Obesity Epidemic

gcadshvjncaxaxcdbcaixc4kkcabfrd5wcaapjbgtcavvpddccad7t9mpcapy4999cayl3l3fcavevdrocav56sm8cae3cmh3ca0fhwjacaew128bca242os2cav195t9cau8jzvzca07mjifcaswut16Obesity is epidemic in the United States. The number of overweight and obese Americans has grown at a disturbing rate, especially over the past few years. Today more Americans are overweight than are normal weight. Over sixty percent of the population is now considered to be overweight, with over 30 percent of the population considered to be obese. This is tragic for America. A very large (and growing) percentage of our citizens are at increased risk for developing serious chronic diseases, and face the prospect of early death. Meanwhile the entire society struggles under the burden of the resulting increase in health care costs.

While genetics plays a role in the predisposition to obesity, the actual development of obesity is strongly influenced by environmental factors, most notably a sedentary lifestyle. Exercise is essential in weight management. For example, if an extra 100 calories a day is consumed above that needed by the body, in one year that will result in a ten pound weight gain. This is particularly tragic since a 20 minute walk is sufficient to burn those extra calories for many people! There are a number of web sites that allow a visitor free access to calculations on how many calories an individual would burn doing various activities based on weight http://www.realage.com/racafe/exest.aspx is one such site. Pick a favorite food, snack, whatever and see the energy cost of that item for you. It is quite illuminating!

Portion size is a large part of the problem. As our lives have become increasingly busy, more and more Americans have turned to restaurant food, sit down or take out, for many of their meals. In an effort to attract customers many establishments began to offer larger portions of high-calorie food at inexpensive prices. Ever fond of a bargain, Americans have been quick to take advantage of these supersized portions. Since people tend to eat more if given more in a portion, calorie consumption has significantly increased. In time the larger portions have come to be considered normal and expected. Thus the amount of food we eat has increased during the same time period that more and more people have become sedentary. Weight gain has been the result.

Risks of obesity include: coronary artery disease (CAD), heart attack, heart failure, angina, abnormal heartbeat, high blood pressure, elevated cholesterol and triglycerides levels, lowered beneficial HDL cholesterol levels, stroke, type 2 diabetes, and certain cancers such as prostate, gallbladder, colorectal, breast, endometrial and kidney. In addition, obesity increases the risk of developing gallstones (in women), liver problems such as an enlarged liver, cirrhosis, or a fatty liver, gastroesophageal reflux disease (GERD), sleep apnea, asthma, shallow breathing (Pickwickian syndrome) which can lead to heart disease, and arthritis. Obesity also increases the risk of reproductive problems such as irregular periods, an increased risk of birth defects, especially neural tube defects, and an increased risk of death of the mother and baby.

The risk of developing type 2 diabetes increases as a person gets heavier. This is very unfortunate as diabetes is a major risk factor for the development of heart disease. While obese individuals are more at risk for arthritis than normal weight individuals, each additional few pounds of weight gain increases the risk for developing this potentially debilitating condition. Finally, recent research suggests that being obese can increase the risk of lowered mental ability, especially in memory and learning, in men over time.

The location of body fat is also important in assessing risk. If the fat accumulates disproportionably around the abdomen, it is an independent predictor of increased risk and morbidity. Thus individuals whose fat accumulates around the abdomen are at greater risk than individuals whose fat accumulates around the hips and thighs. A man with a waist measurement of more than 40 inches or a woman with a waist measurement greater than 35 inches is considered at increased risk for type 2 diabetes, high blood pressure, high cholesterol, and coronary artery disease than normal weight individuals or those whose fat accumulates around the hips.

Starting Your Weight Management Program

Here are some key issues in starting your weight management program:

kcamyyh2ocam65bg4caumfjfrcaiiuwkrcasmdkricaqfsyorcas13zm2caen2igpcax3ps46caewcqp7ca0jez5zcajlnppwcapasu20ca7ghgb5cafzuxzycarv0ja6casg0u10cahmu2h4cawykw0kWhy are you trying to lose weight? Food is a significant part of our lives. Deciding to make a lifetime commitment to eating better is a big step. You will be most likely to succeed if you are making the change because you have made the decision for yourself and are not merely to please other people.

What worked or did not work during previous attempts to lose weight? There is much to be learned from examining what didn’t work in the past. Do not think of these experiences as “failures” but rather as learning experiences. This is a lifelong journey and modern life makes eating and weight control challenging. You are to be applauded for your courage in deciding to make a change.

Eating is not just a biological necessity it is also an emotional outlet. Think about what triggers you to overeat and develop some alternative behaviors to use when the urge to eat for emotional comfort occurs.

Build yourself a support system of people who care about you and will encourage you in your weight loss efforts. If at all possible avoid people who do NOT want you to succeed for their own personal reasons.

There are no quick fixes. The best diet is a lifetime choice to eat a well balanced diet of healthy foods (and occasional treats) and increase daily activity.

Every time you make a healthy food choice your body benefits. Every bit of increased exercise counts. Even a small weight loss, 10% of your weight, can significantly improve your health.

A healthy weight loss is one or two pounds a week maximum.

Very low calorie diets can be dangerous and the weight loss may be gained back rapidly when the diet ends. Most people can safely lose weight on a low calorie diet, 1200-1500 calories a day for women, 1500-1800 calories a day for men.

