OBESITY MANAGEMENT
Can include lifestyle changes,medications, or surgery. The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term but maintaining this weight loss is frequently difficult and often requires making exercise and a lower calorie diet a permanent part of an individual's lifestyle. Success rates of long-term weight loss maintenance with lifestyle changes are low, ranging from 2 to 20%.Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child. The National Institutes of Health recommend a weight loss goal of 5% to 10% of the person's current weight over six months.
EXERCISE : The most effective means of exercise to reduce With use, muscles consume energy derived from both fat and glycogen. Due to the large size of leg muscles, walking, running, and cycling are body fat . Exercise affects macronutrient balance. During moderate exercise, equivalent to a brisk walk, there is a shift to greater use of fat as a fuel.
To maintain health, the American Heart Association recommends a minimum of 30 minutes of moderate exercise at least 5 days a week.The Cochrane Collaboration found that exercising alone led to limited weight loss. In combination with diet, however, it resulted in a 1 kilogram weight loss over dieting alone. A 1.5 kilograms (3.3 pounds) loss was observed with a greater degree of exercise. Even though exercise as carried out in the general population has only modest effects, a dose response curve is found, and very intense exercise can lead to substantial weight loss. During 20 weeks of basic military training with no dietary restriction, obese military recruits lost 12.5 kg (28 lb). High levels of physical activity seem to be necessary to maintain weight loss. A pedometer appears useful for motivation. Over an average of 18-weeks of use physical activity increased by 27% resulting in a 0.38 decrease in BMI
DIETING- Diets to promote weight loss are generally divided into four categories: low-fat, low-carbohydrate,low-calorie, and very low calorie. A meta-analysis of six randomized controlled trials found no difference between three of the main diet types (low calorie,low carbohydrate, and low fat), with a 2–4 kilograms (4.4–8.8 lb) weight loss in all studies. At two years these three methods resulted in similar weight loss irrespective of the macronutrients emphasized. High protein diets do not appear to make any difference. A diet high in simple sugars such as those in soft drinks increases weight. Very low calorie diets provide 200–800 kcal/day,maintaining protein intake but limiting calories from both fat and carbohydrates. They subject the body to starvation and produce an average weekly weight loss of 1.5–2.5 kilograms (3.3–5.5 lb ). These diets are not recommended for general use as they are associated with adverse side effects such as loss of lean muscle mass, increased risks of gout, and electrolyte imbalances. People attempting these diets must be monitored closely by a physician to prevent complications.
TREATMENT-The goal of obesity treatment is to reach and stay at a healthy weight. You may need to work with a team of health professionals — including a dietitian, behavior counselor or an obesity specialist — to help you understand and make changes in your eating and activity habits. The initial treatment goal is usually a modest weight loss — 3 to 5 percent of your total weight. That means that if you weigh 200 pounds (91kg) and are obese by BMI standards, you would need to lose only about 6 to 10 pounds (2.7 to 4.5 kg) for your health to begin to improve. However, the more weight you lose, the greater the benefits. All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your level of obesity, your overall health and your willingness to participate in your weight-loss plan.
Other treatment tools include: Dietary Changes : Cutting calories, Feeling full onless, Making healthier choices, Restricting certain foods, Meal replacements.
Exercise and Activity : Exercise, Keepmoving.
Behavior Change: Counseling,Support groups.
Prescription Weight-Loss Medications Weight-loss Surgery: Gastric bypass surgery, Laparoscopic adjustable gastric banding(LAGB), Biliopancreatic diversion with duodenal, Switch Gastric sleeve.
Diagnosis If your BMI is in the obese range, your health care provider will typically review your health history in detail, perform a physical exam and recommend some tests.These exams and tests generally include:
Taking your health history: Your doctor may review your weight history, weight-loss efforts ,eating patterns, what other conditions you've had, medications, and other issues about your health. Your doctor may also review your family's health history to see if you may be predisposed to certain conditions.
A general physical exam: This includes also measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.
Calculating your BMI: Your doctor will check your body mass index (BMI) to determine your level of obesity. This should be done at least once a year. Your BMI also helps determine your overall health risk and what treatment may be appropriate.
Measuring your waist circumference: Fat stored around your waist, sometimes called visceral fat or abdominal fat, may further increase your risk of diseases, such as diabetes and heart disease. Women with a waist measurement (circumference) of more than 35 inches (80 centimeters, or cm) and men with a waist measurement of more than 40 inches (102 cm) may have more health risks than do people with smaller waist measurements. Like the BMI measurement, your waist circumference should be checked at least once a year.Checking for other health problems: If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure and diabetes.
Blood tests: What tests you have depend on your health, risk factors and any current symptoms you may be having. Tests may include a cholesterol test, liver function tests, a fasting glucose, a thyroid test and others. Your doctor may also recommend certain heart tests, such as an electrocardiogram.Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you already have. And this will guide treatment decisions.