06-11-2012, 01:16 PM
WEIGHT LOSS MANAGEMENT OF OVERWEIGHT AND OBESITY
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Introduction
The report from the International Obesity Taskforce (IOTF) on worldwide prevalence rate shows that the pediatric obesity epidemic has spread globally. The worldwide prevalence of overweight in children and adolescents is approximately 10% with many western countries approaching 30%. Because of the number of the subjects, obesity is now recognized as a healthcare issue on an epidemic scale but it yet remains an unsolved medical problem(1). As many as 30 million Indians are overweight, and obesity continues rise, says statistics revealed by the National Family Health Survey (NFHS). The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. Around 20 per cent of school-going children are overweight, as the prevalence of obesity is increasing in epidemic proportions worldwide especially in developed countries, and the problem in India is also increasing, the survey said.
Obesity and overweight are conditions in which weight gain (predominantly fat) has reached the point of endangering health. The prevention and management of obesity has been a national governmental policy concern for a number of years; the Chief Medical Officer’s Annual Report 2002 (Department of Health, 2003) highlighted obesity as ‘the health time bomb’ and recognized that obesity is a growing challenge for government as a whole(2).
Why Treat Overweight and Obesity?
Obesity is clearly associated with increased morbidity and mortality. There is strong evidence that weight loss in overweight and obese individuals reduces risk factors for diabetes and cardiovascular disease (CVD). Strong evidence exists that weight loss reduces blood pressure in both overweight hypertensive and nonhypertensive individuals; reduces serum triglycerides and increases high-density lipoprotein (HDL)-cholesterol; and generally produces some reduction in total serum cholesterol and low-density lipoprotein (LDL)-cholesterol. Weight loss reduces blood glucose levels in overweight and obese persons without diabetes; and weight loss also reduces blood glucose levels. Although there have been no prospective trials to show changes in mortality with weight loss in obese patients, reductions in risk factors would suggest that development of type 2 diabetes and CVD would be reduced with weight loss(6).
Health Risks Associated with Overweight and Obesity
Overweight (BMI 25–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) are independent risk factors for several chronic disease conditions including coronary heart disease, hypertension, elevated cholesterol, and diabetes. The prevalence of these conditions increases as BMI increases. The risk for developing diabetes also increases with increasing weight. Compared to a healthy weight person, an overweight individual is 3 times more likely to develop diabetes within 10 years. This risk rises dramatically to 23 times the risk at the higher BMI levels (BMI ≥35 kg/m2). Individuals with diabetes are also at an increased risk of developing coronary heart disease. Coronary heart disease is the leading cause of diabetes-related death.
The Beneficial Health Effects of Weight Loss
A 10 to 20 pound weight loss often improves blood pressure, blood cholesterol, and triglyceride levels. Weight loss is also an effective therapy for reducing the risk of diabetes. A subanalysis of a Diabetes Prevention Program cohort comprised of adults with impaired glucose tolerance receiving an intensive lifestyle intervention, found a 16% reduction in risk for developing diabetes for every kilogram of weight loss, independent of diet and physical activity.
Weight loss has a similar effect on the risk for developing hypertension. In another observational study, a cohort composed of overweight, middle-aged adults without hypertension, found that a moderate weight loss of 15 pounds or more reduced the long-term risk of developing hypertension by 28%. Furthermore, in a clinical study of individuals with metabolic syndrome, weight reduction was shown to reduce elevated triglycerides, systolic and diastolic blood pressure, serum glucose, and total cholesterol.
The Biggest Mistakes That People Make When They Want to Lose Weight!
It seems that losing weight is now more popular than ever. The concept appears on TV, in newspapers and magazines, it is discussed on radio and it is even a common topic of conversation among people of all ages. The problem is, the path to losing weight and more importantly, keeping it off, is filled with ‘land mines’ all designed to stop weight-loss results in their tracks as well as destroy motivation to reach the destination. Below is given some of the most common mistakes people make when they want to lose weight(7).
Skip Meals.
