Table Abstract Despite decades of efficacy-based research on weight loss interventions, the obesity epidemic in the United States persists, especially in underserved populations. We attribute the lack of progress in reducing overweight and obesity to the current system, which favors efficacy-based studies of weight loss programs, that is, those that are proven in randomized controlled trials RCTs. We suggest a parallel approach that includes studies that investigate existing community-based weight loss programs to augment the current system in order to have a larger effect on the obesity epidemic. The purpose of this article is twofold:
However, they started off as medical terms, with specific definitions, that allowed health professionals to communicate clearly to each other. It is easy to calculate if you know your weight and height in metric units, alternatively you may use a chart Figure 1or one of many web based calculators.
Body mass index takes in to account that taller people will weigh more than shorter people, and was initially developed as a simple means to estimate body composition. It does not take in to account the effects of age, gender, ethnicity or muscle mass.
Despite its shortcomings, body mass index is widely used in medicine as it is easy to calculate, and because studies have shown people with a low or high BMI are at increased risk of developing serious medical conditions.
Almost certainly obesity develops when a person with a genetic tendency to store food energy useful for the long periods of fasting in our historylives in an environment where food energy is readily available. Although our underlying genes only change very slowly, our social environment has changed much more rapidly think about how your grandparents shopped, cooked, ate and worked when they grew up.
For this reason, obesity has become a rapidly growing problem throughout the world. In New Zealand, obesity affected Figure 3 - New Zealand obesity trends 3 8 Health Consequences of Obesity The significance of obesity from a health care point of view is its association with many common medical conditions such as diabetes, high blood pressure and arthritis Figure 4.
It is certainly possible for heavy people to be otherwise completely healthy, but in general, with an elevated BMI the risk of developing the conditions shown in figure 4 is increased. Aside from these specific medical conditions, obesity is also associated with decreased mobility, decreased quality of life, and increased use of the health care system overall.
Bariatrics is the term used to describe the medical specialty of the treatment of excess weight. It incorporates bariatric medicine, or treatment through medications, and bariatric surgery which is operations to help with weight loss.
In general, in order to lose weight, it is necessary to consume fewer calories than are burned. A calorie is simply a measure of how much energy is contained in food the metric equivalent is a kilojoule or kj.
We burn energy through a combination of our basal metabolic rate the energy used by our internal organsand activity Figure 5. In other words, a cup of rice contains more energy than a cup of celery. Figure 5 - Energy balance 5 10 Although most people are able to sustain a calorie per day deficit of energy in the short term, in the long term it becomes much more difficult.
Basal metabolic rate, and energy burned through activity both decrease as a person loses weight, so in order to continue to lose weight dietary intake needs to be further restricted. Also, eventually a person s hunger often overcomes the voluntary restriction of food intake. When energy intake returns to the previous level, as energy burned has decreased, people tend to regain weight, often to a higher level than when they started.
Bariatric surgery works by helping people to feel satisfied while only eating a very small proportion of food. In this way, people are able to achieve the long term calorie deficit required for substantial weight loss.
Weight loss after bariatric surgery is achieved by eating very small portions of healthy food, and being physically active. This requires lifelong dedication and hard work.
The difference after surgery is that hunger signals no longer sabotage these attempts. The growing problem of obesity, along with its consequences led to the National Institutes of Health in the United States to develop a position statement in Many similar statements have since been published by national health bodies worldwide, although they all contain similar recommendations.
They recommend bariatric surgery in the following circumstances: In general, bariatric surgery is not recommended in the presence of uncontrolled medical, psychological or substance abuse issues.
Cigarette smoking is associated with an increased risk of certain complications after bariatric surgery, and therefore it is necessary to have quit smoking prior to going ahead with surgery.
Here at Southern DHB, we are continually looking at ways that we might increase funding and access to bariatric surgery.~ An Introduction to Weight Loss Surgery and the Southern DHB Bariatric Program Mark Smith MBChB MMedSci FRACS Renee Ladbrook PGDipDiet BSc Table of Contents Morbid Obesity 1 What are we talking about?.
Introduction to r-bridal.com Obesity/Weight Loss Program In this r-bridal.com video, we will introduce to you the parts of a comprehensive weight loss program and the approach that r-bridal.com takes to help you reach your goals. Whether your weight-loss goals involve trying to lose 5 pounds or more than 50, the same principles determine how much weight you lose and how fast your weight loss will occur.
Remembering the following simple healthy eating diet tips and putting them into practice can lead to weight reduction without the aid of any special diet plans, weight loss .
This document concerns weight loss, an issue constantly on many people's minds. Most everyone wants to be slim and toned, but the reality is that it is far easier to gain weight than to lose it.
On the following pages causes of weight gain are reviewed, along with numerous reasons why people should devote the effort necessary to reduce their . operations to help with weight loss.
Many bariatric surgeons now add the word 'metabolic' to the specialty name, to acknowledge the effectiveness of weight loss operations in . Weight Loss – Introduction When you start see the first sign of becoming overweight that is the best time to start acting and focus on weight loss.
Don’t wait till you are hit by the iceberg of lifestyle diseases.