Obesity

Description

America is obsessed with weight control. Yet, while much of the country actively diets, fitness magazines fly off of the newsstand shelves, and low-and no-fat foods crowd supermarket shelves, many studies estimate that approximately half of this country’s citizens are overweight, and this includes children.

Federal health agencies, such as the National Institutes of Health, the National Center for Health Statistics, and the Food and Drug Administration (FDA), have recently created and issued new, more stringent guidelines as to what constitutes being overweight and what constitutes obesity. Instead of centering around the classic and widely used height-and-weight-tables made popular by the Metropolitan Life Health Insurance Company, the new guidelines measure something called body mass index, or BMI. Your BMI equals 704.5 multiplied by your weight in pounds divided by your height in inches squared. For example, if you are 150 pounds and 5 feet, 8 inches tall (68 inches), your BMI can be calculated this way: 704.5 X 150 (pounds) / 4624 (that’s 682) = BMI of 22.8. If your BMI lies between 25 to 29.9 you are considered-by these federal guidelines-to be overweight. Obesity begins at a BMI of 30.

For the general public, the word obese conjures images of very large individuals, perhaps weighing 300 pounds or more. In the medical community, however, the word obese is used to describe a weight that directly compromises health and makes an individual susceptible to various medical conditions, including hypertension, diabetes, heart disease, stroke, and certain cancers.

Obesity is caused when there is no balance between the calories one consumes and the calories one uses. Simple overeating and under-exercising is the most common reason for this excessive weight gain, though a small number of individuals have a physical reason-such as hypothyroidism or an overly slow metabolism-that makes the body store calories as fat instead of burning them.

Signs and Symptoms

• Having a body mass index (BMI) of 30 or higher in addition to one or more of the following:
• Increased blood pressure
• Low exercise tolerance
• Increased respiratory rate

Conventional Medical Treatment

If you choose to see your physician, he or she may run a series of tests to eliminate any medical reason for your excess weight, such as a thyroid condition. If there is no identifiable medical reason for your weight, however, your doctor will suggest a weight loss plan. How you do this depends on how overweight you are and the lifestyle you lead at the moment. With severe obesity, for example, the heart can be phenomenally taxed, prompting your physician to put you on a liquid or other quick-loss diet only until a specified amount of weight comes off, and you can begin to add moderate exercise to a low-fat, reduced-calorie diet. In a small number of cases, medication is prescribed to help suppress appetite or to reduce metabolism of dietary fats. Note: FDA guidelines state that these medications should only be prescribed to individuals with a BMI of 30 or more.

The typical weight loss plan includes a medically supervised regime of low-fat foods and low-impact aerobic exercise until you reach a goal weight. Be warned: Once you reach this goal, you must continue eating nutritiously and exercising-otherwise, the number on the scale will begin to creep back up to where it used to be.

Complementary and alternative Treatments

Nutrition and Supplementation

Sound nutrition is the key to preventing obesity, shedding excess pounds, and helping maintain a healthy weight. Balancing your calories is important. There are three components in food that provide calories: carbohydrates, protein, and fat. Let’s take a look at each. Carbohydrates are plant foods that furnish your body with energy. They regulate bowel function and protect against heart disease and certain types of cancer. Low-calorie, nutrient-rich whole grains, fruits, and vegetables fall into this category and have the added advantage of being high in fiber. Healthy foods high in complex carbohydrates include whole grains, beans, lentils, and plain baked potatoes. Tofu, dried legumes, nuts, and seeds are good sources of complex carbohydrates as well as being good sources of protein.

If you’re battling a weight problem, beware of refined carbohydrates, including sugar and white flour products. Such foods should be severely restricted if not totally avoided. About 30 percent of your calories should come from carbohydrates.

Protein is essential in building, repairing, and maintaining bodily tissues-your muscles and organs. Protein is a key component of enzymes, hormones, and many body fluids. It is found in all animal foods (meat, fish, poultry, dairy) as well as in vegetable sources, such as dried legumes, especially soy, nuts, and seeds. Get 40 percent of Your daily calories from protein.

Fat is not necessarily evil. Healthy fats, such as those found in avocados, olives, raw nuts, seeds, and fish contain essential fatty acids. Avoid the saturated animal fats found in butter, cream, gravies, ice cream, whole milk, and rich dressings, and the hydrogenated fats found in cookies, cakes, pies, chips and crackers, fast foods, junk foods, and many prepared foods. However, if you’re trying to lose weight, do not automatically cut all fats from your diet, as some fat is necessary to help your body absorb certain essential vitamins. Fats also are building blocks for hormones, cushion the organs, and provide energy. Adjust your diet so only 20 to 30 percent of your daily calories come from fats, and only 8 to 10 percent of that from saturated fats.

Balance is the key to weight loss and weight management. You need to eat a wide variety of nutrient-rich whole foods. Include more fruits, vegetables, whole grains, and plant-based proteins. Most fruits and vegetables are low in calories but high in essential nutrients. Vegetables, such as broccoli, carrots, cauliflower, collards, green beans, onions, spinach, and all whole grains, are high in fiber. Fiber is essential in maintaining a healthy weight because it keeps the colon clean and allows for easier digestion. Eat two to three servings of nutrient-rich fruits-such as cantaloupe, grape-fruit, strawberries, and watermelon-each day, plus three to seven half-cup servings of vegetables.

