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Nov 21, 2009
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Obesity in US Adults: 2007
No State Meets Healthy People 2010 Goals
According to data from the Behavioral Risk Factor Surveillance System (BRFSS), no state met the Healthy People 2010 objective of 15 percent, and 30 states were 10 or more percentage points away from the objective. The Healthy People 2010 (HP2010) national health objectives include one to reduce the proportion of adults who are obese to 15 percent.
These latest figures from the CDC demonstrate that obesity continues to be a significant public health problem. The Healthy People 2010 (HP2010) national health objectives include one to reduce the proportion of adults who are obese to 15% (objective 19-2) (1). Obesity is defined as a body mass index (BMI) of 30 or above. BMI is calculated using height and weight. For example, a 5-foot, 9-inch adult who weighs 203 pounds would have a BMI of 30, thus putting this person into the obese category.
This analysis estimated the 2007 obesity prevalence among adults, by state, from self-reported weight and height data from the Behavioral Risk Factor Surveillance System (BRFSS). No state met the Healthy People 2010 objective of 15% and 30 states were 10 or more percentage points away from the objective. State-specific obesity prevalence ranged from 18.7% to 32.0%.
Among 2007 BRFSS respondents:
- 25.6% were obese.
- 26.4% of men and 24.8% of women were obese.
- The obesity prevalence ranged from 19.1% for men and women aged 18--29 years to 31.7% and 30.2%, respectively, for men and women aged 50--59 years.
- By race/ethnicity and sex the obesity prevalence was highest for non-Hispanic black women (39.0%) followed by non-Hispanic black men (32.1%).
- The obesity prevalence was higher in the South (27.3%) and Midwest (26.5%) and lower in the Northeast (24.4%) and West (23.1%).
CDC conducts obesity prevention programs and activities in many different settings and with a wide range of partners, including state and local health and education departments and communities across the country. For example, as part of CDC’s Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases, the Washington State implemented a community intervention that promotes environmental and policy changes to help encourage healthful nutrition and physical activity behavior. Changes include widening sidewalks, connecting systems of paths for pedestrians and cyclists in a community, and creating community gardens.
CDC also works with employers and work-site health experts to translate evidence-based recommendations from the Task Force on Community Preventive Services (2) on work-site interventions for preventing obesity into business practice. One product from this collaboration will include a return on investment cost calculator to assist businesses in making the case for initiation and maintenance of wellness programs, especially those that promote weight management. In addition, an interactive website will provide guidance for the creation, expansion or customization of work-site obesity programs. These tools and products will enable employers to more easily implement the evidenced-based recommendations.
References:
1. US Department of Health and Human Services. Healthy People 2010 (conference ed, in 2 vols). Washington DC: US Department of Health and Human Services; 2000. Available at: http://www.health.gov/healthypeople.
2. CDC. Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services. MMWR 2005;54(RR-10):1--12.
Data Source:
State-Specific Prevalence of Obesity Among Adults in the United States, 2007. MMWR, 2008;57(28):765-768.
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Posted at 10:30 pm by saihasari
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Nov 17, 2009
Republished from the pages of National Geographic magazine
Written by Cathy Newman
August 2004
Finally, after two decades of trying and failing to lose weight with (you name it) Weight Watchers, NutriSystem, a nutritionist, a personal trainer—not to mention the therapist who derided her for being fat—it has come down to this: Linda Hay is sitting in an examining room at the Virginia Commonwealth University Medical Center in Richmond with Harvey Sugerman, the surgeon who will perform a gastric bypass operation on her in two weeks.
Gastric bypass is major surgery that shrinks the stomach's capacity from wine bottle to shotglass size and reconfigures the small intestine. Most patients lose about two-thirds of their excess weight within a year of surgery. "Gastric bypass surgery is a tool," Sugerman says. "It reduces the stomach. The patient can't eat as much. In most instances, if a bypass patient eats sugar or fatty foods, it provokes a dumping syndrome that causes flushing, nausea, sweating." You could say it's almost like Antabuse for the obese. Even so, the operation fails in 15 percent of cases. Some patients can subvert the surgery. They overeat by snacking continuously.
And the surgery is risky. The list of possible complications includes blood clots in the lung, pneumonia, infection, leakage from the reshaped intestinal tract, and—in one out of a hundred cases—death.
Hay, 39, is five feet five (1.7 meters) and weighs 314 pounds (142.4 kilograms); she is morbidly obese, which makes her a candidate for the surgery. Her managerial level job in the human resources department of a financial company demands tact, efficiency, and organization—qualities she exudes. She has a close circle of friends who would do anything for her, a clear sense of who she is, and few illusions of who she is not. She dresses stylishly, has long blond hair swept back by a headband, a classic oval face, and fair complexion. But she is—let's face it—huge.
When I ask about her decision to have surgery, she describes the humiliation of asking for a seat-belt extender on a plane; her reluctance to go to movies because the seats are too narrow; the time she signed up for a dating service, put down as body type "a few extra pounds," got a few responses, and then, opting for honesty, changed it to "large." This time she got none. She lists health problems associated with her weight: high blood pressure, varicose veins, pain and swelling in her feet and ankles, depression. "You take control for a while," she says, "then you fail yet again, and you're more depressed than ever."
Linda Hay has considered the risks and decided to have surgery. Nonetheless she is anxious. "No one at the office knows I'm going to do this," she confesses. "Someone said, 'Have a good week,' and my mind kept racing to the worst-case scenario…What if?"
It seems, I say, turning to Sugerman, that this is surgery for the desperate.
He nods. "Surgery is a drastic solution," he says, "but then obesity is a drastic problem."
It's become a far too familiar headline: Today one out of three Americans is obese, twice as many as three decades ago, and enough for the Centers for Disease Control and Prevention to declare obesity an epidemic. More disturbing are statistics relating to children: 15 percent of children and teens are overweight, a nearly three-fold jump from 1980. Obesity is defined by your body mass index, or BMI, a fancy calculation in which your weight is divided by your height. If it's 25, you're overweight. If it's 30, you're obese. Over 40, you're morbidly obese.
