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Introduction to Weight Loss

Weight Loss

An Epidemic Of Obesity

According to the World Health Organization, worldwide obesity has more than doubled since 1980 and in 2014, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 600 million were obese.  Their research also shows that 39% of adults aged 18 years and over were overweight in 2014, and 13% were obese. They found that most of the world's population live in countries where overweight and obesity kills more people than underweight.  These numbers describe a tragic public health situation. Being overweight increases a person's risk of serious illness. A very large (and growing) percentage of citizens are at increased risk for developing serious chronic diseases, and face the prospect of early disability or death as the result of being overweight. Meanwhile the entire society struggles under the burden of the resulting increase in health care costs.

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Fast Facts: Learn! Fast!

What are the health risks of being overweight?

  • Overweight and obese people are at increased risk of developing serious and sometimes life-threatening illnesses as they age, including:
    • Heart Disease, Heart Attack and Heart Failure
    • Coronary Artery Disease (CAD)
    • High Blood Pressure
    • Angina
    • Abnormal heartbeat
    • Cholesterol problems (leading to heart disease)
    • Elevated LDL ("bad") cholesterol and triglycerides levels
    • Lowered beneficial HDL ("good") cholesterol levels
    • Stroke
    • Type 2 Diabetes (the kind you develop rather than are born with)
    • Cancers (prostate, gallbladder, colorectal, breast, endometrial and kidney)
    • Liver problems (such as an enlarged liver, cirrhosis or a fatty liver)
    • Gastroesophageal ("Acid") Reflux Disease (GERD)
    • Sleep Apnea (Snoring and difficulty breathing while sleeping)
    • Asthma Shallow breathing (Pickwickian syndrome which can lead to heart disease)
    • Arthritis
    • Gallstones (in women)
    • Reproductive problems (irregular periods, increased birth defects, especially neural tube defects, and an increased risk of death of the mother and baby).
    • Memory and learning problems (in men)
  • How fat is distributed on the body has important implications for health risks as well. Fat that accumulates around the abdomen and stomach areas (e.g., the so called "beer belly" or "love handle") predicts more serious health problems than does fat that accumulates around the hips and thighs.
  • Men with waist measurements of more than 40 inches or woman with waist measurements greater than 35 inches are at higher risk for developing type 2 diabetes, high blood pressure, high cholesterol, and coronary artery disease than are normal weight individuals or those whose fat accumulates around the hips.

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What are the psychological consequences of being overweight?

  • Psychological consequences of being overweight or obese can include lowered self-esteem and anxiety, and more serious disorders such as depression and eating disorders such as binge eating, bulimia and anorexia.
  • If the negative health and shame aspects of being overweight aren't enough, overweight people also tend to have less energy than their normal weight peers.
  • Because it takes them more effort than their peers to be active, they tend to gravitate towards low-activity lifestyles and become sedentary.
  • An unfortunate circle develops wherein the less active people become the greater their risk of gaining still more weight, and the more weight people gain, the less likely they are to become more active.
  • Life stresses seem more overwhelming as exercise (which could begin the process of reversing this downward spiral of decreasing energy levels) is avoided and a major opportunity for the reduction of muscle tension, stress and anxiety is lost.
  • Over time, even ordinary tasks of daily life like going up a flight of stairs can lead to exhaustion and a sense of premature aging.

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What factors determine a person's weight?

  • People's weights are determined by multiple factors including their genetic background, eating habits, metabolic rate and their general activity level.
  • Genes influence body weight by setting basic parameters on the body's metabolic efficiency (the efficiency with which the body burns calories).
  • Genes governing metabolism run in families. If one of your parents is obese you are several times more likely to be obese yourself than someone who has parents of a healthy weight, and if both of your parents are obese you are at a very high risk of becoming obese yourself.
  • Apart from genetics, people's metabolic rates are largely determined by how active they are.
  • Inactivity accelerates loss of muscle tissue over time which decreases metabolism, making it all but certain that weight will be gained.
  • People's food related habits and cultural expectations are also important determinants of their weight, influencing the types and amounts of foods consumed.
  • People who eat quickly tend to eat more than people who eat slowly as it takes a few minutes for your stomach to tell your brain it is full.
  • Exercise is an essential component of a healthy weight management program. Where a person's genetics are more or less set at conception, the amount of energy a person expends in physical activity is under voluntary control.

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What types of foods are best to consume?

  • A good starting place for diet and nutrition information is the USDA's research-based Food Pyramid guide which starts by dividing foods into the following six food groups: Grains, Vegetables, Fruits, Oils, Milk, and Meat & Beans.
  • The six groups are then arranged into a pyramid shape to indicate the relative proportions of each food that people should eat each day.
  • The pyramid now includes a physical exercise component as part of the essential food groups, to indicate that regular physical exercise for at least 30 minutes a day, most days of the week (60 minutes a day for children and teens!), is vital for everyone's health.
  • There are six classes of necessary nutrients found in foods: carbohydrates, fats, protein, vitamins, minerals and water.
  • These nutrients perform three vital life functions: they provide energy, they promote body growth and maintenance, and they assist in regulating bodily processes.
  • With the exception of water, each nutrient class contains a variety of different subtypes of that nutrient.
  • Some of these nutrient subtypes can be better for health than others. For example, within the fats class, there are saturated fats, mono-unsaturated fats and poly-unsaturated fats.
  • Like fats, carbohydrate subtypes are not all equally nutritious.
  • All nutrients, including carbohydrates, fats and proteins, are essential for life and should be present in a healthy diet.
  • Rather than attempting to eliminate nutrient classes as some reducing diets seem to suggest, the wisest course is to select a diet based heavily on the healthier types of nutrients from each nutrient class including fresh fruits and vegetables, whole grain breads and cereals, lean meats, fish and poultry, low fat or nonfat dairy products, and the sparing use of healthy fats such as olive oil.
  • Refined sugars, white flour, and partially-hydrogenated oils should be avoided.
  • Less nutritious foods, including steaks, hot dogs and sausages, cream and butter, and cake and ice cream can be eaten on an occasional basis but should not become staples of an everyday diet.

