Are
you having an uphill struggle?
Thirty five percent of American
adults are obese and five and a half percent are morbidly obese.
The annual cost for obesity and
overweight in the U.S. is two hundred seventy billion dollars.
Obese people spend forty percent more
on health care compared to those with normal weight.
Medical conditions linked to obesity
include hypertension, asthma, joint pain, diabetes, elevated lipids, sleep
apnea, gallbladder disease, and arthritis.
A tool to evaluate obesity is the BMI
(body mass index). It is calculated by a formula that incorporates body weight
and height.
Here are BMI guidelines.
Less than 18.5: underweight.
18.5 to 24.9 normal
weight.
25.0 to 29.9 overweight.
30 and higher: obesity.
BMI scoring doesn’t consider
distribution of muscle and bone mass. It underestimates body fat in lean and
elderly people, muscle wasting disease, eating disorders, and morbid obesity. It
overestimates health risk in body builders and athletes. Have you noticed body physiques
of the current Olympic participants?
Over
the Counter weight loss products.
These include Raspberry Ketone, Sensa (malto-dextrin), and Belvic Diet Patch. Beware:
Safety and effectiveness of these products are unknown.
Prescription
weight loss medicine. Qysmia, a
combination of Phentermine and topiramate, is pending approval by the FDA. Its
side effects include memory disturbance, depression, anxiety, dizziness, and elevated
heart rate.
You might consider traditional treatment
options, such as diet, exercise, and calorie restriction. A ten percent weight
loss over six months is possible but difficult to maintain. Exercise combined
with calorie reduction is more effective than diet alone.
Operative treatment. Bariatric
surgery is an alternative for people with high BMI who’ve had no success with diet
and exercise. The three available procedures are gastric banding, bypass, and
Rou-En-Y. In 2010, the American Diabetes Association recommended that bariatric
surgery “should be considered for adults with BMI greater than thirty five and
diabetes,” especially if the diabetes is “poorly controlled with lifestyle
changes and prescription medicine.” The American Heart Association recommends bariatric
surgery as “the only effective long term treatment option for the severely
obese patient.”
The FDA approved gastric banding in
2001. Its advantages include no stapling or stomach removal, gradual weight
loss, and an approximate sixty percent weight loss over five years. The band is
adjustable and has minimal side effect risks, such as loose stools. Periodic postoperative
followups and healthy lifestyle are crucial to maintain weight loss.
Rou-en-Y surgery involves bypassing
most of the stomach and rerouting the intestine. Weight loss is rapid during the
first year. Complications include difficulty in reversing the stomach sapling,
vitamin deficiency, longer post-operative recovery, and “dumping syndrome,” a
condition that causes nausea, flushing, and sweating.
In sleeve gastrectomy, two thirds of
the stomach is removed. There is rapid initial weight loss. However, this
procedure can affect secretion of stomach fluids and is not surgically reversible.
Source: First Report Managed Care; June 12; Special Disease State
Update; Obesity: The Economic Burden, The Disease, and the Solution.
If questions, contact Dr. Clem at clementhanson@blogspot.com.