The broadening of America is everywhere you look, or sit. The Puget Sound ferries in Washington have increased the width of their seats from 18 to 20 inches (20.3 to 50.8 centimeters) to allow squeeze-in room for people with bigger bottoms. In Colorado an ambulance company has retrofitted its vehicles with a winch and a plus-size compartment to handle patients weighing up to half a ton (0.45 metric tons). Even the Final Resting Place has had to accommodate our growing girth. An Indiana manufacturer of caskets now offers a double-oversize model—38 inches (96.5 centimeters) wide, compared with a standard 24 inches (61 centimeters).
Being overweight is associated with 400,000 deaths a year and an increased risk of heart disease, type 2 diabetes, and colon, breast, and endometrial cancers. Most poignant is the psychological pain of those stigmatized by obesity. In one study at Michigan State University, undergraduates said they would be more inclined to marry an embezzler or cocaine user than an obese person.
How did Americans get so fat? Where did we go wrong? It depends on who you ask. I asked Robert Atkins last year, a month before the purveyor of today's hottest diet died from a head injury suffered in a fall. He sat in guru-like serenity behind a black leather-top desk in his Manhattan office. His expression remained impassive, with an occasional lapse into wryness. He seemed to float, as if hovering above the storm of contention his diet provokes.
"We went wrong by allowing the American Medical Association and the United States Department of Agriculture to say: 'You've got to go on a low-fat diet.' They failed to take into account that when people do that, they increase their carbohydrates."
For breakfast that morning, Atkins (who said he was six feet [two meters] tall, 189 pounds [85.7 kilograms]) had eaten a sausage-and-cheese omelet, two ounces (0.06 liters) of tomato juice, and tea without sugar. His wonderland diet books say yes to bacon, eggs, and lobster dripping with butter and tell readers to lay off the bread and fruit. Slashing carbohydrates and sticking to protein and fat, Atkins claimed, prompts the body to burn fat through a metabolic process known as ketosis. Another purported advantage: Remaining in near ketosis makes it easier for people to control hunger.
In the post-Atkins era, pork rinds have become a snack sensation, egg consumption has risen, and "doing Atkins" is now synonymous with adhering to a high-protein, low-carb diet. Since 1972 his Diet Revolution and the updated version published in 1992 have sold 18 million copies. The latest edition has been translated into 25 languages. But not, as yet, in Italian. "They didn't want to give up their pasta," he said.
To be sure, Americans are filling up on carbohydrates like pasta, potatoes, and bread. In the early '70s we ate 136 pounds (61.7 kilograms) of flour and cereal products per capita, and now it's 200 pounds (90.7 kilograms). Most of those products are highly processed grains, like white bread, that are low in fiber and absorbed into the bloodstream more quickly than high-fiber whole grains. Such foods have a high glycemic index, which means they prompt a sharp spike in glucose and trigger a corresponding spike in insulin production from the pancreas. Atkins and other advocates of low-carbohydrate diets claim that surges in insulin cause blood sugar to plummet, which in turn creates cravings for more carbs—and on and —on in a spiraling raise-you-one war between glucose and insulin. The trouble is, research doesn't back that up: Low blood sugar hasn't been directly linked to hunger. And unless you have diabetes, blood sugar remains generally stable anyway.
Not everyone has converted to the Atkins gospel. Dean Ornish, director of the Preventive Medicine Research Institute in Sausalito, California, is one of the original advocates of a low-fat diet as a way to lower heart disease risk. He contends that following Atkins's diet might help you lose weight in the short run, but at the cost of "mortgaging your health." He cites an increased risk of breast cancer, prostate cancer, and heart disease, not to mention headaches, constipation, and even bad breath as the price you pay for the Atkins diet.
"Atkins is right about us eating too many simple carbohydrates," he says. But Ornish argues the solution is to replace them with complex carbohydrates like whole grains and vegetables, not more fat. "Atkins gets into trouble when he says to eat bacon and go into ketosis. It's a toxic state. Look, I'd love to tell people it's OK to eat bacon and sausage, but it's not. You can lose weight in ways that aren't good for you. Smoking causes you to lose weight, as do amphetamines. But it's not just about losing weight, it's losing weight in a way that is helpful. There are no long-term studies to support this diet."
As a closing question for Atkins, I had asked him how he wanted to be remembered. "As a person who changed mainstream medicine's approach," he replied. "I hope I live long enough to see that." A month after his death, the New England Journal of Medicine reported that in the short run, people on the Atkins diet did lose more weight than those on a low-fat diet, and there was no real difference in cholesterol between the two groups. The catch: Those on Atkins started regaining weight after six months, and by year's end were on par with the comparison group. The jury is still out on the diet's long-term effects, but the National Institutes of Health is funding a five-year study that may render a verdict.
Even so, not even Atkins's death has silenced the critics. "I want to know why he didn't have himself autopsied, so we could see for ourselves what his coronary arteries looked like," one nutrition expert hissed when I broached the subject of Atkins's death. "That's what a real scientist would have done."
If even the experts can't agree which diet is best, who are we supposed to believe?
"Me, of course," says Marion Nestle, professor of nutrition, food studies, and public health at New York University. "Beyond that, how about using some common sense? It's a simple matter of eating fewer calories. But nobody wants to talk about calories because doing so does not sell books." She's right. The government recommends 1,600 calories a day for the average sedentary woman and 2,200 for men. In 2000 our reported per capita daily calorie consumption was 1,877 for women and 2,618 for men—roughly 300 calories more than we need.
So in one sense, the obesity crisis is the result of simple math. It's a calories in, calories out calculation. The First Law of Fat says that anything you eat beyond your immediate need for energy, from avocados to ziti, converts to fat. "A calorie is a calorie is a calorie," says Lawrence Cheskin, director of the Johns Hopkins Weight Management Center, whether it comes from fat, protein, or carbohydrate. Cheskin, who is six foot one (1.85 meters) and weighs 160 pounds (72.8 kilograms), has never had a weight problem himself. "Who said life is fair?" he observes.
