Obesity

Increased weightThickness around the midsectionObvious areas of fat deposits DiagnosisYour doctor can often determine if you are obese by looking at your body and assessing the percentage of body fat. Methods of assessing body fat include: Height and weight tablesBody mass indexMeasuring body folds with a caliperMeasuring waist-to-hip ratioWater-displacement tests Tests may include: Blood teststo rule out other medical conditions that may cause excess body weight TreatmentObesity is difficult to treat. Cultural factors, personal habits, lifestyle, and genetics all affect obesity treatment.Approaches to weight loss include: Keep a Food DiaryKeep track of everything you eat and drink. Increase Physical Activity and ExerciseAsk your doctor about how to begin an appropriate exercise program. Limit the amount of time you spend watching television and using the computer. This is especially important for children. Reduce Total Calories Eaten Per Day Your doctor or a dietitian can determine what your total calorie intake should be based on: Your current weightYour weight loss goals Portion size is an important determinant of calorie intake. In a recent study, 130 obese subjects with type 2 diabetes were randomly divided into two groups. One group used commercially available portion control plates every day for six months; the other (control) group received dietary teaching but did not use the plates. Subjects who used the plates were significantly more successful at losing weight and reducing their use of diabetes medications compared to the control group. *

Reduce Dietary Saturated and Trans Fat and Limit Refined Carbohydrate IntakeKeep fat intake under 35% of total calories eaten daily. Guidelines from the National Cholesterol Education Program have increased fat intake to allow a maximum of 35% fat, a recommendation that is especially helpful for obese people since they are prone to prediabetes. Behavior Therapy Behavior therapy may help you understand: When you tend to overeatWhy you tend to overeatHow to combat overeating tendencies Weight-Loss ProgramsResearch on the effectiveness of weight-loss programs is limited. They do seem to work for some people, however. Team Up With a PartnerSome studies suggest that a partner or group may help you improve your diet and fitness. MedicationsMedications for weight loss are available, such as sibutraline (Meridia), orlistat (Xenical), and metformin (Glucophage), but some have led to serious complications. Do not use over-the-counter or herbal remedies for weight loss unless your doctor monitors you for side effects. Your doctor can make recommendations about prescription weight-loss drugs. Bariatric SurgerySurgical procedures reduce the size of the stomach and rearrange the digestive tract. The smaller stomach can only hold a tiny portion of food at a time. Operations include gastric bypass and laparoscopic gastric banding. These procedures are only an option for people who are dangerously overweight, due to the potential for serious complications.

Gastric Bypass 2008 Nucleus Medical Art, Inc. Note: Complications of untreated obesity include: Decreased energyHeart diseaseHigh blood pressureType 2 diabetesGallstones Worsening arthritis symptoms Increased risk of certain cancersGoutInfertilitySleep apnea Poor self-image, depression Prevention Preventing obesity can be difficult because so many factors influence your weight. General recommendations include: Consult your doctor or a dietician about an appropriate number of calories to eat per day.Eat a diet with no more than 35% of daily calories from fat.Follow a medically approved, appropriate exercise program.Limit the amount of time you spend watching TV, using the computer, and other sedentary activities.Talk to your doctor or a qualified exercise professional about working physical activity into your daily life.Ask a dietitian for help planning a diet that will help you maintain a healthy weight or lose weight if necessary.Learn to eat smaller portions of food. Most Americans eat portions that are super-sized, or too large. You can learn about appropriate portion sizes by talking to a dietitian. RESOURCES: American Dietetic Association

http://www.eatright.org/ The Obesity Societyhttp://www.obesity.org/ CANADIAN RESOURCES: Canada's Food GuideHealth Canadahttp://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html/ Dietitians of Canadahttp://www.dietitians.ca/ References: Cecil R, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Co; 2000. Dietary guidelines for Americans. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.health.gov/dietaryguidelines/dga2005/document/default.htm. Accessed June 8, 2008. Glycemic indexa new way of looking at carbs. Canadian Diabetes Association website. Available at: http://www.diabetes.ca/Section_About/glycemic.asp. Updated June 2005. Accessed January 23, 2008. Goroll AH, Mulley AG, Mulley AG Jr. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000. Obesity. EBSCO Dynamed website. Available at: http://www.dynamed.com. Accessed December 20, 2007. Obesity, bias, and stigmatization. The Obesity Society website. Available at: http://www.obesity.org/information/weight_bias.asp. Accessed June 8, 2008.

Thompson WG, Cook DA, Clark MM, Bardia A, Levine JA. Treatment of obesity. Mayo Clin Proc. 2007;82:93-101. *Updated Treatment section on 8/21/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Pedersen SD, Kang J, Kline GA. Portion control plate for weight loss in obese patients with type 2 diabetes mellitus: a controlled clinical trial. Arch Intern Med. 2007;167:1277-1283. Last reviewed December 2007 by Jill Landis, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.