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Obesity
Obesity
is being defined as more than 20 % above the ideal weight. It is
an issue in most western countries and in New Zealand has been rising
since the 1970’s. Being overweight, which is defined as anything
above your ideal body weight up to 20%, has also increased in most
countries including New Zealand.
The cause of obesity
is multifactorial. Idiopathic obesity is assumed to be due to an
imbalance between food intake and energy expenditure, basically
eating more than needed for a person’s body size without the
physical activity and proper exercise. This is fairly common, with
the availability of processed, high calorie foods.
Some medical conditions can be contributing factors in obesity and
weight gain. Endocrine disorders may cause obesity. These would
include: excess insulin (Type II Diabetes) excess cortisol (Cushing's
syndrome or corticosteroid drug use), hypothyroidism and hypothalamic
disorders. Excess weight gain may also be caused by estrogen dominance,
where for both men and women elevated levels of estrogen cause android
or central obesity. This is an accumulation of fat around the abdomen
(which may also be called beer belly in males) as opposed the hips
(gynoid obesity).
Psychological factors
may be present, some think as a cause of weight gain but more as
a result. Eating patterns associated with depression and deviant
eating patterns, such a binge eating disorder and night-eating syndrome
can cause weight gain. But more likely is a general sense of depression
and alienation, as people and females in particular can view problem
with weight as a source of prejudice and discrimination.
A sedentary lifestyle
as an independent risk factor of obesity should be noted, as television
watching has been demonstrated to be linked to the onset of obesity.
This can be explained by the lack of physical activity and lowering
of the basal metabolic rate, the rate of energy our body create
in order to perform the physiological functions. Also important
to note, exercise tends to be lower in those who watch a lot of
TV. The intake of food may not be lower in these people who exercise
less and may even be more, contributing even more to weight gain.
Other risk factors
for obesity include: parental obesity; pregnancy; high fat diet;
some medications such as antidepressants and oral steroid hormones;
and low socioeconomic status.
Symptoms
Many people realize
that they may have a problem with weight without any physical symptoms.
A change in clothing sizes is one indication that people of both
sexes may notice, even if other factors are not present.
Obesity and weight
gain may lead to joint problems such as seen with osteoarthritis;
skin conditions due to increased sweating, and can lead to problems
regulating blood sugar, diabetes and cardiovascular disease.
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Diagnosis
and Pharmaceutical Interventions
The diagnosis of
obesity and weight gain is quite simple and is sometimes only gauged
with observation. For exact measurement, the body mass index (BMI)
is calculated. This is determined by calculating weight in kgs by
height in meteres squared. BMI’s indicate the range of body
sizes, as underweight is defined as being 18.5, normal weight is
18.5-24.9, overweight is defined as 25.0-29.9 and obese is defined
as 30.0 and above.
Pharmaceutical medications
for obesity and weight gain may fall in and out of favor by both
the public and medical professional depending on the efficiency
and potential side effects. Some medications that may be used are
diethylpropion (tenuate), phentermine (umine) and sibutramine (reductil).
These medications should be discontinued after 12 weeks if failure
to achieve a weight reduction of 5% has not happened. They should
not be used in cases of advanced arteriosclerosis, hyperthyroidism,
known hypersensitivity, or idiosyncrasy to the sympathomimetic amines,
glaucoma, agitated states, and patients with a history of drug abuse.
Phentermine in particular should not be used in alcoholic patients
weather it is active or in remission. In rare cases the use of these
medications has been associated with an increased risk of developing
primary pulmonary hypertension (PPH), a rare but often fatal disorder.
Other side effects include elevation of blood pressure and overall
central nervous system stimulation such as jitteriness, blurred
vision, dry mouth, changes with libido, loss of appetite, insomnia
and depression.
Because of the range
of side effects from these medications; one option that has gained
popularity in the treatment of obesity is the surgical intervention
of gastric bypass, or stomach stapling. It is usually done when
the BMI is over 40 and other treatments have not worked. This decreases
the size of the normal stomach, creating a stomach that sometimes
is no more than 25 ml in volume. As a complication from this procedure,
some vitamins may become deficient, especially ones that are absorbed
in the stomach like vitamin B12.