The Second Law of Fat: The line between being in and out of energy balance is slight. Suppose you consume a mere 5 percent over a 2,000-calorie-a-day average. "That's just one hundred calories; it's a glass of apple juice," says Rudolph Leibel, head of molecular genetics at Columbia University College of Physicians and Surgeons. "But those few extra calories can mean a huge weight gain." Since one pound (.45 kilograms) of body weight is roughly equivalent to 3,500 calories, that glass of juice adds up to an extra 10 pounds (4.5 kilograms) over a year. Alternatively, you'd gain 10 pounds (4.5 kilograms) if, due to a more sedentary lifestyle—driving instead of walking, taking the escalator instead of the stairs—you started burning 100 fewer calories a day.
"We know people get fat by overeating slightly more than they burn, but we don't know why they do it," Leibel says. "I'm convinced our overeating is not willful or the result of a deranged upbringing. It's the genes talking, but it's a very complicated language. Genetics are everything."
In the 1960s James V. Neel, a geneticist at the University of Michigan, listened in on one genetic conversation. In his "thrifty gene" hypothesis, Neel suggested that some of us inherited genes that make us exceptionally efficient in our intake and use of calories. Our bodies are good at converting food into fat and then hanging on to it. This trait may have helped our ancestors survive when calories were few and far between, Neel speculated.
But fast-forward to the 21st century, when calorie supply isn't a problem, and genes that favor gaining weight have outlived their usefulness. Evolution betrays us. We store fat for the famine that never comes. "If we understood the genetics well enough," says Anna Mae Diehl, a professor of medicine at Johns Hopkins School of Medicine, "we could fingerprint people when they are born and say: Ah, good genes. Lucky you. You can eat whatever you want. Or: Uh-oh. Poor kid. Better never have a doughnut."
A team led by Jeff Friedman at Rockefeller University discovered a piece of the genetic puzzle in 1994. In studies of obese mice, the scientists identified a gene that tells the body how to make leptin, a hormone that decreases appetite. Leptin, produced in the fat cell itself, turned out to be part of a thermostat-like system that maintains weight at a constant level. Think of it as a watchdog guarding against starvation by monitoring body fat. It doesn't wait for you to become skinny; it acts within a few days to correct any perceived imbalance. Lose weight and leptin levels fall, prompting you to eat more and gain back the weight. Put on some extra pounds and leptin goes up; you eat less. It's part of an intricate biochemical and neurological circuitry that flashes signals on and off like a sailor's semaphore: EAT! DON'T EAT! EAT!
So if we take enough leptin, we can all fit into our high school prom outfits? It didn't turn out that way. Injecting leptin into people with a rare congenital inability to produce it does cause them to lose weight, but it wouldn't do much for the rest of us. In clinical trials, what worked in mice didn't always translate to humans.
The discovery of leptin and a number of other promising hormones has not yet produced a miracle drug. But genetic research is providing clues about why some people are more likely to get fat than others. We tend to assume that people who overeat simply lack willpower. What seems increasingly clear, however, is that the drive to overeat has strong biological underpinnings. People who are genetically susceptible to obesity don't necessarily have slow metabolisms that help their bodies hang on to fat. Instead, they may have a stronger biological drive to eat, especially in an environment where food is tasty, cheap, and plentiful.
The real question, says Friedman, isn't why so many of us are getting fat, but why, in our food-rich environment, is anyone thin at all?
One morning I click on the tube to see what food messages are reaching America's living rooms. According to a 2001 study published in the Journal of Nutrition Education, the average child in the U.S. will watch nearly 10,000 commercials touting food or beverages a year.
Click.
A huge bag of Double Delight Oreos swims into view…
Click.
Martha Stewart, looking as if she hadn't a care in the world, is making a chocolate ganache.
Click.
Finally, amid a sea of sugar, an image of healthy food flashes by:
It's Bugs Bunny, munching a carrot.
What's a broccoli-pushing parent to do?
"We live in a toxic environment," says Kelly Brownell, director of the Yale Center for Eating and Weight Disorders. "It's like trying to treat an alcoholic in a town where there's a bar every 10 feet (3.1 meters). Bad food is cheap, heavily promoted, and engineered to taste good. Healthy food is hard to get, not promoted, and expensive. If you came down from Mars and saw all this, what else would you predict except an obesity epidemic?"
Brownell favors the intervention of legislation that would, for example, suspend food advertising directed at children or remove soft drinks and snack foods from school vending machines. "The parallels with tobacco are interesting," he says. "We could search for a drug that would cancel out the effects of smoking, or we could go right to the cause and do everything possible to get rid of cigarettes."
Perhaps what this country really needs to fight fat is a mom. Make that a vintage mom, with a gingham apron tied around her waist as she places a bowl of vegetables on the table next to a skinless roast chicken. "Instead," says Harry Balzer, vice president of NPD, a marketing research firm that has been tracking what and where Americans eat for nearly a quarter of a century, "the restaurant has become the ultimate kitchen appliance."
Because I, too, deserve a break today, I am sitting inside a McDonald's in State College, Pennsylvania, with Barbara Rolls, professor of nutritional sciences at the Pennsylvania State University. For twelve dollars and change, Rolls and I have ordered a Happy Meal with cheeseburger, Coke, and fries; a Big Mac with medium fries and large Coke; and the Grilled Chicken California Cobb Salad with a packet of Caesar dressing. Inspection begins. Rolls peers at the Big Mac (600 calories) like an entomologist classifying a new species. The kid's Happy Meal cheeseburger turns out to be a regular size cheeseburger (330 calories). In total, 2,470 calories are sitting on the red plastic tray in front of us; if we clean our plates, we will each have consumed 77 percent of our daily caloric requirement in just one meal.
As we talk, I absently reach into a small bag of fries and scarf down the contents. Rolls calls this "mindless eating." "We pay little attention to the actual need for food," she says. In one experiment she and her students fed subjects baked pasta. "Some days we offered a normal portion. Some days we offered a portion 50 percent bigger for the same price. If we served them 50 percent more, they ate it. They just kept eating."