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What should I know about diet pills or surgery for weight loss?

  • Various "diet" pills have been around for decades. All existing pills produce at best only moderate results, and come with significant negative side effects, may not work for everyone, and the lost weight is usually regained when the drugs are stopped.
  • Any dieter considering the use of medicines or herbal preparations to assist with their weight loss program should check with their doctor and pharmacist first, especially if they are taking prescription medicines.
  • Medicines, supplements and herbal preparations can potentially interfere with the functioning of other prescription medications.
  • Weight loss surgery (otherwise known as bariatric surgery) changes the anatomy of the digestive tract so to limit the amount of food people can eat and digest.
  • Bariatric surgery carries significant risks, including the possibility of death, and requires significant lifestyle changes of patients when it is successful.
  • Because of these risks and responsibilities, bariatric surgery is usually reserved as a treatment of last resort for severely obese people whose lives are threatened by serious health problems as a result of their obesity.
  • Gastric bypass, the most common type of bariatric surgery, restricts stomach size.
  • Candidates for gastric bypass surgery are usually screened in advance by a multidisciplinary medical team which attempts to determine if the surgery is right for each patient.
  • Gastric bypass surgery can produce dramatic results at the price of substantial risk.
  • Bypass patients have less opportunity to absorb nutrients from food and are at risk for mineral and vitamin deficiencies.

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How can I prepare to lose weight?

  • Preparing a weight loss program means setting up the conditions that will make it most easily possible for you to achieve your weight loss goals.
  • There are numerous important choices to make during the preparation stage, including the form your diet will take, how much weight you will attempt to lose, how you will keep yourself motivated to make progress towards your goals, and how you will monitor your progress.
  • An important first step is to examine your motives for wanting to lose weight. Deciding to make a lifetime commitment to diet and exercise is a big step. You will be most likely to succeed in such a program if you want it for yourself and are not merely trying to please other people.
  • Having decided to go forward with your planning, you need to choose a realistic and personally desirable weight loss target goal.
  • Do a review of literature describing several popular reducing plans to decide which one appeals to you best.
  • Keep in mind that all reducing plans work the same way, by restricting the total number of calories you eat so that you achieve a negative energy balance.
  • Also keep in mind that the diet changes you'll need to make are permanent and will not end with you achieving your weight loss goal.
  • Having made a reduction diet choice, use your knowledge of past diet efforts to customize it so that you are less likely to fail. Think about the things that trigger you to overeat and generate plans to address these triggers.
  • There is no need for speed in dieting, and in fact, speed can be dangerous to your health. A healthy weight loss rate is one or two pounds a week maximum.
  • It's an excellent idea to combine your dietary weight loss efforts with an exercise program. Exercise is the key to sustained weight management.

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How can I maintain my weight over the long term after initially losing weight?

  • While having met your weight loss goals is definitely a cause for celebration, it is not a license for going back to your old "eat what I feel like" ways.
  • Sustaining weight loss is not a sprint but rather a marathon of lifelong change.
  • Long term weight loss and maintenance depends on dozens of daily choices made correctly more times than not over long periods of time.
  • In order to keep your weight off, you'll need to start on a maintenance diet sooner rather than later.
  • If your reducing plan wasn't itself a nutritionally balanced diet make sure that you move towards eating such a diet as soon as you have met your weight loss goals.
  • Continue to eat a balanced and nutritionally sound diet on an ongoing basis, limit your sweets intake, and include more fresh fruits and vegetables, whole grains, healthy unsaturated fats and lean meats in your diet.
  • It may take you a while to determine the proper amount of food you can eat post-diet without gaining weight.
  • While it's likely that you'll be able to eat more than you were while on your reducing diet and still maintain your gains, you will never again be able to eat whatever you feel like eating whenever you feel like it without risking weight gain.
  • Your chances of sustaining your weight loss will rise dramatically if you begin and stick with a program of regular physical exercise of a sort you enjoy.
  • There will be times when, for whatever reason, you will give in to temptation or fatigue and eat things you should not, or fail to exercise when you should.
  • Your chances of sustaining your weight loss will also rise significantly if you create contingency plans to help you minimize the impact these lapses will have on your maintenance compliance.
  • In addictions counseling the acronym HALT stands for four conditions that addicts are taught to avoid so as to minimize relapse: Hungry, Angry, Lonely and Tired. These same distressing conditions can make dietary lapses more likely too.
  • Consciously plan for occasional indulgences. If you are really craving something, allow yourself permission to occasionally have a normal portion of that food.
  • Actively plan for how you'll manage your diet over the holidays, rather than simply getting depressed about what you are missing.
  • When lapses occur, do what you can to learn from them. Have a sense of humor about the situation, and then react appropriately.
  • Truly long term weight loss is possible only when people make lifestyle changes that support weight loss; remaining committed to watching their diet and meeting their exercise goals on an ongoing basis.

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