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Lifestyle
and Dietary Modifications
The effect of exercise
alone (without dietary restriction) on weight loss is small, partly
because muscle mass often increases even while fat tissue is reduced,
and perhaps because some exercising people will experience increased
appetites. The long-term effect of regular exercise on weight loss
is much better, and exercise appears to help people maintain weight
loss. People who have successfully maintained weight loss for over
two years report continuing high levels of physical activity. Combining
exercise with healthier eating habits results in the best short-
and long-term effects on weight loss, and should reduce the risk
of many serious diseases. This also may help with people who experience
“weight cycling” (repetitive weight loss and gain),
who have a tendency toward binge eating. The most successful weight-loss
programs (in which weight stays off, mood stays even, and no binge
eating occurs) appear to use a combination of moderate caloric restriction,
moderate exercise, and behaviour modification, including examination
and adjustment of eating habits.
When overweight
people attend group sessions aimed at changing eating and exercise
patterns, keep daily records of food intake and exercise, and eat
a specific low-calorie diet the outcome is much more successful.
Group sessions where participants are given information and help
on how to make lifestyle changes appear to improve the chances of
losing weight and keeping it off. Such changes may include shopping
from a list, storing foods out of sight, keeping portion sizes under
control, and avoiding fast-food restaurants. Behavior-change techniques
are considered useful for helping people break old habits and form
more healthful habits. These techniques may be learned from counselling
professionals, support groups, educational programs, or books.
Problem-solving techniques are used in some types of counselling
to help people maintain changes in their behaviour.
Calories in the
diet come from fat, carbohydrate, protein, or alcohol. Dietary changes
to reduce weight may be geared at any limiting calories from one
of these elements and/or by emphasizing foods that are believed
to result in reduced calorie intake. Some currently popular diets
restrict fat while emphasizing fibre and a balanced intake of healthful
foods. Others restrict carbohydrates, either to extremely low amounts
as in the Atkins diet, or to a lesser degree, emphasizing foods
low in the glycemic index or high in protein
Low-fat, low-calorie,
high-fibre, balanced diets are recommended by many doctors for weight
loss. According to controlled studies, when people are allowed to
eat as much food as they desire on a low-fat diet, they tend to
lose more weight than people eating a regular diet. However, low-fat
diets have not been shown to be more effective than other weight-loss
diets that restrict calories. Nonetheless, a low-fat, high-fibre,
balanced diet has additional potential benefits, such as reducing
the risk of chronic diseases including cardiovascular disease and
cancer
Low-carbohydrate,
high-fat diets such as the Atkins diet are very popular among people
trying to lose weight. An analysis of preliminary studies of this
type of diet concluded that its effectiveness is primarily due to
reduced calorie intake. The effect of low-carbohydrate diets on
cardiovascular risk is also an unresolved issue. Some studies have
shown a worsening of certain cardiovascular risk factors in people
using a low-carbohydrate, high-fat diet for up to one year. Adverse
changes included increases in blood levels of homocysteine, lipoprotein(a),
and fibrinogen, and a decrease in blood flow to the heart. Individuals
wishing to consume a very-low-carbohydrate diet for weight loss
or for other reasons should be monitored by a doctor.
Diets that emphasize
choosing foods with a low glycemic index have been show to help
control appetite in some studies. Glycemic index and glycemic load
describe the tendency of foods to raise blood sugar. Eating meals
containing foods that are low in glycemic index or glycemic load
may influence appetite and other body mechanisms that affect excessive
weight gain. Most low qlycemic foods are high in fibre and adequate
amounts of dietary fibre are believed to be important for people
wishing to lose weight. Fibre adds bulk to the diet and tends to
produce a sense of fullness, helping people consume fewer calories.
A recent review of weight-loss trials that did not restrict calories
concluded that higher fibre diets improved weight-loss results,
especially in people who were overweight.
Although the relationship
between food sensitivities and body weight remains uncertain, many
believe that chronic food allergy may lead to overeating and obesity.
It is thought that this is a result of a craving of the offending
foods, leading to overacting. By identifying and stabilising food
sensitivities many people experience an increased energy level due
to a healthier diet.
People who go on
and off diets frequently complain that it takes fewer calories to
produce weight gain with each weight fluctuation. Evidence now clearly
demonstrates that the body gets "stingier" in its use
of calories after each diet. This means it becomes easier to gain
weight and harder to lose it the next time. Dietary changes need
to be long term.
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Nutritional
factors shown to be beneficial
Multiple
vitamin minerals
Diets that are low in total calories may not contain adequate amounts
of various vitamins and minerals. For that reason, taking a multiple
vitamin-mineral supplement is advocated by proponents of many types
of weight-loss programs, and is essential when calorie intake will
be less than 1,100 calories per day.
