Obesity And Weight Management
An estimated 60 percent of Americans aged 20 years and older are considered overweight and one-quarter are considered obese. Obesity is most often the result of inactivity, unhealthy diet and bad eating habits, pregnancy, and certain medical conditions such as Cushing’s syndrome and hypothyroidism.
Obesity significantly increases risk of developing conditions such as:
- Heart disease, stroke and high blood pressure
- Type 2 diabetes and high cholesterol level
- Breathing disorders, including sleep apnea
- Gallbladder disease
- Some form of cancers such as colon and breast cancers
- Gynecologic problems, such as infertility and irregular periods
- Erectile dysfunction
- Nonalcoholic fatty liver disease
- Metabolic syndrome ( a combination of high blood sugar, high blood pressure, high triglycerides and low HDL cholesterol)
- Depression and low self-esteem
- Discrimination and social isolation
There are countless weight-loss strategies available in United States but many are short-term and ineffective. Many obese people try different diet programs and use over the counter medications or herbal therapies. However, less than 5% succeed in losing a significant amount of weight. Majority of people gain the weight back soon after they stop the diet program.
DIET AND EXERCISE:
A successful weight loss program needs supervision of a healthcare professional who can implement individualized diet and exercise program. FDA approved medications are also added when indicated to help lose weight and maintain it.
Dietary Modification and physical activity are cornerstones to a successful weight loss program. A diet should restrict your calorie intake, but maintain your nutrition. A healthy eating plan is low in saturated fat, trans fat, cholesterol, salt, and added sugar. In general, to lose 1 to 2 pounds a week, you should cut back your calorie intake by 500 to 1,000 calories a day. Women are encouraged to restrict their daily calorie intake to 1200-1500 calories per day. Men are encouraged to restrict their daily calorie intake to 1500-1800 per day.
Physical activity greatly increases your chance of long-term weight loss. It is a key component for any long-term weight management program, particularly weight-loss surgery. Calorie restriction alone, will slow your metabolism. Daily physical activity can help boost your metabolism, helping you lose weight and keep weight off over time. Exercise also:
- Lower your risk for heart disease, diabetes, high blood pressure
- Strengthen your muscles and slow bone loss
- Give you more energy in morning time
- Help you relax and better cope with stress
- Help you sleep better at night
- Help you concentrate better at work
- Give a sense of well-being
Weight-loss medicines approved by the Food and Drug Administration (FDA) might be an option for people who have not succeeded losing weight using lifestyle changes. Patients on drug therapy usually lose up to 10% of their body weight. However, the weight loss usually plateaus after few months. Therefore, regular exercise and a proper diet program are necessary for keeping the weight off. Weight-loss medicines might be suitable for adults who are obese (a BMI of 30 or greater) or who have BMIs of 27 or greater, and who are at risk for heart disease (have diabetes, high blood pressure, etc).
Weight-loss surgery, also called bariatric surgery, is an option for some patients. It is usually not covered by health insurances unless the patient has tried at least 6 months of diet and exercise as well as weight loss medication under the supervision of a certified healthcare professional.
Weight-loss surgery for obesity may be considered if :
- Your BMI is 35 to 39.9, and you also have a weight-related health problem, such as diabetes or high blood pressure
- You have extreme obesity with a body mass index of 40 or higher
OFFICE VISIT AND CONSULTATION:
During your office exam, a full health history is taken including past medical conditions,
your weight history, past weight-loss efforts, exercise habits, eating patterns, current medications, and your family’s health history.
Then you will undergo a physical exam which includes measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; calculating your BMI (Body Mass Index) to determine your level of obesity; Measuring your waist circumference; listening to your heart and lungs; and examining your abdomen.
Lastly, you will have a comprehensive blood tests including cholesterol test, liver function tests, fasting glucose, a thyroid test and testosterone level (in men). You may also have an EKG during your initial visit.
You and your physician will come up with a diet, exercise and medication plan during the visit.