low-carbohydrate, non-energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered."[43]
The Women's Health Initiative Randomized Controlled Dietary Modification Trial[44] found that a diet of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily resulted in:
no reduction in cardiovascular disease[45]
an insignificant reduction in invasive breast cancer[46]
no reductions in colorectal cancer[47]
Additional recent randomized controlled trials have found that:
A comparison of Atkins, Zone diet, Ornish diet, and LEARN diet in premenopausal women found the greatest benefit from the Atkins diet.[48]
The choice of diet for a specific person may be influenced by measuring the invididual's insulin secretion:
In young adults "Reducing glycemic [carbohydrate] load may be especially important to achieve weight loss among individuals with high insulin secretion."[49] This is consistent with prior studies of diabetic patients in which low carbohydrate diets were more beneficial.[50][51]
The American Diabetes Association released for the first time a recommendation for a low carbohydrate diet to reduce weight for those with or at risk of Type 2 diabetes. The American Diabetes Association released its 2008 Clinical Practice Recommendations for physicians in January 20
Much more difficult than reducing body fat is keeping it off. Eighty to ninety-five percent of those who lose 10% or more of their body mass by dieting regain all that weight back within two to five years. The body has systems that maintain its homeostasis at certain set points, including body weight.[citation needed] Therefore, keeping weight off generally requires making exercise and eating right a permanent part of a person's lifestyle. Certain nutrients, such as phenylalanine, are natural appetite suppressants which allow resetting of the body's set point for body weight.[citation needed]
Clinical protocols
In a clinical practice guideline by the American College of Physicians, the following five recommendations are made:[33]
People with a BMI of over 30 should be counseled on diet, exercise and other relevant behavioral interventions, and set a realistic goal for weight loss.
If these goals are not achieved, pharmacotherapy can be offered. The patient needs to be informed of the possibility of side-effects and the unavailability of long-term safety and efficacy data.
Drug therapy may consist of sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may be used on a selective basis. Evidence is not sufficient to recommend sertraline, topiramate, or zonisamide.
In patients with BMI > 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated. The patient needs to be aware of the potential complications.
Those requiring bariatric surgery should be referred to high-volume referral centers, as the evidence suggests that surgeons who frequently perform these procedures have fewer complications.
A clinical practice guideline by the US Preventive Services Task Force (USPSTF) concluded that the evidence is insufficient to recommend for or against routine behavioral counseling to promote a healthy diet in unselected patients in primary care settings, but that intensive behavioral dietary counseling is recommended in those with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians.[34][35]
Exercise
Exercise requires energy (calories). Calories are stored in body fat. The body breaks down its fat stores in order to provide energy during prolonged aerobic exercise. The largest muscles in the body are the leg muscles, and naturally these burn the most calories, which make walking, running, and cycling among the most effective forms of exercise for reducing body fat.
A meta-analysis of randomized controlled trials by the international Cochrane Collaboration found that "exercise combined with diet resulted in a greater weight reduction than diet alone".[36]
Dieting
Main article: Dieting
In general, dieting means eating less. Various dietary approaches have been proposed, some of which have been compared by randomized controlled trials:
A comparison of Dr. Atkins', Slim-Fast's, Weight Watchers', and Rosemary Conley's diets found no significant differences.[37]
A comparison of Atkins diet, Zone diet, Weight Watchers, and Ornish diet noted:[38]
"all 4 diets resulted in modest statistically significant weight loss at 1 year, with no statistically significant differences between diets"
"The higher discontinuation rates for the Atkins and Ornish diet groups suggest many individuals found these diets to be too extreme"
Low carbohydrate versus low fat
Main article: Medical research related to low-carbohydrate diets
Many studies have focused on diets that reduce calories via a low-carbohydrate (Atkins diet, Zone diet) diet versus a low-fat diet (LEARN diet, Ornish diet). The Nurses' Health Study, an observational cohort study, found that low carbohydrate diets based on vegetable sources of fat and protein are associated with less coronary heart disease.[39]
A meta-analysis of randomized controlled trials by the international Cochrane Collaboration in 2002 concluded[40] that fat-restricted diets are no better than calorie restricted diets in achieving long term weight loss in overweight or obese people.