Unless you’re a committed vegetarian, there’s no need to eliminate animal products from your diet. However, by building your meals around fruits, vegetables, and grains, you’ll naturally consume smaller amounts of dairy products and animal protein. When you do eat foods from these last two groups, make healthy choices: skim or 1 percent milk; non-fat or low-fat yogurt; reduced fat cheeses; low-fat or fat-free sour cream; lean, skinless meats prepared without additional fats.

Portion control is essential, too, especially where protein is concerned. A good rule of thumb is to limit your animal protein portion to serving no larger than the palm of your hand.

Limiting fats is a good place to start, but take it further. Excess sodium contributes to obesity as well as to high blood pressure and the risk of heart attack and stroke. To enhance the flavor of your food, use onions, fresh garlic, and ginger root. Dijon mustard, fresh lemons and limes, flavored vinegars, and plenty of herbs and spices are good replacements for salt.

It’s easy to get caught up in numbers, but caloric needs vary with each individual. Do you lead a sedentary lifestyle or are you more active? What is your age? your gender? your genetic his tory? All of these factor into figuring out how many calories you need, so it’s important that you sit down with a nutritionist to figure out a regimen that is well matched to your specific requirements.

One statistic is indisputable: To lose one pound of fat, you must burn 3,500 calories more than you take in, or consume 3,500 fewer calories than you need. If you’re aiming to lose weight, it’s realistic to expect to lose one pound a week if, on a daily basis, you eat 500 fewer calories than you need or burn 500 calories through exercise. A loss of one to two pounds per week is considered healthy.

All the wholesome foods in the world won’t help if you don’t exercise. In addition to making you feel better physically, exercise improves your emotional and mental outlook. You don’t need to spend a lot of time exercising: 30 minutes of walking a day for five to seven days a week is suf ficient, and will put you on a course for maintaining a healthy weight.

Nutritional supplements can help as well. Here is a daily supplement guide:

• chromium picolinate (200 to 400 mcg)-increases lean body mass and boosts energy
• L-carnitine (500 to 1000 mg)-helps burn fatty acids
• lecithin (1 tbsp)-emulsifies fat
• evening primrose oil (500 mg)-provides essential fatty acids and controls appetite
• vitamin C with bioflavonoids (3000 to 6000 mg)-speeds up a slow metabolism
• pyruvate (as directed)-helps burn fat
• garcinia (as directed)-reduces appetite
• St. John’s wort (300 mg, 3 times daily)-can reduce cravings (Do not use in conjunction with antidepressants. St. John’s wort may act as a mild monoamine oxidase inhibitor [MAOI]; consult your healthcare provider regarding potential dietary and medication restrictions.)

(Consult your healthcare provider regarding the duration of treatment.)

Ayurvedic Medicine

According to Ayurveda, obesity is a kapha disorder in which the gastric fire is strong but the cellular fire is weak. To control weight, Ayurvedic practitioners may suggest eating less fat and exercising more. They also may recommend taking guggul or garcinia cambozia, urge you to consume your main meal early in the day, and recommend chewing your food slowly to savor each mouthful.

Ayurvedic products are available at many health food stores and Indian pharmacies. Remember to consult with your doctor before starting a weight-management program.

Traditional Chinese Medicine

Acupuncture Acupuncture can be used to improve the flow of chi throughout the body (which may help boost metabolism) and to regulate any imbalances. It is also effective in curbing excessive or unhealthy food cravings that may contribute to obesity and weight gain. Acupuncture also can help stimulate metabolic change and reduce an overabundance of dampness in the body which, in turn, helps the person better control bingeing.

Acupressure Acupressure may be helpful in reducing cravings and restoring the flow of chi throughout the body. It also can improve the body’s ability to burn fat and enhance digestion. Points that are typically manipulated during a weight-loss massage session include Bladder 20, 23, and 36; Spleen 10; and Stomach 34.

Chinese Herbal Therapy Chinese medicine views obesity as an overabundance of dampness and phlegm within the body-in other words, metabolic laziness. To help counteract this excess accumulation, black pepper may be prescribed to hasten and enhance digestion, while Japanese honeysuckle may be used for its diuretic properties. Joint fir (also known as ephedra or Ma Huang) is a time-honored anti-obesity herb that works by regulating appetite and stimulating sluggish metabolism, but must be used under the direction of an herb-trained acupuncturist to achieve the best results.

Depending upon what is determined to be the root cause of a patient’s obesity, a Chinese medical expert may recommend the following over the-counter combination preparations: Apricot Seed and Linum, Poria Five Herb Combination Minor Bupleurum, Ledebouriella and Platycodon’ or Stephania and Astragalus formulas.

Yoga and Meditation

A routine of gentle yoga and meditation can help you stay focused on weight management, improve your strength, and acquire a healthy self-image. If you haven’t exercised before, start with four or five poses, such as the Sun Salutation, Camel, Cobra, Spinal Twist, and Supported Shoulder Stand, and practice them daily. Deep breathing is also advised.