Betrayed by our genes, confused by the experts, we graze in endless pastures of food while the statistics grow more chilling. "Some of the earlier treatments like jaw wiring were extreme, but so is gastric bypass," Rolls says. "It's like the prefrontal lobotomy used to treat mental illness in the past."
Last year surgeons performed gastric bypass operations on 103,200 patients, with a complication rate of 7 percent. Linda Hay's four-hour operation was complicated by pneumonia. She stayed in the hospital five days longer than expected. A year and a half later, she has lost 162 pounds (73.5 kilograms). She feels full quickly and eats sparingly—a protein shake for breakfast; salad or sandwich for lunch; Lean Cuisine for dinner.
Hay has given away her size 4X clothes, buys size 10 pants, and can climb a flight of stairs without gasping for breath. "And I've caught the eye of men when I go out—especially in my new convertible."
Short of stapling our stomachs, will we ever solve the problem of fat? Meanwhile the struggle has turned global. For the first time, the Worldwatch Institute reports, there are as many overfed, overweight people in the world as those who are underfed and underweight.
"There is no feast which does not come to an end," an ancient Chinese proverb warns.
Extras: See photos, field notes, and more from this National Geographic article. |
Posted at 05:09 am by saihasari
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What Is Obesity?
Obesity is an excess proportion of total body fat. A person is considered obese when his or her weight is 20% or more above normal weight. The most common measure of obesity is the body mass index or BMI. A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30.
"Morbid obesity" means that a person is either 50%-100% over normal weight, more than 100 pounds over normal weight, has a BMI of 40 or higher, or is sufficiently overweight to severely interfere with health or normal function.
What Causes Obesity?
Obesity occurs when a person consumes more calories than he or she burns. For many people this boils down to eating too much and exercising too little. But there are other factors that also play a role in obesity. These may include:
- Age. As you get older, your body's ability to metabolize food slows down and you do not require as many calories to maintain your weight. This is why people note that they eat the same and do the same activities as they did when they were 20 years old, but at age 40, gain weight.
- Gender. Women tend to be more overweight than men. Men have a higher resting metabolic rate (meaning they burn more energy at rest) than women, so men require more calories to maintain their body weight. Additionally, when women become postmenopausal, their metabolic rate decreases. That is partly why many women gain weight after menopause.
- Genetics. Obesity (and thinness) tends to run in families. In a study of adults who were adopted as children, researchers found that participating adult weights were closer to their biological parents' weights than their adoptive parents'. The environment provided by the adoptive family apparently had less influence on the development of obesity than the person's genetic makeup. In fact, if your biological mother is heavy as an adult, there is approximately a 75% chance that you will be heavy. If your biological mother is thin, there is also a 75% chance that you will be thin. Nevertheless, people who feel that their genes have doomed them to a lifetime of obesity should take heart. Many people genetically predisposed to obesity do not become obese or are able to lose weight and keep it off.
- Environmental factors. Although genes are an important factor in many cases of obesity, a person's environment also plays a significant role. Environmental factors include lifestyle behaviors such as what a person eats and how active he or she is.
- Physical activity. Active individuals require more calories than less active ones to maintain their weight. Additionally, physical activity tends to decrease appetite in obese individuals while increasing the body's ability to preferentially metabolize fat as an energy source. Much of the increase in obesity in the last 20 years is thought to have resulted from the decreased level of daily physical activity.
- Psychological factors. Psychological factors also influence eating habits and obesity. Many people eat in response to negative emotions such as boredom, sadness, or anger. While most overweight people have no more psychological disturbances than people at their normal weight, about 30% of people who seek treatment for serious weight problems have difficulties with binge eating. During a binge-eating episode, people eat large amounts of food while feeling they can't control how much they are eating.
- Illness. Although not as common as many believe, there are some illnesses that can cause obesity. These include hormone problems such as hypothyroidism (poorly acting thyroid slows metabolism), depression, and some rare diseases of the brain that can lead to overeating.
- Medication. Certain drugs, such as steroids and some antidepressants, may cause excessive weight gain.
Emotional Aspects of Obesity
One of the most painful aspects of obesity may be the emotional suffering it causes. American society places great emphasis on physical appearance, often equating attractiveness with slimness or muscularity. In addition, many people wrongly stereotype obese people as gluttonous, lazy, or both. However, more and more evidence contradicts this assumption. Obese people often face prejudice or discrimination at work, at school, while looking for a job, and in social situations. Feelings of rejection, shame, or depression are common.
When to Seek Help for Obesity
You should call your doctor if you are having emotional problems related to your obesity, need help losing weight, or if you fall into either of the following categories.
- If your BMI is 30 or greater, you're considered obese. You should talk to your doctor about losing weight since you are at high risk of having health problems.
- If you have an "apple shape" -- a so-called, "potbelly" or "spare tire" -- you carry more fat in and around your abdominal organs. Fat in your abdomen increases your risk of many of the serious conditions associated with obesity. Women's waist measurement should fall below 35 inches. Men's should be less than 40 inches. If you have a large waist circumference, talk to your doctor about how you can lose weight.
Posted at 05:05 am by saihasari
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Nov 15, 2009
overweight, obesity and weight loss
Overweight, Obesity, and Weight Loss
Frequently Asked Questions
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Health Snapshot: Overweight, Obesity, and Weight Loss
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See also . . .
How many women in the United States are overweight or obese?
Over 60 percent of U.S. adult women are overweight, according to 2007 estimates from the National Center for Health Statistics of the Center for Disease Control and Prevention. Just over one-third of overweight adult women are obese.
How do I know if I’m overweight or obese?
Find out your body mass index (BMI). BMI is a measure of body fat based on height and weight. People with a BMI of 25 to 29.9 are considered overweight. People with a BMI of 30 or more are considered obese.
Body Mass Index
You can find out your BMI by using the calculator at www.nhlbisupport.com/bmi/bmicalc.htm or the chart at www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm.
What causes someone to become overweight or obese?
You can become overweight or obese when you eat more calories (KAL-oh-rees) than you use. A calorie is a unit of energy in the food you eat. Your body needs this energy to function and to be active. But if you take in more energy than your body uses, you will gain weight.