A more recent meta-analysis that included randomized controlled trials published after the Cochrane review[41][42][38] found that "low-carbohydrate, non-energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered."[43]
The Women's Health Initiative Randomized Controlled Dietary Modification Trial[44] found that a diet of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily resulted in:
no reduction in cardiovascular disease[45]
an insignificant reduction in invasive breast cancer[46]
no reductions in colorectal cancer[47]
Additional recent randomized controlled trials have found that:
A comparison of Atkins, Zone diet, Ornish diet, and LEARN diet in premenopausal women found the greatest benefit from the Atkins diet.[48]
The choice of diet for a specific person may be influenced by measuring the invididual's insulin secretion:
In young adults "Reducing glycemic [carbohydrate] load may be especially important to achieve weight loss among individuals with high insulin secretion."[49] This is consistent with prior studies of diabetic patients in which low carbohydrate diets were more beneficial.[50][51]
The American Diabetes Association released for the first time a recommendation for a low carbohydrate diet to reduce weight for those with or at risk of Type 2 diabetes. The American Diabetes Association released its 2008 Clinical Practice Recommendations for physicians in January 20
Genetics & Illness
As with many medical conditions, the calorific imbalance that results in obesity often develops from a combination of genetic and environmental factors. Polymorphisms in various genes controlling appetite, metabolism, and adipokine release predispose to obesity, but the condition requires availability of sufficient calories, and possibly other factors, to develop fully. Various genetic conditions that feature obesity have been identified (such as Prader-Willi syndrome, Bardet-Biedl syndrome, MOMO syndrome, leptin receptor mutations and melanocortin receptor mutations), but known single-locus mutations have been found in only about 5% of obese individuals. While it is thought that a large proportion of the causative genes are still to be identified, much obesity is likely the result of interactions between multiple genes, and non-genetic factors are likely also important.
A 2007 study identified fairly common mutations in the FTO gene; heterozygotes had a 30% increased risk of obesity, while homozygotes faced a 70% increased risk.[25]
On a population level, the thrifty gene hypothesis postulates that certain ethnic groups may be more prone to obesity than others, and the ability to take advantage of rare periods of abundance and use such abundance by storing energy efficiently may have been an evolutionary advantage in times when food was scarce. Individuals with greater adipose reserves were more likely to survive famine. This tendency to store fat is likely maladaptive in a society with stable food supplies.[26]
Medical illness
Certain physical and mental illnesses and particular pharmaceutical substances may predispose to obesity. Apart from the fact that correcting these situations may improve the obesity, the presence of increased body weight may complicate the management of others.
Medical illnesses that increase obesity risk include several rare congenital syndromes (listed above), hypothyroidism, Cushing's syndrome, growth hormone deficiency.[27] Smoking cessation is a known cause for moderate weight gain, as nicotine suppresses appetite. Certain medications (e.g. steroids, atypical antipsychotics, some fertility medication) may cause weight gain.
Mental illnesses may also increase obesity risk, specifically some eating disorders such as bulimia nervosa, binge eating disorder, and compulsive overeating (also known as food addiction).
A 2007 study identified fairly common mutations in the FTO gene; heterozygotes had a 30% increased risk of obesity, while homozygotes faced a 70% increased risk.[25]
On a population level, the thrifty gene hypothesis postulates that certain ethnic groups may be more prone to obesity than others, and the ability to take advantage of rare periods of abundance and use such abundance by storing energy efficiently may have been an evolutionary advantage in times when food was scarce. Individuals with greater adipose reserves were more likely to survive famine. This tendency to store fat is likely maladaptive in a society with stable food supplies.[26]
Medical illness
Certain physical and mental illnesses and particular pharmaceutical substances may predispose to obesity. Apart from the fact that correcting these situations may improve the obesity, the presence of increased body weight may complicate the management of others.
