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Obesity and Weightloss
What is obesity?
Obesity is the most common nutrition-related disorder in the western world. It is defined as an abnormal increase of fat in the subcutaneous connective tissues. It occurs when more calories are consumed than the body's energy needs over a period of time. The excessive nutrition is then accumulated and stored as fat in the body. In general, a person is considered obese when his/her body fatness is greater than normal standard by 20%.
The most common way to measure body composition is using Body Mass Index (BMI):
BMI =
Weight (kg)
Height (m2)Healthy Range is between 20-25
BMI Grading <18 Very underweight 18-20 Underweight 20-25 0. Healthy Weight< 26-30 I. Overwweight 31-40 II. Obese 41+ III. Morbidly obese
Reasons for obesity
Factors Explanations Sex
Women have higher body fat ratio than men.
Age
Most prevalent in middle-age, but can occur at any stage of life. The body metabolisms of the middle-aged or elderly people are slower than the younger people so when the same calorie of food are consumed, it tends to accumulate in the body.
Genetic
Hereditary Tendencies. If the body weight of the parent is normal the tendency of the child become overweight is 7%; if one of the parent's body weight is over the normal, then the tendency of the child become overweight is 40%; if both of the parent are overweight then the tendency is 80%.
Endocrine
Women more commonly begins at puberty, during pregnancy, or menopause
Cushing's syndrome, decline of growth and thyroid hormone.
Metabolism
Diabetic, hyperlipidaemia, insulin resistance
Drugs
Use of antidepressants, steroids, oral contraceptives, phenothiazines and insulin are known to contribute to weight gain.
Physical Activities
Lack of physical exercise causing excess calorie intake and accumulated in the body and transformed into fat.
Dietary
Improper diet or overeating
Consume higher calories food or sweet or greasy food
Eat too much salty food that causing the accumulation of water in the body and increase body weight.
Bedtime snacks.
Socio-economic
In affluent society - less physical activities and consumed more high caloric and fatty food.
In less affluent societies - consume high carbohydrate foods
Psychological
Depression or anxiety or emotional disturbances which overeating replaces other gratifications.
Alcohol
Problem drinking. 1g of alcohol can produce 7 Kcal of energy.
Smoking
Cessation of smoking often associated with weight gain due to a loss of nicotine's effects
Why is it important to maintain your body weight?
Obesity is a growing problem around the world. The number of people who are overweight or obese, both adults and children, has reached a wide proportion throughout the western world. In Australia, in 1999-2000 Australian Diabetes, Obesity and Lifestyle Study, an estimated 67% of adult males, 52% of adult females were classified as overweight or obese, or that is around 7 millions Australian adults. In children and adolescents, the estimated is 20-25% of Australian children are either overweight or obese, that is doubled the number in the past 10 years.
Why is it important to maintain your body weight? It is not only because it is unpleasing to look at but also obesity is a major leading cause of many chronic diseases. Many of these are often preventable if the body weight is controlled.
The consequences of obesity
Area Diseases Metabolism Hyperinsulinemia, insulin resistance, non-insulin dependent diabetic mellitus (NIDDM), hyperlipidemia, hypercholesterolemia, cholelithiasis
Cardiovascular Hypertension, atherosclerosis, ischaemic heart disease, coronary vascular disease, stroke
Physical Osteoarthritis, sciatica, varicose veins, thromboembolism, hernia, hypoventilation (Pickwickian) syndrome, back problem
Psychological Low self-esteem Others Gallbladder disease, sleep apnoea, breathlessness, asthma, depression, fatigue.
Increased cancer risk such as cancer of colon, rectum, prostate (in men), or breast, cervix or uterus (in women)In our society, many studies have been performed in dealing with this issue. Theoretically, there are two main principles to treat obesity. Firstly is to reduce caloric intake to less than is expended in daily activity through better dietary choices. Secondly is adequate exercise and activity to increase energy output. The treatment options for obesity include a reduced-calorie diet, increased activity, behaviour modification, pharmacotherapy, and surgery. However, many of these treatment modalities reported is either harmful to the body or has low success rate and major side effects.
General Management
Diet Work with dietician to reduce the intake of calories. Ideally to lose 0.5kg in a week need to reduce 500 KCal/daily from the diet. This is to calculate the energy that the body needed in a day then subtract 500 Kcal/day from the meal.13
Exercise Apart from the low caloric diet, regular exercise to increase energy output is another important management to reduce weight. Exercise not only can increase the energy expenditure but also increase the body metabolism to reduce the fat accumulation.
Drugs Use of anorexiants, such as amphetamine derivatives (not used anymore), diethylproprion, and fenflurmine, to subdue hunger. However, this is not very strongly recommended due to the side effects.
Surgery
Gastroplasty - to reduce food intake by delaying gastric emptying and giving a feeling of fullness after a small meal
Gastric balloon – to insert a silicone balloon into the stomach in order to reduce its capacity and reduce food intake
Wiring of the jaw – to reduce amount of food intake.
Liposuction – to take out the fatty tissue.
Behaviour
Obesity is generally caused by the improper diet or between meal nibbling or bedtime snacks. Therefore, the change of life style or behaviour can also help in the progress of losing weight.
Others
Chinese medicine, massage, acupuncture, hypnotherapy, naturopathic, folk remedy
The Role of Chinese Medicine
In Chinese Medicine theory, obesity is closed related to the disharmony of the digestion system that is the functions of the Spleen and Stomach. The Spleen is dominating the digestion and transportation of food while the Stomach is receiving and “rotting” the food. In addition, the Spleen Qi dominates ascending and the Stomach Qi descending in order to accomplish digestion, absorption, and transportation of food. The Spleen and Stomach provide the material basis of the acquired constitution, and are regarded as the source to produce Qi and Blood. When the Spleen and Stomach Qi are healthy, the functions of digestion, absorption, and transportation are vigorous. When they are not working properly, all sorts of digestion problems such as loss of appetite, retention of food, abdominal distension, lassitude will result. Therefore, the treatment principle is to regulate the functions of the Spleen and Stomach.
So, Chinese Medicine is a good adjuvant therapy with the dietician to control body weight. It can help with the digestions and reduce anxiety of hunger without any side effects or feel lassitude. However, it is not a panacea or a wonder cure in the treatment of weight control. But, the Chinese herbal medicine and the acupuncture are effective in making the process of losing weight easier and maintain that loss if the patient is willing to change their lifestyle.
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