Many factors can play a role in becoming overweight or obese. These factors include:
- Behaviors, such as eating too many calories or not getting enough physical activity
- Environment and culture
- Genes
Overweight and obesity problems keep getting worse in the United States. Some cultural reasons for this include:
- Bigger portion sizes
- Little time to exercise or cook healthy meals
- Using cars to get places instead of walking
What are the health effects of being overweight or obese?
Being overweight or obese can increase your risk of:
- Heart disease
- Stroke
- Type 2 diabetes
- High blood pressure
- Breathing problems
- Arthritis
- Gallbladder disease
- Some kinds of cancer
But excess body weight isn't the only health risk. The places where you store your body fat also affect your health. Women with a "pear" shape tend to store fat in their hips and buttocks. Women with an "apple" shape store fat around their waists. If your waist is more than 35 inches, you may have a higher risk of weight-related health problems.
What is the best way for me to lose weight?
The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor.
Safe weight-loss programs that work well:
- set a goal of slow and steady weight loss — 1 to 2 pounds per week
- offer low-calorie eating plans with a wide range of healthy foods
- encourage you to be more physically active
- teach you about healthy eating and physical activity
- adapt to your likes and dislikes and cultural background
- help you keep weight off after you lose it
How can I make healthier food choices?
The U.S. Department of Health and Human Services (HHS) and Department of Agriculture (USDA) offer tips for healthy eating in Dietary Guidelines for All Americans.
- Focus on fruits. Eat a variety of fruits — fresh, frozen, canned, or dried — rather than fruit juice for most of your fruit choices. For a 2,000-calorie diet, you will need 2 cups of fruit each day. An example of 2 cups is 1 small banana, 1 large orange, and 1/4 cup of dried apricots or peaches.
- Vary your veggies. Eat more:
- dark green veggies, such as broccoli, kale, and other dark leafy greens
- orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash
- beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans, split peas, and lentils
- Get your calcium-rich foods. Each day, drink 3 cups of low-fat or fat-free milk. Or, you can get an equivalent amount of low-fat yogurt and/or low-fat cheese each day. 1.5 ounces of cheese equals 1 cup of milk. If you don't or can't consume milk, choose lactose-free milk products and/or calcium-fortified foods and drinks.
- Make half your grains whole. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta each day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as "whole" in the list of ingredients.
- Go lean with protein. Choose lean meats and poultry. Bake it, broil it, or grill it. Vary your protein choices with more fish, beans, peas, nuts, and seeds.
- Limit saturated fats. Get less than 10 percent of your calories from saturated fatty acids. Most fats should come from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When choosing and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
- Limit salt. Get less than 2,300 mg of sodium (about 1 teaspoon of salt) each day.
How can physical activity help?
The new 2008 Physical Activity Guidelines for Americans state that an active lifestyle can lower your risk of early death from a variety of causes. There is strong evidence that regular physical activity can also lower your risk of:
- Heart disease
- Stroke
- High blood pressure
- Unhealthy cholesterol levels
- Type 2 diabetes
- Metabolic syndrome
- Colon cancer
- Breast cancer
- Falls
- Depression
Regular activity can help prevent unhealthy weight gain and also help with weight loss, when combined with lower calorie intake. If you are overweight or obese, losing weight can lower your risk for many diseases. Being overweight or obese increases your risk of heart disease, high blood pressure, stroke, type 2 diabetes, breathing problems, osteoarthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), and some cancers.
Regular physical activity can also improve your cardiorespiratory (heart, lungs, and blood vessels) and muscular fitness. For older adults, activity can improve mental function.
Physical activity may also help:
- Improve functional health for older adults
- Reduce waistline size
- Lower risk of hip fracture
- Lower risk of lung cancer
- Lower risk of endometrial cancer
- Maintain weight after weight loss
- Increase bone density
- Improve sleep quality
Health benefits are gained by doing the following each week:
Moderate Activity
During moderate-intensity activities you should notice an increase in your heart rate, but you should still be able to talk comfortably. An example of a moderate-intensity activity is walking on a level surface at a brisk pace (about 3 to 4 miles per hour). Other examples include ballroom dancing, leisurely bicycling, moderate housework, and waiting tables. | |
- 2 hours and 30 minutes of moderate-intensity aerobic physical activity or
- 1 hour and 15 minutes of vigorous-intensity aerobic physical activity or
- A combination of moderate and vigorous-intensity aerobic physical activity and
- Muscle-strengthening activities on 2 or more days
Vigorous Activity
If your heart rate increases a lot and you are breathing so hard that it is difficult to carry on a conversation, you are probably doing vigorous-intensity activity. Examples of vigorous-intensity activities include jogging, bicycling fast or uphill, singles tennis, and pushing a hand mower. | |
This physical activity should be in addition to your routine activities of daily living, such as cleaning or spending a few minutes walking from the parking lot to your office.
If you want to lose a substantial (more than 5 percent of body weight) amount of weight, you need a high amount of physical activity unless you also lower calorie intake. This is also the case if you are trying to keep the weight off. Many people need to do more than 300 minutes of moderate-intensity activity a week to meet weight-control goals.
How You Can Increase Your Physical Activity
| If you normally... |
Try this instead! |
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park as close as possible to the store |
park farther away |
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let the dog out back |
take the dog for a walk |
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take the elevator |
take the stairs |
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have lunch delivered |
walk to pick up lunch |
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relax while the kids play |
get involved in their activity |
What drugs are approved for long-term treatment of obesity?
The Food and Drug Administration has approved two medicines for long-term treatment of obesity:
- Sibutramine (si-BYOO-tra-meen) suppresses your appetite.
- Orlistat (OR-li-stat) keeps your body from absorbing fat from the food you eat.
These medicines are for people who:
- Have a BMI of 30 or higher
- Have a BMI of 27 or higher and weight-related health problems or health risks
If you take these medicines, you will need to follow a healthy eating and physical activity plan at the same time.
Before taking these medicines, talk with your doctor about the benefits and the side effects.