Keep in mind that everyone’s metabolism is different. In order to lose a pound you must burn 3500 calories more than you take in. The trick is to find changes that are easy or even enjoyable. For example, it is really easy to substitute diet soda for regular soda, or substitute low or fat-free dairy products for the higher fat variety. Or eat a piece of fruit instead of a bag of chips. If you choose a form of exercise that you enjoy you will find that you will want to stick with it because it makes you feel good and enriches your life.

Diets work because a dieter eats fewer calories than are needed to maintain their current weight. After reviewing diet options and your food diary, you will know more about yourself. If you eat too many high-saturated fatty foods, then reduce the type and amount of these foods. If you overeat for emotional reasons then try and find alternative behaviors. For example, while yoga does not burn huge numbers of calories it can relieve stress. If you practice a few yoga poses when you are upset (perhaps while listening to soothing music) you will often find that you begin to feel better without having to eat half a cheesecake, or a bag of chips or a pint of premium ice cream..

Slowly change your eating habits. Learn what a serving of a food is really supposed to be and begin to measure your food. Serve the food on smaller plates and eat slowly. Eating slowly will allow you to notice at what point you are satisfied—if you gobble down your food you completely eliminate this appreciation and can turn up overeating and feeling uncomfortable.

Try to include more fruits and vegetables in your diet. If you are worried about a glycemic number then pick primarily from fruits and vegetables that have a low glycemic number. Eating foods in combination also decreases the glycemic impact of a single food.

Food diary

A food diary is a notebook in which you record absolutely everything you eat or drink over a period of time. As part of preparation information should be kept for at least three weekdays and a weekend. A lot of people eat differently over the weekend than during the week. The important thing is to be ABSOLUTELY honest. No one else needs to see this notebook but you, but you need to know the truth. In addition to the items and their quantities, be sure and record where you ate the food and how you felt.

Using the scales

During the preparation phase weigh frequently, and settle on a specific time of day for your baseline weight. Early morning, before breakfast, is usually the best time of day to weigh. Be sure and do follow-up weight checks at the same time of day as the baseline weight to keep normal daily weight fluctuations from making you feel like you are not making progress when you really are. Weighing several times a day during the preparation phase allows you to observe your normal body fluctuations during the day. Just drinking a couple glasses of water can make the numbers on the scale go up. After the assessment period weigh only about once a week at the same time as your baseline measure.

BMI

The current “gold standard” for determining a healthy weight is the body mass index (BMI). Body mass index is determined by dividing the weight in kg by the height in meters ². In general a BMI of 30 or over indicative of obesity, while a BMI between 25 and 29 indicates being overweight. BMI is not a reflection on how we look, or a comparison of our weight with one of the media’s idealized slim, toned bodies, it is rather a reflection of the effect excess fat has on your health.

A BMI table and accompanying comments are available as part of the Report of the Dietary Guidelines Advisory Committee on The Dietary Guidelines for Americans (2000). These guidelines may be read on line, printed out in PDF format or ordered at http://www.health.gov/dietaryguidelines/

Circumference measurements

Two important circumference measurements are those of the narrowest point at the waistline and the broadest point at the hip. These two measurements can then be used to determine the waist-to-hip ratio (WTH). The waist measurement is divided by the hip measurement. High WTH ratios are associated with greater health risks. In other words if a person has most of their extra body weight in the hips and legs it is less dangerous for their health than if the fat was stored in the trunk of the body.

A waist circumference of 40 inches in men and 35 inches in women is cause for concern if there are other health problems than being overweight may worsen.

In addition to your waist and hips, it is also helpful to measure thighs, upper arms, chest, neck and anywhere else you are concerned about reducing. Since muscle weighs more than fat the scales may not be completely reliable witnesses to the changes going on during a weight loss/exercise program. A periodic check of circumference measurements may well show a decrease in size even if the scales do not indicate much change. Muscle takes up less space than fat and will often result in your dimensions decreasing even if the scales are not so cooperative.

Body fat measurement

A baseline estimate of your body composition (body fat mass vs. lean body mass) is very informative. Two of the most cost effective ways of estimating body fat are through skinfold caliper measurements or by weighting on a bio-electric impedance scale. Bio-electric impedance analysis is a painless process in which a known current is based through the body. Lean body mass is a good conductor of electricity whereas fatty tissue is not. The scale is able to come up with an estimate between the fat-free mass and total body water and the amount of resistance found by the analyzer.

Skinfold caliper measurements should be made by an experienced medical or fitness professional. Some gyms offer this service; some also have commercial bio-electric impedance scales. Bathroom scales that also provide estimates of body fat via impedance are also available at many retail stores. It is advisable to have skinfold measurements and impedance weight measured taken at the same time of day. You should also have had plenty of fluids to drink and not worked out for 12 hours before the measurements.

Another helpful measurement is wrist circumference or a measurement of the width of the elbow, the space between the opposing bony protrusions on either side of the bent elbow. The elbow measurement is most accurately taken with calipers. These measurements provide ways of estimating the size of your body frame which is part of the calculation in determining just how much you should weigh. A small boned person should weigh less than a big boned person—and likewise it is not realistic for a person with big bones to achieve the weight goals of a smaller boned person of the same height.