Medical illnesses that increase obesity risk include several rare congenital syndromes (listed above), hypothyroidism, Cushing's syndrome, growth hormone deficiency.[27] Smoking cessation is a known cause for moderate weight gain, as nicotine suppresses appetite. Certain medications (e.g. steroids, atypical antipsychotics, some fertility medication) may cause weight gain.
Mental illnesses may also increase obesity risk, specifically some eating disorders such as bulimia nervosa, binge eating disorder, and compulsive overeating (also known as food addiction).
Lifestyle
Most researchers have concluded that the combination of an excessive nutrient intake and a sedentary lifestyle are the main cause for the rapid acceleration of obesity in Western society in the last quarter of the 20th century. [21]
Despite the widespread availability of nutritional information in schools, doctors' offices, on the internet and on groceries,[22] it is evident that overeating remains a substantial problem. For instance, reliance on energy-dense fast-food meals tripled between 1977 and 1995, and calorie intake quadrupled over the same period.[23]
However, dietary intake in itself is insufficient to explain the phenomenal rise in levels of obesity in much of the industrialized world during recent years. An increasingly sedentary lifestyle also has a significant role to play. More and more research into child obesity, for example, links such things as the school run, with the current high levels of this disease. [24]
Less well established life style issues which may influence obesity include a stressful mentality and insufficient
Despite the widespread availability of nutritional information in schools, doctors' offices, on the internet and on groceries,[22] it is evident that overeating remains a substantial problem. For instance, reliance on energy-dense fast-food meals tripled between 1977 and 1995, and calorie intake quadrupled over the same period.[23]
However, dietary intake in itself is insufficient to explain the phenomenal rise in levels of obesity in much of the industrialized world during recent years. An increasingly sedentary lifestyle also has a significant role to play. More and more research into child obesity, for example, links such things as the school run, with the current high levels of this disease. [24]
Less well established life style issues which may influence obesity include a stressful mentality and insufficient
Waist
Waist circumference
BMI does not take into account differing ratios of adipose to lean tissue; nor does it distinguish between differing forms of adiposity, some of which may correlate more closely with cardiovascular risk. Increasing understanding of the biology of different forms of adipose tissue has shown that visceral fat or central obesity (male-type or apple-type obesity) has a much stronger correlation, particularly with cardiovascular disease, than the BMI alone.[10]
The absolute waist circumference (>102 cm in men and >88 cm in women) or waist-hip ratio (>0.9 for men and >0.85 for women)[10] are both used as measures of central obesity.
In a cohort of almost 15,000 subjects from the National Health and Nutrition Examination Survey (NHANES) III study, waist circumference explained obesity-related health risk significantly better than BMI when metabolic syndrome was taken as an outcome measure.[11]
Body fat measurement
An alternative way to determine obesity is to assess percent body fat. Doctors and scientists generally agree that men with more than 25% body fat and women with more than 30% body fat are obese. However, it is difficult to measure body fat precisely. The most accepted method has been to weigh a person underwater, but underwater weighing is a procedure limited to laboratories with special equipment. Two simpler methods for measuring body fat are the skinfold test, in which a pinch of skin is precisely measured to determine the thickness of the subcutaneous fat layer; or bioelectrical impedance analysis, usually only carried out at specialist clinics. Their routine use is discouraged.[12]
Other measurements of body fat include computed tomography (CT/CAT scan), magnetic resonance imaging (MRI/NMR), and dual energy X-ray absorptiometry (DXA)
BMI does not take into account differing ratios of adipose to lean tissue; nor does it distinguish between differing forms of adiposity, some of which may correlate more closely with cardiovascular risk. Increasing understanding of the biology of different forms of adipose tissue has shown that visceral fat or central obesity (male-type or apple-type obesity) has a much stronger correlation, particularly with cardiovascular disease, than the BMI alone.[10]
The absolute waist circumference (>102 cm in men and >88 cm in women) or waist-hip ratio (>0.9 for men and >0.85 for women)[10] are both used as measures of central obesity.
