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Tommy Smothers

What is obesity

Obesity is defined as having an abnormal increase of body fat which is also called adipose tissue mass. An obese person is 20 percent or more above desirable weight. In the last decade obesity has been on the rise in both women and men.

Scale weight is a total measure of bone, muscle, fluid, organs, and fat. Weight measurements reflected by the bathroom scale or compared to standard height and weight tables does not allow for weight changes which occur due to aging, exercise, or frame size. Therefore, more emphasis should be placed on body composition and healthy lifestyles with less on body weight alone.

Obese people should be evaluated for medical consequences of their obesity. Motivated persons are encourage to enter medically supervised treatment programs that use a multidisciplinary approach to weight loss.

Many people are tempted by ads that use celebrities to tout liquid fasting diets for weight loss. Ads claim quick and easy weight loss with use of such products. Very obese patients may be referred to these types of diets. Their diets are carefully supervised by their healthcare provider.

Medically supervised fasts are very low calorie diets which provide from 400 to 800 calories per day. While most of these diets are low in calories, the protein provision is very high. The purpose of these diets is to promote fat loss, not muscle loss. The high protein content helps prevent large losses of muscle tissue. Electrolytes, vitamins and minerals are also supplemented.

Binge eating can be triggered by many things such as stress, depression, loneliness or anger. Food is used as a way of dealing with issues other than hunger.

During a binge, 10,000 to 20,000 calories can be consumed throughout the day. Binges usually consist of foods like cookies, candy, chips, ice cream and many other high calorie foods. Binges are often done in secret. After a binge, many of the feelings that caused the binge, like stress, may have subsided only to be replaced with feelings of guilt and lack of self-control.

The following guidelines have been developed that may help control binge eating: - Eat only at established meal times. - Avoid keeping foods around that may trigger bingeing. - Avoid fad or very restrictive diets. - Keep a food diary and log to assess what prompted the binge.

Overfat or overweight?

When the muscle's capacity to store fat is exceeded, excess fat is then stored outside the muscle, around body organs and under the skin. The fat that is now being added to the body results in the person becoming overfat and overweight.

Body composition describes the percentages of fat, muscle and bone in your body. Many experts think men's bodies should be between 12 to 18 percent fat, while women's should be 18 to 22 percent fat.

The risk of developing weight associated medical problems increases if the majority of body fat is located in the abdominal area. This risk decreases if body fat is primarily located in the hips, buttock and thigh region.

Height and weight tables are generally used to determine how person's weight compares to a standard. However, weight in these tables is an overall measure of all components of the body. Individuals may differ in muscle, frame size and percentage of body fat. The waist to hip ratio of body composition assessment provides information on where the majority of body fat is located.

Fat blocker drugs

The medications most often used in the management of obesity are commonly known as "appetite suppressant" medications. Appetite suppressant medications promote weight loss by increasing metabolism and by decreasing appetite or increasing the feeling of being full. These medications work by increasing the serotonin and/or catecholamine - two brain chemicals that affect mood, appetite and metabolism.

The most recent drug in the fight against obesity is Xenical. A new class of non-systemic anti-obesity drug called lipase inhibitors which act in the gastrointestinal tract to prevent the absorption of fat by about 30 percent. Drugs in this class do not achieve their effect through brain chemistry or central nervous system stimulation. In other words, Xenical is not an appetite suppressant or metabolic inducer.

People respond differently to appetite suppressant medications, and some people experience more weight loss than others. Some obese patients using medication lose more than 10 percent of their starting body weight- an amount of weight loss that may reduce risk factors for obesity - related diseases, such as high blood pressure or diabetes.

Maximum weight loss usually occurs within six months of starting medication treatment. Weight tends to level off or increase during the remainder of treatment. Studies suggest that if a patient does not lose at least four pounds over four weeks on a particular medication, then that medication is unlikely to help the patient achieve significant weight loss.

When considering long-term appetite suppressant medication treatment for obesity, you should consider the following areas of concern and potential risks. Currently, all prescription medications to treat obesity are controlled substances, meaning doctors need to follow certain restrictions when prescribing appetite suppressant medications. Although abuse and dependence are not common with non-amphetamine appetite suppressant medications, doctors should be cautious when they prescribe these medications for patients with a history of alcohol or other drug abuse.

Most studies of appetite suppressant medications show that a patient's weight tends to level off after four to six months while still on medication treatment. While some patients and physicians may be concerned that this shows tolerance to the medications, the leveling off may mean that the medication has reached its limit of effectiveness. Based on the currently available studies, it is not clear if weight gain with continuing treatment is due to drug tolerance.

Obesity often is viewed as the result of a lack of willpower, weakness, or a lifestyle "choice" - the choice to overeat and under exercise. The belief that persons choose to be obese adds to the hesitation of health professionals and patients to accept the use of long-term appetite suppressant medication treatment to manage obesity.

Appetite suppressant medications are not "magic bullets", or a one- shot fix. They cannot take the place of improving one's diet and becoming more physically active. The major role of medications appears to be to help a person stay on a diet and exercise plan to keep off the weight they lose.

Definitions

FDA

• Food and Drug Administration: A government agency that oversees public safety in relation to drugs and medical devices. The FDA gives approval to pharmaceutical companies for commercial marketing of their products.

Fat blocker

• Drugs that block the absorption of fat or calories, and lose substantial weight.

Overweight

• Weighing more than is normal, necessary, or allowed, especially having more body weight than is considered normal or healthy for one's age or build.

Appetite

• An instinctive physical desire, especially one for food or drink. Decreased desire to eat is termed anorexia, while polyphagia (or "hyperphagia") is increased eating. Disregulation of appetite contributes to anorexia nervosa and cachexia, or oppositely, overeating.

Diabetes

• Any of several metabolic disorders marked by excessive discharge of urine and persistent thirst, especially one of the two types of diabetes mellitus.

Diet

• A regulated selection of foods, as for medical reasons or cosmetic weight loss.


• A solutions designed to reduce or suppress the appetite.

Fat

• Any of various soft, solid, or semisolid organic compounds constituting the esters of glycerol and fatty acids and their associated organic groups.

Obesity

• The condition of being obese; increased body weight caused by excessive accumulation of fat.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

Suppress

• To curtail or prohibit the activities of.


• To inhibit the expression of (an impulse, for example).


• To bring to an end forcibly as if by imposing a heavy weight.

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