Dose: as recommended on bottle
Calcium
In a study of obese people consuming a low-calorie diet for 24 weeks,
those receiving a calcium supplement lost significantly more weight
than those given a placebo. It is possible that calcium supplementation
enhances weight loss only when the diet is low in calcium.
Dose: 800 mg a day
Chromium
The mineral chromium plays an essential role in the metabolism of
carbohydrates and fats and in the action of insulin.
Dose: 200 mcg a day
5-HTP
5-hydroxytryptophan (5-HTP), the precursor to the chemical messenger
(neurotransmitter) serotonin, has been shown in three short-term
controlled trials to reduce appetite and to promote weight loss.
This may be due to increased well being and energy level.
Dose: 50 mg three times per day with meals
Fibre
Fibre supplements are one way to add fibre to a weight-loss diet.
Fibre can add to the bodies’ detoxification process, by encouraging
normal bowel movements and increasing the solubility of bile.
Dose: as recommended on bottle
Pyruvate
Pyruvate, a compound that occurs naturally in the body, might aid
weight-loss efforts. Some studies suggest that pyruvate supplementation
leads to weight loss by increasing the resting metabolic rate.
Dose: 3-6 grams a day
CLA
Conjugated linoleic acid (CLA) is thought to increase metabolic
rate, decrease abdominal fat and enhance muscle growth. It may also
lower resistance to insulin, a factor in diabetes type II.
Dose: 2-4 g a day with meals
HCA
Hydroxycitric acid (HCA), extracted from the rind of the Garcinia
cambogia fruit grown in Southeast Asia, has a chemical composition
similar to that of citric acid (the primary acid in oranges and
other citrus fruits). Preliminary studies in animals suggest that
HCA may be a useful weight-loss aid.
Dose: 1000 mg before meals
Whey protein
Whey protein may aid weight loss due to its effect on appetite.
In studies whey protein consumption resulted in more hunger satisfaction
and reduced the amount of food eaten compared with other protein
powders. Protein powders work will taken in the morning for those
with sugar cravings early in the day.
Dose: as directed on bottle
Green Tea
Extracts
Green tea extract rich in polyphenols (epigallocatechin gallate,
or EGCG) may support a weight-loss program by increasing energy
or by inhibiting the digestion of fat in the intestine. Although
green tea does contain caffeine and caffeine is known to stimulate
metabolism, it appears that other substances besides caffeine were
responsible for at least part of the weight loss. Attempting to
drink enough green tea to achieve health benefits can lead over
consumption and may cause irritability, insomnia, nervousness, and
tachycardia.
Dose: 500-1500 mg of extracts standardized
80% total polyphenols.
Gymnema
(Gymnema sylvestre)
Gymnema improves the ability of insulin to regulate blood sugar,
and is helpful when dealing with food cravings.
Dose: 400-600 mg a day
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Recommended
NaturalMeds for Obesity & Weight
LifeForce
Multiple
Life Force Multiple, the most complete daily formula available,
is scientifically designed to deliver essential cellular energy
and balance to vital systems and organs.
Dose: 4 capsules with food Pack size: 60 &
120 capsules
Calcium
Citrate
Calcium Citrate is a form of calcium that is more soluble and better
absorbed by the body than other forms of calcium.
Dose: 1 tablet a day with food Pack size:
90 tablets
5-HTP
50 mg
Studies have shown that 5-HTP increases the amount and availability
of serotonin, a neurotransmitter, produced by the body.
Dose: begin with 1 capsule, gradually increasing
dosage up to two capsules daily, if needed, three times a day, away
from food Pack size: 30 tablets
Chromium
GTF 200 mcg
A mineral essential for blood sugar regulation, here chromium is
combined with niacin, another part of what is called the glucose
tolerance factor (GTF).
Dose: 1 table twice a day Pack size: 60 tablets
Diet
Metabo-7
Diet Metabo-7 supports seven major body systems involved in healthy
and successful weight loss, without the overstimulation associated
with other diet products. It contains effective and naturally occurring
metabolic activators and calming neurotransmitters, for a balanced
approach to weight loss, including green tea extract and Gymnema.
Dose: 1 tablet 3 times a day before meals
Pack size: 45 tablets
Trifala
Trifala is a combination of three herbs – Terminalia chebula
(haritaki), Terminalia bellerica (bahera), and Embelica officinalis
(amla) – which is referred in almost every Ayurvedic textbook.
It supports the immune system and is one of the richest available
sources of Vitamin C. Trifala has bowel-regulating and mild laxative
effects, aiding both digestion and elimination.
Dose: 1 capsule three times a day Pack size:
90 capsules
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