In a cohort of almost 15,000 subjects from the National Health and Nutrition Examination Survey (NHANES) III study, waist circumference explained obesity-related health risk significantly better than BMI when metabolic syndrome was taken as an outcome measure.[11]
Body fat measurement
An alternative way to determine obesity is to assess percent body fat. Doctors and scientists generally agree that men with more than 25% body fat and women with more than 30% body fat are obese. However, it is difficult to measure body fat precisely. The most accepted method has been to weigh a person underwater, but underwater weighing is a procedure limited to laboratories with special equipment. Two simpler methods for measuring body fat are the skinfold test, in which a pinch of skin is precisely measured to determine the thickness of the subcutaneous fat layer; or bioelectrical impedance analysis, usually only carried out at specialist clinics. Their routine use is discouraged.[12]
Other measurements of body fat include computed tomography (CT/CAT scan), magnetic resonance imaging (MRI/NMR), and dual energy X-ray absorptiometry (DXA)
Body Mass Index
BMI
BMI, or body mass index, is a simple and widely used method for estimating body fat.[4] BMI was developed by the Belgian statistician and anthropometrist Adolphe Quetelet.[5] It is calculated by dividing the subject's weight by the square of his/her height, typically expressed either in metric or US "Customary" units:
Metric: BMI = kg / m2
Where kg is the subject's weight in kilograms and m is the subject's height in metres.
US/Customary: BMI = lb * 703 / in2
Where lb is the subject's weight in pounds and in is the subject's height in inches.
The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:[6]
A BMI less than 18.5 is underweight
A BMI of 18.5–24.9 is normal weight
A BMI of 25.0–29.9 is overweight
A BMI of 30.0–39.9 is obese
A BMI of 40.0 or higher is severely (or morbidly) obese
A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity.[7][8]
In a clinical setting, physicians take into account race, ethnicity, lean mass (muscularity), age, sex, and other factors which can affect the interpretation of BMI. BMI overestimates body fat in persons who are very muscular, and it can underestimate body fat in persons who have lost body mass (e.g. many elderly).[1] Mild obesity as defined by BMI alone is not a cardiac risk factor, and hence BMI cannot be used as a sole clinical and epidemiological predictor of cardiovascular health.[9]
BMI, or body mass index, is a simple and widely used method for estimating body fat.[4] BMI was developed by the Belgian statistician and anthropometrist Adolphe Quetelet.[5] It is calculated by dividing the subject's weight by the square of his/her height, typically expressed either in metric or US "Customary" units:
Metric: BMI = kg / m2
Where kg is the subject's weight in kilograms and m is the subject's height in metres.
US/Customary: BMI = lb * 703 / in2
Where lb is the subject's weight in pounds and in is the subject's height in inches.
The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:[6]
A BMI less than 18.5 is underweight
A BMI of 18.5–24.9 is normal weight
A BMI of 25.0–29.9 is overweight
A BMI of 30.0–39.9 is obese
A BMI of 40.0 or higher is severely (or morbidly) obese
A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity.[7][8]
In a clinical setting, physicians take into account race, ethnicity, lean mass (muscularity), age, sex, and other factors which can affect the interpretation of BMI. BMI overestimates body fat in persons who are very muscular, and it can underestimate body fat in persons who have lost body mass (e.g. many elderly).[1] Mild obesity as defined by BMI alone is not a cardiac risk factor, and hence BMI cannot be used as a sole clinical and epidemiological predictor of cardiovascular health.[9]
What is Obesity
Obesity is a condition in which the natural energy reserve, stored in the fatty tissue of humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality.
Although obesity is an individual clinical condition, it is increasingly viewed as a serious and growing public health problem: excessive body weight has been shown to predispose to various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea and osteoarthritis.
Although obesity is an individual clinical condition, it is increasingly viewed as a serious and growing public health problem: excessive body weight has been shown to predispose to various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea and osteoarthritis.
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