- Sibutramine can raise your blood pressure and heart rate. You should not take this medicine if you have a history of high blood pressure, heart problems, or strokes. Other side effects include dry mouth, headache, constipation, anxiety, and trouble sleeping.
- Orlistat may cause diarrhea, cramping, gas, and leakage of oily stool. Eating a low-fat diet can help prevent these side effects. This medicine may also prevent your body from absorbing some vitamins. Talk with your doctor about whether you should take a vitamin supplement.
What surgical options are available to treat weight loss?
Weight loss surgeries — also called bariatric (bair-ee-AT-rik) surgeries — can help treat obesity. You should only consider surgical treatment for weight loss if you:
- Have a BMI of 40 or higher
- Have a BMI of 35 or higher and weight-related health problems
- Have not had success with other weight-loss methods
Common types of weight loss surgeries are:
- Roux-en-Y (ROO-en-WEYE) gastric bypass. The surgeon uses surgical staples to create a small stomach pouch. This limits the amount of food you can eat. The pouch is attached to the middle part of the small intestine. Food bypasses the upper part of the small intestine and stomach, reducing the amount of calories and nutrients your body absorbs.
- Laparoscopic (LAP-uh-ruh-SKAWP-ik) gastric banding. A band is placed around the upper stomach to create a small pouch and narrow passage into the rest of the stomach. This limits the amount of food you can eat. The size of the band can be adjusted. A surgeon can remove the band if needed.
- Biliopancreatic (bil-ee-oh-pan-kree-at-ik) diversion (BPD) or BPD with duodenal (doo-AW-duh-nul) switch (BPD/DS). In BPD, a large part of the stomach is removed, leaving a small pouch. The pouch is connected to the last part of the small intestine, bypassing other parts of the small intestine. In BPD/DS, less of the stomach and small intestine are removed. This surgery reduces the amount of food you can eat and the amount of calories and nutrients your body absorbs from food. This surgery is used less often than other types of surgery because of the high risk of malnutrition.
If you are thinking about weight-loss surgery, talk with your doctor about changes you will need to make after the surgery. You will need to:
- Follow your doctor's directions as you heal
- Make lasting changes in the way you eat
- Follow a healthy eating plan and be physically active
- Take vitamins and minerals if needed
You should also talk to your doctor about risks and side effects of weight loss surgery. Side effects may include:
- Infection
- Leaking from staples
- Hernia
- Blood clots in the leg veins that travel to your lungs (pulmonary embolism)
- Dumping syndrome, in which food moves from your stomach to your intestines too quickly
- Not getting enough vitamins and minerals from food
Is liposuction a treatment for obesity?
Liposuction (LY-poh-suhk-shuhn) is not a treatment for obesity. In this procedure, a surgeon removes fat from under the skin. Liposuction can be used to reshape parts of your body. But this surgery does not promise lasting weight loss.
I'm concerned about my children's eating and physical activity levels. How can I help improve their habits?
The things children learn when they are young are hard to change as they get older. This is true for their eating and physical activity habits. Many children have a poor diet and are not very active. They may eat foods high in calories and fat and not eat enough fruits and vegetables. They also may watch TV, play video games, or use the computer instead of being active.
Kids who are overweight have a greater chance of becoming obese adults. Overweight children may develop weight-related health problems like high blood pressure and diabetes at a young age. You can find out if your child is overweight or obese by using the Body Mass Index for children and teens.
Body Mass Index for Children and Teens
You can find out your child’s BMI by using the calculator at http://www.girlshealth.gov/nutrition/weight/bmi_calc.cfm.
You can help your child build healthy eating and activity habits.
- Limit time spent watching TV, playing video games, and using the computer.
- Make sure your child is physically active for 1 hour each day.
- Find out about activity programs in your community.
- Ask your children what they like to do and what they’d like to try, like Little League Baseball or a swim team.
- Plan activities for the whole family – like hiking, walking, or playing ball.
- Help your children eat healthy foods.
- Have your children plan and cook healthy meals with you.
- Don’t do other things while you eat, like watch TV.
- Give your kids healthy snacks, like fruits, whole-grain crackers, and vegetables.
- Limit your trips to fast-food restaurants.
- Involve the whole family in healthy eating. Don’t single out your children by their weight.
We know children do what they see — not always what they are told. Set a good example for your children. Your kids will learn to eat right and be active by watching you. Setting a good example can mean a lifetime of good habits for you and your kids.
For more information
For more information on overweight, obesity and weight loss, please call womenshealth.gov at 1-800-994-9662 or contact the following organizations:
Steps to a HealthierUS, HHS
Phone number: (800) 336-4797
Internet address: http://www.healthierus.gov
Weight Control Information Network, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, HHS
Phone number: (877) 946-4627
Internet address: http://win.niddk.nih.gov
Food and Nutrition Information Center, USDA
Internet address: http://www.nutrition.gov
MyPyramid.gov, U.S. Department of Agriculture
Phone number: (888) 779-7264
Internet address: http://www.mypyramid.gov
The President’s Council on Physical Fitness and Sports
Phone number: (202) 690-9000
Internet address: http://www.fitness.gov
National Heart, Lung, and Blood Institute Information Center (NHLBI), National Institutes of Health, HHS
Phone number: (301) 592-8573
Internet address: http://www.nhlbi.nih.gov
Food and Drug Administration (FDA), HHS
Phone number: (888) 463-6332 (consumer information)
Internet address: http://www.fda.gov
American Society of Bariatric Physicians
Phone number: (303) 770-2526
Internet address: http://www.asbp.org/siterun_data/
International Food Information Council
Phone number: (202) 296-6540
Internet address: http://www.ific.org
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.
Posted at 11:52 pm by saihasari
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What Are Overweight and Obesity?
The terms “overweight” and “obesity” refer to a person’s overall body weight and where the extra weight comes from. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat. The most useful measure of overweight and obesity is the body mass index (BMI). BMI is based on height and weight and is used for adults, children, and teens. For more information about BMI, see “How Are Overweight and Obesity Diagnosed?”
Millions of Americans and people worldwide are overweight or obese. Being overweight or obese puts you at risk for many diseases and conditions. The more body fat that you carry around and the more you weigh, the more likely you are to develop heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.
