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To lose weight - eat properly and exercise - its that easy !!!!

(Original article by: Amy Randall-Ray, M.S.)

Understanding the Terms
You often see the terms obesity and overweight interchanged, but this article focuses solely on obesity, which is characterized by an excess accumulation of fat. The term overweight simply refers to someone who weighs more than should based on weight-for height tables, but they may not be obese. Their excess weight may be in the form of muscle mass, which is not an indicator of poor health. Generally, men with more than 25 percent body fat and women with more than 30 percent body fat are considered to be obese. Doctors may measure your fat using either bioelectrical impedance or skinfold thickness. Because these two means of measuring fat are not always available, obesity is often measured using Body Mass Index (BMI). This is a calculation which divides height by weight. Those who have a BMI of greater than 30 are considered to be obese. Unfortunately, this calculation does not take in to account muscle mass, which can sometimes lead to error. With these considerations in mind, it is estimated that between one-third and one-half of adult Americans are obese.

Are all people who are obese have the same risks?
Not always…….People should not only be concerned with how much excess body fat they carry, but also with where that excess body fat is placed. Women typically collect fat in their hips and buttocks, giving their figures a “pear” (gynoid pattern) shape. Men, on the other hand, usually build up fat round their bellies, giving them more of an “apple” (android pattern) shape. People whose fat is concentrated mostly in the abdomen are more likely to develop many of the health problems associated with obesity.

What are the Risks of Obesity?
Numerous studies have demonstrated that the android pattern is associated with a variety of metabolic derangements, including dyslipidemia, hypertension, and glucose intolerance. These derangements are associated with many diseases including type 2 diabetes mellitus, coronary heart disease, and stroke. In addition, obesity can also cause sleep apnea and pulmonary dysfunction, gallbladder disease, liver disease, musculoskeletal disease, and has been linked to some types of cancer (endometrial, breast, prostate, and colon). But don't be fooled, if you do not have the android pattern or apple shape and most of your fat is situated from your hips down, you are still at risk for some of these problems, specifically musculoskeletal disease, which can lead to osteoarthritis. As your percent body fat increases, your risk of death due to the above mentioned diseases also increases.

How do I lose weight?
Typically, weight is gained over many years, so don't be surprised if it takes a while to get the weight off and it usually involves a life style change. Fast weight loss may also be dangerous. Health care professionals believe weight loss of 1-2 pounds per week is safe. It is important to remember that if you are obese a quick fix or a fad diet will not do the trick. Fad diets and quick weight loss supplements promise the world and rarely deliver. It is not even a simple diet or dieting in general. Because there are so many variables that come in to play, it may be necessary to seek out professional help from doctors, dietitians, exercise specialists, and sometimes psychologists. It is a combination of healthy eating which should be individualized to you, exercise, and behavior change which can help you reach your goals of weight loss and reduce your risk obesity related diseases.

Healthy eating – How do I start?
It is important to meet with a dietitian, so they can educate you and help you plan smart, healthy meals, which are individualized for you. Healthy eating should be adaptations of your taste and habits and should be foods that are easily obtainable. There is no known proven magical food which can speed weight loss. You should question anyone who tries to put you on rigid rituals – such as only eating fruits in the morning or not eating meat after milk products. This is not necessary nor is it sound advice. They can help you learn how to cut the fat down significantly when you are cooking and also how to grocery shop for more healthy foods. A common myth that is thought to be true by many people trying to loose weight is that they can eat anything they want as long as it is fat free. Actually, as the trend in America moves toward companies making more and more fat free products, we have not seen a decline in the number of obese people, but rather in increase. Fat free foods are not calorie free. Generally, as fat is taken out of food it is replaced with sugar. The body converts sugar to fat if it is not used for energy in daily activity. If a person was consuming more fat free foods and also increasing their exercise, the equation would work, but increased calories whether fat or carbohydrates (sugar) with no activity or exercise will only lead to weight gain. Total calorie reduction with an emphasis on reducing total fat intake is the key. In addition, the food guide pyramid was created to help people learn how to eat healthily and more wisely. The food guide pyramid can be found on almost all packaged labels. It proposes that everyone eat 6-11 servings of grain a day, which includes bread, cereals, and rice, 2-4 fruits, 3-5 vegetables, 2-3 dairy products, and 2-3 servings of protein including meat or beans. Bread, dairy, and meat products should be low fat or lean. Serving sizes change according to the food group. It is important to understand what the food guide pyramid means by a serving size. One serving size of bread does not mean 5 slices, it is only one slice and a serving of meat is not a 12 ounce steak, but rather 3 ounces. If you are following the food guide pyramid, but not losing weight, you are probably choosing foods too high in fat and your serving sizes are probably still too large. You can visit to learn more about the food guide pyramid.

What are the recommendations for exercise?
Exercise seems to be the most dreaded area of weight loss and this usually occurs because people are unrealistic with their goals and start off doing too much. If you have never exercised and all the sudden you are faced with the challenge, don't expect to be able to run 5 miles on the first day or even one mile. Make sure your goals are reasonable. Initial activities may be walking or swimming at a slow pace. You can start out by walking 30 minutes for three days a week and can build to 45 minutes of more intense walking, at least five days a week. Even if you can't walk 30 minutes on the first day, don't get discouraged. Do what you can and make your goals attainable. Once you have lost some weight, the exercise will get easier and you will feel better. Eventually, you will be able to do some type of physical activity daily. In addition, you can break your exercise up throughout the day. If your goal is 30 minutes per day, try two 15-minute walks. Most importantly, find something that you like to do. Don't start running because you think that is the only way to loose weight, but you dislike it. If you don't like to run, the chances are small that you will be motivated to do it and keep it up over a period of time. Try a variety of exercises and then choose some that you like. An exercise physiologist can help you determine what would be a good place for you to start and give you ideas on what you may like. One last tip, it is usually much more fun to exercise with someone and you can keep each other motivated.

What about behavior changes?
Techniques for modification of eating behaviors include positive reinforcement, stimulus control and environmental management, and self-monitoring. Stimulus control and environmental management involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. Self-monitoring refers to observing and recording some aspect of your behavior, such as calorie intake or exercise sessions. In addition, setting goals can be very effective. Goals should always be specific, attainable, and forgiving. Learn to read your body and understand when it is full, so you don't overeat.

What about prescription medications?
Currently, the most common anti-obesity drugs are sibutramine (Meridia) and Orlistat (Xenical). Weight loss with these drugs has been very minimal in most patients, who have significant weight to loose. If used, they should only be taken under strict supervision of a physician. The safety of the prolonged therapeutic use of these compounds has not been demonstrated and they could potentially cause problems. There also may be potential for dependence, development of tolerance and other side effects including elevations in blood pressure and pulse, which may cause a real problem in significantly obese people. These are not drugs you can stay on forever, so your best bet is to concentrate your weight loss efforts with your diet, exercise and behavior modifications.

Prevention for the future
The best treatment for obesity is prevention. Be conscious of your body and how it changes through out life. Some weight gain as you get older may be inevitable, but large amounts of excess weight gain can be avoided. If your mother or father is obese the chances that you will become obese are significant. If your child is obese intervene sooner rather than later so you can reduce their risks of developing diseases from obesity. Help yourself and your family to live a healthy lifestyle and prevent large amounts of weight gain by eating healthy and incorporating exercise into your lifestyle.

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