Obesity

Obesity:  General Information

Obesity is common in the United States. A program of weight loss is recommended for many reasons. There is a close relationship between obesity and many diseases. Obesity contributes to the development of hypertension (high blood pressure), wear-and-tear arthritis, and elevated blood cholesterol with its associated problems of hardening of the arteries, heart attacks, and stroke.

The simplicity of the problem of obesity belies the difficulty of its management. Food can be considered the equivalent of fuel. It must be either used or stored after absorption. If you eat more than you need to use, you store the remainder. The storage form is fat. To remain thin, you need to eat no more, on average, than you use, on average. To lose weight, you need to adjust food intake to less than the amount of energy you use. The body makes up the difference by withdrawing fat from storage, with a net result of some weight loss.

Almost all weight-loss programs depend on adjusting the dietary intake to include fewer calories. Some programs also address the kinds of foods that you eat and the mix of the various food groups. Some foods are more fat prone than others even if eaten in equal calorie amounts. Successful weight-loss programs are those that not only result in a loss of weight but also change your eating habits so that you do not regain weight after the diet is finished. One must learn to restrain intake to the amount of food needed to meet daily energy needs and avoid storage as fat.

Important Points in Treatment
Your physician can help you select a regimen of diet and exercise that produces weight loss without being a danger to your health. Several observations may help you adjust to the changes necessary for weight loss.

• Fat deposits accumulate slowly and leave slowly. Day-to-day weight changes are unlikely to be meaningful measures of the effectiveness of your program.
• When fat serves as a source for energy, the chemical reactions that occur produce water. You will not note a loss in weight until the body excretes this water. Some people on a diet may retain water for a week or more before excretion begins and weight loss becomes apparent.
• Recreational exercise alone and exercise for fitness consume calories, but unless carried to extremes, exercise is not an effective weight-control program. Exercise is an effective addition when combined with dietary management for weight control. The levels of exercise appropriate for any individual vary with other health problems and the degree of fitness at the beginning of an exercise program.

Notify Our Office If ...

• You wish to undertake a weight-loss program.
• You wish to undertake a exercise program.

Obesity:  Diet and Weight Loss

General Information
Obesity is a frequent feature of the elderly. Some people are fat throughout their lives, but many more gain weight with the passage of time. A change to a more sedentary lifestyle with retirement is also a factor in weight gain among the elderly. Except for the very svelte, most people will respond to inquiry by indicating they would like to lose some weight. It is no surprise that you can find support for almost any position you wish to take concerning nutrition. Conflicting advice is the rule, not the exception. Although every diet offered for weight loss has demonstrable examples of success, it is also true that no diet is consistently so successful that it has swept the field.

What follows is a common sense approach to deciding if you should diet and how you might diet. Caveat emptor (let the buyer beware) applies. It is easier not to gain excess weight than it is to lose it.

Should You Diet?
Weight loss is only a consideration for the overweight. There are tables that can help you determine if you are overweight. It is also possible to calculate a figure called the body mass index, which is a good indicator of whether you are overweight.

A second concern is whether there will be a health benefit to weight loss that balances with the personal cost and effort needed to successfully lose weight. There is information that if you are healthy but overweight when you reach senior years there may be little benefit to longevity from weight loss. Thus if you are happy and healthy at your current weight, there may not be a compelling reason to lose weight. There are, however, a number of diseases that are made worse by obesity. There is also the common sense observation that one’s quality of life may be enhanced by weight loss. A third observation is that illness—particularly health care emergencies—seems to fall harder on the obese.

Diabetes, hypertension (high blood pressure), hypercholesterolemia (high blood cholesterol), hyperlipidemia (high blood fats), osteoarthritis (wear and tear arthritis), chronic pulmonary disease, heart failure, and a host of other diseases common in the elderly are improved in their management and control by the loss of excess weight. The risks imposed by surgery and trauma are less if you are not overweight.

How Should You Diet?
If you have a medical problem that is in part or whole managed by a therapeutic diet, then that is the diet you should follow. Problems with diabetes and high blood fats are the best, but not the only, examples.

If you are dieting primarily for weight loss rather than management of a disease, you will need to select and adopt a diet that you are willing to follow for the rest of your life. Your customary style of eating is what has led you to the obesity that you are trying to reverse. If you adopt a diet that permits you to lose weight but after reaching your target weight you return to your customary diet, you will regain your lost weight. There is little sense in this case in trying in the first place. To lose weight, you have to change your customary habit and style of eating, and to keep the weight off you must maintain some of this change forever. The key to success is to select a diet that you can live with. This eliminates most fad diets, diets where you must buy special foods, or supplements and diets that are relentlessly monotonous.

Five Keys to Successful Dieting

1. Eat when you are hungry, not by the clock or by custom. If your stomach does not tell you it is hungry, don’t fill it.
2. Eat slowly. Put your fork down between bites. Don’t gorge.
3. Stop when you are full. Don’t feel you must clean your plate.
4. Limit your intake of foods that contain sugar or are easily converted to sugar. This includes sweets, sweet drinks, sweetened desserts, white breads, potatoes, rice, pasta unless made from whole grain flour, and carrots. Eliminate these to lose weight and limit them to maintain your weight loss.
5. When dieting, some exercise is always beneficial in the weight loss process.

Call Our Office If ...

• You would like to initiate a weight loss program.
• You have been given a therapeutic diet but are having difficulty understanding what you should eat and what you should avoid.