"Diet and Weight Management"


    What is Obesity

    The definition of obesity varies depending on what one reads, but
    in general, it is a chronic condition defined by an excess amount
    body fat. A certain amount of body fat is necessary for storing
    energy, heat insulation, shock absorption, and other functions.
    The normal amount of body fat (expressed as percentage of body
    fat) is between 25-30% in women and 18-23% in men. Women with
    over 30% body fat and men with over 25% body fat are considered
    obese.

    How common is obesity?

    Obesity has reached epidemic proportions in the United States.
    One in three Americans is obese. Obesity is also increasing rapidly
    throughout the world, and the incidence of obesity has nearly
    doubled form 1991 to 1998.

    What are the health risks associated with obesity?

    Obesity is not just a cosmetic consideration; it is a dire health
    dilemma directly harmful to one's health. In the United States,
    roughly 300,000 deaths per year are directly related to obesity,
    and more than 80% of these deaths are in patients with a BMI
    (body mass index, which will be discussed later in this article)
    over 30. Obesity also increases the risk of developing a number
    of chronic diseases including:

    Insulin Resistance. Insulin is necessary for the transport of blood
    glucose (sugar) into the cells of muscle and fat (which is then
    used for energy). By transporting glucose into cells, insulin keeps
    the blood glucose levels in the normal range. Insulin resistance (IR)
    is the condition whereby the effectiveness of insulin in transporting
    glucose (sugar) into cells is diminished. Fat cells are more insulin
    resistant than muscle cells; therefore, one important cause of IR is
    obesity. The pancreas initially responds to IR by producing more
    insulin. As long as the pancreas can produce enough insulin to
    overcome this resistance, blood glucose levels remain normal.
    This IR state (characterized by normal blood glucose levels and high insulin levels)
    can last years. Once the pancreas can no longer keep up with producing high levels
    of insulin, blood glucose levels begin to rise, resulting in type 2 diabetes, thus IR is a
    pre-diabetes condition. In fact scientists now believe that the atherosclerosis
    (hardening of the arteries) associated with diabetes likely develops during this IR
    period.

    Type 2 (adult-onset) diabetes. The risk of type 2 diabetes increases with the degree
    and duration of obesity. Type 2 diabetes is associated with central obesity; a person
    with central obesity has excess fat around his/her waist, so that the body is shaped
    like an apple.

    High blood pressure (hypertension). Hypertension is common among obese adults.
    A Norwegian study showed that weight gain tended to increase blood pressure in
    women more significantly than in men. The risk of developing high blood pressure
    is also higher in obese people who are apple shaped (central obesity) than in
    people who are pear shaped (fat distribution mainly in hips and thighs).
    High cholesterol (hypercholesterolemia) Stroke (cerebrovascular accident or CVA)

    Heart attack. The Nurses Health Study found that the risk of developing coronary artery
    disease increased 3 to 4 times in women who had a BMI greater than 29. A Finnish
    study showed that for every one kilogram (2.2 pounds) increase in body weight, the risk
    of death from coronary artery disease increased by one percent. In patients who have
    already had a heart attack, obesity is associated with an increased likelihood of a
    second heart attack. Congestive heart failure

    Cancer. While not conclusively proven, some observational studies have linked obesity
    to cancer of the colon in men and women, cancer of the rectum and prostate in men,
    and cancer of the gallbladder and uterus in women. Obesity may also be associated
    with breast cancer, particularly in postmenopausal women. Fat tissue is important in
    the production of estrogen, and prolonged exposure to high levels of estrogen
    increases the risk of breast cancer.
    Gallstones
    Gout and gouty arthritis
    Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back
    Sleep apnea
    Pickwickian syndrome (obesity, red face, underventilation, and drowsiness)

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