Overcoming Obesity

Womens Healthcare Topics
James Brann, MD 26 years of Obstetrics and Gynecology Experience
   
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Women Who Want to Lose Weight Must Stay with Their Dieting Plan

Overcoming Obesity

overcoming obesity

Success with dieting is not a factor of which diet plan you use, but rather whether or not you can stick with the program. Women who continue their diet plan for one year or more lose more weight and reduce their body mass index (BMI) more than short term fad dieters. Losing weight and keeping the weight off results from healthy long-term behavioral changes in your diet, not fad diets.

There is no doubt about it… obesity is a growing problem among women the world over. America may admittedly be considered if not a “fast food” then at minimum a “food” nation, with a population of citizens that is among the heaviest in the world.

The National Center for Health Statistics recently showed that the percentage of obese people in the United States has steadily risen during the last decade, to as much as 30% in 2000 alone.

Health Consequences of Obesity
There are many people who are 'overweight' that are simply willing to embrace and accept their bodies on an 'as is' basis. While a strong sense of self esteem is nothing to sneeze at, obesity is a major problem that simply can't be brushed aside. Obesity is more than being overweight. It is a life threatening condition.

Obesity can lead to many health and medical complications including:

  • Shortened life span.
  • Diabetes Mellitus.
  • Gallstones.
  • High blood pressure.
  • Heart disease.
  • Osteoarthritis.
  • Stroke.
  • Sleep apnea or other related sleep disorders.
  • Cancer.
  • Low self esteem.
  • Depression.

While many people lose weight via fad diets and other non-consistent approaches, they typically regain the weight quickly. Worse, they tend to gain more weight over time exacerbating the problem they were trying to address in the first place.

I Want to Lose Weight
How do I Start?

If you are obese, your approach to weight loss might vary somewhat from the average person. For the obese person, losing weight may be a matter of life and death.

First and foremost it is vital that you do not begin a weight loss regimen without seeking the professional assistance and advice of your health care professional. Together with a healthcare provider you can decide on appropriate treatment goals, a healthy weight loss strategy and monitor your progress effectively over time.

First your physician needs to determine the severity of your problem. Your physician will first calculate your Body Mass Index (BMI) by measuring your weight and height.

Generally the following guidelines apply:

  • BMI between 19 and 24 = normal
  • BMI between 25 and 29 = overweight
  • BMI between 30 and 39 = obese
  • BMI over 39 = extreme obesity

To determine your approximate BMI you can use the tables provided below. Simply find your height in inches on the left of the sheet, and your corresponding body weight in the graph. The number at the top of the column will equal your approximate BMI.     

 BODY MASS INDEX

The next step is for your physician to determine your risk for heart disease. The level of risk you experience will depend on a number of factors including your BMI. Your risk of heart disease will increase if you have any of the following:

  • Whether or not you have high blood pressure.
  • The presence of excessive abdominal fat.
  • High blood cholesterol.
  • Family history of heart disease or diabetes.
  • Whether or not your obesity existed prior to age 40.

All of these factors may compound your risk for cardiac disease with an abnormal BMI. General guidelines from heart disease risk for BMI are as follows:

  • BMI between 20 to 25 = little or no risk for heart disease
  • BMI between 25 to 30 = low risk for heart disease
  • BMI between 30 to 35 = moderate risk for hear disease
  • BMI between 35 to 40 = high risk for heart disease
  • BMI above 40 = extremely high risk for heart disease

 BODY MASS INDEX

What are the Types of Treatment?
For most obese patients, physicians will recommend a combination of different therapies that may include exercise, dieting, drug therapy and behavior modification.

Behavior modification:
The best approach is one that tackles weight loss from a long term perspective. This will involve behavior modification.

Your physician may work with you to determine what behavior modifications will be necessary for you to realize success. This may involve identifying your eating triggers and overcoming them.

One approach taken to weight loss involves having the patient write down the food they eat and the emotions associated with eating. This can help the patient to identify emotional triggers related to obesity.

Other forms of behavior modification therapy may involve a method called 'stimulus control' where you work to break the chain of events that lead to overeating. You may do this by restricting the places that you eat, chewing food a certain number of times or even restricting the utensils you use to eat with.


Behavior modification will help you to change your unhealthy eating habits and should include other factors that will help you to lose weight:

  • Having an adequate support system. It is important that you enlist the assistance and support of friends and family members that can help you eliminate stress and anxiety and support you in times when you are down.
  • Reduce stress. Stress and anxiety can contribute to obesity. It often leads to uncontrolled eating in obese people. It is important that you learn to identify stressors and develop a system for overcoming stress. This may involve visualizations, meditation and even exercise.
  • Adopt a routine. Your routine should include regular exercise. Work with your physician and possibly a trainer to develop a routine that is appropriate for your build and current size.

Modify your diet:
You should be working with a nutritionist to help you lose weight through healthy dietary changes. Your body will need a certain number of calories simply to function during the day. Diets between 1,200 and 1,500 calories that are nutritionally sound each day is perfect. Conventional weight reduction diets recommend fewer calories per day than your body requires maintaining itself.

Most people will succeed on diets that consist of between 1,200 and 1,500 calories. It is however important that you discuss your needs with your healthcare provider or a dietician, to determine a program and healthy eating plan that is consistent with your personal needs and long term goals.

A Note on Medication
Medication is available for some people, and may be helpful for losing weight when combined with diet, exercise and appropriate behavior modification strategies.

The decision to initiate drug therapy should be one that you make with your physician. You will need to weight the benefits and risks.

Never undertake medication therapy without the advice and consent of your physician.

Drug therapy is often reserved for people that have a BMI over 30 kg/m2 and other risk factors, which may include high blood pressure or heart disease.

Some of the more common drugs that are prescribed or used include:

  • Sibutramine - this is an appetite suppressant under the name Meridia and Reductil. There are side effects associated with use, and this drug is not suitable for patients with a history of heart or vascular diseases.
  • Orlistat - This drug decreases the amount of fat absorbed by the body and may help improve cholesterol levels. There are side effects associated with use including gastrointestinal distress.
  • Ephedra - This is a drug commonly found in over the counter weight loss pills. Though ephedra may aid weight loss, it is generally considered unsafe. SERIOUS side effects may result including heart palpitations, headache and even death.

Surgery as an Option
For some the problem of obesity may be severe enough to warrant surgery. Surgery is typically reserved for patients that are severely obese and have failed to attain measurable progress using other methods of weight control including diet and exercise.

Surgery should be reserved for patients that have a BMI greater than 40, or greater than 35 with severe complications.

There are several different forms of surgery available including the following:

  • Gastric Bypass - This type of surgery requires that the physician create a stomach pouch that connects to the intestines.
  • Gastroplasty - This is a more common form of surgery that decreases the size of the stomach, resulting in a full feeling sooner after eating.
  • Lap-banding - This procedure involves the placement of a plastic band around the upper stomach which can inhibit the amount of space available in the stomach for consumption.

As with any surgery there are risks associated with stomach surgeries. It is important that you consult with your physician and explore all of your options prior to embarking on a treatment protocol for obesity.

By working together with your physician, you will find there is hope and you can overcome obesity. You can and do deserve to lead a life that is rich and rewarding. Simply educating yourself about obesity is the first step toward leading a more healthy life.




   




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