This is the most common action people take when they want to lose weight and this is exactly why they are overweight! Many people skip meals under the assumption that if they eat less it must lose weight. Skipping meals is certainly not the best way to eat less. Skipping meals invokes the body’s ‘Anti-Starvation Response’, which causes a drop in metabolism, a loss of muscle, an increase in the activity of fat-storing enzymes and an increase in appetite. A far more effective approach is to have 5 or 6 small meals/ snacks each day. Doing so will keep the metabolism elevated, stop the body from going into a catabolic state (breaking down muscle tissue), limit the activity of those pesky fat storing enzymes and of course help to suppress the appetite.
Focus on just losing weight.
There is nothing wrong with wanting to lose weight fast and it certainly is possible to lose a large amount of weight in a relatively short period of time. A 10kg weight loss in 28 days is quite achievable but it is important to keep in mind that losing more than half a kilo a week is likely to be losses of muscle, water and stored carbohydrate in addition to some fat. It is certainly not going to be entirely from fat. People who have a tendency to hold excess fluid will quickly lose it by following many of the advanced weight-loss strategies.
It is actually a physiological impossibility to lose body fat quickly; the body simply won’t allow it. The bodies have been designed to hold on to the fat stores as much as possible.
By doing so, it is possible to survive for a long period of time, as there is a good source of energy to draw from if needed. Unfortunately, our bodies haven’t adapted to our ‘modern day’ lifestyle where famines are very rare.
When weight loss is faster than a kilo a week the body has a greater tendency to ‘rebound’. This means one may put the weight back on very quickly unless the habits that have helped to achieve the rapid weight loss in the first place are maintained.
Don’t Use a Multi-Directional Approach.
When someone makes a decision to lose weight they generally make changes to their nutritional habits. Unfortunately, only making changes to the eating habits is bound to fail simply because the body will always find a way to adapt to a reduction in the food intake. It does this by invoking the ‘Anti-Starvation Response’ as mentioned earlier. A far better approach is to attack the excess weight from a number of different directions rather than just one. It is suggested to examine the lifestyle in the areas of, Nutrition, Supplementation, Aerobic Exercise and Resistance Exercise. By focusing on each of these areas and incorporating the various principles that relate to them into the lifestyle, one will be amazed at how quickly the weight is lost and how easy it will be to keep it off and it must become a lifestyle.
Try Another Diet.
It is amazing how many people go on diets, starve, suffer, and put themselves through pain. Then, when they lose weight they celebrate and welcome the fact that they can now go back to eating ‘normally’ again. Of course, the moment they do, the weight piles back on and usually with reinforcements! Then they decide that the diet they followed didn’t work so they try another one, again, with the same results. The definition of insanity is trying to do the same thing over and over again and expecting a different result. This definition is perfect for dieting. The best way to lose weight is to never go on a diet again, they simply don’t work. Decide to make some minor changes to the current eating habits that are sustainable for the rest of the life. If one can’t maintain the changes then it is guaranteed that the weight-loss results that is achieved is will be short-lived.
Avoid Lifting Weights.
When people want to lose weight, weight training, or resistance training, is never considered as an option. The reason is that many people have the mistaken belief that lifting weights will ‘bulk them up’, cause them to grow facial hair, make women look like men or cause their voice to lower 3 octaves!
Despite this, resistance training is probably the most under-estimated way to lose weight fast! If a mildly calorie-restricted nutritional plan is followed, it is virtually impossible to increase the muscle mass because there are no extra calories to use for building muscle. Lifting weights under these circumstances will simply force the body to maintain its
existing muscle mass, which results in maintenance of the metabolism and therefore there is body’s weight-loss and fat-burning ability.
Don’t Make Permanent Lifestyle Changes.
Once people achieve the weight loss they desire rarely do they maintain the lifestyle that helped them achieve the result. Often they will say that it is too difficult to maintain so they return to previous lifestyle habits- the habits that caused them to put on weight in the first place! This is known as relapse.
In order to maintain the result it is absolutely essential that one must maintain the habits that helped them to achieve it. Of course, one can modify them slightly and still maintain the result. For example, the frequency of the exercise program can be decreased , so instead of exercising every day one can exercise every second day or instead of only having one ‘Treat Meal’ a week it can be two. Therefore, one can still maintain the exercise and healthy eating habits but modify them to make them more sustainable. Remember these habits must be maintained for the rest of your life.