A person’s weight is a result of many factors. These factors include environment, family history and genetics, metabolism (the way your body changes food and oxygen into energy), behavior or habits, and other factors.
Certain things, like family history, can’t be changed. However, other things—like a person’s lifestyle habits—can be changed. You can help prevent or treat overweight and obesity if you:
- Follow a healthful diet, while keeping your calorie needs in mind
- Are physically active
- Limit the time you spend being physically inactive
Weight loss medicines and surgery also are options for some people who need to lose weight if lifestyle changes don’t work.
Outlook
Reaching and staying at a healthy weight is a long-term challenge for people who are overweight or obese. But it also can be a chance to lower your risk of other serious health problems. With the right treatment and motivation, it’s possible to lose weight and lower your long-term disease risk.
Posted at 11:48 pm by saihasari
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Obesity Treatment
For most people who are overweight or obese, the safest and most effective way to lose weight is to eat less and exercise more. If you eat less and exercise more, you will lose weight. It is as simple as that. There are no magic pills. Diets that sound too good to be true are just that
Self-Care at Home
By decreasing daily calorie intake by 500 calories or expending an extra 500 calories during exercise each day, you will lose about 1 pound per week.
Any good diet plan will include exercise. It helps to increase metabolism and is one less opportunity to eat during the day. You should exercise for at least 30 minutes, 5 times a week. Regular exercise also helps your heart and lungs and lowers triglyceride levels that can cause heart disease. It also increases the HDL ("good cholesterol") levels. Even simple measures such as taking the stairs instead of the elevator and short walks eventually add up to a lot of calories burned.
Group support programs such as Weight Watchers or Take Off Pounds Sensibly, known as TOPS, provide peer support and promote healthy habits.
For a more complete discussion of lifestyle changes that are helpful in losing weight, see Weight Loss and Control.
Of special interest to women who have gained weight after having a baby is the fact that breastfeeding helps you shed some extra pounds. It is good for your baby, too.
Medical Treatment
Medical treatment of obesity focuses on lifestyle changes such as eating less and increasing activity level. There are medications that can promote weight loss, although they work only in conjunction with eating less and exercising more.
Most medications that promote weight loss work by suppressing the appetite. Some medications used in the past have been shown to be unsafe and are no longer available. The newer appetite-suppressing medications are thought to be safe, but they do have side effects and may interact with certain other drugs. They are used only under the supervision of a health care provider.
For more information about weight-loss medications, go to the article Medication in the Treatment of Obesity.
Some weight-loss products are known to be dangerous. The safety of others is in question. This includes certain prescription and over-the-counter drugs and herbal supplements. Avoid them.
- "Phen-fen" and Redux - These prescription drugs have been removed from the market in the United States and many other countries. They are linked to heart valve problems and pulmonary hypertension. Pulmonary hypertension affects the blood vessels in the lungs and is often fatal.
- Ephedra - This natural substance is essentially an herbal phen-fen. It is the active ingredient in MaHuang and is used as a stimulant and appetite suppressant. Ephedra resembles the amphetamines-the popular "diet drugs" that were banned in the 1970s-in that it is highly addictive. Ephedra is often combined with caffeine and aspirin ("the Stack"), which increases the thermogenic (fat-burning) effect of ephedra. Ephedra increases the risk of high blood pressure, irregular heartbeat, insomnia, seizures, heart attack, stroke, and death. The FDA has recently banned ephedra because it has been linked to more than 100 deaths.
- Phenylpropanolamine (PPA) is often found in appetite suppressants as well as over-the-counter cough and cold remedies. The FDA has recommended that products containing PPA be removed from the market. Studies have suggested that this product is associated with an increased risk of hemorrhagic (bleeding) stroke in women.
Some people have tried combining more than one weight-loss drug or combining a weight-loss drug with other drugs for the purposes of losing weight. The safety and effectiveness of such drug "cocktails" is not known.
Medications
The following medications are available in the United States by prescription. If you have been unsuccessful losing weight through diet and exercise, ask your doctor about these medications. For more information about these drugs, see Medication in the Treatment of Obesity. These are not a substitute for dietary management. Over the long term, successful long-term weight loss requires changes in overall eating patterns.
- Sibutramine (Meridia) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) in 1996. It may be recommended for people who are more than 30 pounds overweight. In clinical trials, people who took this drug lost an average of 5-10 percent of their body weight. It may also help to keep weight off. It works by making the person feel full and thereby decreases food intake. It may cause an increase in blood pressure and should not be used by people who are on a number of other medications, such as antidepressants.
- Orlistat (Xenical) is a prescription medication approved by the FDA in 1999. Your doctor may prescribe it if you weigh more than 30 percent over your healthy body weight or have a BMI greater than 30. Over 1 year, people who followed a weight-loss diet and took orlistat lost an average of 13.4 pounds, almost 8 pounds more than people who used diet alone to lose weight. It works by reducing the absorption of fat from the intestine. Diarrhea and incontinence of stood may be side effects of this medicine.
Prevention
Reversing obesity and its health risks requires changing the habits of a lifetime. Eating less over the long term means learning to think about your eating habits and patterns.
What makes you overeat? Coffee break at work? Going out with friends? Watching TV? Late afternoon energy lag? Late night sweet tooth? Are you the one who finishes the last serving of dinner just so there won't be any leftovers? Do you eat high-calorie fast foods or snacks because you don't have time or energy to cook? Having some insight into your overeating habits helps you to avoid your problem situations and reach your weight goal.
Likewise, increasing your activity level is largely a matter of changing your attitude. You don't have to be a marathon runner. Look for ways to increase your activity level doing things you enjoy.
For some strategies that may help you change your habits, go to the article Weight Loss and Control.
Posted at 11:28 pm by saihasari
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Obesity Causes
Weight gain occurs when you eat more calories than your body uses up. If the food you eat provides more calories than your body needs, the excess is converted to fat. Initially, fat cells increase in size. When they can no longer expand, they increase in number. If you lose weight, the size of the fat cells decreases, but the number of cells does not.
- Obesity, however, has many causes. The reasons for the imbalance between calorie intake and consumption vary by individual. Your age, sex, and genes, psychological makeup, and environmental factors all may contribute.
- Genes: Obesity tends to run in families. This is caused both by genes and by shared diet and lifestyle habits. Having obese relatives does not guarantee that you will be obese.
- Emotions: Some people overeat because of depression, hopelessness, anger, boredom, and many other reasons that have nothing to do with hunger. This doesn't mean that overweight and obese people have more emotional problems than other people. It just means that their feelings influence their eating habits, causing them to overeat. In some unusual cases, obesity may be used as a defense mechanism because of the perceived social pressures related to being more physically desirable, particularly in young girls. In these cases, as with the other emotional causes, psychological intervention may be helpful.
- Environmental factors: The most important environmental factor is lifestyle. Your eating habits and activity level are partly learned from the people around you. Overeating and sedentary habits (inactivity) are the most important risk factors for obesity.
- Sex: Men have more muscle than women, on average. Because muscle burns more calories than other types of tissue, men use more calories than women, even at rest. Thus, women are more likely than men to gain weight with the same calorie intake.
- Age: People tend to lose muscle and gain fat as they age. Their metabolism also slows somewhat. Both of these lower their calorie requirements.
- Pregnancy: Women tend to weigh an average of 4-6 pounds more after a pregnancy than they did before the pregnancy. This can compound with each pregnancy. This weight gain may contribute to obesity in women.
- Certain medical conditions and medications can cause or promote obesity, although these are much less common causes of obesity than overeating and inactivity. Some examples of these are as follows:
- "Glands" (hormonal problems) are rarely the cause of obesity.
- Obesity can be associated with other eating disorders, such as binge eating or bulimia.
- The distribution of your body fat also plays a role in determining your risk of obesity-related health problems. There are at least 2 different kinds of body fat. Studies conducted in Scandinavia have shown that excess body fat distributed around the waist ("apple"-shaped figure, intra-abdominal fat) carries more risk than fat distributed on the hips and thighs ("pear"-shaped figure, fat under the skin).
Posted at 11:27 pm by saihasari
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Obesity Overview
The foods we eat every day contribute to our well-being. Foods provide us with the nutrients we need for healthy bodies and the calories we need for energy. If we eat too much, however, the extra food turns to fat and is stored in our bodies. If we overeat regularly, we gain weight, and if we continue to gain weight, we may become obese.
Obesity means accumulation of excess fat on the body. Obesity is considered a chronic (long-term) disease, like high blood pressure or diabetes. It has many serious long-term consequences for your health, and it is the second leading cause of preventable deaths in the United States (tobacco is the first). Obesity is defined as having a body mass index (BMI) of greater than 30. The BMI is a measure of your weight relative to your height. See eMedicine's Body Mass Index Calculator.
Obesity is an epidemic in the United States and in other developed countries. More than half of Americans are overweight-including at least 1 in 5 children. Nearly one third are obese. Obesity is on the rise in our society because food is abundant and physical activity is optional.
Each year, Americans spend billions of dollars on dieting, diet foods, diet books, diet pills, and the like. Another $45 billion is spent on treating the diseases associated with obesity. Furthermore, businesses suffer an estimated $20 billion loss in productivity each year from absence due to illness caused by obesity.
Posted at 11:25 pm by saihasari
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Is Resveratrol the Key to Weight Loss?
Any keen weight loss person will tell you that part of the basic arithmetic necessary to lose weight is by consuming way less calories through food and drinks than the number of calories you require during daily activity. However, this person will also tell you that it takes negative 3000 calories to lose a kilo of body mass. This makes long-term weight loss a difficult, but most of all, time-consuming road to travel along.
Resveratrol might just be the key to successful weight-loss! It's antioxidative and completely herbal properties allow those people who are struggling to lose weight stay healthy whilst dieting. Yet it could also just be the right alternative to expensive exercise programs, diet aids or dicey surgery.
Many amongst us will be familiar with the France diet. Yes, it is the diet that allows you to continue eating pretty much the same as you did before (although there is some emphasis on daily exercise). The foods you consume as part of this diet, are those low in saturated fat but high in dietary fibre and monounsaturated fats. In fact, the mandatory consumption of red wine is one of the reasons this diet is successful; red wine contains flavonoids, known for their powerful antioxidant properties. Resveratrol combines the most effective aspects of the Mediterranean diet, making it the ideal weight-loss aid.
Besides Resveratrol containing flavanoids, Resveratrol itself (an ingredient found particularly in blue grape skins) promotes the maintenance of healthy cholesterol levels, optimisation of both metabolic and immune pathways and sustains the health of insulin. These factors are all key in stimulating weight loss. You might wonder why the government is not promoting the drinking of red wine to reduce the number of obesity cases in the US; this is because red wine contains quite some unnecessary calories which over long-term only add inches to the waistline. A single Resveratrol capsule will give you as much resveratrol as found in 35 bottles of red wine, yet save you from the 20,000 calories (or 6.67 kilograms of additional weight).
Another effective aspect of Resveratrol Select is the Green Tea Extract (EGCG) ingredient. Long-term use of green tea increases the metabolism rate in the body which results in burning, thus reducing excessive fat. The final key ingredient in Resveratrol Select is Chromium. Chromium is a niacin-based mineral which manages how the body uses the hormone insulin, which in turn directs how the body burns carbohydrates, sugars, fats and protein.
But remember, no matter how many dieting aids you use, even if they are the highly efficient Resveratrol Select capsules, exercise must be part of your daily and healthy journey on the road to weight-loss. The Mediterranean diet does stretch the importance of exercise in order to lose weight. Resveratrol Select therefore also includes L-Theanin and caffeine which is fundamental for energy to perform whilst exercising. Yes, Resveratrol Select can be the key to start the engine and get you down the road faster.
Fore more information on Resveratrol Select please visit this website: www.bestlifeshop.com
Posted at 11:19 pm by saihasari
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How Effective is Muscle Force Max Supplement?
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Posted at 11:16 pm by saihasari
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